Experience Freedom with all your

Life Essentials taken care of.

Health & Medical Wealth

Wellness Expenses Creation

Introducing

Tata AIA
Pro-Fit

A first-of-its-kind Health Solution offering Health Cover,

Wellness, Medical Benefits and Life Cover while
growing your Wealth over the long-term.

Special Features

Worldwide Health Market

Treatment Cover for Linked
Cover Whole Life Returns

For internal circulation only.

S. no. Content Page no.

1 Overview of Pro-Fit 3

2 5

3 6

4 7

5 8

6 Plans available under OPD Care 9

7 10

8 Important Points for Policyholder 11

9 Underwriting Guidelines 13

10 Claims Process 14

11 List of surgeries/Day care procedures/Critical Illnesses 15

12 Discounts 24

This material is used for training purposes. Strictly for Internal Circulation Only
 WITH PRO-FIT, ENJOY THE BENEFITS

Tata AIA
Sampoorna
Health OPDCare
Non Linked, Non-Participating, Individual Health Rider Linked, Non-Participating, individual Health Rider

Surgical Cover Daycare Cover Critical illness Cover Hospital Cover

Benefit payout for 133 listed Benefit payout for 136 listed Benefit payout on diagnosis Get daily cash benefit of up to
surgeries and unlimited and all other non-listed of any of covered 57 Critical `20,000/- on hospitalization
non-listed surgeries daycare surgeries illnesses. & Up to `40,000/- on ICU
admission

Disability Cover Death Cover Whole of Life cover

Lump-sum payout in case Ensure financial Enjoy the benefit of
of Total and Permanent protection to your loved cover up to 100 years
Disability due to accident ones in your absence of age

OT E C T WE LL
PR

Tata AIA
Pro-Fit

GET WELL

OPD Care cover Global Coverage Overseas Treatment Booster

Get services like Outpatient Avail best-in-class Avail additional 10% of sum
consultations, physiotherapy medical care globally. assured to cover overhead
sessions, pharmacy & expenses for self and
diagnostic cover etc companion.

Cashless claims Click & Claim Health Concierge

Experience cashless Enjoy claim settlement Get personal assistance
claim service across by just uploading for admission and
network hospitals photocopies of reports. discharge process

For internal circulation only.

 Market Linked Returns
Free annual health Opportunity to build a health corpus
checks with Vitality through a range of funds.

• Fund your below treatments through tax-free withdrawals from health fund

AYUSH treatments Wellness retreats Panchakarma Nutrition and

Ayurveda, Yoga, and Include yoga, meditation, Fivefold therapy that is weight loss
Naturopathy, Unani, Siddha healing treatments, or used to clean the body
and Homeopathy counselling sessions by of toxic materials
professionals.

Chronic care coaching

Virtual coach assistance to guide you to maintain health through the below health
conditions such as Hypertension, diabetes, obesity and thyroid disorder

WELL
LIVE

Tata AIA
Pro-Fit

SAV L
E WEL

Vitality discounts No Claim Reward Smart Lady benefits for female/

Up front discount on first Additional 1% discount on 2nd girl child life assured
year premium and renewal & 3rd year renewal premium if • 2% discount on premium
premium discount based on no claim is made in 1st & 2nd • Extra allocation of 0.50% of
vitality status policy years respectively premium to the fund value

Super 30 Transgender Auto Debit Tax

2% discount for life 2% discount for Additional units worth Benefits as per
assured age less than transgender life `120/- per year allocated prevailing tax laws
or equal to 30 years assured to the fund value

This material is strictly meant for internal circulation solely for training and/or education of the employees or agents or advisors and
should not be further circulated or used for presentation/ solicitation to a prospect or general public at large.
 Tata AIA
Sampoorna
Health
Non Linked, Non-Participating, Individual Health Rider

SurgiCash

Technological advancements have made

surgical treatment effective as well as expensive
While undergoing a surgery, one should focus on right treatment & fast recovery.

r
r
r

Surgery Doctor fee Admission Diagnostics Medical Ambulance Follow-Up

expense cost bills cost Treatment

TATA AIA Sampoorna Health- SurgiCash, provides lump

sum benefit to manage not only surgery costs but also other costs such as
follow up costs, medical bills, etc.

