We cover for:
1. The insured must age between 14 days - 80 years old with healthy and not any disability or mental disorder on the effective date of policy.
2. This policy does not cover injury / illness / chronic disease which occur before effective date of policy and still not recover on the first effective date and unnecessary medical treatment.
3. This insurance policy is not covered any illness that occur within 30 days (Waiting Period) since the first effective.
4. This insurance policy is not covered illness as following : All Tumour or Cysts, Cholesystistic, Hemorrhoids, Hernias, Cataract, Tonsil or Adenoid any Calculus, Varicose vain and Endometriosis which occur within 120 days (Waiting Period) after first effective date of policy.
5. The two or more treatments as Inpatient Hospitalisation (IPD) in the same disability will have following conditions;
5.1 The treatments will be counted as the same disability unless such treatments occur within 90 days after the same disability.
5.2 The treatments will be counted as the new disability, if that treatments occur over 90 days after the same disability.
6. Medical treatment for emergency accident basis within 24 hours after the accident and include continuing treatment within 31 days after receive the first treatment but not exceed actual expense or maximum limit of coverage.
7. Health care card is provided for the insured to service with hospital network.
8. Company reserves right to adjust the premium for renewal policy, the renewal premium is consider from age of insured and claim experience.
9. This proposal is valid for 30 days from proposed date.
10. Terms and condition will be based on each policy
11.Buyer should read and understand detail of coverage and conditions before making a decision to purchase insurance policy.
TIP Long Stay Visa Proposal >> Click <<
For more information, please contact to Dhipaya branch (near your address)
Coverages |
Limit of Coverage (Baht) |
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Plan 1 |
Plan 2 |
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1. Medical Expense for INPATIENT HOSPITALISATION (IPD) of injury or illness |
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Maximum limit of Medical Expense per incident or accident not exceed or per year |
3,500,000 |
3,500,000 |
|
Deductible per incident or accident |
- |
10,000 |
|
1.1Room and Board including Nursing service fee |
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- Standard Room and board (Maximum per day, not exceed 90 days) |
10,000 |
10,000 |
|
- ICU/CCU Room and board (Maximum per day, not exceed 15 days) |
20,000 |
20,000 |
|
(The total maximum benefits for Standard room, ICU/CCU would not exceed 90 days per any injury or illness) |
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1.2Hospital General Expenses |
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- Hospital General Expenses |
150,000 |
150,000 |
|
- Emergency Ambulance Charges ( Included in Hospital General Expenses) |
5,000 |
5,000 |
|
1.3Emergency Treatment for an accident |
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- Medical treatment for emergency accident basis within 24 hours after the accident and include continuing treatment within 31 days after receive the first treatment (Included in Hospital General Expenses) |
50,000 |
50,000 |
|
1.4Surgical Procedure fees |
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- Surgical Fee (Actual expenses) |
250,000 |
250,000 |
1.5Doctor Visit fees |
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- Doctor Visit fees for in-patient hospital 1 visit per day (Maximum of 90 days) |
2,000 |
2,000 |
|
1.6Specialist Physician consultation fees | |||
- Specialist Physician Consultation fees but non-surgical treatment (Included in Hospital General Expenses) |
10,000 |
10,000 |
|
- Specialist's consultation and evaluation fees prior to surgery (Included in Surgical fee) |
10,000 |
10,000 |
|
2. OUT-PATIENT HOSPITALISATION (OPD) of injury or illness. |
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- OUT-PATIENT HOSPITALISATION (OPD) (Maximum 1 visit per day, limit 30 visits per year) |
1,500 |
1,500 |
|
3. Personal Accident ( PA2 ) |
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-Loss of life, Dismemberment, Loss of sight, Loss of hearing, Loss of speech or Permanent disability (PA 2) (Excluding murder/assault and riding on or travelling by motorcycle) |
100,000 |
100,000 |
Total Premium / Person / Year (Baht) (Included Stamp) |
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Age (Years) |
Plan 1 |
Plan 2 |
|
14 Days - 5 Years |
88,000 |
76,000 |
|
6 - 15 |
57,000 |
49,000 |
|
16 - 30 |
34,000 |
29,000 |
|
31 - 40 |
32,000 |
2 7,000 |
|
41 - 50 |
43,000 |
37,000 |
|
51 - 60 |
55,000 |
47,000 |
|
61 - 70 |
69,000 |
59, 000 |
|
71 - 80 |
90,000 |
76,000 |