|
Maximum Sum Insured per Person
|
|
BENEFITS
|
Bronze Plan |
Gold Plan |
Platinum Plan |
Diamond Plan
|
| I. ACCIDENT INSURANCE |
|
|
|
|
| 1. Death / Total Permanent Disability due to accident
(100% Sum Insured) |
200,000,000 |
500,000,000 |
1,000,000,000 |
2,000,000,000 |
| 2. Medical expenses due to accident |
20,000,000 |
50,000,000 |
100,000,000 |
200,000,000 |
| II. INPATIENT TREATMENT INSURANCE FOR ILLNESS, DISEASE AND MATERNITY |
75,000,000/
year |
150,000,000/
year |
300,000,000/
year |
450,000,000/
year |
| A. INPATIENT TREATMENT FOR ILLNESS AND DISEASE |
|
|
|
|
| 1. Hospitalization: Medical treatment expenses incurred during hospitalization as prescribed by the attending physician. |
1,500,000/
day |
3,000,000/
day |
7,000,000/
day |
12,000,000/
day |
| 50,000,000/
year |
100,000,000/
year |
200,000,000/
year |
300,000,000/
year |
| 2. Surgery Expenses: Expenses related to an inpatient surgery/procedure or outpatient surgery |
50,000,000/
year |
100,000,000/
year |
200,000,000/
year |
300,000,000/
year |
| 3. Pre-Hospitalization Treatment Expenses. Annual limit:
(Covers one consultation within 30 days prior to hospitalization) |
2,000,000 |
5,000,000 |
12,000,000 |
20,000,000 |
| 4. Post-Hospitalization Treatment Expenses (within 30 days). Annual limit |
2,000,000 |
5,000,000 |
12,000,000 |
20,000,000 |
| 5. Hospital Cash Allowance (60 days/year) Applicable only to hospitalization at public hospitals. |
50,000/day |
120,000/day |
250,000/day |
400,000/day |
| 6. Home Nursing Care Expenses (within 15 days after discharge). Annual limit |
2,000,000 |
5,000,000 |
12,000,000 |
20,000,000 |
| 7. Ambulance / Emergency Road Transport Expenses. Annual limit |
2,000,000 |
5,000,000 |
10,000,000 |
15,000,000 |
| 8. Funeral Allowance applicable in the event of death during hospitalization. |
2,000,000 |
2,000,000 |
5,000,000 |
5,000,000 |
| 9. Rehabilitation Benefit when hospitalized for inpatient treatment due to illness or disease, as agreed by the parties. The benefit is paid based on the daily limit specified in Item 1A, Section II, but not exceeding the following amount. |
500,000/year |
2,000,000/year |
3,000,000/year |
5,000,000/year |
| 10. Cancer Treatment Coverage for hospitalization or surgery related to cancer treatment (in accordance with Items 1A to 6A of Section II – Inpatient Treatment for Illness and Disease), subject to mutual agreement between the parties and not exceeding the specified limit |
10,000,000 |
15,000,000 |
30,000,000 |
40,000,000 |
| B. MATERNITY INPATIENT COVERAGE (CHILDBIRTH AND MATERNITY COMPLICATIONS) |
|
|
|
|
| Coverage agreed upon by the parties, including benefit limits under Items 1A to 7A of Section II, but not exceeding the following annual sum insured |
10,000,000 |
20,000,000 |
40,000,000 |
60,000,000 |
| 1. Normal delivery / maternity complications |
5,000,000 |
10,000,000 |
20,000,000 |
30,000,000 |
| 2. Cesarean delivery |
10,000,000 |
20,000,000 |
40,000,000 |
60,000,000 |
| III. DEATH / TOTAL PERMANENT DISABILITY DUE TO ILLNESS OR DISEASE |
100,000,000 |
250,000,000 |
500,000,000 |
1,000,000,000 |
| IV. OUTPATIENT BENEFITS FOR ILLNESS, DISEASE AND BASIC DENTAL CARE (Combined annual limit for both benefits) |
5,000,000 |
12,000,000 |
20,000,000 |
30,000,000 |
| 1. Outpatient consultation and treatment |
500,000/visit |
1,200,000/visit |
2,000,000/visit |
3,000,000/visit |
| 2. Basic dental care (annual limit) |
1,000,000 |
2,000,000 |
5,000,000 |
10,000,000 |
| V. HOSPITAL BENEFIT DUE TO ACCIDENT |
|
|
|
|
| Maximum Sum Insured per year |
6,000,000 |
12,000,000 |
18,000,000 |
60,000,000 |
| Allowance payable during hospitalization for treatment of injuries caused by an accident, calculated per day of hospitalization. |
100,000/day |
200,000/day |
300,000/day |
1,000,000/day |
| Maximum number of days per year |
60 days. |
| Benefits subject to mutual agreement between the parties. |
- For minor accidents not requiring surgery, the hospitalization allowance is limited to a maximum of 5 days per hospitalization episode and up to 2 hospitalizations per year.
- For Platinum and Diamond plans, the hospitalization allowance is up to twice the medical treatment expenses already paid by the insured, with a minimum allowance equivalent to 1 day of hospitalization.
|