133 listed & all unlisted 136 listed & all unlisted Coverage up to Enjoy Global Coverage
surgeries covered day care surgeries R10 Lacs per annum to 100% of sum
covered assured

Yearly recharge Return of balance Restoration Diagnostic Whole life

of sum assured premium option cover option

Simple & hassle-free Claim settlement Discounts~ ~

85 years of age of up to R5,000 cashless claim facility basis photocopy
per policy year of reports
~
Refer discounts page for more details

This material is used for training purposes. Strictly for Internal Circulation Only
 Tata AIA
Sampoorna
Health
Non Linked, Non-Participating, Individual Health Rider

CritiCash

1 in 9 individuals in India have 1 in 29 women is likely 50% of all heart attacks

a risk of developing cancer to develop breast cancer in Indian men occur
before the age of 75 years.1 during her lifetime.1 under 50 years of age.

These are all critical illnesses, and in order to fund their treatment, the following costs have to be borne:

Costs incurred to recover from Critical Illness

Lifestyle
Surgery Costs Diagnostics related expenses Daily expenses when
& medical bills you're away from work

These costs can set you back and eventually make you compromise on your life goals

TATA AIA Sampoorna Health - CritiCash

57 Critical Illnesses Extensive Critical Enjoy Global Overseas Treatment

covered Illnesses Coverage to 150% of sum assured Coverage Booster

Option of zero Return of balance Diagnostic Test Whole Life

survival period premium option Cover option years of age

Ambulance cost Simple & hassle-free Claim settlement Discounts

~

claim facility basis photocopy

R 5,000 per policy year of reports ~
Refer discounts page for more details
This material is used for training purposes. Strictly for Internal Circulation Only
 Tata AIA
Sampoorna
Health
Non Linked, Non-Participating, Individual Health Rider

HospiCash

Hospitalization is a costly affair. It not only includes costs related to the patient directly but also indirect costs like
travel and food of family member accompanying the patient. Many a times, we do not even foresee these indirect
costs. Hence, we need a plan that holistically covers all expenses.

Tata AIA Sampoorna Health HospiCash

Daily ICU Recuperation Option to choose Enjoy Global

of up to R20,000 coverage for Coverage
up to R40,000 15/30/45/60 days annually

Yearly recharge Return of balance Restoration Diagnostic Test Whole Life

of sum assured premium option Cover option

Ambulance cost Simple & Claim settlement Discounts*

post 85 years hassle-free basis photocopy
of age R5,000 per cashless of reports
policy year claim facility *
Refer discounts page for more details

This material is used for training purposes. Strictly for Internal Circulation Only
 Maintaining good health
is now at your fingertips with

OPDCare
Linked, Non-Participating, individual Health Rider

Doctor/Specialist Chronic Care

Consultations Management
In-person/ face to face consultations with 18+ Virtual coach assistance to guide you to
specialties and general physicians maintain health through health conditions,
24x7 virtual consultations with general physicians, such as:
psychologists and across 18+ specialties 1. Hypertension 2. Diabetes
Seamless mobile app access to book in-person or 3. Obesity 4. Thyroid disorder
virtual consultations
Convenient contact via chat/phone with general
physicians and psychologists Wellness & Value-
Added Services
Up to 15% discount on Pharmacy
Pharmacy Up to 20% discount on diagnostics, home
sample and centre visit
Health Risk Assessment (HRA) included
Wallet additions to purchase medicines as
prescribed by the health experts
Nutrition
Management
Diagnostics
Virtual nutrient management sessions
with health experts
Diagnostic cover including pathology and
radiology Emotional
Coverage of minor procedures included
Wellness
Guided meditations, mental health
Physiotherapy podcasts and mood tracker

Physiotherapy sessions to treat any illness or Emergency Care

deformity as prescribed by the medical
practitioner Provide assistance in booking ambulance
promptly during life-threatening health
conditions

Think no more, start your journey for a secured and safer life!

