Comprehensive Healthcare Insurance for Individuals

product overview

• a.       Anyone who meets the following conditions shall be eligible for this insurance:
  -        Age: From 15 days old to 69 years old (calculated according to the last birthday); and
  -        Insured person over 65 years old only is covered provided that he/she has been insured with the Company for at least 2 consecutive years.
  -        In case of a person under 15 years old, the Company accepts insurance with the condition that he/she participates in the same insurance Policy with the Father and/or Mother or the Father/Mother has participated in at least one type of health insurance with the Company. The insurance program of the dependent person shall only be applied at the same level or lower than the program of the Father or Mother. Unless otherwise agreed.
  -        Individual who meets the conditions of a Dependent as defined in the Policy.
  b.       The Company shall not provide cover and/or shall not be liable to:
  -        Persons suffering from mental illness, down syndrome, or leprosy;
  -        Persons with a percentage of permanent disablement or loss of work ability 50% or more; Percentage of permanent disablement is determined according to written confirmation from competent professional authority and/or legal license;
  -        At the time of renewal, the Insured Person is over 69 years old;
  -        People who have or are suffering from one of the following diseases or conditions: Parkinson's, Alzheimer's, Motor neuron disease, Multiple sclerosis, Multiple sclerosis, Muscular dystrophy, Myasthenia gravis, Epilepsy, Hydrocephalus, Cerebral palsy, Paraplegia, Schizophrenia, Schizoaffective disorder, Delusional disorder, Mental disorder, Dementia, Intellectual disability, Down syndrome, Leprosy.
• -        People who have or are suffering from one of the following serious diseases:
  •        Cancer;
• •        Brain surgery;
• •        Stroke, Cerebral hemorrhage, Atherosclerosis;
  •        Chronic obstructive pulmonary disease (COPD), Pneumonectomy, Cor pulmonale;
  •        Myocardial infarction, Aortic surgery, Heart valve surgery, Heart transplant;
  •        Decompensated cirrhosis, Liver failure, End-stage renal failure, Renal medullary cysts;
  •        Bone marrow transplantation, Bone marrow failure;
  •        In a coma or vegetative state
  •        Persons are under inpatient treatment for accident or disease.
  c.       If the Company may discover the ineligibility after the inception date, the Company shall have the right to cancel the coverage for such an ineligible person and refund the earned premiums minus policy administration and management fee. 

• No benefit shall be payable during the Waiting Period specified below:
  1. Applicable to all Insured Persons:
  - Treatment of pre-existing diseases: 365 days;
  - Death, permanent total disability due to pre-existing disease: 365 days;
  - Maternity (Normal delivery, Caesarean section): 270 days;
  - Death due to Maternity: 270 days;
  - Maternity (Pregnancy complications): 90 days;
  - Death, Permanent Total Disability due to Normal Diseases: 90 days;
  - Normal Diseases: 30 days;
  - Insured risks caused by other accidents: Not applicable;
  - Death, Permanent Total Disability due to accident: Not applicable;
  2. Only applicable to the Insured from 15 days old to under 5 years old:
  - Upper respiratory tract infections (Tonsillitis, Acute or chronic adenoiditis/hypertrophy, Lower respiratory tract infections, Bronchitis, bronchiolitis, bronchopneumonia, pneumonia): 90 days.

• This refers to an illness or injury of the insured that existed prior to the First Effective date and:
  -        The insured has required treatment within 3 years before the First Effective date;
  -        Symptoms of the illness or injury have appeared or occurred with the insured before the effective date, which the insured was aware of or conscious of, regardless of whether the insured actually sought examination or treatment.