HOSPITALIZATION & SURGERY INSURANCE BENEFITS
Cost of Hospital Room
The cost of room includes the isolation room, meals and room services per day paid as from the first day of treatment and registered as an in-patient, in accordance with what has been paid by the Participant, but does not exceed the Cost of Room per day stated in the Table on Hospitalization and Surgery Benefits.
Intensive Care Unit (HCU/ICU/ICCU) Cost
The Intensive Care Unit Cost per day is paid in accordance with what has been paid by the participant, that will not exceed the Intensive Care Unit Cost per day as stated in the Table on Hospitalization and Surgery Benefits.
Cost of Doctor's Visit in Hospital
The Cost of Doctor's Visit during hospitalization is paid in accordance with the amount paid by the Participant, that does not exceed the total day multiplied by the maximum limit of Doctor's Visit Cost in Hospital as stated in the Table on Hospitalization and Surgery Benefits.
Cost of Specialist Consultation in Hospital
Total Cost of Specialist Consultation during hospitalization is paid in accordance with what has been paid by the Participant, but does not exceed the total number of days multiplied by maximum limit of Cost of Specialist Consultation in Hospital as stated in the Table on Hospitalization and Surgery Benefits. Consultation of Specialist must be at the request of the Medical Doctor in charge.
Miscellaneous Hospitalization Costs
The reimbursement of Miscellaneous Hospitalization Cost consists of Medicines, transfusion, supporting examination (not including the Cost of the treating Medical Doctor or interpret the results of the examination), medical equipment. Treatment and supporting equipment for medical rehabilitation except the purchase of wheelchair, substitute equipment / prosthesis and crutches, Health care/service in the Emergency Unit/Clinic/Medical Doctor, performed on the first day of hospitalization and Administration.
Cost of Surgery
Included in the Cost of Surgery are Cost of Surgeons Team, Cost of Anaesthetists Team, Cost of operation/surgery room (including the cost of recovery room, equipment and Medicines in the operation/surgery room) and consultation cost pre (15 days) and post (15 days) of confinement date.
If the surgery is performed through two or more incisions on the skin, the Cost of Surgery is paid based on a maximum of 100% (one hundred percent) of the highest surgery category among the other surgeries.
If the surgery performed is not mentioned in the Table on Hospitalization Surgery, the Insurer has the right to determine the category of surgery, which is the final decision.
Cost of Outpatient Emergency Care
Cost of emergency care and treatment on an Injury resulting from an Accident performed within a period of 2x 24 (twenty-four) hours as from the occurrence of the Accident.
Cost of Dental Emergency Care
Cost of emergency care and treatment including treatment for damaged original tooth due to Accident, except the installation of crown and bridge performed within a period of 7 (seven) days as from the occurrence of the Accident.
Cost of Pre and Post-Hospitalization
Cost of Outpatient related to One Disability at the time of hospitalization, within a period of 30 (thirty) days before and 30 (thirty) days after hospitalization, is paid in accordance with the amount paid by the Participant, but does not exceed the amount as stated in the Table on Hospitalization and Surgery Benefits.
Cost of Renal Dialysis and Chemotherapy
Cost of renal dialysis and/or chemotherapy, as recommended by doctor. The cost does not exceed the maximum limit of Cost of Renal Dialysis and Chemotherapy as stated in the Table on Hospitalization and Surgery Benefits.
Total Permanent Disability
If Participant have total permanent disability, benefit is paid to policyholder or beneficiary, in accordance to Table on Hospitalization and Surgery Benefits.
Term Life
If Participant died, benefit is paid to policyholder or beneficiary, in accordance to Table on Hospitalization and Surgery Benefits.
