NhCPngquy djnh chungDi{,u 1

1.1 Trli nhO'ng khai ni",m dU'Q'cdjnh nghia dU'ai day, cac Ihual ngO',lli dU'Q'cvi{,1hoa Irongquy lac, di~u khoan cua bao hi{,m be IrQ'nay se co nghia nhU'quy djnh, giai Ihich trangBan quy tac va di{,u khoan cua HQ'pd6ng bao hi{,m chinh.

1.1.1 "Bac sf' la bac si dU'Q'c~p phep, dang ky hQ'pphap va hanh ngh€. Irong ph<lmvi gi~yphep Iheo pMp lual Vi",1Nam. Sac si khong bao g6m NgU'il'i dU'Q'cbao hi{,m, vQ',ch6nghOacIhanh vien gia dinh In,J'cU{'p cua NgU'il'idU'Q'Cbao hi~m.

1.1.2 "San quy lac va di{,u khoan bao hi{,m bo Ir9'" la ban quy tilc va di€.ukhoim cua Baohi{,m bo trQ'nay.

1.1.3 "Baa hi{,m bo Ire;>'''la bao hi{,m ho trQ'vien phi dU'Q'cCong Iy cung ~p cho Ben muabao hi{,m thea quy djnh I<liBan quy tilc va di€.ukhoan bao hi{,m bo trQ'nay.

1.1.4 "Ben mua bao hi{,m" dU'Q'chi{,u la Ben mua bao hi{,m cua HQ'pd6ng bao hi{,m chinh.

1.1.5 "B~nh nhan noi Iru" la NgU'il'i dU'Q'cbao hi{,m cO lam Ihu luc nhaP vien va phai Namvien, va viec Nam vien cua NgU'il'idU'Q'cbao hi{,m la Djch Vuy I{, dln Ihi{,1d{, dU'Q'cch~ndoan va di€.uIri ThU'O'nglal.

1.1.6 "Cham soc y I{," la djch Vu do Bac si hOacY la cham soc cho NgU'il'i dU'Q'cbao hi{,mlien tuc ngay sau khi NgU'il'i dU'Q'Cbao hi{,m k{,t thuc Nam vien Iheo chi dinh cUaSac siva dU'Q'CCong Iy chap thuan la mot Dich Vu y I{, din Ihi{,1.Cham soc y I{, phai dU'Q'cIhl,J'chien lrang il nhal 06 (sau) giil' moi ngay.

1.1.7 "CO' sO-y I{," la 10chl1c dU'Q'clhanh lap hQ'pphap va hO<l1dong theo pMp lual Viel Nam(n{,u viec ~p giay phep nay Iheo yeu du phap IUal nha nU'ac do) va dap ling dU'Q'ccacyeu dlu sau:

a. dU'Q'cthanh laP nham li{,p nhan, cham soc, kham va di€.uIri y t{, cho ngU'il'i bj omdau, b",nh lal, thU'O'ngtich;

b. co d~y du nang Il,J'cva phU'O'ngtien d{, thl,J'chien cac ca phau thual y khoa;

c. co d~y du di€.ukien cho hO<ltdong di€.utri noi Inj va theo doi benh nhan;

d. khong phai la mot nO'idi€.udU'ang, dU'ang b",nh, nO'icho ngU'il'i gia an dU'ang, nO'icho ngU'il'i nghien ma luy hay mot 10chl1c IU'O'ngII,J'.

1.1.8 "Djch vl,JY t{, cAn thi{,f' co nghia la dich Vuy t{, ma Iheo nhan dinh cua Sac si do Congty chi djnh la:

a. c~n thi{'t, phu hQ'pva hieu qua doi vai tinh tn,mgThU'O'ngtat cua NgU'il'i dU'Q'cbao

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Q~".f.~f~l~~'.~~~~ an sao hi~m be IrQ" Sao hi~m ho IrQ'vi",n phi

!Itt y~ 'i." ...I I \'~!.,,{r", ";i' Q Y TAc, D1eu KHOAN SAN pHAM BAa HII~MB6 TRQ'.\.0\ "fA.,' ."., Z' BAa HIEM HO TR'" VIE:. N PHi ., .~., .J-";j7~J~ v

~~ theo Gong van s6: ..,),4::11S ngay..A!4.{jz.t?a.cua 89 Ta;chinh)

Quy lac, dieu khoan bao hi~m n<3yla nhO'ngnoi dung Ihoa Ihuan be sung giO'aCong ty va Senmua bao hi{,m nham bao hi~m be sung cho npU'il'idU'Q'cdjnh nghia la NgU'il'i dU'Q'cbao hi~mIheo Sao hi{,m be IrQ'nay, khi Ben mua bao hiem yeu dlu Iham gia Ihem san ph~m "Bao hi{,mho Ir9' vi~n phi" va dong Ihem khoan phi bao hi~m be IrQ'.

