ประกันภัยการเดินทางในประเทศ Domestic Travel Insurance
Insurance Policy Smart Thailand Traveller*
*Smart Thailand Traveller is the marketing name for Travel Accident Policy for persons and general groups
Tabel of contents
Travel Accident Policy for persons and general groups
Section 1 – Definitions 3
Section 2 - General Conditions 4
Section 3 – Exclusions 8
Section 4 - Coverage Agreement 8
Insuring Agreement
Death, Dismemberment, Loss of sight or Total Permanent Disability 9
Medical Expense due to injury 12
Third Party Liability 15
Limit of Liability arising from Murder and Assault 17 Extended Cover to Riding or Travelling on Motorcycle 18
AXA Nationwide Network 21
Remark: The English version is a translation of the original in Thai for information purpose only. In case of a discrepancy, the Thai original shall prevail. Smart Thailand Traveller Insurance
In reliance upon the statement made in the proposal for insurance which is considered a part of this Insurance Policy, and in consideration of the premium paid by the Insured, and subject to the insuring agreements, exclusions, general conditions and attached endorsements of this Insurance Policy, the Company agrees to the Policyholder or the Insured as follows
Section 1 – Definitions ,/!0,/"5-/"00&,+01,4%& %0-" &Ɯ *" +&+$0% 3" ""+ 11 %"!&+ +6- /1,#1%&0 &+02/ + "-,)& 60% )) " /02 %0-" &Ɯ *" +&+$4%"/"3"/1%"60% )) --" /Ǿ2+)"00otherwise stated in this Insurance Policy. “Insurance Policy” *" +01%"-,)& 60 %"!2)"Ǿ1"/* +! ,+!&1&,+0Ǿ ,3"/ $" $/""*"+1Ǿ exclusions, endorsed document, special condition, application, certification, insurance endorsement and other declaration that the Insured has signed as a part of the Insurance Policy. “Company” means AXA Insurance Public Company Limited as the Insurer of this Insurance Policy "Policyholder" means a person named as policyholder in the policy schedule who arranges the Insurance Policy for the Insured’s benefit. “Insured” means a person named as the Insured in the schedule and/ or the "+!,/0"*"+14%,&0 ,3"/"! 61%&0I+02/ + "P,)& 6 “Accident” means +"3"+14%& %% --"+002!!"+)6#/,*"51"/+ )*" +0$&3&+$ rise to a result which is not intended or anticipated by the Insured. “Injury” means bodily injury which is caused directly and solely from an Accident and is independent from other causes. "Any loss or damage" means ,!&)6&+'2/602ƛ"/"! 61%"&+02/"! 0 /"02)1,# + &!"+1 and which cause death, dismemberment, loss of sight, disability or requires the Insured to be medically treated. “Deductible” means 1%"Ɯ/01Ɯ5"! *,2+14%& %1%"P,)& 6%,)!"/,/1%"I+02/"!&0 responsible for paying per each Accident.
Travel Accident Policy Hand Book 3 Ȋ/ip!2/ 1&,+ȋ *" +01/ 3")!2/ 1&,+0,#1%" +02/"!4%& %1%" ,3"/ $"01 /10 +!"+!0 within the insurance period. ǖǽ + 0",#,*"01& /&-Ǿ1%" ,3"/ $"0% ))01 /10&+ "1%"I+02/"! )" 3"01%"/"0&!"+ "#,/1%"1/&- ,+0" 21&3")62+1&)1%"I+02/"! reaches the residence/ office unless otherwise specified in this Policy. Ǘǽ + 0",#21 ,2+!1/&-Ǿ1%" ,3"/ $"0% ))01 /10&+ "1%"I+02/"! )" 3"01%"/"0&!"+ "#,/1%"1/&- ,+0" 21&3")62+1&)1%"I+02/"! /" %"01%"/"0&!"+ "ȡ,ƛ& ",/&+ǗǙ%,2/00&+ "1%"I+02/"! //&3"0% &) +!2+)"00,1%"/4&0"0-" &Ɯ"!&+1%&0,)& 6ǽ ǘǽ + 0",#1%"I+02/"!&01%"-"/0,+1/ 3")&+$1,% &) +!ț + ,2+!ȜǾ 1%" ,3"/ $"0% ))01 /10&+ "1%"I+02/"! //&3"0% &) +! ,+1&+2,201,1%"1&*"1% 11%"I+02/"!)" 3"0% &) +! 2+)"00,1%"/4&0"0-" &Ɯ"!&+1%&0,)& 6ǽ “Terrorism” means 3&,)"+1 1&,+ +!ȡ,/1%/" 1 6 +6-"/0,+,/$/,2-,#-"/0,+ regardless of such action is done alone or in representation or in ,++" 1&,+4&1% +6,/$ +&7 1&,+Ǿ$,3"/+*"+1#,/-,)&1& ),/ /")&$&,20/"02)1Ǿ&!",),$6# &1%,/0&*&) /, '" 1&3"Ǿ&+ )2!&+$1, &*- 11%"$,3"/+*"+1 +!ȡ,/-2 )& ,/- /1& )1%"/",#1, " ,*" in panic.
Section 2 - General Terms and Conditions 1. Insurance Contract This insurance contract is executed based on the reliance on the statement declared by the Insured in the application form and additional declaration (if any) duly signed by the Insured as evidence to accept such insurance according to the Insurance Contract; this Insurance Policy is thus issued by the Company as evidence.
