..:: COMPREHENSIVE HEALTHCARE INSURANCE (SUPERIOR PACKAGE

COMPREHENSIVE HEALTHCARE INSURANCE (SUPERIOR PACKAGE – EXPAT CARE)

Claims procedure

OVERVIEW
INSURANCE COVERAGE
EXCLUSION
PRODUCT DOCUMENT
CLAIMS GUIDELINE
OTHER PRODUCTS

product overview

Eligibility:

Age: from fifteen (15) days old to seventy-five (75) years old

The following shall not be eligible for this insurance:

Persons have been refused to be insured or renewed a Health Insurance policy by any Insurers
Persons suffering from mental illness or leprosy
Persons with a permanent disablement rating from 50% and above (*)
Persons are in inpatient treatment due to accident or illness/Persons are under treatment for any disease or injury (applicable for new added Insureds)

Waiting period:

Not applied

Territorial limit:

Vietnam, Asia, Worldwide depend on Insured person's selection.

Main definition:
(*) Special Diseases: Diseases including cancer, tumors of all kinds, hypertension, cardiovascular diseases, stomach ulcers, chronic osteoarthritis, intestinal ulcers, hepatitis, endometritis, hemorrhoids, kidney stones and gallstones, tuberculosis, cataracts and sinusitis.

(* *) Pre-existing disease:
- Has been diagnosed or treated before the effective date or the date of the most recent reinstatement (nearest) of the policy.
- Existed prior to the First Effective Date of the Policy, this Pre-existing Condition had manifested signs or symptoms within 36 months before the Effective Date or the most recent reinstatement date of thePolicy, and was reasonably recognizable by the Insured or by any ordinary person.
- The determination of a pre-existing disease shall be based on medical records or legally established medical facilities, medical documents issued by the Ministry of Health and competent authorities, or information provided by the Policyholder, the Insured on the insurance claim or the supplementary information form.

INSURANCE COVERAGE

main coverage

MEDICAL EXPENSE DUE TO ACCIDENT

Medical expenses due to Accident: The Company shall pay any Covered Expenses incurred within twenty-four (24) months from the occurrence of an Accident for any medical diagnosis and treatment, surgery, hospitalization and nursing including costs of medical supplies and ambulance service charges
Emergency Medical Evacuation and Repatriation
Arrangement and Payment of Emergency Medical Evacuation
Arrangement and Payment of Repatriation expenses
Arrangement and Payment of Mortal Remains Repatriation expenses

MEDICAL EXPENSE DUE TO ILLNESS

Pay any medical expenses and emergency medical evacuation and repatriation expenses incurred as a result of an Illness and not otherwise excluded by TMIV's insurance policy, up to the limit of medical expenses due to Illness.

extended coverage

OPTIONAL BENEFITS:

Dental treatment
Maternity care
Death and Total Permanent Disablement due to Accident
Death and Total Permanent Disablement due to Illness or Maternity
Partial Permanent Disablement due to Accident
Allowances for job loss, reduced income during the period of treatment due to Accident
Daily allowance during in-patient treatment due to Illness

EXCLUSION

GENERAL EXCLUSION

Take part in professional sport
Special illnesses, pre-existing diseases, and pre-existing injuries during Waiting Period.
Test or treatment of mental disorder, mental illness
Suicide, intentional self-injury
Being under the influence of alcohol, drugs
Any violation of applicable laws
Cosmetic reconstructive surgery or treatment
Medical check up
Congenital Conditions
Dental care or Maternity care, except other agreement on Schedule
Obesity treatment

INSURANCE PREMIUM

Insurance premiums are determined based on risk assessment and specific insurance pricing principles of the product. For detailed advice and appropriate quotes, please contact Tokio Marine Insurance Vietnam Co. directly.