This insurance provides compensation for Daily Inpatient, Intensive Care, Additional Benefits, Operational / Surgical Costs, Death Compensation as a result of an accident that you experience.
Covers the Participants from losses against risks, namely:
If the Insured is hospitalized, the Insurer will pay a sum of money in the amount as stated in the summary of coverage.
If the Insured Person is subjected to Intensive Care, the Insurer will pay a sum of money in the amount as stated in the summary of coverage.
Special Provisions for Daily Inpatient and Intensive Care (ICU) Benefits:
a. Both of these benefits apply to treatment as a direct result of an accident and/or due to one of the diseases covered by the Policy.
b. The sum insured benefits are:
• Due to Accident:
i. Daily Inpatient Compensation: max. 30 (thirty) days per incident
ii. Intensive Care (ICU) Daily Benefits: max. 30 (thirty) days per year
• Due to one disease
Daily Inpatient Benefits and/or Intensive Care (ICU) Daily Benefits : a max. of 14 (fourteen days) per year.
The maximum number of Hospitalization and/or Intensive Care does not exceed 120 (one hundred and twenty) days in one coverage period.
a. The cost of laboratory examinations and/or other support if the Insured suffers from one of the diseases covered by the Policy with the following conditions:
i. The Insured suffers from one of the covered diseases, namely:
Typhoid fever
Dengue fever
Diphtheria
Pneumonia
Tuberculosis
ii. The compensation is paid if the result of the disease the Insured must undergo Hospitalization according to the doctor's recommendation
iii. The amount of compensation is calculated from the costs incurred by the Insured to carry out laboratory/other supporting examinations recommended by the doctor in the maximum amount of the benefit taken.
b. Ambulance costs, emergency dental care and first aid as a result of an accident, provided that the accident causes the Insured to be hospitalized.
The ambulance fee in question is to bring the Insured from the scene to the Hospital in an emergency, including for the purpose of inter-hospital referral in the event of medical action required by the Insured.
Provides free coverage for Covid-19 disease with the following conditions:
a. This free coverage for Covid-19 is only valid for fourteen (14) days from the effective date of this Policy.
b. The insured who is infected with Covid-19 must be hospitalized in a hospital or clinic appointed by the Indonesian government and undergo a polymerase chain reaction (PCR) examination as a condition of the claim procedure.
c. The benefits of this free coverage are:
i. Daily Cash Benefit in Hospital due to Covid-19 IDR 1,000,000 / day (one million Rupiah per day), maximum up to 30 days. This Daily Cash Benefit at the Hospital is a reimbursement system on a return and will be paid only as long as the Insured is treated at a Hospital or Clinic designated by the Indonesian Government for Covid-19 treatment.
ii. Additional benefits (laboratory, ambulance fees) related to Covid-19 are up to a maximum of IDR 1,000,000.00 (one million rupiah).
We do not cover for loss or liability directly or indirectly caused by or arising from or in connection with:
1. Hospitalization that occurs within 30 days from the policy date, unless caused by an accident,
2. Hospitalization or Diagnosis for pre-existing conditions,
3. All illnesses other than the five diseases covered by the policy,
4. Accidents as a result of:
- air traffic accidents, except as a legitimate passenger
- boxing, wrestling and all martial arts or extreme activities
- participate in criminal acts and/or violate the applicable laws and regulations and intentionally
- Assignment of the Military or Police Service and or related to
or who are seconded to it,
- Attempted suicide or self-injury either in
conscious or unconscious state
- intentional, planned and desired action by the Insured
5. Death caused by causes other than accident
6. Misuse of narcotics, psychotropics, alcohol, poisons, gases or similar substances
This is general information and is not an insurance contract/agreement. Detail terms and conditions will be referred to the policy. It is crucial that you read and understand the policy's terms and conditions well.
You might find your answers in FAQs.
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