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* Only for OPD Per Time Rider participating in MTL Fit
- OPD Per Time Rider is the marketing name of Outpatient Treatment Rider (OPD), and OPD Maochai Rider is the marketing name of OPD Maochai Rider.
- OPD Per Time Rider and OPD Maochai Rider must be purchased to be attached to the policy which is still effective.
- The coverage of the rider must not exceed the coverage period of the life insurance policy that this rider is attached to.
- OPD Per Time Rider provides an outpatient treatment once a day, up to 30 times a year. The treatment of a disease or its complication of the same disease is limited to 7 times. However, if ongoing treatment for the same disease is required, but the gap of such treatment from the last treatment is longer than 14 days, it shall be regarded as a treatment of new disease.
- OPD Per Time Rider has the 30-day waiting period for general diseases of 30 days.
- Conditions are according to the medical standard and necessity. - Underwriting is subject to the Company’s rules.
- Premium is eligible for tax deduction. Conditions are as specified by the Revenue Department.
Q: What is OPD Per Time Rider and OPD Maochai Rider? Why are they a must?
A: When you get sick, you will be covered even without being hospitalized as OPD Per Time Rider covers OPD medical expenses up to 30 times per year and OPD Maochai Rider covers OPD medical expenses in annual lump sum payment under the limit. The riders cover doctor fees, diagnosis charges and OPD medication expenses until the age of 99 years.
Q: Must OPD Per Time Rider and OPD Maochai Rider be purchased and attached to a life insurance policy (base contract)?
A: Both riders must be purchased and attached to a life insurance policy (base contract). For more information, please contact the Company’s agent or call Tel. 1766, available 24/7.
Q: Will OPD Per Time Rider and OPD Maochai Rider 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 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. The Company shall not pay the benefit under this rider for the following illnesses that occurred within 180 days from the effective date or the last reinstatement date of the rider according to conditions stated in the contract: thyroid disease, epilepsy, diabetes, allergy, hypertension, heart disease and stomach disease.
Q: What are the entry age and coverage period of OPD Per Time Rider and OPD Maochai Rider?
A: For OPD Per Time Rider, the entry age is 6 years - 80 years (renewable until the age of 98 years), and coverage period is until the age of 99 years. For OPD Maochai Rider, the entry age is 6 years - 80 years (renewable until the age of 98 years), and coverage period is until the age of 99 years.
Q: Do premiums of OPD Per Time Rider and OPD Maochai Rider increase based on increasing age range?
A: Premiums of OPD Per Time Rider and OPD Maochai Rider increase based on increasing age range of the insured.
Q: Are premiums of OPD Per Time Rider and OPD Maochai Rider eligible for tax deduction?
A: The premiums of OPD Per Time Rider and OPD Maochai Rider are eligible for personal income tax deduction according to the Notification of the Director-General of the Revenue Department on Income Tax No. 383
Q: Do OPD Per Time Rider and OPD Maochai Rider need to be purchased to attach to a life insurance policy (base contract)?
A: OPD Per Time Rider and OPD Maochai Rider need to be purchased to attach to a life insurance policy (base contract) only.
Q: Can OPD Per Time Rider and OPD Maochai Rider be attached to an existing insurance policy?
A : It can be attached to an existing policy according to the conditions. However, such insurance policy (base contract) must have minimum sum insured of 50,000 Baht. In this regard, it is subject to condition of minimum sum insured of each insurance plan. Moreover, coverage period from the application date must be more than 1 year.
Q: Is health checkup required to purchase OPD Per Time Rider and OPD Maochai Rider?
A: The applicant must truthfully declare the health information in the application form to the Company. However, health checkup is according to the Company’s rules.
Exclusions of the rider with a total of 26 clauses, for example;
This rider shall not cover medical expenses or damages incurred from injury or illness (including its complications), conditions, or abnormality that arises from:
1. Chronic disease, illness or injury that has not been cured prior to the insurance contract issue date, treatment for congenital disorder, or pervasive developmental disorder or genetic disorder.
2. 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.
3. Pregnancy, miscarriage, abortion, childbirth, any pregnancy complications, infertility resolutions (including diagnosis and treatment), sterilization or birth control.
4. AIDS, venereal disease, or sexually transmitted diseases including Acquired Immune Deficiency Syndrome caused by AIDS virus and this also covers the opportunistic infection, or any other infections or illnesses, which the blood test shows positive HIV (Human Immunodeficiency Virus), the opportunistic infection includes, but not limited to, the Pneumocystis Carinii Pneumonia, Organism causing Chronic Enteritis, Disseminated Virus and/or Fungi Infection, Malignant Neoplasm. It also includes, but not limited to, Kaposi’s Sarcoma, Central Nervous System Lymphoma and/or any other critical Illness known in modern medical that it is a condition of Acquired Immunodeficiency Syndrome or a cause for someone’s sudden death, illness or disability. AIDS includes HIV (Human Immunodeficiency Virus) causing Encephalopathy Dementia.
5. 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 sex change surgery.
The Company shall not pay the benefit under this rider for
1.Any illness which incurs within 30 days from the effective date of this rider or the date that the Company approves to increase benefits of this rider or the last reinstatement date of this rider, whichever is the latest; or
2.The following illnesses which incur within 120 days from the effective date of this rider or the date that the Company approves to increase benefits of this rider or the last reinstatement date of this rider, whichever is the latest.
-Tumors, cysts or all types of cancer
-Hemorrhoid
-All types of hernia
-Pterygium or cataract
-Tonsillectomy or adenoidectomy
-All types of stones
-Varicose vein
-Endometriosis or
3.The following illnesses which incur within 180 days from the effective date of this rider or the date that the Company approves to increase benefits of this rider or the last reinstatement date of this rider, whichever is the latest.
-Thyroid disease
-Epilepsy
-Diabetes
-Allergy
-Hypertension
-Heart disease
-Stomach disease
Buyers should have an understanding in the details of coverage and conditions every time before making a decision to purchase insurance.
