3️⃣Limit 3: Hospital Bill Percentage

Limit 3 calculates the maximum claimable amount based on the actual cost of the medically insurable event — specifically, the hospital bill submitted during the claim. It is one of four metrics used to determine the Initial Reimbursement Amount, and the lowest value among all four limits will be used.

By default, Limit 3 caps the reimbursement to 30% of the hospital bill. This ensures that claims remain proportional to real-world expenses and helps prevent overpayment from the treasury.

🔓 Enhanced Cap for Governance Holders

Wallets that perpetually hold at least 1 governance token (to be deployed on Ethereum) for a minimum of 1 year may qualify for an increased cap of 70% of the hospital bill.

This enhancement rewards long-term participation and supports the broader goal of decentralized governance and coverage expansion.

🎯 Purpose of the Hospital Bill Cap

• Align reimbursement amounts with actual medical costs

• Prevent excessive claims that could compromise treasury sustainability

• Encourage responsible financial planning alongside token holding

• Incentivize governance token participation for enhanced benefits

Limit 3 works in tandem with the other three limits. The final Initial Reimbursement Amount will be the lowest value among all limits set by the Project Founder.

For sample computations and to learn how each limit works to balance each other out, feel free to use and play with the calculator located on the right lower portion of the project website.