Coverage and Benefits

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Death Benefit of AIA Term 85 (Non Par)

While the policy is in force and has not been converted to ETI according to the right of policy value as indicated in the policy, The Company shall pay death benefit up to the highest amount among the following:
 

  1. Sum assured as indicated in policy or endorsement (if any)
  2. Cash surrender value
  3. Total paid premium amount that the Company has received

In addition, in the case that the sum assured amount is reduced while the policy is in force, the total premium will be decreased proportionately to the reduced sum assured.

Important Conditions of AIA Term 85 (Non Par) Insurance Plan

The Company will not cover the following cases:
 

  1. In case the Insured voids the contract, does not reveal the truth or declares a false statement. However, the Company will not dispute or object to the invalidity of the contract if the Insured is alive for 2 years or more from the contract’s effective date or the latest reinstatement date or the date on which the Company approves the additional sum assured only for an increased portion.
  2. The Insured committing suicide within one year from the policy effective date or the latest reinstatement date or the date on which the Company approves the additional sum assured only for an increased portion, or is murdered by the beneficiary.
  3. The Insured has inaccurately declared their age, and the Company has found out that the actual age is out of the age range on premium rates that the Company is currently using.

Important Conditions of AIA Health Happy Rider

Waiting Period of AIA Health Happy Rider
 

  1. Any illnesses occurring within 30 days following the date on which this rider is issued or reinstated, whichever is later or
  2. Any of the following illnesses occurring within 120 days following the date on which this rider is issued or reinstated, whichever is later:

 
Pre-existing Conditions of AIA Health Happy Rider

The Company shall not pay any benefit under this rider for chronic disease, injury or illness (including any complication arising therefrom) that is not cured before the contract effective date except:
 

  1. If the Insured has informed the Company and the Company agreed to underwrite the risk without any exclusion, or
  2. Chronic disease, injury or illness (including complication) has not shown any symptom and has never been examined or diagnosed by physician or the Insured has never visited or consulted with the physician within 5 years before this rider became effective for the first time and within 3 years after this rider became effective for the first time.

Limitation of Coverage Place Liability under the Coverage

This rider provides coverage for medical treatment incurred in Thailand.

In case of the medical treatments that are taken place outside of Thailand’s territory, the Company will provide coverage specifically according to the benefits table as follows:
 

  1. Physical injuries from accidents
  2. Emergency illnesses in overseas in accordance with the definitions specified in this rider

    The first hospitalized date in overseas must fall within the first 90 days of travelling outside of Thailand’s territory for each trip. The Company will provide coverage for the necessary and appropriate expenses incurred from the medical treatments in accordance with the medical necessity and standards in each other countries.
     

Emergency illnesses in overseas refers to:
 

  1. Injury or sudden illness that is life-threatening, for which, if not received timely medical action to correct the respiratory system circulatory system or nervous system, patients have a high chance of dying. or exacerbate the injury or illness of an emergency patient or cause a sudden complication, such as "cardiac arrest", apnea, "shock" from severe blood loss, convulsions continually or convulsions until cyanosis, lethargy, unconsciousness, unconsciousness, severe chest pain from a blocked coronary artery that requires thrombolytic medication, immediate cerebrovascular symptoms that requires fibrinolytic drugs, heavy and persistent bleeding, etc.
  2. Injury or illness which is very acute or severe pain that may require urgent medical action. Otherwise, the injury or illness of the emergency patient will be severe or cause complications which can result in death or later disabilities, such as body temperature below 35 degrees Celsius or above 40 degrees Celsius, pulse slower than 40 or faster than 150 beats/minute, systolic blood pressure below 90 mmHg or diastolic greater than 130 mmHg, difficulty breathing or shortness of breath, especially if combined with other clinical features such as unconsciousness, convulsions, paralysis, blindness, sudden deafness, severe blood loss very pale or green, extreme pain or excruciating pain, hands and feet are cold and sweaty, etc., including accidents, especially very large and many wounds, such as major multiple fractures, burns, back injury with or without spinal cord damage, etc.

Some Exclusions of AIA Health Happy Rider

  1. The Insured is under surgical or other treatment for the purposes of cosmetic, skincare, acne, melasma, freckle, dandruff, hair loss or weight loss, or an optional surgery; however, the cosmetic surgery to address wounds suffered from an accident under the policy contract will be covered.
  2. Pregnancy, miscarriage, abortion, delivering a child, complications of pregnancy, infertility issues (including investigation and treatment), sterilization or birth control except choriocarcinoma.
  3. Standard health examination, inpatient hospitalization request or surgery request, recovery after hospitalization whether for rehabilitation or resting or staying in hospital to get medical assistance, examination or treatment which is non-related to an illness which is a cause of hospitalization, injury or illness diagnosis, treatment or examination to investigate cause of disease which is not a medical necessity or does not meet medical standards.
  4. Any treatments that are not modern western medicine including alternative medicine.
  5. Suicide, attempted suicide, self-harm or attempted self-harm either inflicted by the Insured or by other people with consent of the Insured whether sane or insane, including injuries caused by accidents after consuming or injecting toxic drugs or substances into the body, or overdoses of prescription drugs.

Requirements

Premium Rates

Standard annual insurance premium for the age of 11 to 75 years old (depending on gender, age, payment mode and insurance plan)

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Gender Annual Premium (baht)
Plan 1 Plan 2 Plan 3 Plan 4
Female 15,556 - 103,262 19,356 - 122,562 22,756 - 170,762 29,056 - 217,062
Male 15,458 - 105,080 18,458 - 123,680 22,058 - 171,780 28,158 - 217,480

 

 
A rider is an insurance policy that has a renewable one-year rider term. To renew this Rider, the Company reserves the right to change the Insuring Agreement such as adding a Copayment condition according to the rate and criteria as follows.
 

  1. 30% copayment rate of the covered expenses shall apply in the case the Insured has submitted claims caused by Simple Diseases from Inpatient benefits at least 3 times or more in a hospital within a policy year, and the claim ratio of insured for such claims under this rider equals or greater than 200%; or
  2. 30% copayment rate of the covered expenses shall apply in the case the Iinsured has submitted claims from Inpatient benefits at least three 3 times or more in a hospital within a policy year and the claim ratio for such claims of the Insured under this rider equals or is greater than 400%. This provision shall not include treatment expenses for critical illnesses as specifically listed in the document attached hereto (link) and/or major surgery.
     

As mentioned, if the Company applies copayment conditions under this rider according to 1. and 2., the Company will set 50% copayment rate of the covered expenses. Apart from that, the Company reserves the right to change the premium during a policy year due to various factors including age, occupation and the Company’s claim experiences. For medical riders, other factors can cause an increase in premiums such as the medical inflation rate or historical claim payments of the portfolio. Such adjustment of the premium rate is subject to approval from the Registrar.

How to apply

Seek consultation and advice for life insurance planning by contacting Bangkok Bank branches that offer this service, or call 1333

AIA Company Limited Tel. (66) 0 2353 8855, Website www.aia.co.th