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Coverage Plan
 

Health Insurance Coverage Maximum Payable per Disability/Time/Year

SP1500
150,000
SP2000
200,000
SP3000
300,000
SP4000
400,000
SP6000
600,000
SP12000
1,200,000
 

In-patient Hospitalization (IPD) Coverage

 

- Room and Board, Including Nursing Care (Max. per disability/time)

90,000

120,000

180,000

240,000

360,000

720,000

  - Normal Room (Max. per day, limit 60 days)
1,500
2,000
3,000
4,000
6,000
12,000
 

     - ICU Room (Max. per day, limit 15 days)

3,000
4,000
6,000
8,000
12,000
24,000
  - General Expenses (Max. per disability/time)
15,000
20,000
30,000
40,000
60,000
120,000
  - Emergency OPD Treatment for Accident (Including in General Expenses
3,000
4,000
6,000
8,000
12,000
24,000
  - Special Consultation Fee (Including in General Expenses)
1,500
2,000
3,000
4,000
6,000
12,000
 

- Ambulance Fee (Including in General Expenses)

1,000
1,000
1,000
1,000
1,000
1,000
 

Surgical Coverage

 

- Surgeon's Operation Fee (Max. per disability/time, as per Actual Expenses)

22,500
30,000
45,000
60,000
90,000
180,000
  - Surgical Consultation Fee (Including in Surgeon's Operation Fee)
2,250
3,000
4,500
6,000
9,000
18,000
 

Physician Care Coverage

 

- Physician Care (Max. per disability/time)

22,500
30,000
45,000
60,000
90,000
180,000
  - In-patient Physician Visit Fee (Max. per day, limit 60 days
375
500
750
1,000
1,500
3,000
 

Personal Accident Coverage (PA 2)

 

- Accidental Death, Dismemberment, and Total Permanent Disability

100,000
100,000
100,000
100,000
100,000
100,000
 

Out-patient Benefits (OPD) (Optional Purchase)

OPD 800
OPD 1000
OPD 1500
OPD 2000
OPD 2500
OPD 3000
 

- Maximum Payable per Year)

32,000
40,000
60,000
80,000
100,000
120,000
 
- Maximum Payable per Day (Max. 1 visit per day, limit 30 visits per year)
800
1,000
1,500
2,000
2,500
3,000
 
- X-ray and Laboratory Test Expenses (Maximum per year)
8,000
10,000
15,000
20,000
25,000
30,000
   
 

Annual Premium Includes Duty Stamp and SBT (Baht)

 

IPD

Age (Years)

SP1500
SP2000
SP3000
SP4000
SP6000

SP12000

15 วัน - 5
14,894 19,713 29,352 38,992 58,270 81,405
6 - 10
7,664 10,074 14,894 19,713 29,352 40,919
11 - 20
5,598 7,320 10,762 14,205 21,090 29,352
21 - 35
4,565 5,943 8,696 11,452 16,959 23,570
36 - 40
5,186 6,770 9,936 13,103 19,439 27,038
41 - 45
5,598 7,320 10,762 14,205 21,090 29,352
46 - 50
6,631 8,696 12,828 16,959 25,221 35,136
51 - 55
7,664 10,074 14,894 19,713 29,352 40,919
56 - 60
8,696 11,452 16,959 22,468 33,483 46,704
61 - 65
10,850 14,292 21,177 28,062 41,833 58,357
*66 - 70
15,154 19,974 29,612 39,253 58,530 81,665
*71 - 75
21,698 28,582 42,353 56,123 52,720 116,713
*76 - 80
32,025 42,353 63,008 83,665 124,975 174,549

*Renew only

           
   
 

OPD

Age (Years)

OPD 800
OPD 1000
OPD 1500
OPD 2000
OPD 2500

OPD
3000

15 วัน - 5
17,510 21,482 31,410 41,339 51,266 61,195
6 - 10
8,756 10,742 15,705 20,671 25,634 30,598
11 - 20
6,255 7,673 11,219 14,765 18,311 21,856
21 - 35
5,004 6,138 8,975 11,811 14,648 17,485
36 - 40
5,755 7,060 10,322 13,614 16,846 20,108
41 - 45
6,255 7,673 11,219 14,765 18,310 21,856
46 - 50
7,506 9,207 13,462 17,717 21,972 26,227
51 - 55
8,756 10,742 15,705 20,671 25,634 30,598
56 - 60
10,006 12,276 17,949 23,622 29,295 34,969
61 - 65
12,508 15,345 22,436 29,528 36,619 43,711
*66 - 70
17,510 21,482 31,410 41,339 51,266 61,195

* Renew only

 
Remark  
 

1. Standard premium for each age band for the first policy year only
2. Eligible to apply for the first year coverage from 15 days up to 65 years of age, renewable up to 80 years of age for IPD and up to 70 years of age for OPD.
3. IPD coverage must be purchased first in order to be able to purchase OPD coverage, in case of purchase OPD as optional, OPD premium will be added to IPD premium.
4. Renewal year premium will be adjusted according to increasing age of each insured person
5. Renewal year premium of each insured person may be charged higher, up to 100 percent of standard premium, according to underwriting experience of the previous policy year
6. 10 percent discount for the renewal year for no claim bonus .

 
     

Insuring Agreement

 
  • This health insurance covers for treatment expenses resulting from injury from an accident or suffers from sickness for the actual expenses paid, up to the maximum limit of benefit as stated in the schedule of the insurance policy.
• Details of insuring agreement shall be referred to the insurance policy.
 
     

Coverage Commencement

 
  • Coverage for sickness shall be start covered after the first 30 days waiting period, except 8 types of sicknesses that stipulated in the insurance policy shall be start covered after 120 days waiting period.
• Coverage for injury from accident and shall be start covered immediately from the policy effective date.
 
     
Exclusions  
  • Pre-existing conditions, including related symptoms and chronic conditions that the applicant has had before this insurance policy is in effect, congenital abnormality or genetic disorders
• Cosmetic surgery, beautification treatment, or aging relieve treatment
• Treatment or surgery related to eyesight, dental or gum
• Treatment related to mental disorder
• Treatment which is not considered a modern medicine including alternative medicine.
• Health check up and preventive vaccination
• Suicide or suicide attempt, self inflicted injury
• Other exclusions shall be referred to the insurance policy
 
     

Apply for Coverage and Support Document

 
  • Fill the Application Form and Applicant’s Health Condition Declaration Form truthfully and sign to certify *
• Submit copy of ID Card or copy of Passport for foreigner
• For the youth, submit copy of ID Card or Birth Certification together with copy of ID Card of the parent
• The company reserves the right to reject any application or accept with exclusions, according to underwriting standard of the company.
• The company reserves the right not to renew each insured person within the first 2 years after start coverage.
 
     

* In case the applicant knows any fact but declares false statement or fails to declare it, in which should the company acknowledge it prior, the company may increase the insurance premium or reject the application, this insurance policy shall be voided, according to the Civil and Commercial Code, Section 865. The company has the right to dissolve it,
**The insured person can request for policy cancellation within 90 days after the first policy year effective date, and the company shall refund full premium before tax and duty to the insured person, in case there is no claims.

Remark
Information in this brochure is only preliminary information provided for the applicant to consider for applying for health insurance coverage from the company, all insuring conditions shall be referred to Definition, General Conditions, General Exclusions, and Insuring Agreement of the health insurance policy of the company.