San ph~m be IrQ'"Bao hi{,m h6 Ir9' vi~n phi" la 10<lisan ph~m khong chia lai va khong co giat~ hoan I<li.

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Quy t~c va Dillu khoan sao hi€lmb6 trQ'- sao hi€lmh6 trQ'vi(ln phi

hi€lm; va

b. co phlJ'O'ngthlfC, quy trinh va thil'1 hl;m dillu t~ th6ng nh~t v&i cac hlJ'&ng diln ykhoa cua cac t6 chlfC y t~, cham soc slfC khoe, nghi€m ClfU hoac t6 chlfc chlnhphu dlJ'Q'cCong ty ch~p thu~m;va

c. pM hQ'pv&i cac ch~n doan, dillu lr!; va

d. dlJ'Q'Cth€l hi(ln biing cac biing chlfng y khoa riing cac dich v~ y t~ do an loan vahi(lu qua (hoac se dem lai hi(lu qua) cho vi(lc dillu trj hoac ch~n doan, hoac d€ldillut~ ThlJ'O'ng~t hoac tinh trang slfC khoe de dQad~n tinh mang cua NglJ'il'i dlJ'Q'cbao hi€lmhOac la mQt nghien ClfU lam sang co ki€lmsoat va sll' d~ng cac phlJ'O'ngthlfC nghien ClfUtheo tleu chuAn qu6c l~.

1.1.9 "Niim vi~n" la vi(lc NglJ'il'i dlJ'Q'cbao hi€lm niim nQi tru qua dem, khong ng~t quang,lrong CO'5& Y t~ theo chi dinh va dlJ'&i5\1'cham soc va theo doi thlJ'il'ng xuyen cua Sacsi. Gi~y xu~t vi(ln la chlfng tlr c~n thi~t d€lyeu c~u b6i thlJ'il'ng cho quylln lQ'inay.

1.1.10 "NgLP6'idLPQ'cbao hi~m" la ca nhan hl(ln dang ClJ'tru tai Vi(lt Nam, tlr 01 (mQt)d~n 60(sau mlJ'O'i)tu6i (theo sinh nhat vlra qua) vao ngay hi(lu l\I'c cua Sao hi€lmb6 trQ'nay, vadlJ'Q'CCong ty ch~p thuan bao hi~m lheo San quy t~c va dillu khoan bao hi€lmbo trQ'nay.

1.1.11 "NgLP6'i th\l hLP60ng"la ca nhan hOac t6 cMc dlJ'Q'cSen mua bao hi€lm chi dinh lrongDO'nyeu ~u bao hi€lmd~ nhan quylln lQ'ibao hi~m theo Sao hi€lmb6 trQ'nay.

1.1.12 "PhAu thu(it" la mQtqua trinh phau thuat d€ldillu tr! ThlJ'O'ngtat do nhfrng yeu c~u ~nthi~t va hQ'pIy vll mat y khoa dlJ'Q'cth\l'c hi(ln b&i Sac si cua CO'5& Y t~ co chuyen monphil hQ'pva dlJ'Q'Cth\l'c hien trong phOngphau thuat cua CO'5& Y l~. Vi m~c dlch cuaSao hi~m b6 trQ'nay, Phau lhuat khong bao g6m cac philu lhuat dlJ'Q'cth\l'c hien trongph6ng ~p ClfU hOac dlJ'Q'clh\l'c hien trong khi NglJ'il'i dlJ'Q'cbao hi€lm khong phai laSenh nhan nQitru.

1.1.13 "Ph6ng cham soc d~c bi~t" hOac "(leu)" la mQt bQphan cua CO'5& Y t~. SQphannay:

a. dlJ'Q'Cthanh lap d€lth\l'c hien chlJ'O'ngtrinh cham soc va dillu tri dac biet; va

b. danh neng cho cac b(lnh nhan trong dillu kien nguy kich va ~n 5\1'theo doi vaki~m tra y t~ lien t~c cua Sac si; va

c. dlJ'Q'ctrang bi cac thi~t bj, thu6c, phlJ'O'ngtien khac c~n cho viec ClfU s6ng benhnhan mQtcach nhanh chong; va

d. khOngphai la ph6ng hau philu, ph6n9 h6i slfC, ph6ng cham soc dac biet thuQCcackhoa kham chfra benh hOacph6ng cap cUou.