In case of the Insured has already known but provided false statement in the declaration as mentioned in first paragraph, or already known any fact but concealed thereof, of which if it is known to the Company, it may motivate the Company to demand higher premium or refuse to execute insurance contact. In this regard, this insurance contract shall become void pursuant to Section 865 of Civil and Commercial Code and the Company is entitled to terminate this insurance contract.
The Company cannot deny acceptance of responsibility except where there has been material misrepresentation in the aforementioned documents submitted by the applicant. 2. Completion and Alteration of Insurance Policy
This Insurance Policy composes of Insuring Agreement and Endorsement. Alteration in this insurance contact shall be valid upon being consented by the Company and endorse in this Insurance Policy or its endorsement.
Travel Accident Policy Hand Book 4 3. Period of Insurance
The Insurance Policy shall provide the coverage for the Insured as the definition “Trip duration” every trip shall be in the period of insurance which does not exceeded maximum 90 days, unless otherwise specified in this Insurance Policy. In case of medical emergency , hijack, delay or inoperative plan that make the Insured delay the travel back on planned schedule, the Insurance Policy will automatically extend the coverage until finish as the definition of “Trip duration”. 4. Report of Accident
The Insured, beneficiary or representative of the said person, as the case may be, must inform the Company in case of injury, any loss or damage that could cause the claiming for benefit which covered under this Insurance Policy without delay. In case of death, notice must be reported to the Company immediately, unless it can be proved that there is reasonable explanation why the notice cannot be made in a timely manner and the notification is given to the Company as soon as possible. 5. Beneficiary
The Insured can specify the beneficiary. In the event of Insured’s death, the Company will pay any benefits under this insuring agreement to the named beneficiary. If name of the beneficiary is not specified, the Company will pay any benefits to the estate of the Insured.
In the case that there is only one beneficiary named in the Insurance Policy and the beneficiary dies before the Insured or at the same time, the Insured has to inform the Company in writing for changing the beneficiary. If the Insured failed to so, the Company will pay any benefits to the estate of the Insured.
In the case that there is more than one beneficiary named in the Insurance Policy and any beneficiaries die before the Insured, the Insured has to inform the Company in writing for changing the beneficiary or changing the benefits of the remaining beneficiaries. If the Insured failed to do so, the Company will pay that benefit to the rest beneficiaries equally upon the Insured's dead.
6. Medical Examination
The Company has the right to require a medical examination and diagnosis records of the Insured as deemed necessary and also entitled to perform autopsy if necessary, within the limit of law or religious doctrine by the expenses of the Company
In case the Policyholder, Insured, beneficiary or their representative, as the case may be, does not allow the Company to review a medical examination and diagnosis records for process of claim consideration, the Company can reject the coverage for the Insured.
Travel Accident Policy Hand Book 5 ǜǽCompensation payment
Compensation for death will be paid to the beneficiary or statutory heir, while other compensation will be paid to the Insured. The Company will compensate within 15 days commencing from the date the Company received complete and correct proof of loss or damage.
In case it is doubtful that such above mentioned claim is not in compliance with the insuring agreement in the Insurance Policy, the prescribed period may be extended as deemed necessary but shall not exceed 90 days commencing from the date received complete documents by the Company.
If the Company is unable to complete compensation payment within the above mentioned specified period, the Company shall be responsible to pay15% interest per annum of the payable amount commencing from the due date. 8. The limit of liability during period of insurance
Throughout the period of insurance, the Company shall compensate as the insuring agreement for death benefit, dismemberment, loss of sight or total permanent disability not exceed the amount stated in the schedule. If the Company has not fully compensated for death benefit, dismemberment, loss of sight or total permanent disability, the Company shall cover to the end of insurance period for the balance of sum insured stated in insuring agreement and/or the endorsement (If any)
9. Arbitrator
In case of dispute, contradictory, or any claim under the Insurance Policy between the Insured and the Company. If the Insured desired or finds it necessary to settle the dispute, contradictory or any claim by arbitration,the Company must comply and allow the case to be judged by arbitration according to the arbitration regulation governed by the Office of Insurance Commission (OIC).
10. Automatic termination The Insurance Policy will be terminated automatically when the Insured is imprisoned. 11. Cancellation and Reimbursement 1ǖǽǖ%",*- +60% ))$&3"1%"+,1& ",#cancellation 1,1%" +02/"!#,/ 1)" 01ǖǚ! 60 &+ !3 + " 11%") 01&+#,/*"! !!/"001,1%"C,*- +6 6/"$&01"/"!-,01ǽ +1%&0 0"Ǿ1%" C,*- +6 will reimburse the paid premium to the Insured as Pro-Rata. ǖǖǽǗ%"I+02/"!0% ))$&3"1%"4/&11"++,1& ",#cancellation1,1%"C,*- +6 +!$"11%" reimbursement which will be deducted from the used up amount, calculated by the short-term premium rate stated below
Travel Accident Policy Hand Book 6 The Schedule of short term premium rate
Period of Insurance Percentage of Annual (not exceed/month) Premium rate 1 15 2 25 3 35 Ǚ Ǚǚ 5 55 6 65 7 75 8 ǝǕ Ǟ 85 ǖǕ ǞǕ 11 Ǟǚ 12 ǖǕǕ
Cancellation of Insurance Policy according to this condition regardless by any party, the entire Insurance Policy must be canceled. It is not possible to select cancellation only any part of coverage during Policy Year.
12. Precedent Condition
The Company shall not be liable to compensate the Insured or other persons under this Insurance Policy unless the Insured, the beneficiary or their representative, as the case may be, have fully and correctly complied with the insurance contract and condition of this Insurance Policy.
