*In the case of choosing the coverage plan of 5 million Baht with deductible under the selected
coverage plan
- Coverage area of D Kids Plus Campaign is Thailand only.
- D Kids Plus Campaign is a marketing name of D Health Plus Rider.
- D Health Rider must be attached to a policy which is still in force only
- The coverage of this rider must not exceed the coverage period of the life insurance policy to
which this rider is attached. - Room, board, and nursing service fees (standard single room) for up to 180 days per any
hospitalization - Room, board, and hospital service expenses including ICU room fee up to 60 days
- Home medication expenses based on medical necessity for up to 7 days, but not exceeding
20,000 Baht per any hospitalization - Waiting period for illnesses due to general disease is 30 days.
- Underwriting is subject to the Company’s rules.
- Premium is eligible for tax deduction. Conditions are as specified by the Revenue Department.
- Please study coverage details, conditions and exclusions before making a decision to purchase
insurance.
Q: What is the insurable age and when does the coverage end?
A: Entry age is 30 days to 10 years old. The coverage is provided until the age of 99.
Q: Does D Kids Plus Campaign need to be attached to a base life insurance policy?
A: D Kids Plus Campaign is a marketing name of D Health Plus Rider; it must be attached to a base life insurance policy.
Q: After I buy it, will it be effective immediately?
A: The rider has the 30-day waiting period after the effective date. The following diseases will be covered if they occur 120 days after the effective date or the reinstatement date according to conditions stated in the contract: Tumors, cysts, or all types of malignancy/cancer, hemorrhoid, all types of hernia, pterygium or cataract, tonsillectomy or adenoidectomy, all types of stone, varicose vein and endometriosis.
Q: Does premium of D Kids Campaign increase based on the increasing age range?
A: Yes, it is based on the increasing age range of the insured.
Q: What does D Kids Plus take care of?
A: Feel at ease when your children get sick if you purchase D Kids Plus Rider as it provides coverage for both IPD benefit when hospitalization and OPD benefit for continuous treatment and rehabilitation up to 5 million Baht.* It covers standard single room in any hospital, board, nursing service, ICU room up to 60 days (once room, board and nursing service fees are included, it must not exceed 180 days), doctor fee, medication fee, examination fee, surgery fee and physical therapy fee. It covers both minor or major surgery or injury from an accident within 24 hours even without being hospitalized. The benefits were paid based on actual expenses after deducting the deductible responsible by the insured.
Q: What is deductible?
A: It is the amount of expenses paid by the insured, other welfare or other policies (if any). D Kids Plus Campaign will cover the amount exceeding the deductible amount. The limit is in accordance with the chosen plan.
Q: Do all plans of D Kids Plus Campaign have deductible options?
A: Every plan of D Kids Plus Campaign includes deductible options. In this regard, the limit is in accordance with the chosen plan.
Q: What is the coverage area of D Kids Plus Campaign?
A: Coverage area is only in Thailand, except cases of injury due to an accident or illness that needs an emergency treatment whereby the first hospitalization date must be within 90 days after traveling outside the coverage area each time.
Q: Is health checkup required when applying for D Kids Plus Campaign?
A: It is subject to the Company’s rules.
Q: Is the premium of this rider eligible for tax deduction?
A: Yes, it is eligible for personal income tax deduction according to the Notification of the Director-General of the Revenue Department on Income Tax No. 383.
Q: What is the convertible option?
A: It is an option to reduce deductible (change for more coverage). The insured receives a privilege to not going through the underwriting process again (without the need to declare health information again). Moreover, waiting period and pre-existing conditions according to the changing plan will not be applied.
Q: What products are available for the convertible option?
A: At present, the Company provides the privilege for D Health Rider, D Health Rider (N) or D Health Plus
Rider Plan with Deductible, including D Kids Project or D Kids Plus Project (excluding those attached to unit-linked insurance) according to conditions specified by the Company.
Q: Is convertible option available for all plans?
A: No. Exercising the convertible option is subject to the convertible option criteria for rider and deductible reduction table. In this regard, the coverage plan after conversion is subject to the Company’s available rider/coverage plan at that time.
Q: Can the convertible option change benefit limit per any hospitalization?
A: No. Convertible option is an option to reduce deductible which the benefit limit must be equivalent to the original coverage plan.
Q: Which age range is eligible for convertible option?
