ประกันสุขภาพเหมาจ่าย, ประกันสุขภาพแผนซิมเพิล เฮลท์

 

 

 

 

Health Insurance Simple Health Plan

 

 

ประกันสุขภาพแผนซิมเพิล เฮลท์ คุ้มครองค่ารักษาพยาบาลสูงสุด 5 ล้านบาท/ต่อครั้งต่อโรค

Medical expense coverage
for Maximum Plan is THB 5,000,000 per confinement

ประกันสุขภาพแผนซิมเพิล, ค่าห้องพักสูงสุด 7,000 บาท/วัน

Room & Board
up to THB 7,000 per day

ประกันสุขภาพแผนซิมเพิล เสียชีวิตจากอุบัติเหตุ (อ.บ.2) 10,000 บาท

Personal Accident
(Or.Bor.2) THB 10,000

  1. Lifetime renewal
  2. Monthly premium payments available
  3. Deductible plan to save on premium

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Description Benefits (Baht)
Plan 1 Plan 2 Plan 3 Plan 4
Maximum benefit for an injury or sickness per confinement* 500,000 1,000,000 3,000,000 5,000,000
Benefits for Inpatient Care
Section 1 Room and board including service charges (inpatient)
Non-intensive care room,
maximum payable per day
2,000 3,000 5,000 7,000
Intensive Care Unit (ICU),
maximum payable per day
(with a maximum limit of 15 days
4,000 6,000 10,000 14,000
Section 2 Medical expenses (Inpatient) 90% of eligible expenses
Section 3 Emergency ambulance services,
maximum payable per trip
1,000 1,500 2,000 3,000
Additional Benefit
Personal Accident (Or.Bor.2)** 10,000
Optional Benefit
The Insuring Agreement for Outpatient Medical Treatment,
per visit (maximum benefit 1 visit per day, 30 visits per year)
- 1,000 1,000
1,500
1,000
1,500
2,000 
Deductible***
Deductible per confinement* 50,000 / 100,000

Remark:
*Each hospitalization as Inpatient for medical treatment(s), or each major surgery treatment without the hospitalization as inpatient (day surgery), in a hospital or medical facility. In this regard, hospitalizations as Inpatient for treatments, or major surgery treatments without hospitalization as inpatient (day surgery) in a hospital or medical facility, regardless of how many times, due to the same injury or sickness which has not been cured, including related or continuous complications, within 90 days from the date of last discharge from the hospital or medical facility will be considered as a single confinement.

**Applicable to the Insuring Agreement for Personal Accident, Death, Dismemberment, Loss of Sight, Loss of Hearing, Loss of Speech or Permanent Disability Benefits (Or.Bor.2). 50% coverage in case of motorcycle accident.

***Deductible is applicable to an inclusion of inpatient coverage (all 1-3 Sections).

  • Eligible for applicants' aged between 20years to 65 years old. If the applicant applies for the insurance before 60 years old and continuously renews the policy will receive the right for lifetime renewal but if the applicant applies for the insurance from the age of 60 years and above will be receive the right to renew the policy until 80 years old.
  • For insured who hold more than one insurance policy with Allianz Ayudhya General Insurance, the maximum benefit for medical treatment must not exceed THB 30 million. The maximum benefits for Personal Accident insurance must not exceed THB 1 million per person, including all active policieswith the company.
  • Insurance period : 1 year, renewable according to the conditions specified in the policy
  • Terms and conditions of coverage and underwriting as specfified by the company.

Can be used for income tax deduction rights according to the rules of the Revenue Department.

Chronic diseases, injury or sickness (including complications), conditions or abnormalities that have occurred before entering into the
insurance contract.
Medical expenses incurred for

  • Sickness that occurs within first 30 days from the eective date of the insurance policy.
  • Sickness or disease that occurs within 120 days of policy in the case of Tumor Cyst or Cancer, Hemorrhoids, Hernias, Pterygium or Cataract, Tonsillectomy or Adenoidectomy, Stones, Varicose veins, and Endometriosis.

Example of Exclusions:

  • Chronic diseases, injury or sickness (including complications), symptoms or abnormalities that were present before insurance start (Pre-existing Condition)
  • Medical expenses incurred
    - Within 30 days from effective date for any illness or
    - Within 120 days from effective date for the following illnesses: tumors, cysts, or all types of cancer, hemorrhoids, all types of hernias, pterygium or cataracts, tonsillectomy or adenoids, all types of stones, varicose veins in the legs. and endometriosis, excluding emergency surgery that is not due to conditions related to various diseases which was before insurance start (Pre-existing Condition)
  • Not covered medical treatment occurring abroad
  1. This document is not part of the insurance policy.
  2. The applicant is advised to always study detail of coverage, condition and exclusion carefully before making decision to buy insurance.
  3. It is the responsibility of the Insured to make premium payments. Insurance agencies and brokers only facilitate for the service.
  4. Underwritten by Allianz Ayudhya General Insurance Public Company Limited
  5. This insurance plan provides coverage for medical treatment occurring in Thailand only.

Similar coverage

  • Personal health and accident insurance policy (TOP-UP)

Optional benefits

  • Outpatient benefits (maximum 1 visit per day, and not exceed 30 visits per year)