This material is used for training purposes. Strictly for Internal Circulation Only
 OPD
Benefit OPD OPD OPD OPD
OPD Basic Advance
Category Standard Essential Advance Comprehensive
Plus

Virtual Con-
12 12 12 12 16 20
sultations

Out Patient
Consulta- x x 6 8 12 18
tions

3 Prescriptions 5 Prescriptions 4 Prescriptions 6 Prescriptions

Pharmacy x x
@Rs 250 @Rs 250 @Rs 500 @Rs 500

4 Prescriptions 6 Prescriptions 8 Prescriptions 5 Prescriptions 7 Prescriptions

Diagnostics x
@Rs 250 @Rs 250 @Rs 250 @Rs 500 @Rs 500

Prescribed
Physiother- x × 6 8 10 12
apy

Emotional Unlimited Un- Unlimited Uncapped

6 6 6 8
Wellness capped Usage Usage

Nutrition
Manage- 6 6 6 8 10 10
ment

Chronic
Basic Health Basic Health Basic Health
Care Man- × × Basic Health Coaching
Coaching Coaching Coaching
agement*

Emergency
Care assis- × × × × Available Available
tance

Upto 15-20% Upto 15-20% Upto 15-20% Upto 15-20% Upto 15-20%
Value Add- Upto 15-20% on Phar-
on Pharmacy on Pharmacy & on Pharmacy & on Pharmacy & on Pharmacy &
ed Services macy & Diagnostics
& Diagnostics Diagnostics Diagnostics Diagnostics Diagnostics

This material is used for training purposes. Strictly for Internal Circulation Only
With TATA AIA Pro-Fit you can now enjoy the benefit of market linked
returns to build your health fund and withdraw tax-free from the same
-
starting 6th policy year for any health consultations, medicines, diag
nostics and any treatments/ procedures recommended by registered
medical professionals.

Policy Year

This material is used for training purposes. Strictly for Internal Circulation Only
Important Points for Policyholder
understanding of what is covered and what is not, allows you to make informed decisions. TATA AIA

section explains the common terminologies and policy exclusions that you should be aware of. By know-

of claims.

Common terminologies and their meanings:

• General Waiting Period is the initial period ranging up to 6 months from policy start date during which
claims only due to accident are admissible. Details given in the table below.

• Pre-existing diseases
-> Any medical condition where medical advice or treatment was recommended by physician
with in 48 months before the start of the policy.
-> Disclosure of Pre-existing diseases is very important in order to get them covered after 48
months of waiting period.
• Cooling-off Period is the period of 6 months between two minor critical illness claims during which
minor CI claims are not admissible. However major/catastrophic claims are admissible during this
period.

after getting diagnosed with a critical illness for a successful claim. TATA AIA Pro-Fit offers an
option to choose survival period of 0 days as well.

Applicable Clause Period

HospiCash 30 Days

SurgiCash 30 Days

Waiting Period 90 days for major & catastrophic

CritiCash illnesses and 180 days for minor
illness

OPD Care 30 Days

SurgiCash 24 months / 48 Months

HospiCash, SurgiCash &

Pre-Existing Diseases 48 Months
CritiCash

Cooling-off Period CritiCash 180 Days between 2 minor CI

Survival Period CritiCash 0 or 7 Days

This material is used for training purposes. Strictly for Internal Circulation Only
24 Months waiting period:
S. No. Disease S. No. Disease

1 Benign ENT disorders 11 Gout and Rheumatism

2 Tonsillectomy 12 Hernia of all types

3 Adenoidectomy 13 Hydrocele

4 Mastoidectomy 14 Non-Infective Arthritis

5 Tympanoplasty 15 Piles, Fissures and Fistula in anus

6 Hysterectomy 16 Pilonidal sinus, Sinusitis and related disorders

All internal and external benign tumours,

Prolapse inter Vertebral Disc and Spinal Diseases
7 cysts, polyps of any kind, including benign 17
unless arising from accident
breast lumps
Calculi in urinary system, Gall Bladder and Bile
8 Benign prostate hypertrophy 18
duct, excluding malignancy.