1.1.14 "Tai n~n" co nghia la mQt5\1'kien hOacmQIchu6i 5\1'kien khong bj gian doan gay ra b&itac dQng cua mQt I\I'ChOacmQt vat b~t ngil' tlr ben ngoai, khong chu dinh va ngoai ymu6n cua NglJ'il'i dlJ'Q'cbao hl€lm len cO'th€l NglJ'il'i dlJ'Q'cbao hi~m, xay ra trong lhil'igian Sao hi€lm b6 trQ' nay cOn hieu l\I'c. S\I' kien hOac chU6i 5\1'kien neu lren phai languyen nhan duy nh~t, tr\l'c ti~p, va khong lien quan d~n b~t ky nguyen nhan nao khacgay ra ThlJ'O'ngtat val hOactll' vong cho NglJ'il'idlJ'Q'cbao hl~m.

1.1.15 "ThLPO'ngt(it" la 15mdau, benh tal hOac thlJ'O'ngtich xay ra trong khi NglJ'il'1dlJ'Q'cbaohi€lmdlJ'Q'cbao hi~m theo Sao hi~m be.trQ'nay, bao g6m cac bi~n chlfng, om dau, benhtat hOacthlJ'O'ngtich k~t hQ'p.

1.1.16 "Y ta" la nhan vien y t~ dlJ'Q'c~p phep hanh nghll hQ'pphap theo phap luat Vi(lt Nam.

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1

Quy tilc va £li€lu khoan sao hi~m b6 trQ' - sao hi~m ha trQ' vi(m phi

f)i~u 2 Thai h,m clla Sao hi~m b6 trl?'

2.1 Thai h(ln clla Sao hi~m be. trQ' dU'Q'Ctinh tlf ngay hi~u h,J'cclla Sao hi~m be. trQ' d~n ngayk~t thuc thai h(ln clla Sao hi~m be. trQ' va dU'Q'Cghi tren Gii\y ch(Png nhan bao hi~m, trlftfU'ang hQ'p chi\m d(Pt trU'ac h(ln theo San quy tilc va di€lu khoan bao hi~m be. trQ' nay.

2.2 Gia h(ln: Sao hi~m be. trQ' nay dU'Q'ctU' de;,nggia h(ln va Phi bao hi~m co th~ thay de.i t(limai thai d;~m gia h(ln Sao hiem be. trQ' nay, trlf tfU'ang hl)'p quy dinh t(li di€lu 2.5.

2.3 N~u vi~c gia h(ln dU'l)'c chi\p thuan, thai h(ln clla moi Iiln gia h(ln la 01 (me;,t)nam.

2.4 Trong moi trU'ang hl)'p, thai h(ln hl)'p d6ng clla Sao hi~m be. trQ' khong dU'l)'c VU'Q'!quathai h(ln clla HQ'p d6ng bao hi~m chinh.

2.5 Vao bi\t ky Ngay kyoni~m hQ'p d6ng nao, Sen mua bao hi~m c6 quy€ln khong gia h(lnSao hi~m be. trl)' va Gong ty co quy€ln tlf ch6i gia h(ln Sao hi~m be. trQ' nay biing cachthong bao biing van ban cho Sen mua bao hi~m trU'ac 30 (ba mU'O'i) ngay.

Dillu 3 56 tilln bao hi~m, Phi bao hi~m va dinh ky dong phi bao hi~m.

3.1 s6 ti€ln bao hi~m clla Sao hi~m be. trl)' nay dU'Q'c ghi tren Gii\y ch(Png nhan bao hi~mhOac cac phu luc (n~u co).

3.2 Phi bao hi~m clla Sao hi~m b6 trl)' nay dU'Q'cghi tren Gii\y chU'ng nhan bao hi~m hOaccac phu luc (n~u c6). Phi bao hi~m phai dU'Q'c dong khi d~n h(ln, ngay ca khi NgU'aidU'Q'cbao hi~m dang Niim vi~n.

