Insurance Policy for Traveling Aboard: SOMPO TravelEN].pdf · Insurance Policy for Traveling Aboard: SOMPO Travel By relying on the statement in the request for insurance, which is

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Insurance Policy for Traveling Aboard: SOMPO Travel

By relying on the statement in the request for insurance, which is a part of this insurance policy and to repay the

insurance premium that the insured shall pay under the requirements of general conditions and provisions, coverage conditions,

exclusions, and addendums of this insurance policy, the Company makes promises to the covered recipient as follows:

Section 1 Definition

The statements and the explanations with specific definition that are given in any parts of this insurance policy

shall be considered as having the identical definition, whether they appear in any parts, unless specified otherwise in this

insurance policy.

1.1 Insurance Policy means Policy Schedule, general conditions and provisions, coverage

agreements, general exclusions, addendums of insurance policy,

request form for insurance, endorsement of insurance policy and

summary documents for conditions, coverage agreements, and

exclusions of this insurance policy that shall be considered as a part

of this insurance contract.

1.2 Company means The Company that issues this insurance policy.

1.3 Insured means An individual with the name as Insured in the Policy Schedule,

which is the individual who receives the coverage according to this

insurance policy.

1.4 Accident means The incident that occurs suddenly from the external factors and

affects the Insured without intention or anticipation.

1.5 Injury means The physical injury, which is the direct result from the accident that

occurs individually and independently from other causes.

1.6 Illness means Symptoms, abnormalities, illnesses, or diseases that occur with the

Insured immediately, suddenly, or unexpectedly by which it shall

occur after this insurance policy is effective. Hence, it shall be

clearly shown that it occurs by oneself and independent from other

causes.

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1.7 Deductible means The amount that the Insured shall be responsible for according to the

coverage agreements and/or the addendums of insurance contract (if

any).

1.8 Doctor means A person who graduates from Doctor of Medicine with registration

from the Medical Council of Thailand and the authorization to

perform the medical professional in the locality that provides the

medical or surgical service.

1.9 Nurse means A person who receives the nursing professional license.

1.10 Inpatient means A person who is admitted in the hospital or the medical health

facility for no less than 6 hours in which the person is needed to be

registered as inpatient by receiving the diagnosis and the suggestion

from the doctor according to the indicators that is the medical

standard in the appropriate period for the treatment, injury, or

illness. It shall include the acceptance as inpatient and then pass

away before completing 6 hours.

1.11 Outpatient means A person who receives the service of the medical treatment in

outpatient department or in emergency room of the hospital or the

medical health facility or the clinic in which there is no necessity

according to the diagnosis and the indicator that is the medical

standard in receiving the treatment as inpatient.

1.12 Hospital means Any infirmary that provides the medical service in which the patient

can stay overnight with the components in terms of place and the

adequate number of medical personnel, including the complete

service management, especially the room for major surgery that

receives the authorization to register as a hospital according to the

health facility law of the territory.

1.13 Medical health facility means Any health infirmary that provides the medical service in which the

patient can stay overnight and receives the authorization to register

as a medical health facility according to the law of the territory.

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1.14 Clinic means The health facility of the conventional medicine that receives

authorization to operate by which the doctor will perform the

medical treatment and diagnose the disease, but is unable to accept

the patient overnight and receives the authorization to register as a

clinic according to the law of the territory.

1.15 Medical standard means The rules or the practical guidelines of the universal conventional

medicine that bring about the treatment plan that is suitable with the

patients according to the medical necessity and conforms with the

summary of the history of injuries, illnesses, detections, biopsy

results, or others (if any).

1.16 Medical necessity means The medical services with the conditions as follows:

(1) It shall conform to the diagnosis and the treatment according

to the condition of injury of illness of the customer;

(2) It shall contain the medical indication clearly according the

current standards of medical practice;

(3) It shall not be done for the convenience of the customer or the

family of the customer or the medical service provider solely; and

(4) It shall be the service of medical treatment according to the

proper standards of patient care according to the necessity of the

condition of injury or the illness of the customer.

1.17 Necessity and reasonable

expense

means The medical treatment and/or any expenses that should be when

comparing with the service providing that the hospital, the medical

health facility, or the clinic has charged from the general patients of

the hospital of the medical health facility, or the clinic that the

Insured has received the treatment.

1.18 Pre-existing condition means The diseases (including complications), symptoms, or abnormalities

that occur with the Insured within 12 months prior to each traveling

date with the importance of seeking for the diagnosis, care, or

treatment.

1.19 AIDS means Acquired Immune Deficiency Syndrome that comes from AIDS

infection, including the opportunistic infection, malignant

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neoplasm, or diseases or any illnesses with the blood test result as

positive of HIV (Human Immuno Deficiency Virus). The

opportunistic infection shall include but not be limited to the disease

that causes organism or chronic enteritis, virus, and/or disseminated

fungi infection. The malignant neoplasm shall include but not be

limited to Kaposi’s Sarcoma, Central Nervous System Lymphoma,

and/or other critical illnesses, which are currently known as

Acquired Immune Deficiency Syndrome or the disease that causes

instant death, illness, or disability. AIDS shall include HIV (Human

Immuno Deficiency Virus), Encephalopathy Dementia, and the

spreading of viruses.