9 Cataract and age-related eye ailments 19 Varicose Veins and Varicose Ulcers

10 Gastric/ Duodenal Ulcer 20 Internal Congenital Anomalies

48 Months waiting period:

S. No. Disease

1 Treatment for joint replacement unless arising from accident

2 Age-related Osteoarthritis & Osteoporosis

This material is used for training purposes. Strictly for Internal Circulation Only
 Underwriting Guidelines

Product Eligibility
Min. Income: Rs. 2L
Min. Education: All, except illiterates
Age Proof: Standard age proof

Sum Assured Eligibility

Benefit (Rs.) Eligible Lives
5 Cr Earning
ATPD
50 L Housewife Student Retired

20,000 Earning Housewife Student Retired

Hospicash
(per day) 10,000 Agriculturist

Surgicash 10 L Earning Housewife Student Retired Agriculturist

2.5 Cr Earning

25 L Housewife
Criticash
15 L Student Agriculturist

10 L Retired

Financial Underwriting
Financial Underwri�ng Requirements
Cri�cash > Rs. 40 L Yes
Hospicash and Surgicash No
ATPD > Rs. 3 Cr Yes

Financial Eligibility Financial Eligibility

(Based on Age, Annual Income and Income Mul�ple) - Cri�cash (Based on Age, Annual Income and Income Mul�ple) - ATPD
Annual Income Mul�ple
Age (Years) Age (Years) Annual Income mul�ple
For CI SA up to Rs. 1 Cr For CI SA above Rs. 1 Cr
18-35 12 5 18 - 60 15
36-50 10 5
51-60 5 5
60-65 5
61-65 3 3

Medical Underwriting
Risk Aggrega�on Rules Non Medical Limits
Age Above 55
Applied Cri�cash Sum Assured Cri�cash Age 18-35 Years Age 36-45 Years Age 46-50 Years Age 51-55 Years
Years

(Current & simultaneous Up to 5,00,000

applica�ons) + Exis�ng CI benefit 
Cri�cash of the life assured with TATA-AIA
5,00,001 to 10,00,000  
Life in last 24 months 10,00,001 to 25,00,000   
25,00,001 to 2,50,00,000     

Age- 18-50 Age Above 55

Applied Sum Assured (Current and

Hospicash Years
Age- 51-55 Years
Years

Simultaneous applica�ons) + 2500 to 7,500

Hospicash Exis�ng Hospicash Per day limit 7,501 to 10,000 
with TATA AIA
10,001 to 20,000 
- NML  -Non NML

Age-18 - 55 Age Above 55

Applied Sum Assured (Current Surgicash Years Years
Surgicash and Simultaneous applica�ons) +
Up to 5,00,000
Exis�ng Surgicash with TATA AIA
> 5,00,000 -10,00,00 

Medicals will be triggered in case of adverse health disclosures in applica�on form

For internal circula�on only and not to be used for solicita�on purposes.

This material is used for training purposes. Strictly for Internal Circulation Only
 Medi Assist for your Health Benefits needs

Send intimation Avail eCashless for

for faster provisional
claims settlement preauthorization before
hospitalization

Track claims
View E-card in real-time
on-the-go

Locate
Access electronic network hospitals
medical records
24x7
Track your
renewals
Order
Medicines
Schedule a
health screening

Pocket It !
And enjoy seamless access to Health Insurance & Wellness
In case of any queries, contact to our toll free number: 18004259449
SMS "CLAIMS <claim number>" to +91 96631 49992 to know the claim status

Download the App Now!

Apple App Store Google Play Store

Address: IBC Knowledge Park, Tower D, 4th Floor, Bannerghatta Main Rd, 4/1, Bengaluru, Karnataka 560029
www.mediassist.in