3.3 Eljnh ky va h~ s6 dong phi clla HQ'p d6ng bao hi~m da ky k~t va dU'Q'cap dung cho dinhky va h~ s6 dong phi bao hi~m clla Sao hi~m be. trl)' nay. Khi co SU'thay de.i v€l dinh kyhOac h~ s6 dong phi bao hi~m clla HQ'pd6ng bao hi~m chinh da ky k~l, dinh ky va h~ s6dong phi clla hQ'p d6ng bao hi~m be. sung nay se dU'l)'c thay d6; tU'O'ng (Png.

3.4 Tuy theo chi\p thuan clla Se;,Tai chinh, tyoI~ phi bao hi~m co th~ thay de.i trong thai h(lnhi~u lU'c clla Sao hi~m b6 trQ' nay va Gong ty se thong bao cho biing van ban Sen muabao hi~m trU'ac 30 (ba mU'O'i)ngay.

Dillu 4 Hii,iu Il,l'c cua Sao hi~m b6 trl?'

4.1 Ngay hi~u lU'c clla Sao hi~m be. trQ' nay la ngay Gong ty chi\p thuan bao hi~m cho NgU'aidU'Q'cbao h;~m sau khi Sen mua bao hi~m da di€ln vao ElO'n yeu cilu bao hi~m va dongdll Phi bao hi~m ban dilu clla Sao hi~m b6 trQ' nay vai di€lu ki~n NgU'ai dU'l)'c bao hi~mphai con s6ng. Ngay hi~u lU'c clla Sao hi~m be. trQ' nay dU'Q'cghi tren Gii\y ch(Png nhanbao hi~m hOac cac phu luc (n~u co).

4.2 Sao hi~m be. trQ' nay se chi\m dlrt hi~u IU'c khi me;,ttrong cac tfU'ang hQ'p sau xay ra:

1.2 GaC di€lu khoan va di€lu ki~n clla HQ'p d6ng bao hi~m se dU'Q'cap dung cho Sao hi~m be.trQ' nay:

a. N~u co nhung mau thwln giua San quy tilc va di€lu khoan bao hi~m be. trQ' nayvai San quy tilc va di€lu khoan Clla HQ'p d6ng bao hi~m chinh, nhung quy dinh cllaSan quy tilc va di€lu khoan bao hi~m be. trQ' nay se dU'Q'cap dung.

b. N~u San quy tilc va di€lu khoan bao hi~m be. trQ' nay khonq co quy dinh v€l me;,tvi\nd€l ma vi\n d€l do da dU'Q'cquy dinh t(li San quy tilc va dieu khoan clia HQ'p d6ngbao hi~m chinh, San quy tilc va di€lu khoan bao hi~m be. trQ' nay se dU'Q'chi~u lada bao g6m cac quy djnh v€l vtm d€l do.

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3R

Quy I!lc va Di€oukhoan sao hilom b6 IrQ' - Sao hilom ho IrQ' vi~n phi

a. Sao hilom b6 IrQ' ch~m dlil hi~u I\pc Iheo quy djnh I(li San quy I!lc va di€oukhoannay;ho~c

b. Sao hilom b6 IrQ' h~1 h(ln; ho~c

c. HQ'p d6ng bao hilom chinh ch~m dlil hi~u I\pc ho~c chuylon sang linh Ir(lng duy Irlhi~u I\pc v&i s6 ti€onbao hilom giam; ho~c

d. Cong ty nh(\n dU'Q'cYElUdiu ch~m dlit Sao hilom b6 IrQ' mlY b!lng van ban cua Senmua bao hillm; ho~c

e. Cong Iy Ilr ch6i gia h(ln Sao hiEflmb6 IrQ' nay theo quy djnh t(li di€ou2.5; ho~c

f. Cac IrU'ang hQ'p khac Iheo quy dinh phap lu(\!.

f)j~u 5 Quy~n lQ'i bao hilom

N~u NgU'ai dU'Q'cbao hillm N!lm viiin Irong khi Sao hiEflmb6 trQ' nay co hieu I\pc, Cong Iyse Ihanh loan cac quy~n lQ'i bao hillm sau, nhU'ng khong VU'Q'Iqua gi&i h,m 16i da 100(m(lt tram) I~n s6 ti€onbao hillm cua Sao hillm b6 IrQ' nay mili nam.

5.1 Quy€on lQ'i hil IrQ' n!lm vi~n

N~u NgU'ai dU'Q'cbao hiEflmphai N!lm viiin nhU' la Siinh nhan n(li tru tai CO' sa y I~, CongIy se chi tra s6 ti€onbao hiEflmcua Sao hiEflmb6 IrQ' nay cho moi ngay niim viiin.

