Mao Chai Extra Campaign

Q: Warranty period and how long is the coverage period?
A: Insurance can be made from the age of 11-90 years and will be covered until the age of 99 years.

Q: What are advantages of Mao Chai Extra Campaign and why do I have to buy it?
A: Mao Chai Extra Campaign provides lump sum coverage based on actual amount. It covers both illness and surgery for critical illnesses and general diseases of up to 500,000 Baht per any hospitalization (*). You can get coverage with affordable premium, and hospitalization at any hospital with additional room fee of 4,000 Baht per day(*).
 
Q: Who should apply for Mao Chai Extra Campaign?
A: It is suitable for freelancers or fresh graduates who do not have medical welfare or would like to have additional health coverage. Mao Chai Extra Campaign will give peace of mind and lighten burden of medical expenses in case of unexpected events.
 
Q: What is coverage of Mao Chai Extra Campaign?
A: Mao Chai Extra Campaign provides lump sum coverage based on actual amount for daily room, board, and nursing service fees for both illness and surgery in case of inpatient hospitalization. It covers critical illnesses and general diseases up to 500,000 Baht per any hospitalization (*), additional room fee of 4,000 Baht per day(*) and doubled amount for ICU hospitalization (up to 120 days when combined).
 
Q: Will it be effective immediately if I buy it?
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 latest reinstatement date of the rider according to the 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 the premium of Mao Chai Extra Campaign increase based on increasing age of the insured?
A: Yes, the premium increases based on increasing age of the insured.

Q: Is Mao Chai Extra Campaign eligible for tax deduction?
A: Yes, it is. The premium of this rider is eligible for personal income tax deduction according to the Notification of the Director-General of the Revenue Department on Income Tax No. 383.

Remark:
(*)In case of choosing coverage plan 3

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 Extra Care Rider(N) 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
- General medical checkup, individual request for admission in a hospital,or individual request for surgery, rest recovery or rest cure, or hospitalization with assistant, diagnosis or treatment which is not directly related to the illness that is the reason of hospitalization, diagnosis of injury or illness, treatment or diagnosis to find a cause which is not a medical necessity or not based on medical standard
- Diagnosis and treatments of ophthalmic disorders and LASIK surgeries, expenses on visual aids or treatment of vision abnormality
-Treatment or rehabilitation for narcotic substance, cigarette, alcohol or psychotropic substances
- Diagnosis and treatment other than conventional medicine, including alternative medicine

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.

In this regard, for the renewal of this rider, the Company reserves the right to amend the conditions of coverage by adding a condition requiring copayment from the insured according to the following rates and criteria.

(1) Copayment at 30% of the covered expenses in cases where the insured has claimed benefits for simple diseases and has been hospitalized as an inpatient 3 or more times within the policy year, with a claim ratio under this rider exceeding 200%, or
(2) Copayment at 30% of the covered expenses in cases where the insured has claimed benefits for inpatient hospitalization 3 or more times within the policy year, with a claim ratio under this rider exceeding 400%, excluding claims for critical illness treatment and/or major surgeries.
If the claims of each insured under this rider meet the criteria (1) and (2), the Company shall impose a copayment condition of 50% of the covered expenses.

If the Company imposes a copayment condition on the insured and later the insured's claims or claim ratio decreases below the specified criteria, the Company shall consider reducing the copayment rate for the insured, in accordance with the Company’s terms and conditions.

The claim ratio is calculated by dividing the total claims approved and paid by the Company during the policy year by the premium for that policy year.

If the Company adds a condition requiring copayment from the insured according to the rates and criteria above, the Company shall issue evidence regarding the copayment rates and criteria to the insured at least 15 days before the policy anniversary date.

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/cance
- 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.