This material is used for training purposes. Strictly for Internal Circulation Only
List of Surgeries:
Organ system Surgery/Procedure Payout %
1 Surgery of the Aorta 100
2 Proximal Aortic Aneurysmal repair by coronary artery transplantation 100
Operations on 3 Repair of Cerebral or Spinal Arterio- Venous Malformations or aneurysms 100
Blood Vessels 4 Surgery of Carotid Artery 50
Major vein repair with or without grafting for traumatic & nontraumatic
5 50
lesions
6 Partial Pharyngectomy 50
7 Total Pharyngectomy 75
Operations on neck,
8 Total Laryngectomy 75
pharynx, larynx and
trachea Wide excision and Major reconstruction of malignant Oro-pharyngeal
9 75
tumors
10 Tracheal reconstruction for various lesion 50
11 Replantation of upper limb 75
12 Replantation of lower limb 75
13 Entrapment syndrome- decompression surgery 50
14 Total hip replacement (With Cement) 50
15 Total hip replacement (Without Cement) 50
16 Total hip replacement- Others 50
17 Total Knee replacement (With Cement) 50
18 Total Knee replacement (Without Cement) 50
19 Total Knee replacement- Others 50
20 Total prosthetic replacement of other joint using cement 50
21 Total prosthetic replacement of other joint not using cement 50

Operations on the 22 Other total prosthetic replacement of other joint 50

bones, muscles and 23 Prosthetic replacement of head of femur using cement 50
joints
24 Prosthetic replacement of head of femur not using cement 50
25 Other prosthetic replacement of head of femur 50
26 Prosthetic replacement of head of humerus using cement 50
27 Prosthetic replacement of head of humerus not using cement 50
28 Other prosthetic replacement of head of humerus 50
29 Prosthetic replacement/articulation/other bone using cement 50
30 Prosthetic replacement/articulation/other bone not using cement 50
31 Other prosthetic replacement of articulation of other bone 50
32 Prosthetic interposition reconstruction of joint 50
33 Other interposition reconstruction of joint 50
34 Excision reconstruction of joint 50
35 Other reconstruction of joint 50

This material is used for training purposes. Strictly for Internal Circulation Only
 Organ system Surgery/Procedure Payout %
36 Implantation of prosthesis for limb 50
37 Amputation of hand 25
38 Amputation of foot 25
39 Therapeutic knee Arthroscopy 25
40 25
41 Surgical Drainage and Curettage for osteomyelitis 25
Operations on the 42 Radical Mastectomy 75
breast 43 Simple Mastectomy 25
44 Total ear amputation with reconstruction 75
Operations on the ear 45 Trans mastoid removal cholesteatoma with extended Mastoidectomy 75
46 Labyrinthotmy for various lesions 50
47 Orbit Tumor Exenteration /Flap reconstruction 50
Operations on the
48 Corneal or Retinal Repair for Traumatic eye injuries 25
eyes
49 Penetrating injuries of the eye or repair of ruptured globe 25
Major reconstructive oro-maxillafacial surgery due to trauma or burns and
50 75
not for cosmetic purpose
Operations on the
Osteotomy including segmental resection with bone grafting for Mandibu-
face 51 75
lar and maxillary lesions
52 Elevation, Exploration and Fixation of fractured Zygoma 50
53 Excision of esophagus and stomach 100
Abdominal-Perineal Pull Through Resection of rectum with Colo-Anal
54 100
Anastomosis
55 Total Esophagectomy 75
56 Total Gastrectomy 75
57 Partial Resection of Liver 75
58 Partial Pancreatectomy 75

Operations on the 59 Resection and Anastomosis of any part of digestive tract 50

Gastrointestinal 60 Open Surgery for treatment of Peptic Ulcer 50
organs
61 Cholecystectomy /Choledochotomy for various Gall bladder lesions 25
62 25
63 TIPS procedure for portal Hypertension 25
64 Hysterectomy for malignant conditions 50
65 Radical prostatovesiculectomy 75
66 Penile replantation for post traumatic amputation 75
67 Penile Amputation repair 50
68 Excision of vagina 50
69 Unilateral or Bilateral excision of adnexa of uterus 50
70 Unilateral or Bilateral excision of testes 25
71 Other operations on Scrotum and tunica vaginalis testis 25

This material is used for training purposes. Strictly for Internal Circulation Only
 Organ system Surgery/Procedure Payout %
72 Reconstruction of the testis 25
73 Open surgical excision and destruction of prostate tissue 25
74 Extirpation of lesion of vulva 25
75 Excision of vulva 25
76 CABG (two or more coronary arteries) via open thoracotomy 100
77 Prosthetic replacement of Heart Valve 100
78 Coronary Angioplasty with Stent implantation 50
79 Pericardiotomy / Pericardectomy 50
Operations on the 80 Implantation of Cardioverter Defebrillator 50
heart 81 Permanent pacemaker Implantation in heart 50
82 Mitral valve repair 75
83 Aortic valve repair 75
84 Tricuspid valve repair 75
85 Pulmonary valve repair 75
86 Total nephrectomy(Not as transplant donor) 50
87 Partial Nephrectomy 50
88 Open extirpation of lesion of kidney 50
89 Excision of ureter 50