5.2 Quy€on lQ'ihil IrQ' cham soc d~c bi('!1

Trong khi Sao hiEflmb6 trQ'mlY cO hiiiu I\pc, ngoai quy€on lQ'i hil IrQ' n!lm viiin quy djnh laidi{,u 5.1, nllu NgU'ai dU'Q'cbao hiEflmphai n!lm t(li Phong cham soc d~c biiil khi dang laSiinh nhan n(li Iru, Cong Iy se chi Ira lhem s6 li€on bao hiEflmcua Sao hillm b6 IrQ' naycho mili ngay n!lm lai Phong cham soc d~c biiit.

Quy€on lQ'i hil IrQ' cham soc d~c biiit se khong dU'Q'cchi tra cho IrU'ang h9'P NgU'ai dU'c;>'cbao hiEflmn!lm lai Phong cham soc d~c biiil dU'ai 24 (hai mU'O'ib6n) gia ho~c cho nhCmgIwang h9'P di{,u Irj lien quan ngay sau khi ph,liu Ihu(\!.

T6ng quy€on lQ'i hil Ir9' cham soc d~c biel chi Ira cho t~1 ca Ihai gian di€ouIrj lai Phongcham soc d~c biiil Irong khi Sao hiEflmb6 IrQ' nay co hiiiu I\pc khong VU'()'! qua 30 (bamU'O'i)ngay mili nam.

5.3 Quy€on 19'ihil IrQ' Ph,liu Ihu(\1

Trong khi Sao hiEflm b6 IrQ' nay co hiiiu I\pc, n~u NgU'ai dU'9'c bao hiEflmphai Irai quaPh,liu Ihu(\l, Cong ty se thanh loan 500% s6 li€onbao hiEflmcua Sao hillm bo IrQ' nay chom(ll I~n Ph,liu Ihu(\!. Trong moi trU'ang hQ'p, Cong ty se chi thanh loan m(ll I~n quyen lQ'iho trQ' ph,liu thu(\t theo di€ounay cho cung m(ll ThU'O'ng I(\t cho du viiic di€ouIrj ThU'O'ngt(\t do yeu c~u nhi€ouhan m(lt I~n Ph,liu Ihu(\!.

5.4 Quy{,n lQ'iho trQ' Cham soc y t~

N~u NgU'ai dU'9'c bao hiEflmphai dU'Q'c Cham soc y t~, Cong ty se thanh loan 50% s6ti€onbao hi€.m cua Sao hiEflmb6 trQ' nay cho moi ngay Cham soc y I~.

T6ng quy€on IQ'; chi Ira cho Cham soc y tEfltrong khi Sao hiEflmb6 trQ' nay cO hiiiu I\pckhong VU'()'!qua 30 (ba mU'O'i)ngay mili nam.

Di~u 6 Thu t~c giai quy~t quy~n lQ'i bao hi~m

6.1 NgU'ai co quy€onnh(\n quy€on lQ'i bao hillm la:

a. NgU'ai thv hU'ang dU'Q'cchi djnh lrong Dan yeu du bao hiEflm;ho~c

417

Quy I~c va Di€lu khoim BaDhi~m b6 IrQ'- BaDhi~m ho IrQ'vi$n phi

b. Ben mua baD hi~m n~u khong cOchi djnh Nglfai IhV hlfO'ng trong DD'nyeu diubaD hi~m ho~c Ifll ca nhling Nglfai thv hlfO'ng dlfQ'Cchi djnh 112vong Irlfac khiNglfai dlfQ'CbaDhi~m Niim vi$n t;;liCD'sO'Y I~; ho~c

c. Trong Irlfang hQ'pco nhi€luhD'nmol Nglfai thv hlfO'ng, n~u co bfll ky Nglfai IhVhlfO'ng nao 112vong Irtrac khi Nglfai dlfQ'CbaD hi~m Niim vi$n l;;Ii CD'sO'Y I~,phiin quy€ln lQ'icua nglfai do se dlfQ'CIra cho Ben mua bao hi~m; ho~c

d. Nglfai Ihll'a k~ hQ'pphap cua Ben mua baD hi~m n~u Ben mua baD hi~m da 112vong.