Travel Accident Policy Hand Book 7 Section 3 – General Exclusions This Insurance Policy does not cover loss or damage due to or consequences of causes as follows; ǖǽ /ț4%"1%"/!" ) /"!,/+,1ȜǾ&+3 0&,+Ǿ 1,##,/"&$+"+"*&"0,/4 /)&("4%"1%"/ !" ) /"!,/,1%"/4&0"Ǿ,/ &3&)4 /Ǿ&+02//" 1&,+Ǿ/" "))&,+Ǿ/&,1Ǿ01/&("Ǿ &3&) ,** ,1&,+Ǿ /"3,)2t& ,+Ǿ ,2-!ȉ"1 1Ǿ* /1& )) 4 ++,2+ "*"+1,/ +6&+ &!"+1 20&+$1%" ++,2+-c"ment or maintenance of martial law. 2. Terrorism ǘǽ !& 1&,+,// !&, 1&3&16#/,* +6+2 )" /#2"),/ +6+2 )" //"#20" /&0&+$#/,*1%" ,* 201&,+,#+2 )" /#2") +! +6-/, "00,#0")#Ȓ0201 &+&+$+2 )" /Ɯ00&,+ȡ#20&,+ǽ Ǚǽ5-),0&,+,#/ !&, 1&3&16,/+2 )" / ,*-,+"+1,/,1%"/% 7 /!,20* 1"/& )4%& % may cause explosion in nuclear process. ǚǽ%"Ɯ/01Ɯ5"! *,2+14%& %1%"&+02/"!*201 "/"0-,+0& )"#,/- 6&+$ 00-" &Ɯ"! &+1%"-,)& 60 %"!2)" +!ȡ,/1%""+!,/0"*"+1ǽț&# +6Ȝ Ǜǽ%&)"1%" +02/"!0"/3"0 0 0,)!&"/Ǿ-,)& "Ǿ,/ 3,)2+1""/,/- /1& &- 1"&+4 /,/ /&*"suppression. 7. While the Insured is taking part in a brawl or taking part in inciting a bawl 8. While the Insured is committing a crime or while the Insured is being arrested or escaping the arrest. Ǟǽ%&)"1%" +02/"!&0"+1"/&+$,/)&3&+$&))"$ ))6&+%"&+$!,*,#% &) +!ǽ
Section 4 - Insuring Agreement Subject to general conditions, insuring agreement, exclusions and attached endorsements of this Insurance Policy, and in compensation for the premium paid by the Insured, the Company agrees to provide coverage only specified in the coverage agreement and/or the endorsement which is attached with this Insurance Policy and sum insured as specified in the schedules only.
Travel Accident Policy Hand Book 8 Insuring Agreement Death, Dismemberment, Loss of sight or Total Permanent Disability
"Ɯ+&1&,+0 “Dismemberment” *" +01%" 211&+$,#4/&01',&+1,/ +()"',&+1 +!0% ))&+ )20&3")6*" + total loss of usage potentiality of such organs with clear medical indication that such organ cannot be able to function at any time in the future. “Loss of sight” means complete blindness, which is permanently incurable. “Total Permanent means disability to the extent of being unable to perform the normal &0 &)&16ȋ !216&+1%" +02/"!ȉ0/"$2) /, 2- 1&,+ +! +6,1%"/, 2- 1&,+ totally and permanently “Inpatient” means the person who is necessary to attend medical treatment in hospital or medical center at least 6 hours and registered as &+- 1&"+1 6-%60& & +ȉ0!& $+,0&0 +! !3& " 0"!,+1%" indication of medical standard and in the period suitable for treatment of such injury and includes the case that the person is admitted and died before 6 hours. “Hospital” means +6%,0-&1 )-/,3&!&+$*"!& )0"/3& "4&1%1%" - &161, "-1 1%"0& (-"/0,+#,/,3"/+&$%11/" 1*"+1 +!-/,3&!"!4&1% 02ƛ& &"+1# &)&1&"0 +!*"!& )-"/0,++") +!#2))/ +$",#0"/3& "0 especially rooms for major operation and duly permitted to registered as hospital pursuant to related law of such territory “Medical center” means +6*"!& ) "+1"/-/,3&!&+$*"!& )0"/3& "#,/,3"/+&$%1- 1&"+1 and duly permitted to register as medical center according to the law such territory. “Medical standard” means rules and regulations of international medical practice that -/,3&!"0 + --/,-/& 1"*"!& )1/" 1*"+1#,/- 1&"+1 ,/!&+$ to the medical necessity and correspond with the summary from 1%"&+'2/6ǾƜ+!&+$0Ǿ 21,-06,/,1%"/0ǽț # +6Ȝ
Travel Accident Policy Hand Book 9 Coverage This Insurance Policy covers any loss or damage or injury of the Insured caused by an accident during the trip, resulting to loss of life, dismemberment, loss of sight or total permanent disability within one hundred and eighty (180) days from the date of accident or the injury causes the Insured to receive continuous medical treatment as an in-patient in a hospital or a medical center and loss of life occurs later because of such injury, the Company will compensate in accordance with the sum insured stated as follows:
100% of the sum insured In case of death 100% of the sum insured In case of total permanent disability and such total permanent !&0 &)&16&0"5&01"!#,/+,1)"001% +ǖǗ ,+0" 21&3"*,+1%0 commencing from the date of accident or there is any clear medical indication that the Insured is becoming total permanent disability. 100% of the sum insured For both hands from wrist joints or feet from ankle joints or both sights. 100% of the sum insured One hand from the wrist joint and one foot from the ankle joint. 100% of the sum insured One hand from the wrist joint and one sight 100% of the sum insured One foot from the ankle joint and one sight 60% of the sum insured One hand from wrist joint 60% of the sum insured One foot from ankle joint 60% of the sum insured One sight The Company will compensate according to this clause only for one maximum item.