Operations on the 90 Total excision of bladder 50

Kidney, ureter and 91 Kidney injury repair 50
bladder
92 Pyloplasty / Ureterocalcycostomy for pelvic ureteric junction obstruction 50
93 Partial excision of bladder 25
94 Therapeutic ureteroscopic operations on ureter 25
95 Urinary diversion 25
96 Replantation of ureter 25
97 Pneumenectomy 75
98 Open Lobectomy of Lung 75
99 Partial Extirpation of Bronchus 75
100 Pleurectomy or Pleural decortication 50
Operations on the
101 Major Nasal Reconstruction due to Traumatic lesions 75
lung and bronchus
102 Total Glossectomy 50
103 Operations on frontal sinus 50
104 Oral Leukoplakia- Wide excision 25
105 Operations on maxillary antrum using sublabial approach 25
106 Craniotomy for malignant Cerebral tumors 100
107 Craniotomy for non malignant space occupying lesions 75
Operations on the
skull, brain and me- 108 Operations on Subarachnoid space of brain 75
ninges
109 Craniotomy- Surgery on meninges of Brain 75
110 Other operations on the meninges of the Brain 75

This material is used for training purposes. Strictly for Internal Circulation Only
 Organ system Surgery/Procedure Payout %
111 Micro vascular decompression of cranial nerves/nervectomy 75
112 Craniotomy for Drainage of Extradural, subdural or intracerebral space 50
Therapeutic Burr Hole on skull- Drainage of Extra-Dural, intra-Dural or
113 25
intracerebral space
114 Unilateral or Bilateral sympathectomy 50
115 Peripheral nerve Graft 50
Operations on the 116 Free Fascia Graft for Facial Nerve Paralysis 50
spine and nerves 117 Excision of deep-seated peripheral nerve tumor 50
118 Multiple Microsurgical Repair of digital nerve 50
119 50
120 Diaphragmatic/Hiatus Hernia Repair 75
Operations on the 121 Thoracotoplasty 75
Thoracic cavity 122 Open excision of benign mediastinal lesions 75
123 Excision of Diaphragmatic tumors 75
124 Pineal Gland excision 100
125 Pituitary Gland excision 100
126 Complete excision of adrenal glands 75
Operations on the
Thyroid, Parathyroid 127 Total thyroidectomy 75
and other endocrine 128 Complete excision of Parathyroid gland 75
glands
129 Partial excision of adrenal glands 50
130 Subtotal/Partial Thyroidectomy 50
131 Partial excision of Parathyroid gland 50
132 Major Excision and grafting of Lymphedema 75
Other operations
133 Splenectomy 75

This material is used for training purposes. Strictly for Internal Circulation Only
List of Day Care Procedures:
1 Stapedectomy
2 Revision of a stapedectomy
3 Other operations on the auditory ossicles
Microsurgical
4 Myringoplasty (Type -I Tympanoplasty)
operations on the
middle ear Tympanoplasty (closure of an eardrum perforation/reconstruction of the auditory ossi-
5
cles)
6 Revision of a tympanoplasty
7 Other microsurgical operations on the middle ear
8 Myringotomy
9 Removal of a tympanic drain
10 Incision of the mastoid process and middle ear
11 Mastoidectomy
Other operations 12 Reconstruction of the middle ear
on the middle &
internal ear 13 Other excisions of the middle and inner ear
14 Fenestration of the inner ear
15 Revision of a fenestration of the inner ear
16 Incision (opening) and destruction (elimination) of the inner ear
17 Other operations on the middle and inner ear
18 Excision and destruction of diseased tissue of the nose
Operations on the 19 Operations on the turbinates (nasal concha)
nose & the nasal
sinuses 20 Other operations on the nose
21 Nasal sinus aspiration
22 Incision of tear glands
23 Other operations on the tear ducts
24 Incision of diseased eyelids
25 Excision and destruction of diseased tissue of the eyelid
26 Incision of diseased eyelids
27 Operations on the canthus and epicanthus
28 Corrective surgery for entropion and ectropion
29 Corrective surgery for blepharoptosis
Operations on the
30 Removal of a foreign body from the conjunctiva
eyes
31 Removal of a foreign body from the cornea
32 Incision of the cornea
33 Operations for pterygium
34 Other operations on the cornea
35 Removal of a foreign body from the lens of the eye
36 Removal of a foreign body from the posterior chamber of the eye
37 Removal of a foreign body from the orbit and eyeball
38 Operation of cataract