6.2 Thu tvc yeu ciiu giai quy~1quy€ln lQ'ibaDhi~m:

Nglfai nh~n quy€ln lQ'ibaD hi~m phai gl2i cho Cong Iy Irong thai gian sam nhfll cO lh~,nhling gifly la sau day:

a. DD'nyeu diu Ihanh loan quy€ln lQ'ida dlfQ'Cke khai diiy du, chinh xac;

b. Siing chlrng v€lquy€ln nhiin quy€ln lQ'ibaD hi~m (gifly uy quy€ln, di chuc, ban sao ygifly chlrng minh nhan di'm, ho~c nhling gifly la xac nhiin hQ'pphap khac);

c. Siing chlrng y I~ V€l5\1'ki$n SlrCkhoe dlfQ'Cyeu diu giai quy~1quy€ln lQ'ibao hi~m,bao g6m:

i. Gifly ra vi$n;

Ii. Gifly ch(mg nhiin phau lhuiil (lrong Irlfang hQ'pphau lhuiil);

iii. Siing chlrng y khoa lien quan d~n vi$c di€lu Irj l<:IiPhong cham soc d~c bi$1(Irong Irlfang hQ'pniim & Ph6ng cham soc d~c bi$I);

Iv. Chlrng Ill' y l~ lien quan d~n Cham soc y I~ dlfQ'CBac si chi djnh, 56 ki~m IraSlrCkhoe, loa Ihu6c (co diiy du chfln doan, chli ky, he;>len diiy du va con dflucua CD' sO'y I~ nD'i Ih\l'c hi$n vi$c Ilf vfln, khilm hoac di€lu Iri), k~1qua xelnghi$m, hoa dD'ncua CD'sO'y I~ c:!lpva cac hoa dD'ncho Cham soc y I~.

d. Ban g6c cac hoa dD'n hQ'p1$lien quan d~n vi$c Niim vi$n cua Nglfai dlfQ'CbaDhi~m.

Cong ty bao IlfU quy€lnyeu diu Ben mua baDhi~m ho~c nglfai nhiin quy€ln lQ'ibao hi~mdlfQ'Cquy dinh l;;Ii di€lu 6.1 Ih\l'c hi$n cong chlrng, chlrng th\l'C, hQ'pphilp hoa lanh 5\1'cac gi:!ly ta, biing chlrng (biing Ti~ng Anh hoac Ti~ng Vi$l) neu Iren. Chi phi do vi$ccung cflp cac gifly la nay se do Ben mua baDhi~m ho~c nglfai nhiin quy€ln lQ'ibaDhi~mchju Irach nhi$m lhanh loan.

6.3 Thai h;;lnyeu ciiu giai quy~1quy€lnlQ'ibao hi~m:

Thai h;;lnyeu ciiu giai quy~1quy€ln lQ'ibaDhi~m la 01 (mot) nam k~ Ill' ngay Nglfai dlfQ'CbaDhi~m k~t thuc Niim vi$n ho~c Cham soc y l~.

Di~u 7 Dj~u khoan gi60ih"n

7.1 Cong ty se chi thanh loan quy€ln lQ'ibaDhi~m Iheo Ban quy I~c va di€lu khoan baD hi~mb6 IrQ' n~u Nglfai dlfQ'CbaD hi~m Niim vi$n d~ di€lu Irj ThlfD'ng liil khong phai do Tain;;ln sau 30 (ba mlfD'i) ngay k~ Ill' ngay hi$u l\I'c cua BaD hi~m b6 IrQ'ho.;;c Ngay khoiphvc hi$u l\I'c hQ'pd6ng, luy vao ngay nao d~n sau.

7.2 Cong Iy se chi Ihanh loan quy€ln lQ'ibaa hi~m thea San quy l~c va di€lu khoan baa hi~mb6 IrQ'n~u Nglfai dlfQ'Cbao hi~m Niim vi$n sau 90 (chin mlfD'i) ngay k~ Ill' ngay hi$ul\I'c cua Baa hi~m b6 IrQ'ho~c Ngay khoi phvc hi$u l\I'c hQ'pd6ng, luy vao ngay nao d~n

5/7

Quy lilc va £Jieu kholm Bao hi~m bo IrQ' - Bao hi~m ho IrQ' vi(in phi

sau, d~ dieu Iri cac b(inh sau: Ihoat vi cac Im;)i, b(inh Iy c(il song bao gom ca dia d(im,khoi u lanh tinh, u nang u XO'cac 10(li, ro hau mon, b(inh lao, viem lUi mal, I:;ICn(ii m(lC Ill'cung, soi li~1 ni(iu, Iri, dl,lc Ihuy linh Ih~, viem amygdale, viem hQng, viem loel d(l day, lalrang, cac btll IhlJ'ang khoang mOi, vach ngan, xoiln mOi bao gom ca cac b(inh Iy xoang,u XO'Ill' cung, clJ'ang giap, Ihoal vi dia d(im, ma ci\1 Ill' cung cO hay khong co ph~n phl,l,b(inh h(i sinh dl,lc, cao huyt:1 ap, li~u dlJ'ang.