Exclusions %&0I+02/ + " Policy!,"0+,1 ,3"/
1. Loss or damage due to or in consequence causes of or occurred at the time as follows; (Unless otherwise extended the coverage and stated in the endorsement)
ǖǽǖ 1&,+,#1%" +02/"!4%&)"2+!"/1%"&+Ɲ2"+ ",# ) ,%,)Ǿ !!& 1&3"!/2$0Ǿ+ / ,1& !/2$01,1%""51"+1,# "&+$2+ )"1, ,+1/,),+"ȉ0*&+!ǽ%"1"/*Ȋ2+!"/1%"&+Ɲ2"+ " ,#)&.2,/ȋ&+ 0",#% 3&+$ ),,!1"01/"#"/01, ),,!ȡ ) ,%,))"3"),#ǖǚǕ*$-"/ "+1 +!,3"/ǽ ǖǽǗ2& &!",/ 11"*-1"!02& &!",/0")#Ȓ&+Ɲ& 1"!&+'2/6ǽ 1.3 Parasite infections except pyrogenic infection, tetanus, or rabies from a wound or cut 02ƛ"/"! 0 /"02)1,# + &!"+1ǽ ǖǽǙ"!& )1/" 1*"+1,/02/$& )1/" 1*"+1"5 "-11%"+" "00 /61/" 1*"+1#,/1%"&+'2/6 4%& %&0 ,3"/"!2+!"/1%&0 +02/ + ",)& 6 +!, 2//&+$4&1%&+1%"-"/&,!,#1%&0 Insurance Policy 1.5 Miscarriage and abortion ǖǽǛ"+1 ) /"Ǿ/,,1 + )1/" 1*"+1"5 "-1+" "00 /6Ɯ/01 &!1/" 1*"+14&1%&+ǜ! 60 following an accident. 1.7 Replacement of or new sets of dentures, dental crowns, artificial denture. 1.8 Food Poisonning ǖǽǞ ( %" 0 /"02)1,# "/+& 1"!&0 Ǿ/,) -0"!&0 Ǿ2 )25 1&,+,/-,+!6)&1&0Ǿ Degeneration or Spondylitis except if there is a fracture or dislocation of spine as a result of an accident.
Travel Accident Policy Hand Book 10 2. Loss or damage occurred at the time as follows; (Unless otherwise extended the coverage and stated in the endorsement)
2.1 While the Insured is hunting for animals, racing of all kinds of car or boat, horse racing, ski and jet ski playing or racing, skate racing, boxing, parachuting (except for the purpose of live saving) boarding or traveling in a hot-air balloon, gliding, bungee jumping, mountain climbing with equipment or diving with oxygen tank and breathing equipment under water. ǗǽǗ%&)"1%"I+02/"!&0 , /!&+$,/1/ 3")&+$&+ + &/ / ƞ4%& %% 0+,)& "+0"#,/ //6&+$- 00"+$"/0,/!,"0+,1,-"/ 1" 0 ,**"/ & ) &/ / ƞǽ Ǘǽǘ%&)"1%"I+02/"!-&),10,/4,/(0 0 /"4&+ +6 &/ / ƞǽ ǗǽǙ%&)"1%"I+02/"!&0/&!&+$,/1/ 3")&+$,+*,1,/ 6 )"ǽ ) &*&+$#,/!" 1% "+"Ɯ1 %" "+"Ɯ & /6&0/".2&/"!1,0"+!1%"#,)),4&+$"3&!"+ "01,1%",*- +64&1%&+ǘǕ! 60 ,**"+ &+$#/,*1%"! 1",#!" 1%,#1%" +02/"! 11%""5-"+0",#1%" "+"Ɯ & /6ǽ 1. Claim Form of the Company Ǘǽ" 1%"/1&Ɯ 1" 3. Copy of Autopsy Report Ǚǽ,-6,#,)& ""-,/1 5. Copies of ID card and House Registration with the mark as “Death” of the Insured. Ǜǽ,-&"0,# /! +! ,20""$&01/ 1&,+,#1%" "+"Ɯ & /6 ǜǽ,-6,#1%" +02/"!ȉ0- 00-,/1,/1/ 3")!, 2*"+1,#1%" +02/"!ǽ 8. Any required document as deemed necessary
Claiming for total permanent disability or dismemberment %"Insured&0/".2&/"!1,0"+!1%"#,)),4&+$"3&!"+ "01,1%",*- +64&1%&+ǘǕ! 60 ,**"+ &+$#/,*1%"! 1"diagnosed by a physician that the Insured suffers from total permanent disability or dismemberment at the expense of the Insured. 1. Claim Form of the Company. Ǘǽ"!& )"/1&Ɯ 1" ,+Ɯ/*&+$1,1 )-"/* +"+1!&0 &)&16,/!&0*"* "/*"+1 ǘǽ,-6,#1%" +02/"!ȉ0- 00-,/1ǽ Ǚǽ+6/".2&/"!!, 2*"+1 0!""*"!+" "00 /6
,+02 *&00&,+,#!, 2*"+104&1%&+1%"0-" &Ɯ"!1&*"0% ))+,1'",- /!&7"1%"/&$%11, ) &*&# 1 + "-/,3"!1% 11%"/"&0/" 0,+ )""5-) + 1&,+4%6 ) &* ,2)!+,1 "* !"&+ 1&*")6* ++"/ +!1% 11%" ) &*4 0Ɯ)"! 00,,+ 0-,00& )"ǽ
Travel Accident Policy Hand Book 11 Insuring Agreement Medical Expense due to injury
"Ɯ+&1&,+0 “Inpatient” means the person who is necessary to attend medical treatment in hospital or medical center at least 6 hours and registered as inpatient by -%60& & +ȉ0!& $+,0&0 +! !3& " 0"!,+1%"&+!& 1&,+,#*"!& ) standard and in the period suitable for treatment of such injury and includes the case that the person is admitted and died before 6 hours “Outpatient” means 1%"-"/0,+4%,/" "&3"!*"!& )0"/3& "&+,21- 1&"+1!"- /1*"+1 or emergency room of the hospital or medical center or clinic, of which by diagnosis and indication of medical standard is not necessary to admit as an inpatient. “Physician” means person who graduated Medical Sciences and is legally registered as "!& )/ 1&1&,+"/1,-/,3&!"), )*"!