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Group Health Insurance


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The program provides medical cover for injuries or illnesses and hospitalisation at any hospitals or any medical institutions, both of public and private, rightful legal practice, at the same time the insured must be not over than 65
years of age, categorised as follows;

IPD Patient

In Patient Department Patient signifies the insured must be receiving medical services at hospitals and concluded by doctors to receive medical treatments for no less than 6 hours consecutively by categorising into the followings;

1. Room and Board

The insured undergoes medical treatments as IPD patient to be entitled with room charges and meals, under injury or illnesses conditions, will be entitled as per actual amount but not higher than the agreed cover amount as stated in the policy.

2. ICU charges

The insured undergoes medical treatment in the hospital’s ICU ward, ICU fees and charges will be covered per admission, per actual amount but no higher than the agreed cover amount as stated in the policy

3. General expenses

The insured undergoes medical treatment as IPD patient under injury or illnesses conditions, will be cover as per actual amount but no higher than the agreed cover amount as stated in the policy

General expenses are the expenses from
    - Prescriptions and medical supplies
    - Wound dressing, conventional splint and plaster cast
    - Physical therapy
    - Heart electrocardiogram examination by X-rays
    - Examination in laboratory
    - Intravenous Injection
    - Blood or Plasma donation
    - Ambulance fees to and from the hospital
    - Hospital service fees
    - Operating room fees
    - Anaesthesia and oxygen agency, including anaesthesiologist fees
    - Basal metabolism examination

4. Surgical fees

The surgical fees for injuries and illnesses per visit and paid as per actual will be entitled for the cover as per actual amount paid or no higher than the agreed cover amount as stated in the policy (for paid per actual amount program). Or as per the rate stated in the policy schedule for surgical fees (surgical fee program).

For more than one time surgical visit per one insured area, the fee of the highest amount will be covered but the amount must not exceed the amounted listed.
Surgical fee refers to the fee of doctor’s operating in surgery including doctors and nurses in assistance.

Minor Surgery or Day Case
The surgery must be operated without admitting as IPD patient and is able to go home right after the operation. Prior to the operation, you must submit the intention of out-patatient surgery type to the Company before attending the surgery.
The Company will indemnify the insured only for surgery cases occurred in hospitals only.

5. Doctor visit fees

The insured undergoes medical treatment as IPD patient, under injury or illnesses conditions, will be cover as per actual amount but not higher than the agreed cover amount as stated in the policy.

6. Specialist’s consultation fees

The insured undergoes medical treatment as OPD patient, will be cover as per actual amount of specialist doctor consultations, but no higher than the agreed cover amount as stated in the policy.

7. Emergency treatment from accidents patient medical expenses

The insured undergoes medical treatment within 72 hours from the accident occurrence and admitted as an OPD patient in the hospitals or medical clinics, will be cover as per actual amount but no higher than the agreed cover amount as stated in the policy.

OPD Patient

The insured undergoes medical treatment as an OPD patient, will be entitled for all medical expenses for injuries or illnesses per visit/per day as per actual amount but no higher than the agreed cover amount as stated in the policy.

Dental Cover

The insured is entitled for gum and natural teeth treatments of scaling, extraction, root canal treatment, wisdom tooth removal and gum inflammation.

Injuries or Fatal Illnesses

The insured is entitled for gum and natural teeth treatments of scaling, extraction, root canal treatment, wisdom tooth removal and gum inflammation.

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