£lieu 8 Tinh tr(lng y te co tnl'O'c

Gong ty khOng Ihanh loan quyen 100ibao hi~m Iheo Bao hi~m bo IrO' nay nt:u NglJ'aidlJ'O'cbao hi~m Nilm vi(in d~ dieu Iri om dau, b(inh hay IhlJ'O'ng tich do Tinh Ir:;lng y tt: cotflJ'ac.

"Tinh Ir(lng y tt: co trlJ'ac" nghia 113om dau, b(inh hOac cac Iri(iu chlrng b(inh hay IhlJ'O'ngtich:

a. ma NglJ'ai dlJ'O'c bao hi~m da dlJ'O'c dieu Irj y It: hOac lit:n Mnh cac xel nghi(imhOac ki~m Ira SlrC khoe hOac Ill' vtln hOOpIy cua Bac si IrlJ'ac ngay hi(iu Il,I'c cuaBao hi~m bo IrO' nay, Irll' IrlJ'ang hoopda Ihong bao va dlJ'O'cGong ty chtlp Ihuan;

b. co Iri(iu chlrng dac hi(iu (dlJ'O'chi~u 113cac dtlu hi(iu chi di~m cho vi(ic chui\n doanb(inh va da dlJ'O'CIi(il ke lrong ph~n cau hoi ve Ihi\m dinh va SlrC khoe cua £JO'nyeuc~u bao hi~m) da xutll hi(in IrlJ'ac ngay hiiiu Il,I'c cua Bao hi~m bo trQ' nay, trirIrlJ'ang hoopdii Ihong bao va dlJ'O'cGong ty chtlp thuan.

£lieu 9 £lieu khoan 10(li trll'

Gong Iy se khong thanh toan btll kY quyen 100ibao hi~m nao nt:u Ngu'ai dlJ'O'cbao hi~mNiim vi(in vi/hoac do nhiYng nguyen nhan Ifl,I'c tit:p hOac gian tit:p lien quan dt:n:

a, Slr dl,lng dich vl,l ¥ It: khong phai 113m(il Djch Vl,l y It: c~n Ihit:1 Iheo djnh nghia l(liBan quy lilc va dieu khoan cua bao hi~m bo IrO' nay;

b, NglJ'ai dlJ'O'cbao hi~m Il,I' tlr, mlJ'U loan I\F Ill', hOac Il,I' gay ra thlJ'O'ng tich hOac co ydinh gay ra IhlJ'O'ng tich cho ban Ihan minh trong linh Ir(lng linh lao hOac mtll Irl;

c, NglJ'ai dlJ'<;J'cbao hi~m hanh d(ing dlJ'ai lac d(ing cua thtYc uong co con, Ihuoc kichIhich, ma tuy dt:n mlrc mtll kha nang kl~m soat y thtYc.

Thual ngiY "dlJ'ai lac d(ing cua IhtYc uong co con" 113Irong IrlJ'ang hOOpxet nghiiimmau hOac cac hinh IhtYc xel nghiiim khac co nong d(i cOn VlJ'Q'tmtYc cho phep theoquy dinh phap IUal.

d, btll ky biinh hOac roi 10:;lnlam Ih~n, nghiiin rlJ'O'u,nghiiin ma luy;

e, nghi dlJ'frng, dieu dlJ'frng, Iinh dlJ'frng hOac dleu Iri l(li cac cO' sa dieu Iri phong,biinh viiin/viiin y hQc dan l(ic hOac Irung lam y It: cac ci\p cho du cac cO' sa nayd(ic laP hOac Ir\Fc Ihu(ic m(il GO'sa y It:;

f. kham stYc khoe dinh ky;

g, biinh hOac linh Ir(lng stYCkhoe btll thlJ'ang do bi\m sinh, dl lruyen;

h, kham, dieu Iri ngll'a Ihai, tri(it san k~ ca khoi phl,lc hOac thay doi cac tinh Ir(lngIrlJ'ac do;

i. kham, dleu Irj vo sinh bao gom, nhlJ'ng khong giai h:;ln dt:n, xel nghiiim, dieu Iri,thu(ic vathoac cac Ihu Ihual nhlJ' Ihl,l linh Irong ong nghiiim (IVF) va btll kY bit:nchung nao lien quan dt:n mang thai, sinh san va cham soc sau khi sinh 113hau quacua viiic dieu tri vo sinh nay;