& )0"/3& ",/02/$"/6ǽ Ȋ)1"/+ 1&3" *" +0 3 /&"16,#1%"/ -"21& ,/-/"3"+1&3"%" )1% /"-/ 1& "0Ǿ02 % 0 Medicine” traditional Thai or Chinese herbal medicine, and similar which is not not considered as modern medicine. “Nurse” means person who is legally licensed to perform the nursing profession. “Hospital” means +6%,0-&1 )-/,3&!&+$*"!& )0"/3& "4&1%1%" - &161, "-1 1%"0& (-"/0,+#,/,3"/+&$%11/" 1*"+1 +!-/,3&!"!4&1%02ƛ& &"+1 # &)&1&"0 +!*"!& )-"/0,++") +!#2))/ +$",#0"/3& "0"0-" & ))6 rooms for major operation and duly permitted to registered as hospital pursuant to related law of such territory. “Medical center” means +6*"!& ) "+1"/-/,3&!&+$*"!& )0"/3& "#,/,3"/+&$%1- 1&"+1 and duly permitted to register as medical center according to the law such territory. “Clinic” means the modern type clinic duly permitted by law to be operated for medical treatment and diagnosis by the physician but without ,3"/+&$%1- 1&"+1ǽ “Medical standard” means /2)"0 +!/"$2) 1&,+0,#&+1"/+ 1&,+ )*"!& )-/ 1& "1% 1-/,3&!"0 an appropriate medical treatment for patient according to the medical necessity and correspond with the summary from the &+'2/6ǾƜ+!&+$0Ǿ 21,-06,/,1%"/0ǽț # +6Ȝ “Customary means medical treatment cost and/or any reasonable expense upon and reasonable ,*- /&+$4&1%0"/3& ",#1%"%,0-&1 ),/*"!& ) "+1"/,/ )&+& medical charge" charged to general patient of the hospital or medical center or clinic where the Insured has been admitted
Travel Accident Policy Hand Book 12 “Medically means /"#"/01,*"!& )0"/3& "2+!"/1%"#,)),4&+$ ,+!&1&,+0ǿȒ +" "00&16ȋ țǖȜ201 ,//"0-,+!4&1%1%"!& $+,0&0 +!1/" 1*"+1 ,/!&+$ to the injury or sickness of the client. țǗȜ201% 3" )" /*"!& )&+!& 1&,+ ,/!&+$1,1%" 2//"+1 medical standard. țǘȜ201+,1,+)6#,/1%" ,+3"+&"+1,#1%" )&"+1,/%&0# *&)6,/ 1%"1/" 1*"+1-/,3&!"/0,)")6Ǿ +! țǙȜ201 "*"!& )0"/3& " ,/!&+$1,1%"02&1 )"01 +! /!,# patient care based on the necessity of injury or sickness of such client.
Coverage The Insurance Policy shall cover the injury of Insured caused by accident during trip duration and require the Insured to receive medical treatment by physician, or requires treatment by nurse within 52 weeks from the date of accident, the Company shall compensate the Insured according to the actual medical expenses incurred which are customary and reasonable medical charges according to the medical necessity. The total amount paid will not exceed the amount specified in the schedule, less the deductible (if any). If the Insured receives compensation from government or other welfare or from other insurers , the Company is responsible only for the excess amount, over that which is covered under the welfare or other insurer’s policy.
Specific Exclusions %&0I+02/ + "Policy !,"0+,1 ,3"/
1. Loss or damage due to or in consequence causes of or occurred at the time as follows; (Unless otherwise extended the coverage and stated in the endorsement) ǖǽǖ 1&,+,#1%" +02/"!4%&)"2+!"/1%"&+Ɲ2"+ ",# ) ,%,)Ǿ !!& 1&3"!/2$0Ǿ+ / ,1& !/2$01,1%""51"+1,# "&+$2+ )"1, ,+1/,),+"ȉ0*&+!ǽ%"1"/*Ȋ2+!"/1%"&+Ɲ2"+ " ,f )&.2,/ȋ&+ 0",#% 3&+$ ),,!1"01/"#"/01, ),,!ȡ ) ,%,))"3"),#ǖǚǕ*$-"/ "+1 +!,3"/ǽ ǖǽǗ2& &!",/ 11"*-1"!02& &!",/0")#Ȓ&+Ɲ& 1"!&+'2/6ǽ 1.3 Parasite infections except pyrogenic infection, tetanus, or rabies from a wound or cut 02ƛ"/"! 0 /"02)1,# + &!"+1ǽ ǖǽǙ"!& )1/" 1*"+1,/02/$& )1/" 1*"+1"5 "-11%"+" "00 /61/" 1*"+1#,/1%" &+'2/6 4%& %&0 ,3"/"!2+!"/1%&0 +02/ + ",)& 6 +!, 2//ed4&1%&+1%"-"/&,! ,#1%&0 Insurance Policy 1.5 Miscarriage and abortion ǖǽǛ"+1 ) /"Ǿ/,,1 + )1/" 1*"+1"5 "-1+" "00 /6Ɯ/01 &!1/" 1*"+14&1%&+ǜ! 60 following an accident. 1.7 Replacement of or new sets of dentures, dental crowns, artificial dentures. 1.8 Food Poisoning ǖǽǞ ( %" 0 /"02)1,# "/+& 1"&0 Ǿ/,) -0"!&0 Ǿ2 )25 1&,+,/-,+!6)&1&0Ǿ Degeneration or Spondylitis except if there is a fracture or dislocation of spine as a result of an accident.
