Coverage and Benefit
| Benefit Details | Coverage Plan | |||
|---|---|---|---|---|
| Plan 300,000 |
Plan 500,000 |
Plan 800,000 |
Plan 1,000,000 |
|
| 1. Death, dismemberment, total and permanent disability due to accident | ||||
| 1.1 General accident | 300,000 | 500,000 | 800,000 | 1,000,000 |
| 1.2 Murder and assault | 300,000 | 500,000 | 800,000 | 1,000,000 |
| 1.3 Motorcycle riding or passenger | 150,000 | 250,000 | 400,000 | 500,000 |
| 2. Medical expense per time (include murder and assault case and motorcycle riding or passenger case) |
30,000 | 50,000 | 80,000 | 100,000 |
| 3. Daily income compensation during hospitalization (including cases of murder, physical assault, and either riding or being a passenger on a motorcycle). Benefit per day (not exceeding 365 days per injury, including clause 3.1 and clause 3.2) |
||||
| 3.1 Room and Board per day (not exceeding 365 days) | 1,000 | 1,000 | 1,000 | 1,000 |
| 3.2 Intensive Care Unit (I.C.U.) per day (not exceeding 7 days) | 2,000 | 2,000 | 2,000 | 2,000 |
| 4. Funeral expense benefits | 15,000 | 15,000 | 15,000 | 20,000 |
| 5. Public accident coverage (additional payment to No. 1.1) (Receive an additional benefit from clause 1.1, doubled) | 300,000 | 500,000 | 800,000 | 1,000,000 |
| Combine the benefits of coverage clause 1.1 and clause 5. | 600,000 | 1,000,000 | 1,600,000 | 2,000,000 |
| 6. Death, dismemberment, total and permanent Disability due to accident on a public holiday (additional coverage is provided from section 1.1.) |
600,000 | 1,000,000 | 1,600,000 | 2,000,000 |
| Combine the benefits of coverage clause 1.1 and clause 6. | 900,000 | 1,500,000 | 2,400,000 | 3,000,000 |
| Combine the benefits of coverage clause 1.1, 4. and clause 6. | 1,200,000 | 2,000,000 | 3,200,000 | 4,000,000 |
| 7. Broken bones | 15,000 | 15,000 | 15,000 | 15,000 |
| Remark : Benefit under section 1.1 increases by 5% annually. | ||||
5 year / 5 year
Public accident means an accident which occurs to the Insured
1. while the Insured is a passenger in a train, skytrain, subway, public transportation bus, minibus, Borkorsor transport bus, affiliated Borkorsor transport bus, affiliated public transportation van.
2. while the insured is an elevator passenger and an accident occurs on a public elevator for carrying persons or goods between floors in public buildings This does not include elevators used in the mines. or construction site.
3. while the insured is in a public building during the opening hours for the general public and a fire broke out in that public building including jumping from the fire to save lives.
Public Holidays mean the days the government declares as national holidays in each calendar and National Labor Day This includes compensatory holidays on that date.
The day the government declares it a public holiday is New Year's Day, Makha Bucha, Chakri Day, Songkran Holiday, H.M. King's Coronation, Royal Ploughing Ceremony, Visakha Bucha Day, H.M. Queen's Birthday, Asanha Bucha, Buddhist Lent, H.M. King's Birthday, H.M. Queen Mother's Birthday, The Passing of King Bhumibol, Chulalongkorn Day, Father's Day, Thailand Constitution Day, and New Year's Eve.
Substitute Day means the day that is gazetted a public holiday in lieu of the public holiday for Christmas Day falling on a Saturday or Sunday. If a public holiday falls on a Saturday or Sunday It shall be deemed that the first working day or the first and second working day following a public holiday is a Substitute Day
The Exclusions contained herein are only some parts of all exclusions stated in the insurance policy. The Company shall not cover any loss or damages due to or a result of either of the following causes.
1. In case that the insured knowingly makes false statement or knowingly omits to disclose any fact to the Company for acknowledgement while applying for the insurance, where if the Company had known of such fact, the Company has the right to void the insurance contract and not to make any policy payment.
2. Suicide, suicide attempt or self-inflicted injury
3. Miscarriage
4. Act of the insured while under the influence of alcohol, narcotic drug or narcotic substance that impairs the mental faculty The term “under the influence of alcohol” is in case of having blood alcohol concentration (BAC) test result of 150 mg/dL or over.
Q: แบบประกันโอเชี่ยนไลฟ์ สมาร์ท พีเอ เหมาะกับใคร ?
A: เหมาะกับผู้ที่ต้องการความคุ้มครองอุบัติเหตุที่จ่ายเบี้ยประกันภัยไม่แพง พร้อมมีค่ารักษาพยาบาล และค่าชดเชยรายได้จากการเกิดอุบัติเหตุ
Q: แบบประกันโอเชี่ยนไลฟ์ สมาร์ท พีเอ ต้องตรวจสุขภาพหรือไม่ ?
A: ไม่ต้องตรวจสุขภาพ แต่แถลงสุขภาพในใบคำขอเอาประกันภัย
Q: แบบประกันโอเชี่ยนไลฟ์ สมาร์ท พีเอ สามารถนำเบี้ยประกันไปใช้สิทธิลดหย่อนภาษีได้หรือไม่ ?
A: เบี้ยประกันภัยบางส่วนสามารถนำไปอ้างอิงลดหย่อนภาษีเงินได้บุคคลธรรมดาได้ตามหลักเกณฑ์ที่กรมสรรพากรกำหนด
Q: แบบประกัน โอเชี่ยนไลฟ์ สมาร์ท พีเอ สามารถขอทำสัญญาเพิ่มเติมแนบได้หรือไม่ ?
A: ไม่สามารถขอทำสัญญาเพิ่มเติมแนบได้
Remark :
*For plan 1,000,000
**For patient standard room
- Bone means Bones of the Skull, Humerus, Femur, Ulna, Radius, Tibia, Fibula except Cartilage.
- Funeral fee caused by illness (after 180 days from the 1st effective date)- Underwriting is subject to the Company’s terms and conditions.
- Health check up and health declaration might be the factor of underwriting process if necessary.
- Benefits and coverage are subject to the health insurance policy’s terms and conditions.
- Tax Deduction according to the rules prescribed by the Revenue Department
- This is only basic information. An insured should read aware of coverage condition, benefits, and exclusions of an insurance policy.