This material is used for training purposes. Strictly for Internal Circulation Only
 39 Incision of a pilonidal sinus
40 Other incisions of the skin and subcutaneous tissues
Surgical wound toilet (wound debridement) and removal of diseased tissue of the skin
41
and subcutaneous tissues
42 Local excision of diseased tissue of the skin and subcutaneous tissues
Operations on the 43 Other excisions of the skin and subcutaneous tissues
skin & subcutane- 44 Simple restoration of surface continuity of the skin and subcutaneous tissues
ous tissues 45 Free skin transplantation, donor site
46 Free skin transplantation, recipient site
47 Revision of skin plasty
48 Other restoration and reconstruction of the skin and subcutaneous tissues
49 Chemosurgery to the skin
50 Destruction of diseased tissue in the skin and subcutaneous tissues
51 Incision, excision and destruction of diseased tissue of the tongue
52 Partial glossectomy
Operations on the
53 Glossectomy
tongue
54 Reconstruction of the tongue
55 Other operations on the tongue
56 Incision and lancing of a salivary gland and a salivary duct
Operations on the 57 Excision of diseased tissue of a salivary gland and a salivary duct
salivary glands & 58 Resection of a salivary gland
salivary ducts 59 Reconstruction of a salivary gland and a salivary duct
60 Other operations on the salivary glands and salivary ducts
61 External incision and drainage in the region of the mouth, jaw and face
62 Incision of the hard and soft palate
Other operations 63 Excision and destruction of diseased hard and soft palate
on the mouth &
face 64 Incision, excision and destruction in the mouth
65
66 Other operations in the mouth
67 Transoral incision and drainage of a pharyngeal abscess
68 Tonsillectomy without adenoidectomy
69 Tonsillectomy with adenoidectomy
70 Excision and destruction of a lingual tonsil
71 Other operations on the tonsils and adenoids
Operations on the
72 Trauma surgery and orthopaedics
tonsils & adenoids
73 Incision on bone, septic and aseptic
74 Closed reduction on fracture, luxation or epiphyseolysis with osteosynthesis
75 Suture and other operations on tendons and tendon sheath
76 Reduction of dislocation under GA
77 Arthroscopic knee aspiration
Operations on the 78 Incision of the breast
breast 79 Operations on the nipple

This material is used for training purposes. Strictly for Internal Circulation Only
 80 Incision and excision of tissue in the perianal region
81
82 Surgical treatment of haemorrhoids
Operations on the 83 Division of the anal sphincter (sphincterotomy)
digestive tract 84 Other operations on the anus
85 Ultrasound guided aspirations
86 Sclerotherapy etc.
87 Laparoscopic cholecystectomy
88 Incision of the ovary
89
90 Other operations on the Fallopian tube
91 Dilatation of the cervical canal
92 Conisation of the uterine cervix
93 Other operations on the uterine cervix
Operations on
94 Incision of the uterus (hysterotomy)
the female sexual
organs 95 Therapeutic curettage
96 Culdotomy
97 Incision of the vagina
Local excision and destruction of diseased tissue of the vagina and the pouch of
98
Douglas
99 Incision of the vulva
100 Operations on Bartholin’s glands (cyst)
101 Incision of the prostate
102 Transurethral excision and destruction of prostate tissue
103 Transurethral and percutaneous destruction of prostate tissue
Operations on the 104 Open surgical excision and destruction of prostate tissue
prostate & seminal 105 Radical prostatovesiculectomy
vesicles 106 Other excision and destruction of prostate tissue
107 Operations on the seminal vesicles
108 Incision and excision of periprostatic tissue
109 Other operations on the prostate
110 Incision of the scrotum and tunica vaginalis testis
Operations on the 111 Operation on a testicular hydrocele
scrotum & tunica 112 Excision and destruction of diseased scrotal tissue
vaginalis testis 113 Plastic reconstruction of the scrotum and tunica vaginalis testis
114 Other operations on the scrotum and tunica vaginalis testis
115 Incision of the testes
116 Excision and destruction of diseased tissue of the testes
Operations on the
117 Reconstruction of the testis
testes
118 Implantation, exchange and removal of a testicular prosthesis
119 Other operations on the penis

