BTA - Policy Wording VNE

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Transcript of BTA - Policy Wording VNE

  • Bao him Di chuyn trong kinh doanh Quy tc bao him 12/2014 1

    BO HIM DI CHUYN TRONG KINH DOANH QUY TC BO HIM

    PHN I CC NH NGHA ................................................................................................................................. 2 PHN II - PHM VI BO HIM ............................................................................................................................. 6

    QUYN LI 1 T VONG V THNG TT VNH VIN DO TAI NN ....................................................... 6 QUYN LI 2 - QUYN LI BNG DO TAI NN ............................................................................................ 6 QUYN LI 3 THANH TON CHI PH Y T V IU TR NHA KHOA DO TAI NN ................................. 7 QUYN LI 4 CHI PH SAU KHI NM VIN ................................................................................................. 8 QUYN LI 5 QUYN LI NM VIN (TI A 60 NGY) .......................................................................... 8 QUYN LI 6 QUYN LI NM VIN GP I KHI IU TR TI PHONG CHM SOC C BIT (TI A 60 NGY) ..................................................................................................................................................... 8 QUYN LI 7 VN CHUYN Y T KHN CP ............................................................................................ 8 QUYN LI 8 HI HNG THI HI ............................................................................................................. 9 QUYN LI 9 THM NGOI CH CA NGI THN HOC BN B ............................................... 9 QUYN LI 10 H TR THU XP DCH VU (CHI P DUNG I VI CHNG TRINH PREMIER) ...... 9 QUYN LI 11 HU B CHUYN I ........................................................................................................... 9 QUYN LI 12 RUT NGN CHUYN I .................................................................................................... 10 QUYN LI 13 CHUYN I B TRI HOAN .................................................................................................. 10 QUYN LI 14 - L NI CHUYN ................................................................................................................ 10 QUYN LI 15 HNH L N CHM ........................................................................................................ 11 QUYN LI 16 - THIT HI HOC MT HNH L ....................................................................................... 11 QUYN LI 17 HNG HOC HOC MT MY TNH XCH TAY ............................................................... 11 QUYN LI 18 MT GIY T I LI .......................................................................................................... 12 QUYN LI 19 MT TIN C NHN .......................................................................................................... 12 QUYN LI 20 CHI PH PHP L ............................................................................................................... 12 QUYN LI 21 TRCH NHIM C NHN .................................................................................................. 12 QUYN LI 22 BI THNG TH TN DUNG .......................................................................................... 13 QUYN LI 23 QU GIO DUC TR EM ................................................................................................... 13

    PHN III CC LOI TR CHUNG ................................................................................................................... 13 PHN IV CC QUY NH CHUNG .................................................................................................................. 15 PHN V CC IU KIN CHUNG .................................................................................................................. 15 PHN VI QUI TRINH KHIU NI V YU CU H TR .............................................................................. 17 PHN VI BNG QUYN LI BO HIM V BIU PH BO HIM ............................................................... 18

  • Bao him Di chuyn trong kinh doanh Quy tc bao him 12/2014 2

    BO HIM DI CHUYN TRONG KINH DOANH QUY TC BO HIM

    Quy tc bo him ny c ban hnh bi Cng ty TNHH Bo him AIG Vit Nam (sau y gi tt l Cng ty) v bao gm cc iu khon v iu kin cua Hp ng bo him c cp cho Chu hp ng bo him. Trn c s ph bo him m Chu hp ng bo him ng hay ng ng v cn c vo giy yu cu bo him v s k khai v/hoc bt c tuyn b no c cung cp cho Cng ty, Cng ty s bo him cho Ngi c bo him theo nhng iu kin c quy nh ti Hp ng bo him ny. Vic bo him bt u c hiu lc khi chuyn i bt u nh c nu r ti Bn tm tt hp ng bo him v s ko di cho n khi Hp ng bo him chm dt ti thi im kt thc chuyn i.

    PHN I CC NH NGHA Tai nn hoc do tai nn c ngha l s kin bt ng, khng lng trc c v ngu nhin dn n t vong, tn tt hay

    thng tt cho Ngi c bo him. Hi chng suy gim h thng min dch (AIDS) c ngha l cc trng hp c xc nh theo cc khi nim cua T

    chc Y t Th gii bao gm Nhim trng c hi, Ung th c tnh, nhim vi rt HIV, cc bnh v no (tm thn phn lit), hi chng tn ph c th cua vi rt HIV hoc bt k bnh hoc m au c xt nghim huyt thanh dng tnh vi HIV.

    a) Nhim trng c hi bao gm nhng khng gii hn bi bnh vim phi, vim rut mn tnh, vi rt v/hoc nhim

    trng nm ly lan.

    b) Ung th c tnh bao gm nhng khng gii hn bii ung th (Kaposis), ung th h thng thn kinh trung ng,

    v/hoc cc bnh c tnh khc c coi l cc nguyn nhn trc tip dn n t vong, m hoc tn tt vi s xut hin cua s suy gim h thng min dch.

