The amount recognized for payment of a particular treatment. It is based on what is considered “reasonable” for that treatment in accordance with the customarily available market price, or in similar to the cost of our agreed designated healthcare provider price, in the country where the treatment was provided or in the area of cover, whichever is lower.
When insured member avails treatment on cash basis from a designated or non-designated provider, insurance company will reimburse the eligible amount as per the policy terms and conditions.