Introduction
Kuwait Petroleum Corporation and its Subsidiaries are providing
Table of contents:
3) Introduction
4) Benefits and Coverages
8) Exclusions
10) Claim settlement Procedure
11) Important Points
 
agreed range of medical services to those employees who desire
to avail treatment in private hospitals rather than in Al-Ahmadi
Hospital. In this regard, a contract is affected with Gulf Insurance
Company K.S.C. which has a wide network of hospitals, medical
centers and clinics.
With the aim of extending the best medical services in accordance
with the Insurance Scheme agreed upon, Kuwait Petroleum
Corporation and Gulf Insurance Company present this handbook
to the employees and their dependants who are covered under the
Scheme to outline the benefits and also the methods of utilizing
these services.
We hope the services would cater to your needs. Participating
Employees are kindly requested to read all the conditions and
instructions stated in this handbook. You may call the Service Call
Center for all enquiries around the clock on the following telephone
numbers:
22 96 1555 – 1 80 20 80
Or visit our website:
http://www.gulfins.com.kw
Benefits and Coverages Benefits and Coverages

It has been agreed to cover the following medical services to participating employees
and their families in accordance with the financial limits stated herein. We kindly
request all participants in the Scheme to adhere to the provisions of the Insurance Benefits and Coverages Maximum Limit
Scheme and according to the stipulated financial limits. In case the limits are exceeded, (Kuwaiti Dinnar)
Insurance Policy will not cover the additional expenses and you will have to seek
compensation from the Corporation or your Company for the amounts exceeding
the Insurance Scheme Limits as per the approved guidelines. • Treatment received in respect of bridges,
crowns (basic type), and dentures.
Benefits and Coverages Maximum Limit
(Kuwaiti Dinnar) • Dental cleaning once a year.
In-Patient benefits which include:
• Medical File Opening fees • General dental inspections or routine
• Daily standard room check-ups, or any fluoride treatment given.
750
• Nursing care
• Surgeon’s and Anesthetist’s fees 10,000 • Treatment related to jaw shrinkage or loss
• Specialist physician’s fees as a result of dental extractions and/or the
• Pathology & Radiology provision of implants.
• Local road Ambulance
• Medicines and drugs related to treatment • Surgical operation carried out by a consultant
prescribed by the doctor. to put a natural tooth back into a jaw bone
after it is knocked out or dislodged in an
Out-Patient benefits which include: accident and for immediate relief of pain
• Medical File Opening fees
• Consultation at clinic 1,750
• Prescribed Medicines
• Radiology and laboratory tests Pregnancy & Maternity Treatments
• Minor procedures
• Day care surgery • Normal delivery: care from beginning of
pregnancy till birth.
Routine Dental treatments which • Caesarian delivery, prescribed drugs and 1,500
include: hospital services
• Extraction, Gum Treatment, Neurectomy, • Tubal Pregnancy and Abortion and nursing
Filling, Root Canal Treatment 750 charges whilst mother in hospital.
• Radiology and prescribed medicines.
• Extraction for a child less than 12 years of
age unless caused by accident.

 
Benefits and Coverages Benefits and Coverages

Benefits and Coverages Maximum Limit

(Kuwaiti Dinnar)
Eligible Insured Kuwaitis
Members
Chronic conditions defined as disease, • Employees (male and female)
illness or injury, which has at least one of the • Spouse of employees
following components: • Employee’s male dependants below age
- Has no known cure, or recurs but treatment 26 years of old provided they are not
is to maintain the condition 2,000 registered with the Public Institution for
- Is caused by changes to your body which Social Security
cannot be reversed • Employee’s female dependants who are
- Require you to be specially trained or unmarried, divorced and widows
rehabilitated • Employee’s dependants who are disabled and
- Needs prolonged supervision, monitoring not registered with the Public Institution for
and treatment Social Security

Expatriates
Territorial limits Inside the State of Kuwait only
• Employees (male and female)
• Wives of male employees
Claims settlement Gulf Insurance Company will settle cost of • Employee’s male dependents below age 26
modes treatment to medical providers within the years of old who have dependant visa
Network subject to maximum limits stated • Employee’s female dependents who are
above unmarried, divorced and widows provided
they have dependant visa
Deductibles Covered members do not bear any share of
medical charges

Age limits • Adults: the maximum age limit is 65 years.

• Children: the minimum age is from birth
of the child.

 
Exclusions
Insurance Policy does not cover the cost of following
treatments:
The following cases do not fall within the purview of Insurance
Scheme and hence the Employee and their dependants shall visit
Al-Ahmadi Hospital or Hospitals of the Ministry of Health – Kuwait
for treatment:
1. AIDS/HIV
2 Misuse and addiction of drugs and alcohol
3. Treatment and drugs related to infertility, impotence
and sexually transmitted diseases
4. Contamination, Wars and Civil Commotion
5. Congenital conditions
6. Convalescence, rehabilitation and general nursing
7. Experimental drugs & treatment
8. Learning difficulties, behavioral & developmental problems
9. Physical aids & devices such as wheel chairs
10. Self-Inflicted Injuries
11. Sleep, speech &/or psychiatric Disorder
12. Organ transplantations and implants
13. Diet/Nutrition
14. General lab tests/medical check up
 
Exclusions
15. Charges related to sexual tonics and cosmetic products
16. Treatments to relieve symptoms of bodily change
associated with puberty
17. Cosmetic and plastic surgery
18. Health hydrous & palliative treatments
19. Deafness caused by a congenital abnormality
20. Preventive treatment such as vaccination
21. Hair Falling
22. Unrecognized doctors and medical centers
23. Epilepsy of any kind
24. Engagement in extreme sports such as motor racing
or scuba diving
25. Insurance Policy shall not cover any medical
charges resulting directly or indirectly from
uncovered cases.
Claim Settlement Procedures
Gulf Insurance Company will provide Insurance Cards (GIC Health
Card) to each individual employee and member of their families
which will be used to pay for medical services. It is our hope that
you keep the card secured because, if it is lost, you will have to refer
to Gulf Insurance to issue a replacement card for KD.2.500.
Please find below the procedure when visiting a medical center:
• Covered member to present GIC Health Card along with the
Civil ID in the authorized medical center within the Network of
Gulf Insurance Company.
• Covered Members shall sign the Claim Form and related invoices
of medical charges at the time of receiving the treatment.
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Important Points
For the sake of clarifying all aspects pertaining to the Insurance
Scheme, Kuwait Petroleum Corporation and Gulf Insurance
Company would like to highlight the following:
1- Each Health Card is assigned to each individual covered member.
In case card is used by unauthorized person, penalties will be
applied according to KPC Personnel Policy.
2- In case of emergency, covered member should always go the
nearest hospital where immediate admission is provided.
3- It is agreed that Insurance Scheme would cover cost of doctor’s
prescription obtained from Authorized Medical Center provided
it is related to covered treatment.
4- When the material status is changed, i.e. newborn or marriage,
please inform the Human Resource Department in your
Company to do the needful to include them under the Insurance
Scheme.
5- Charges of visiting doctors from inside and outside Kuwait
are covered, but shall be payable for the usual, customary and
reasonable charges prevailing in the State of Kuwait for the kind
of treatment and care received
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