    TRAVEL GUARD l thnh vin cua AIG Worldwide Insurance, chuyn cung cp cc dch vu h tr du lch ton cu v cc

    dch vu lin quan cho cc i tc, khch hng bo him ton cu.

    i my bay c ngha l s dung my bay cua hng hng khng thng mi thng thng c php hot ng hp php

    vi t cch l hnh khch c mua v (khng phi l ngi iu khin phng tin hoc thnh vin phi hnh on). Bo lon, bo ng dn s c ngha l tp hp cc cng dn (c t chc hoc khng c t chc) by t quan im

    cua mnh v vic tp hp nhng ngi ny c mang tnh cht bo ng (c th c hoc khng c s can thip cua cnh st v/hoc qun i). Vic tp hp nhng ngi khng nh chu quyn v hot ng thay mt mt nh nc c chu quyn s khng c coi l bo lon hoc bo ng dn s. Cc khi nim ny khng bao gm hnh ng bo lc c nhn. Mt hnh ng c coi l bo lon dn s khi n l vic ko di v/hoc lp li cua mt hnh ng bo lc theo nhm xy ra trong mt quc gia, tnh hoc mt th trn. My bay thng thng c ngha l my bay c cnh c nh c cung cp v vn hnh bi mt hng hng khng

    thng mi c cp php chuyn ch hnh khch thng xuyn c thu ph v my bay ln thng c cung cp v vn hnh bi mt hng hng khng c cp php chuyn ch hnh khch thng xuyn c thu ph v ch hot ng gia cc sn bay thng mi hoc cc sn bay trc thng thng mi c cp php. Nc nguyn x c ngha l quc gia m Ngi c bo him c trao quyn cng dn hoc c tr lu di bi cc

    c quan c thm quyn cua quc gia . Chi ph c bo him l cc chi ph vi hn mc ti a c quy nh ti Phn 7, cho vic vn chuyn, dch vu y t v

    cc trang thit b y t cn thit pht sinh trong qu trnh Vn chuyn y t khn cp cua Ngi c bo him. Tt c mi vic thu xp phng tin i li vn chuyn Ngi c bo him phi l: a) theo ng trc tip v kinh t nht; v b) phi c Cng ty chp thun trc; v c) phi do Travel Guard hoc i din c u quyn cua Travel Guard thu xp. Cc chi ph di chuyn c bit cn phi c kin cua Bc s hnh ngh hp php tham gia iu tr hoc theo cc quy nh chun v vic vn chuyn Ngi c bo him. Cc chi ph v trang thit b y t phi c kin cua Bc s hnh ngh hp php tham gia iu tr.

  • Bao him Di chuyn trong kinh doanh Quy tc bao him 12/2014 3

    Di chuyn y t khn cp c ngha l:

    a) tnh trng sc kho cua Ngi c bo him i hi phi c di chuyn ngay lp tc t ni Ngi c bo him gp thng tt hoc m au n bnh vin gn nht ni c th p ng s iu tr y t cn thit; hoc

    b) sau khi c iu tr bnh vin a phng, tnh trng sc kho cua Ngi c bo him i hi phi di chuyn v Vit Nam tip tuc iu tr hoc phuc hi.

    Thit b chi Golf c ngha l gy chi golf v ti golf.

    Ti sn gia nh c ngha l cc c, dng, qun o v vt dung c nhn thuc s hu cua Ngi c bo him

    hoc cc thnh vin trong gia nh cua Ngi c bo him hoc cua ngi gip vic sinh sng thng xuyn vi gia nh, cc vt kin trc v trang tr ni tht khc do Ngi c bo him s hu (hoc phi chu trch nhim) m khng phi cua chu cho thu nh nhng khng bao gm cc loi vn bn, hp ng, hi phiu, giy n, sc, sc du lch, chng khon, cc loi giy t khc, tin mt v tin giy. Bnh vin c ngha l mt bnh vin (tr nh dng lo, c s chm sc sc khe cho ngi gi, ngi m au kinh

    nin hay nh iu dng phuc hi sc khe) hot ng theo lut php v muc ch iu tr v cha tr nhng ngi b m hoc thng tt vi cc thit b chn on v phu thut v c dch vu y t v theo di iu tr 24 gi. Nm vin c ngha l nm mt bnh vin vi t cch ni tr iu tr y t cn thit v trn c s xut cua mt Bc

    s hnh ngh hp php. Mt ngy nm vin c ngha l 24 (hai mi bn) gi lin tuc m bnh vin tnh ph phng v tin iu tr cho thng tt do tai nn hoc m au. Thng tt c ngha l thng tt thn th cua Ngi c bo him hon ton do tai nn gy ra v c lp vi tt c

    cc nguyn nhn khc dn n t vong hoc tn thng cua Ngi c bo him trong vng 90 ngy k t ngy xy ra tai nn . Ngi c bo him l (nhng) ngi c nu ti Bn tm tt hp ng bo him hoc cc sa i b sung sau ny

    v l cn b, cng nhn vin cua Chu hp ng bo him i cng tc. Phng iu tr c bit (ICU) c ngha l loi phng chuyn kim sot cc chc nng c bn cua c th cua bnh

    nhn trong cc iu kin y t nguy kch i hi mc phuc vu cao cua cc y t v c u cc c s vt cht lm bnh nhn c th tnh li. My tnh xch tay c ngha l cc ton b my tnh xch tay bao gm c cc thit phu tr chun tc cho my tnh xch

    tay. Bt k my hay thit b xch tay no u b loi tr i vi nh ngha ny. Mt ngn tay hoc ngn chn c ngha l mt chc nng hoc t ri t khp ngn tay hoc ngn chn tr ln.

    Mt thnh lc c ngha l mt vnh vin v khng th phuc hi thnh lc khi:

    Nu a dB Mt thch lc mc 500 Hertz Nu b dB Mt thch lc mc 1000 Hertz Nu c dB Mt thch lc mc 2000 Hertz Nu d dB Mt thch lc mc 4000 Hertz 1/6 cua (a+2b+2c+d) l trn 80dB. Mt chi c ngha l mt hon ton chc nng hoc b t ri ton b v vnh vin mt tay tnh t c tay hoc mt chn

    tnh t mt c chn. Mt th lc c ngha l mt th lc ton b, vnh vi