6/7

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1}~.'J

Quy tac va Eli{,ukhoan BaDhi~m bo tr9' • BaDhi~m h6 tr9' vilin phi

j. kham thai, sinh con, say thai, phil thai, cham soc trlJ'6'ckhi sinh. cham soc sau khisinh, bi~n chlrng thai san;

k. blinh lay truy{,n do tinh duc baD gem ca cac di cMng; blinh liem quan d~nAIDS/HIV (h(ii chlrng suy giam mien dich mac phai) va cac phlrc h9'P lien quand~n AIDS;

I. hi~n/cho mo hay b(i ph(in cO'th~;

m. nh(ip vilin chi nham muc dich chan doan hinh anh, v(it Iy trj liliu;n. phau thu(it tham my hoac di{,u tri tham my;

o. phau thu(it chuy~n doi gi6'i tinh;

p. phau thu(it tao hinh do Tinh trang y t~ co tru'6'c;

q. chung ngiFa vac xin, mien dich dU'phong;

r. di{,u tri y t~ thiJ' nghilim khang dlJ'9'cxem la an toan, hiliu qua va phu h9'P v6'i omdau, blinh t(it hoac thlJ'O'ngtich va chlJ'adlJ'9'cy van Vilit Nam ho(ic quoc t~ chapthu(in la phlJ'O'ngthlrc di{,u tri tieu chuan doi v6'i om dau, blinh t(it hoac thlJ'O'ngtichdo tai thai di~m thiJ'nghilim;

s. kham, di{,u tri t(it khuc Xa, gan kinh ap trong; mua hoac siJ'dung cac thi~t bi chinhhinh. h6 tr9' chlrc nang, lap ghep nhan tao nhlJ' chan, tay gia, may tr9' thinh hoaccac thi~t bi c6 tinh chat tlJ'O'ngtU';

t. chi~n tranh hoac cac hanh d(ing gay chi~n, baD gem hanh d(ing xam 11J'9'c,cachanh d(ing thOdjch (cho du co tuyen chi~n hay khang), n(ii chi~n. khai nghia, cachmang, noi /o"n, dao chinh quan SU'hoac ti~m quy{,n;

u. vG khi hat nhan, tia phong Xa hoac chat phong Xa tiF bat ky nguen nhien liliu hatnhan hoac chat thai h"t nhan philt sinh tll' quy trinh dot trong nang 11J'9'nghat nhanhoac quy trinh tU'duy tri SU'phan hach/tong h9'Phat nhan;

v. NglJ'ai dlJ'9'CbaD hi~m tham gia cac hoat d(ing th~ thao chuyen nghilip, hoat d(ingdong th~ mao hi~m ma qua do NglJ'ai dlJ'9'cbao hi~m se hoac co th~ ki~m dlJ'9'cthu nh(ip hoac thu lao, hoac cac ho"t d(ing th~ thao nguy hi~m nhlJ'; dua ngU'avatrlJ'9't tuy~t, dua xe a ta, hoac thU'c hi\in Ian bi~n, trlJ'9'l bang, nhay bungee, cacchuy~n bay tn~n khang (baD gem nhlJ'ng khang gi6'i han nhlJ' du IlJ'9'n, khinh khicilu va nhay du khilc v6'i tlJ' cach khang phai la thuy thu doan hoac hanh khachtren m(it chuy~n bay cha khilch thlJ'ang xuyen theo lich trinh tren mot may baythlJ'O'ngm<li), leo nui, leo nui da, mua v6 nghli thu(it, dam boc, th~ duc nhao lon,th~ duc nhao l(in tren khang, hoac cac hO<ltd(ing thiim do trong hang dong, baccU'c, nui liJ'a, sang bang, rll'ng, thung lOng, sa m<lC,d<li dlJ'O'ng,khang gian hoackhu V\J'ckhang co nglJ'ai;

w. Hanh vi ph<lmtoi cua Ben mua bao hi~m, NglJ'ai dlJ'9'cbao hi~m, hoac NglJ'ai thuhlJ'ang;

x. tham gia au da, danh nhau, bi bat giG'hoac chong CU'vilic bat giG',hilnh vi khieukhlch cua NglJ'ai dlJ'9'cbao hi~m.

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