| VIETNAM HEALTHCARE AND PERSONAL ACCIDENT INSURANCE SECTION A. - MEDICAL EXPENSES INSURANCE The Benefits mentioned in the Table of Benefits are provided to the Insured Person following a Bodily Injury and/or a Sudden Illness as defined herein during the Period of Insurance for actual expenses incurred, subject to a maximum sub-limit specified in the Table of Benefits. |
| Plan | Vietnam Plan | |
| 1 | Territorial Scope Eligible Medical Expenses incurred in |
Vietnam |
| 2 | Yearly maximum limit per person | US$30,000 |
| 3 | ||
| 4 | Room & Board per person per night limit (max. 180 days per year) | US$50 |
| 5 | Room and Board per person per night limit ? Intensive Care Unit (max. 15 days per year) | US$150 |
| 6 | Surgical Charges (while admitted as in-patient) per year limit | US$10,000 |
| 7 | Specialist consultation (max. one visit per day), per year limit | US$500 |
| 8 | Miscellaneous Hospital Expenses (reimbursement charges for pre-hospitalisation diagnostic tests and for charges incurred during an in-patient stay for medically necessary supplies and services) per year limit | US$4,000 |
| 9 | Post- Hospital treatment (within 30 days of admission and discharge from hospital, subject to prior approval of the Company) per year limit | US$500 |
| 10 | Daycare Surgery (Annual limit for any procedure and treatment where the Insured Person is admitted as a Daycare patient) per year limit | US$1,500 |
| 11 | Emergency Accidental Out-patient Services (Annual limit for any procedure and treatment where the Insured Person is admitted as a Daycare patient) | US$2,000 |
| 12 | Medical transportation | full refund |
| 13 | Mortem treatment, Coffin and Local Burial | US$1,000 |
| Note: The medical expenses insurance shall commence 30 days after the Policy is issued. The 30 days waiting period is waived for renewal policies and accidental claims. | ||
| SECTION B. - PERSONAL ACCIDENT INSURANCE If the Insured Person suffers a Bodily Injury within twelve (12) months of the date of the Injury resulting in any of the Insured Events set out in the Table of Personal Accident Benefits, the Company will pay the Benefits stated in that Table. Personal Accident. |
| Age Band^Plan | |
| 18 & below | 3,000 |
| 19-64 | 30,000 |
| INSURED EVENTS | THE BENEFITS | |
| Bodily Injury resulting directly in | being a percentage of the Suminsured tated in the Schedule | |
| 1. Death | 1 | 100% |
| 2. Permanent Total Disablement | 2 | 100% |
| 3. Permanent and incurable paralysis of all limbs | 3 | 100% |
| 4. Permanent total loss of sight of both eyes | 4 | 100% |
| 5. Permanent total loss of two limbs | 5 | 100% |
| 6. Permanent total loss of one limb | 6 | 80% |
| 7. Permanent total loss of hearing in | 7a. both ears | 80% |
| 7b. one ear | 30% | |
| 8. Permanent total loss of four fingers and thumb of either hand | 8 | 50% |
| 9. Permanent total loss of the lens of one eye | 9 | 50% |
| 10. Permanent total loss of sight of one eyes | 10 | 50% |
| 11. Permanent total loss of four fingers of either hand | 11 | 50% |
| 12. Third degree burns and/or resultant disfigurement which covers more than 40% of the entire external body | 12 | 50% |
| 13. Permanent Disablement not otherwise provided | 13. The Company shall have the absolute discretion to determine and pay such percentage of the sum Insured which in the opinion of the Company is not inconsistent with the benefits provided under the insured event 1-12. | |
| 14. Temporary Total Disablement | 14. 0.3% of the sum Insured per day. The payment of Temporary Total Disablement benefits shall not in any event continue for more than 60 consecutive days and shall not commence until 7 days after the disability occurs. | |
ANNUAL PREMIUM TABLE
(In US$)
NΤΫ―Ώ\
| Age | Premium |
| 18 & below | 213 |
| 19-25 | 253 |
| 26-30 | 253 |
| 31-35 | 266 |
| 36-40 | 293 |
| 41-45 | 333 |
| 46-50 | 399 |
| 51-55 | 480 |
| 56-60 | 587 |
| 61-64 | 799 |
| The benefit | 1,000 |
| Premium | 230 |
| Sum Insured | Unisex | |
| 18 & below | 3,000 | 6 |
| 19 | 64 | 30,000 | 54 |
| | The above Premium Schedule is Standard Premium for Occupational Class I |
| | The Standard Premium multiply by 1.25 for Occupational Class II |
| | The Standard Premium multiply by 1.5 for Occupational Class III |
| | The Standard Premium multiply by 2 for Occupational Class IV |
| | The Premium for person under 18 is unchange |