รายชื่อโรงพยาบาลในเครือข่าย
Network Hospital
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Type
Service
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Definition
Accident
A sudden unexpected incident caused by external factors resulting in impact that the Insured does not intend or expect.
Injury
Injury means bodily injury which is caused directly from an accident which solely occurs and is independent from other causes.
Illness
Illness means symptoms, physical abnormalities caused by disease which are contracted of the covered person.
Inpatient
A patient who through medical necessity is hospitalized in a Hospital or Medical Facility to receive treatment for an Injury or Illness for at least six (6) consecutive hours and must be registered as an In-patient, which shall include the case of admission as an Inpatient, but the patient dies before completing the 6-hour period.
Outpatient
A patient who receives the medical treatment for Injury or Illness in an Outpatient Department or Emergency Department of the Hospital or Medical Facility without medical necessity to be admitted as an Inpatient.
Medical Facility
A place granted a medical license or a medical and public health professional practice to the law in its district.
Hospital
A place that provides medical services, able to accommodate patients staying overnight or treat diseases or injuries for 24 hours and obtained a license or is legally registered to operate as a “hospital” in accordance with the local laws providing services.
Clinic
A medical facility providing the medical service but unable to accommodate patients staying overnight and obtained a license or is legally registered to operate as a “clinic” in accordance with the local laws providing services.
Medical Standards
Rules or practices for treating the Injury or Illness in accordance with academic principles in compliance with the standards of the area in which the service is provided, which consist of:
(1) Professional standards and related professional requirements.
(2) Medical Facility standards.
(3) Medicine and Medical Tools Standards.
(4) Non-discriminatory Patient Care
Medical Necessity
The necessity to use medical services or other services of the Hospital or Medical Facility for examination and treatment of Injury or Illness which shall be subject to the following conditions:
(1) The services must be consistent with the diagnosis and treatment according to the symptoms of the Injury or Illness in a treated covered person.
(2) Must comply with medical standard.
(3) The services are not solely for the convenience of the Insured Person or the Insured Person’s family or the medical service provider.