--- title: "Terms and Conditions | BIMA Ghana Insurance Policies" description: "Complete terms and conditions for BIMA Ghana insurance products including B-Care, B-Health, B-Life policies. Coverage details, exclusions, waiting periods, and claim procedures." keywords: "BIMA Ghana terms and conditions, insurance policy terms, B-Care terms, B-Health conditions, B-Life rules" url: "https://bima.com.gh/terms-and-conditions" language: "en" --- # Terms and Conditions Insurance Policy Terms for BIMA Ghana Products B-Care B-Life B-Health ## B-Care Policy The best healthcare plan catering for your medical expenses in Ghana ### Proactive Healthcare Through our health and wellness service, you can choose from a variety of health programs delivered weekly via SMS, our BIMA app or a monthly Interactive Voice Response \(IVR\). Available Health Programs: • Stay Healthy • Diet & Nutrition • Diabetes & Hypertension • Women's Health • Family Health ### What You Get with B-Care #### Hospitalization \(PD\) Coverage: Cashless #### Non-hospitalization \(OPD\) Coverage: Cashless #### 24/7 Doctor Consultation, Lab Tests & Medicine Delivery #### Guaranteed Loyalty Cashback ### Terms & Conditions #### Subscription Exception — What does B-Care not Support? This insurance product does not provide support for certain medical conditions or treatments for the specific tier you are subscribed to. These include but are not limited to: * • Pre-existing/chronic conditions \(metabolic diseases, cardiovascular diseases, cancers, renal diseases, etc.\) * • Cosmetic Elective Surgeries * • Experimental Treatments * • Self-inflicted injuries * • Dental and Eye Care * • Abuse of alcohol and illegal narcotics * • Childbirth within 12 months of the subscription registration date * • Accident due to willful exposure to peril * • Conditions diagnosed or accident/admission occurred prior to commencement of cover as defined under the activation period and other medical services as outlined in the subscription manual BIMA reserves the right to include or exclude other situations not listed as unsupported #### Emergency Situations Include but are not Limited to: * • Severe bleeding * • Severe difficulty in breathing \(shortness of breath\) * • Moderate to severe burns * • Convulsions or seizures * • Change in mental status \(such as unusual behaviour, confusion, difficulty waking from sleep\) * • Head or spinal injuries * • Serious limb impairment or broken bone BIMA reserves the right to identify other situations not listed in this document as emergency ### BIMA Doctor Service The Subscription supports you and your named dependants. The Service manages minor illnesses, provides guidance on your existing and/or chronic medical conditions, and general health advice. It does not cover medical emergencies. In the case of an emergency, we advise you to go to the nearest partner facility. ### Benefit Redemption Period This is the period between subscription and the enjoyment of the Subscription benefits. * • **Access to the Unlimited 24/7 BIMA Doctor Service** starts immediately after registration and successful deduction of the first subscription fee. * • **Non-Hospitalization Care** starts after 30-day period following successful deduction of the first subscription fee. * • **Hospitalisation Care** is redeemable after a 90-day period following successful deduction of the first subscription fee. * • **Pregnancy Hospitalisation Care** has a 12-month benefit redemption period. _Note: Maximum Hospitalisation & Non-Hospitalisation benefit redeemable per month is 20% of the annual limit_ ### Age Criteria Subscriber: 18 to 59 years Dependants \(Children\): 0 to 24 years Other Adults: 1 to 59 years ## B-Life Policy Protecting your family\'s financial future ### Cover This policy insures the subscriber and its registered family member \(parent, spouse, sibling or child\) against hospitalization as a result of accident, partial disability, full disability and death. ### Age The policy covers the policyholder and chosen family member \(spouse, children, parents, siblings\) aged 18 to 69 at the time of registration. ### Commencement Date #### Accident Cover Cover starts immediately upon registration and payment of all premiums. #### Life Cover Cover starts after a 90-day waiting period following registration. Subsequent changes for registered family member will be subject to a 90-day waiting period. ### Policy Terms #### Beneficiary In the event of death of the insured, the benefits shall be paid to the policy holder's legal personal representative \(beneficiary\). A beneficiary may not be registered more than twice. #### No Claims Bonus The no claims bonus is paid to the policyholder's mobile money wallet after 12 months of premium payment without making a claim. #### Cancellation Dial \*714\*99\# to cancel. There is no refund of premium or no claims bonus in case of cancellation. #### Lapsed Period The policy will enter a lapsed state after three months of non-payment and will be activated after six months. ### Exclusions * Self inflicted death * War * Abuse of alcohol and illegal narcotics * Cosmetic Elective surgery ## B-Health Policy Comprehensive health coverage for you and your family ### Who is Covered? **Single Cover** — Policyholder **Joint Cover** \- Policyholder + An insured relative. **Family Cover** — Policyholder + Spouse + Children \(6 children max\) **Family Plus Cover** — Policyholder + Spouse + Children \(6 children max\) + Parents of policy holder + Parents of spouse. All lives must be 'named' on a policy to receive cover. 'Named' lives may be changed on policy at any time, but in the case of a Maternity cover 'named' lives will be subject to a waiting period of 1 year \(max\). ### Waiting Period Access to the **BIMA Doctor Service** starts immediately after registration and payment of the first premium. **Accidental hospital cover** starts from the 1st day of the next month following successful payment of the first premium. However, there is a 30-day waiting period for non-accidental causes of claim. There is a **12-month waiting period** for maternity cover. There is a **3-month waiting period** before the customer can claim their medication support balance. #### Age at Entry Requirement Adults MIN 18yrs MAX 69yrs Children MIN Birth MAX 24yrs #### Medication Support Depending on your policy level, you will receive a monthly contribution that may be used if you have been prescribed medicine, referred to a laboratory or referred to a hospital by a BIMA Doctor upon medical consultation. ### BIMA Doctor Membership covers you and your insured relative. Manages minor illnesses, provides guidance on your existing and/or chronic medical conditions as well as general health advice. Does not cover medical emergencies. In case of an emergency, we advise you go to the nearest hospital. ### Exclusions * Self-inflicted injuries * War * Abuse of alcohol and illegal narcotics * Childbirth within 12 months of policy registration date * Cosmetic Elective surgery ### Cancellation Dial \*714\*99\# to cancel. There is no refund of premium or medication support in case of cancellation. Payment is made through your mobile money wallet every month.