Travel Accident Policy Hand Book 13 2. Loss or damage occurred at the time as follows; (Unless otherwise extended the coverage and stated in the endorsement)
2.1 While the Insured is hunting for animals, racing of all kinds of car or boat, horse racing,, ski and jet ski playing or racing, skate racing, boxing, parachuting (except for the purpose of live saving) boarding or traveling in a hot-air balloon, gliding, bungee jumping, mountain climbing with equipment or diving with oxygen tank and breathing equipment under water ǗǽǗ%&)"1%"I+02/"!&0 , /!&+$,/1/ 3")&+$&+ + &/ / ƞ4%& %% 0+,)& "+0"#,/ //6&+$- 00"+$"/0,/!,"0+,1,-"/ 1" 0 ,**"/ & ) &/ / ƞǽ Ǘǽǘ%&)"1%"I+02/"!-&),10,/4,/(0 0 /"4&+ +6 &/ / ƞǽ ǗǽǙ%&)"1%"I+02/"!&0/&!&+$,/1/ 3")&+$,+*,1,/ 6 )"ǽ 3. The Insurance Policy does not cover the expenses on extra nursing fee, supporting equipment (except crutches), wheelchair, prosthesis, alternative medicine and acupuncture.
Claiming for medical expenses
The Insured is required to send the following evidences to the Company within 30 days after discharge from the hospital, medical center or the date attended to the medical treatment from clinic at the expense of the Insured. 1. Claim form of the company Ǘǽ%60& & +ȉ0/"-,/101 1&+$1%"06*-1,*0Ǿ!& $+,0&0 +!1%"1/" 1*"+1ǽ ǘǽ" "&-1 +!&+3,& "0%,4&+$1%"&1"*&7"!*"!& )"5-"+0"0ǽ Ǚǽ,-6,#1%" +02/"!ȉ0- 00-,/1ǽ 5. Any required document as deemed necessary The receipt with itemized medical expense must be the original receipt. The Company will return the original receipt verify the paid amount, so that the Insured can claim the ) + "#/,*,1%"/i+02/"/0ǽ #1%" +02/"!/" "&3"0/"&* 2/0"*"+1#/,*1%"$,3"/+*"+1,/ ,1%"/ 4")# /"Ǿ1%" +02/"!* 602 *&1 ,-6,#1%"/" "&-10%,4&+$1%" *,2+1- &! 61%" $,3"/+*"+1 or other welfare and claim the balance from the Company. Overseas medical treatment The medical treatment due to the injury under this insuring agreement occurs in the hospital or medical center or clinic out of Thailand. The Company will reimburse the expenses in Thai Baht using the exchange rate as at the specified date on the receipt.
Travel Accident Policy Hand Book 14 Insuring Agreement Third Party Liability "Ɯ+&1&,+0 “Person in family” means spouse and child of Insured. Ȋ),0"") 1&3"ȋ means spouse of the Insured, parents, grandparents, child, sister and /,1%"/,#1%"I+02/"! +!- /"+10,#I+02/"!ȉ00-,20"ǽ “Third Party” *" +0 +6-"/0,+,1%"/1% +/") 1&3"0,/I+02/"!ȉ0# *&)6Ǿ-"/0,+4%, 01 60 With the Insured, employee of the Insured and the person who 1/ 3")4&1%1%"I+02/"!ǽ "Loss of Life, body, injury, means loss of life, injury, sickness including health condition arising from sickness and health accident but exclude psychological trauma. condition"
“Loss and damage of means the physical damage of property whether a part or on the whole property" arising from accident.
“Litigation means court fee, lawyer fee and other expenses for the contention paid "5-"+0"ȋ 61%"I+02/"! +!/" "&3"1%"4/&11"+ ,+0"+1#/,*1%"C,*- +6ǽ Coverage The Insurance Policy covers legal liability to third party which accidentally occurs during the trip duration specified in the schedule. The Company shall compensate the actual amount not exceeding the sum insured stated in the schedule for loss of life, bodily injury or health condition or loss or damage to the property of third party arising from accident and the litigation expense with the written consent from the Company.