This material is used for training purposes. Strictly for Internal Circulation Only
 120 Surgical treatment of a varicocele and a hydrocele of the spermatic cord
Operations on the 121 Excision in the area of the epididymis
spermatic cord, 122 Epididymectomy
epididymis und 123 Reconstruction of the spermatic cord
ductus deferen 124 Reconstruction of the ductus deferens and epidididymis
125 Other operations on the spermatic cord, epididymis and ductus deferens
126 Operations on the foreskin
127 Local excision and destruction of diseased tissue of the penis
Operations on the
128 Amputation of the penis
penis
129 Plastic reconstruction of the penis
130 Other operations on the penis
Operations on the
131 Cystoscopical removal of stones
urinary system
132 Lithotripsy
133 Coronary angiography
Other Operations 134 Haemodialysis
135 Radiotherapy for Cancer
136 Cancer Chemotherapy

This material is used for training purposes. Strictly for Internal Circulation Only
List of Critical Illnesses:
Sr. No Conditions Sr. No Conditions
Major Critical Illnesses
1 18 End Stage Lung Failure
2 Cardiomyopathy 19 Kidney Failure requiring Regular Dialysis
-
3 20 Loss of Independent Existence (Cover up to Age 74)
son’s Disease)
4 Aorta Graft Surgery 21 Loss of limbs
Myocardial Infarction (First Heart
5 22 Major Head Trauma

Open Chest CABG (Coronary Artery

6 23 Motor Neuron Disease with Permanent Symptoms
Bypass Graft)
Open Heart Replacement or Repair
7 24 Multiple Sclerosis with Persisting Symptoms
of Heart Valves
Primary (Idiopathic) Pulmonary Hy-
8 25 Muscular Dystrophy
pertension
Stroke resulting into permanent
9 26 Parkinson’s Disease
symptoms
10 Alzheimer’s Disease 27 Permanent Paralysis of Limbs
11 Apallic Syndrome 28 Poliomyelitis
12 Aplastic Anaemia 29 Progressive Scleroderma
13 Blindness 30 Systemic Lupus Erythematosus with Lupus Nephritis
14 Chronic Relapsing Pancreatitis 31 Third Degree Burns
15 32 Eisenmenger’s Syndrome
16 Creutzfeldt-Jacob disease 33
17 End Stage Liver Failure

Minor Critical Illnesses

Cardiac Arrest requiring permanent
34 45 Carcinoma-in-Situ
Cardiac Pacemaker or ICD insertion
35 Angioplasty 46 Necrotizing Fasciitis
36 Benign Brain Tumour 47 Severe Rheumatoid Arthritis
37 Fulminant Viral Hepatitis 48 Pneumonectomy
38 Severe Osteoporosis 49 Bacterial Meningitis
39 Small Bowel Transplant 50 Encephalitis
40 Intestinal Gangrene requiring surgery 51 Deafness
41 Surgical removal of one kidney 52 Loss of Speech
Percutaneous Transluminal Balloon
42 53 Medullary Cystic Disease
Valvuloplasty or Valvotomy
43 Severe Ulcerative Colitis 54 Amputation of Feet Due to Complications from Diabetes
44 55 Cirrhosis of Liver
Catastrophic Critical Illnesses
56 End Stage Cancer 57 Major Organ/Bone Marrow transplant

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