A: The insured’s 2 eligible age ranges for convertible option are as follows:
• Age range 1: 11-15 years old
• Age range 2: 55-65 years old
The insured is entitled to exercise the convertible option only once per age range in a contract period. The insured must have held the current plan before exercising the convertible option for at least 5 consecutive years.
Q: For eligible age range of 11-15 years old or 55-65 years old for the convertible option, what are the
criteria for that?
A: Considering from age based on policy year (year of birth – current year and count based on policy
anniversary)
Q: Is there any additional fee for the convertible option?
A: There is no fee for exercising the convertible option.
Q: How much is the premium for the convertible option?
A: The Company shall calculate the premium based on the new chosen plan. In this regard, the premium
schedule for the coverage plan after the conversion is subject to the Company’s available coverage plan at that time.
Q: When can the insured exercise the right for the convertible option?
A: If a customer is qualified for the convertible option, the Company will notify and send the request form to exercise the convertible option 3 months prior to the policy anniversary at the age of 11 or 55 years, according to each age range. If the customer wants to exercise the right when receiving the document, they can contact the Company immediately. However, the customer must notify the Company before the policy anniversary at the age of 16 or 66 years, according to each age range.
Pre-existing Condition
The Company shall not pay benefit under this rider for chronic disease, illness (including complications) or injury that is not cured before the effective date of this rider, unless
1) The insured has declared to the Company’s acknowledgment and the Company agrees to accept the risk without imposing exclusions to the coverage, or
2) Chronic disease, injury or illness (including its complications) is asymptomatic and has not been treated or diagnosed by a physician, or has not been seen or consulted a physician within 5 years before the initial effective date of this rider, and within 3 years from the initial effective date of this rider.
Exclusions of D Health Plus Rider from a total of 21 clauses
For Example, The rider shall not cover medical expenses or damages that incurred from injury or illness (including its complications), conditions, or abnormality that arise from:
- Cosmetic surgery or any other diagnosis or treatments for skin beauty purposes, pimple, blemish, and freckles treatment, dandruff and hair fall treatment, or weight control, or elective surgeries, except for reconstructive surgery required after an accident incurred whilst the rider is effective
- Anti-aging diagnosis, treatment or prevention by consuming drugs or substances, hormone replacement therapy for peri-menopausal and postmenopausal women, male or female sexual malfunction, any sexual disorder treatments and sexual reassignment surgery
-Treatment or rehabilitation for narcotic substance, cigarette, alcohol or psychotropic substances
- Treatment under experiment, treatment or diagnosis on obstructive sleep apnea, treatment or diagnosis on sleep disorders and snoring
- Expenses incurred from the diagnosis and treatment that the insured as physician prescribed for himself/herself and also such expenses that incurred from order of physician who is the insured’s father, mother, spouse or child
Policy Renewal on Anniversary Date
This rider may be renewed on the policy’s anniversary date without having to provide evidence, but the Company reserves the right to adjust the premium as specified in Section 14 Re: Premium Adjustment, as approved by the regulator, except in any of the following events, the Company shall reserve the right not to renew the rider. If the insured decides not to renew the rider, Company must inform the insured in writing at least 30 days before the end of the effective period.
1) In case there is the evidence that the insured omits the disclose any fact in the insurance application form or reinstatement form, health declaration form and other declarations related to the formation of health insurance rider which is material so that the Company may be induced to charge higher premium, or refuse to enter into the insurance contract, or provide the coverage with conditions.
2) The insured makes a claim from the fact that he/she has requested for the treatment for injury or illness without medical necessity.
3) The insured makes total claims from all companies for compensation from hospitalization higher than the actual income.
Premium Adjustment
The Company may adjust premium on the policy anniversary date according to the premium rate approved by the Registrar due to the following factors.
1) Age and occupation class of each person.
2) Higher medical expenses or overall claim experience of the portfolio of this rider whereby the Company shall notify the insured in writing via a registered mail or other means accepted by the insured at least 30 days in advance.
- Any illnesses which exist within 30 days counting from the effective date or the latest date of reinstatement of the rider, whichever is the latest; or
- Illnesses due to the following diseases which exist within 120 days counting from the effective date or the latest date of reinstatement of the rider, whichever is the latest.
- Tumors, cysts, or all types of malignancy/cancer
- All types of hernia
- Tonsillectomy or adenoidectomy
- Varicose vein- Hemorrhoid
- Pterygium or cataract
- All types of stone- Endometriosis
Buyers should understand the details, coverage and conditions before deciding to make insurance every time.
