..:: Comprehensive healthcare insurance ::..

COMPREHENSIVE HEALTHCARE INSURANCE

Claims procedure

OVERVIEW
INSURANCE COVERAGE
EXCLUSION
PRODUCT DOCUMENT
CLAIMS GUIDELINE
OTHER PRODUCTS

product overview

Eligibility:

Age: From 15 days old to 80 years old (calculated according to the last birthday), and
Persons over 70 years old only is covered provided that he/she has been insured with the Company for at least 2 consecutive years.
Not suffer from mental illness, down syndrome, or leprosy;
Not have permanent disablement rating or loss of work ability 50% or more;
Not be under Inpatient treatment for accident or disease

Waiting period

30 days from the First Effective Date in case of common Sickness (applicable only to Death/Total Permanent Disablement due to Sickness);
90 days from the First Effective Date in case of maternity complications;
270 days from the First Effective Date in case of childbirth;
365 days from the First Effective Date in case of Pre-Existing Conditions;
90 days from the First Effective Date in case of Special Diseases;

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

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Main definitions
(*) Special diseases:
Means tumors of all types, blood pressure, heart/blood vessels, gastritis/stomach ulcers, Digestive tract inflammation/ ulcers (stomach, duodenum, intestine, colon, rectum, anal fissure, anal fistula excluding appendicitis, acute enteritis), gallbladder and pancreatic disease, chronic polyarthritis, Deviated nasal septum surgery, gallbladder, pancreatic disease, deviated nasal septum surgery, hepatitis of all types, endometritis, hemorrhoids, stones of all types, cataracts, sinusitis, tonsillitis/ Adenoiditis necessitating surgical removal, osteoarthritis, disc herniation, Parkinson’s disease, diabetes, bone density/lipid metabolism disorders.

(**) Pre-existing diseases:
Means any Injury or Sickness sustained by the Insured prior to the start date of the first insurance period and:
- for which treatment has been received for three years prior to the First Effective Date;
- the symptoms of which have appeared or occurred before the start date of the first insurance period and the Insured was aware or should have been aware, whether the Insured was actually examined and treated or not.

INSURANCE COVERAGE

main coverage

I. PERSONAL ACCIDENT

II. DEATH/TOTAL PERMANENT DISABLEMENT DUE TO SICKNESS AND MATERNITY

The Company shall pay the Sum Insured in full to the Beneficiary in the event of the Insured’s death or Total Permanent Disablement resulting from a Sickness or Maternity (if stipulated in the Benefit table) and any sudden and unexplained death but not excluded under this Policy provided that the date of death or the date of determination of total permanent disability occurs within the insurance period (unless otherwise specified).

III. HOSPITALIZATION AND SURGICAL DUE TO SICKNESS AND MATERNITY

extended coverage

Optional benefits:

Outpatient treatment due to sickness

Basic dental care

Special dental care

Special Maternity care

Other Optional Benefit

EXCLUSION

Suicide, violation of law, using alcohol or stimulants
Professional sports activity
Pre-existing condition, special disease during waiting period
Cosmetic treatment and cosmetic orthopedic surgery
Refractive errors such as nearsightedness, farsightedness, astigmatism
Treatment of obesity, weight control program
Treatment or surgery at the Insured person’s request
Sexually transmitted diseases
Mental illness or mental disorders
Other exclusions as described in wording

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.