Specific Conditions %"I+02/"!*20t+,1-/,3&!" +6 $/""*"+11, ,*-"+0 1"1,1%&/!- /16,/,1%"/0,/ +6 1&3&16 20"#/,* --" )&+$,/ +6 0"4&1%,211%"4/&11"+ ,+0"+1,#1%",*- +6ǽ
Travel Accident Policy Hand Book 15 Specific Exclusions
The Insurance Policy dose not cover the liability arising from or related to or caused directly and indirectly by the cases follow; ǖǽ,00,/! * $"1,)&#"Ǿ ,!6,/-/,-"/16,# +6 ,!64%,&01%" claose/") 1&3",/ -"/0,+&+ family of the Insured, a person residing with the Insured, employee in the course of the "*-),6*"+1 +! -"/0,+1/ 3")&+$1,$"1%"/4&1%1%"I+02/"!ǽ 2. Loss or damage to the property belonging to the Insured or control by the Insured. 3. Loss or damage related to legal liability. Ǚǽ,00,/! * $"1,1%"-/,-"/16/") 1"!1,,4+"/0%&-Ǿ-,00"00&,+Ǿ20",#3"%& )"0Ǿ -&01,) ,/-"1,#1%"I+02/"!Ǿclose /") 1&3"0 +!1%"-"/0,+&+# *&)6ǽ ǚǽ" %+& ) !3& ",/0"/3& ",/1/ !",#I+02/"!ǽ Ǜǽ%"I+02/"!-/,3&!"01%"1/" 1*"+1ǽ 7ǽ,2/1'2!$*"+14%& %&0+,11%"!" &0&,+,#%"% &,2/1,/"ƛ" 1"!,/ ,+0" 21&3" execution outside Thailand territory.
Claiming %"I+02/"!&0/".2&/"!1,0"+!1%"#,)),4&+$"3&!"+ "01,1%",*- +64&1%&+ǘǕ! 60 at the occurrence of the third party liability at the expense of the Insured.
1. Claim form of the company Ǘǽ,-6,#1%" +02/"!ȉ0- 00-,/1 +!ȡ,/1/ 3")&+$!, 2*"+1 ǘǽ,-6,#,)& ",ƛ& "/ȉ0! &)6/"-,/1 11%"0 "+",# 1&,+ Ǚǽ+6/".2&/"!!, 2*"+1 0!""*"!+" "00 /6
,+02 *&00&,+,#!, 2*"+104&1%&+1%"0-" &Ɯ"!1&*"0% ))+,1'",- /!&7"1%"/&$%11, ) &*&# 1 + "-/,3"!1% 11%"/"&0/" 0,+ )""5-) + 1&,+4%6 ) &* ,2)!+,1 "* !"&+ 1&*")6* ++"/ +!1% 11%" ) &*4 0Ɯ)"! 00,,+ 0-,00& )"ǽ
Travel Accident Policy Hand Book 16 Limit of Liability arising from Murder and Assault ș) *-. ( )/*!- 1 ' $ )/ ).0- ) *'$ 4!*- -.*). ) ) - '-*0+Ț
Endorsement no. Being a part of the policy No:……..… Issued Date:…….… Insured Name
Effective Period : Start date:………at………..hrs End Date:……… atǻǻǻǻǻǻǻǻǻǻǻǻǻǻǻǻǻhrs Premium Tax Stamp Total
/$.# - 4 "- /# //# $)%0-4*!/# ).0- 0. 4(0- -*- .. 0'/Ǽ /# .0( ).0- . + - insuring "- ( )/ *! /# ) !$/Ǽ $.( ( -( )/Ǽ '*.. *! .$"#/*-/*/ '+ -( ) )/ $. $'$/4.# '' - . /*ǿǿǿ #/ǻ
If anything specified in this clause is contrary to the Insurance Policy, this endorsement shall prevail.
All other term and conditions of this Insurance Policy remain unaltered.
- 1 ' $ )/*'$ 4 ) **& 17 Extended Coverage to Riding or Traveling on Motorcycle ș) *-. ( )/*!- 1 ' $ )/ ).0- ) *'$ 4!*- -.*). ) ) - '-*0+Ț
) *. ( )/ No. Being a part of the policy No:……..… Issued Date:…….… Insured Name Effective Period : Start date:………at………..hrs End Date:……… atǻǻǻǻǻǻǻǻǻǻǻǻǻǻǻǻǻhrs
Sum Insured: Baht
Premium Tax Stamp Total
#$.I).0- ) P*'$ 4# . 3/ ) coverage /*any'*..*- ( " 0. 4 or -$.$)"!-*(Ȉ-$ $)"*-/- 1 '$)"*)(*/*- 4 ' ȉ* 0--ed 0-$)"/# /-$+ durationǻ The Company shall compensate for loss of life, dismemberment, loss of sight or total permanent disability and/or medical expense for the actual medical expenses incurred which are customary and reasonable medical charges according to the medical necessity and medical standard. The total amount paid will not exceed the amount specified in the schedule, less the deductible (if any). If the Insured receives reimbursement from the government welfare or other welfare or other insurance, the company shall compensate only the balance of medical expense and nursing expense.
' $(!*- /# ) !$/. # ) !$ $ -4$.- ,0$- /*. ) /# !*''*2$)" 1$ ) ./*/# *(+ )4 2$/#$)ǖǓ 4. *(( ) $)"!-*(/# / *! /#*!/# ).0- //# 3+ ). *!/# ) !$ $ -4ǻ ǔǻ ' $(*-(of/# C*(+ )4 Ǖǻ /# -/$!$ / ǖǻ *+4*!0/*+.4 +*-/ -/$!$ 4 )*!!$ -*) 0/4- .+*).$ ' !*-/# . *-/# + -/( )/$..0$)"/# - +*-/ǻ Ǘǻ *+4*!*'$ +*-/ -/$!$ 4/# *!!$ r*) 0/4ǻ ǘǻ *+$ .*! - ) *0. "$./- /$*)2$/#/# ( -& .Ȉ /#ȉ*!/# ).0- ǻ Ǚǻ *+$ .*! - ) *0. "$./- /$*)*!/# ) !$ $ -4 ǚǻ *+4*!/# ).0- ȇ.+ ..+*-/*-/- 1 ' * 0( )/*!/# ).0- ǻ Ǜǻ )4- ,0$- * 0( )/ . ( ) .. -4
- 1 ' $ )/*'$ 4 ) **& 18 Claim for medical expenses The Insured is required to send the following evidences to the Company within 30 days after discharge from the hospital, medical center or the date attended to the medical treatment from clinic at the expense of the Insured. 1. Claim form of the Company 2. Physician’s report stating the symptoms, diagnosis and the treatment. 3. Receipt and invoice showing the itemized medical expenses. 4. Copy of the Insured’s passport. 5. Any required document as deemed necessary The receipt with itemized medical expense must be the original receipt. The Company will return the original receipt verify the paid amount, so that the Insured can claim the balance from other insurers. If the Insured receives reimbursement from the government or other welfare, the Insured may submit a copy of the receipt showing the amount paid by the government or other welfare and claim the balance from the Company.
