| Simply Healthy Benefit |
Sum
lnsured(Baht) |
| BASIC HOSPITAL INPATIENT (IPD)
COVERAGE |
SP1000 |
SP1500 |
SP2000 |
SP3000 |
SP4000 |
SP6000 |
SP12000 |
| Maximum Payable per Disability |
100,000 |
150,000 |
200,000 |
300,000 |
400,000 |
600,000 |
1,200,000 |
| Coverage Benefits |
| - Room and Board, including nursing service
(Maximum payable per day, limit 60 days) |
1,000 |
1,500 |
2,000 |
3,000 |
4,000 |
6,000 |
12,000 |
| - ICU Room and Board, including nursing
service (Maximum payable per day. Limit 15 days) |
2,000 |
3,000 |
4,000 |
6,000 |
8,000 |
12,000 |
24,000 |
| - Room and Board. Including nursing service
and ICU (Maximum payable per disability |
60,000 |
90,000 |
120,000 |
180,000 |
240,000 |
360,000 |
720,000 |
| - General Expenses induding OPD tolcw up 30
(Maximum payable per disabilitytime/year) |
10,000 |
15,000 |
20,000 |
30,000 |
40,000 |
60,000 |
120,000 |
| -Emergency OPD Treatment for accdent-first
visit within 24 hours after accident, including follow 15 days (including in
General Expenses) |
2,000 |
3,000 |
4,000 |
6,000 |
8,000 |
12,000 |
24,000 |
| - Special Consultation Fee (including in
General Expenses) |
1,000 |
1,500 |
2,000 |
3,000 |
4,000 |
6,000 |
12,000 |
| - Ambulance Fee (including in General
Expenses) |
1,000 |
1,000 |
1,000 |
1,000 |
1,000 |
1,000 |
1,000 |
| Surgical
Coverage |
| - surgicals Fee (Maximum payable per
disabilitytme/year, as per actual expense) |
15,000 |
22,5000 |
30,000 |
45,000 |
60,000 |
90,000 |
180,000 |
| - Special Consutation Fee for surgical
(including in Surgical’s Fee ) |
1,500 |
2,250 |
3,000 |
4,500 |
6,000 |
9,000 |
18,000 |
| Doctor Visit Coverage |
250 |
375 |
500 |
750 |
1,000 |
1,500 |
3,000 |
| Personal Accident Coverage
(PA 2) |
| - Accidental Death Dismenberment and Total
Permanent Disability |
100,000 |
100,000 |
100,000 |
100,000 |
100,000 |
100,000 |
100,000 |
| (murder/assault/ riding or
bassenger of a motorcie 100 peroent ) |
| Optional Outpatient (OPD) Benefits-Choose
your own OPD coverage |
| Out-patient Coverage (OPD) |
Sum Insured
(Baht) |
| OPD 1 |
OPD2 |
OPD3 |
OPD4 |
OPD5 |
OPD6 |
OPD7 |
| Maximum Payable per Day (Maximum 1 visit per day, limit 30
visits per year ) |
800 |
800 |
1,000 |
1,500 |
2,000 |
2,500 |
3,000 |
| X-ray and Labalortory Test (Maximum per year) |
6,000 |
8,000 |
10,000 |
15,000 |
20,000 |
25,000 |
30,000 |
|