Travel Accident Policy Hand Book 19 AXA Nationwide Network AXA Insureance Public 1168/67 Lumpini Tower 23rd Fl., Rama 4 Rd, Thung Mahamek, Sathorn, Bangkok 10120 0-2118-8000 0-2285-6383 [email protected] www.axa.co.th
AXA Nationwide Network in Thailand Chiang Rai Chiang Mai 08-1936-6124 0-5326-2096-7, 0-5326-1157-8 0-5326-2098 [email protected] [email protected] Hua – Hin Nakhon Sawan 4/104 Soi Mooban Nongkae, Pechkasem Road, 605/380-1 Moo 10, Nakhon Sawan-Phitsanulok Rd., T. Nongkae, A. Hua-Hin, Prachuabkirikan 77110 T. Nakhon Sawan-Tok, A. Muang, NaKhon Sawan 60000 0-3253-6557, 0-3253-6823 0-3253-6101 0-5631-3151-3 0-5631-3154 [email protected] [email protected] Udon Thani Khon Kaen 111/17 Moo 8 Thanon Thahan,T. Mak Khaeng, 272/15 Moo 12 Mittaphap Road, A. Muang, A. Muang, Udon Thani 41000 Khon Kaen 40000 0-4234 1991-3 0-4234-1994 0-4336-5091-3 0-4336-5093 [email protected] [email protected] Ubon Ratchathani Roi Et 145/10 Moo 20 T. Kham Yai, A. Muang, 88/1, Prem Pracharat Road, T. NaiMuang A. Muang Roi Et, Ubon Ratchathani 34000 Roi Et 45000 0-4531 5871-3 0-4531 5847 0-4351 3888-90 0-4351 3884 [email protected] [email protected] Chonburi Nakhon Ratchasima 96/5-6 Moo 3 Praya-Sajja Road, T. Bansuan, 2169/2 Suebsiri Rd, T. NaiMuang A. Muang A. Muang, Chonburi 20000 NakhonRatchasima 30000 0-3828-3244 0-3828-3698 0-4427-8661-3 0-4427-8664 [email protected] [email protected] Rayong Pattaya 331/4 Sukhumvit Rd, T. Noen Phra, A. Muang, 1/47-48 Moo 6, T. Naklua, A. Banglamung, Rayong 21000 Chonburi 20150 0-3880-9223-5 0-3880-9226 0-3848-8907-9, 0-3848-9147-9 0-3848-8906 [email protected] [email protected] Phitsanulok Chanthaburi 666/50 Moo 7, T. Samo Khae, A. Muang, 979/7 Thachalab Rd, T. Ta-lad, A. Muang, Phitsanulok 65000 Chanthaburi 22000 0-5598-6300-2 0-5598-6303 0-3931-3102-4 0-3931-3100 [email protected] [email protected] Surat Thani Samui 201/30-31 Moo 1 Wat Pho-Bang yai Rd., T. Makamtia, 108/30 Moo 1, T. Bo-Thut, A. Koh Samui, A. Muang, Suratthani 84000 Surat Thani 84320 0-7725-6093-6 0-7725-6093-6 Press 3 0-7720-5300-2 0-7720-5488 [email protected] [email protected] Hat Yai Chachoengsao 17, 19 Juti-Uthis 4 Road, T. Hatyai, A. Hatyai, 08-3090-9472 Songkhla 90110 [email protected] 0-7434-6670-2, 0-7434-6654, 0-7434-6508-9 Phuket 0-7434-6670-2 กด 11 2/18-19 Virat - Hongyok Road, T. Talad - Nua, A. Muang, [email protected] Phuket 83000 0-7621-9251, 0-7621-9254-55, 0-7621-9257-9 Nakhon Pathom 0-7621-9249 06-1386-4324 [email protected] [email protected]
0 39332103-5 /Rayong 038809223-5 /HuaHin0 32536557/Surat Thani077205300-2 /Samui 0 77256093-6/ HatYai 074346670-2/Phuket 07621 9251 0 55986300-2/Nakhon Pathom 0613864324/Chachoengsao 0830909472/Chonburi0 3828 3244/Pattaya 038488907-9 /Chanthaburi 0 45315871-3/ KhonKaen043365091-3/Roi Et04351 3888-90/UdonThani04234 1991- AXA NationwideNetwork inThailandChiangRai08 19366124 /ChiangMai053262096-7NakhonSawan 056313151-3/UbonRatchathani AXA Insurance PCL021188000to. 8319,8320,8321,8322 For more information, Please contact Broker youragent, orCustomer Relationship Contact youragent 3 /NakhonRatchasima 04427 8661-3/Phitsanulok
CX201712-25