1.20 Insurance policy year means The period of one year as from the effective date of this insurance

policy or as from the date of insurance policy anniversary in the

following years.

1.21 Terrorism means The action that uses power or violence and/or involves the threat

from the individual or any groups of individual, whether they are

sole actions, substitute actions, or those that are relevant with any

organizations or any governments that are done for the political

results, religions, doctrines, or other similar purposes, including the

need to cause the government and/or the public or any parts of the

public to be in the state of fright.

1.22 Emergency assistance

provider

means The company or juristic person or representative of emergency

assistance provider who is authorized by the company that issues

this insurance policy to provide the emergency assistance while

traveling and other services to the Insured as specified in this

insurance contract.

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Section 2 General Conditions and Provisions

2.1 Insurance Contract

This insurance contract occurs when the Company trusts the statement of the Insured in the request form for

insurance and additional statements (if any) that the Insured has signed as evidence to agree with the insurance according to

the insurance contract. Therefore, the Company has issued this insurance contract.

In case the Insured is already aware but has declared the false statement in the statement according to the first

paragraph or already knows the true statement without notifying the Company in which if the Company was aware of the truth,

it might persuade the Company to demand higher insurance premium or refuse to make the insurance contract, this insurance

contract shall be voided according to Section 865 of Civil and Commercial Code and the Company has the right to annul the

insurance contract.

The Company shall not deny the liability by relying on the statement apart from those that the Insured has

declared in the documents according to the first paragraph.

2.2 Completeness of Contract and Modification of Statement in the Insurance Contract

This insurance policy, including the coverage agreements and the addendums, is combined into the insurance

contract. The modification of any statements in this insurance contract shall receive the consent from the Company and shall

be recorded in the insurance policy or in the addendum for completion.

2.3 Insurance Period

The period of each travel of the Insured that starts and ends within the insurance period.

2.3.1 In case of single trip, the coverage shall begin when the Insured has travelled from the residence for

traveling and it has proceeded continuously until the Insured has travelled back to the residence in Thailand (unless specified

otherwise in this insurance policy).

2.3.2 In case of annual trip to provide the coverage for multiple traveling, each coverage period shall be

identical to Item 2.3.1 and the highest travel period shall not exceed 90 days.

If the travel to Thailand of the Insured is delayed from the normal schedule in which it is the incident that cannot

be expected and is beyond the control of the Insured, the Company shall extend the coverage period of this insurance policy

until the Insured has travelled back to Thailand.

The insurance period shall be extended/determined otherwise, depending on each coverage

agreement/addendum.

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2.4 Notification and Claim for Compensation

The Insured, the beneficiary, or the representative of the said individual as the case may be shall notify the

Company about the loss or the damage without delay. In case of death, notify the Company immediately, unless there are

reasonable causes that it shall not be notified to the Company immediately, but it shall be notified as soon as it shall be done.

In case of the claim for compensation, the Insured, the beneficiary, or the representative of the said individual as

the case may be shall submit the evidence or the documents as specified under the coverage agreement and/or each addendum

and additional documents as required by the Company and as deemed necessary to the Company within the specified period of

time by the expenses of oneself.

The non-submission of documents or evidence within the said period shall not disclaim the right to claim if it

can be shown that there are reasonable causes that the documents or the evidence cannot be submitted within the specified

period of time, but it shall be submitted as soon as it can be done.

2.5 Medical Examination

The Company has the right to check the history of medical treatment and the diagnosis of the Insured as deemed

necessary from this insurance and has the right to perform the biopsy in case of necessity in which it shall not contradict the

law by the expenses of the Company.

In case the Insured does not consent for the Company to check the history of medical treatment and the diagnosis

of the Insured to consider for the compensation payment, the Company shall refuse to provide the coverage to the Insured.

2.6 Compensation Payment

The Company shall pay the compensation within 15 days as from the date that the Company has received the

proof of loss or damage completely and correctly. In the compensation for death, the Company shall make a payment to the

beneficiary. Other compensation shall be paid to the Insured.

In case there are reasonable doubts that the abovementioned claim for compensation of the Company according

to the said insurance policy is not in accordance with the coverage agreements in the insurance policy, the specified period

shall be extended as deemed necessary. However, it shall not exceed 90 days as from the date that the Company has received

the documents completely.

If the Company is not be able to pay the compensation within the specified period of time, the Company shall be

responsible for the interest at the rate of 15 percent per year of the amount paid as from the payment due date.

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2.7 Insurance Premium Payment and Rescission of Insurance Policy

2.7.1 The Insured shall pay the insurance premium immediately or before the starting date of the coverage.

2.7.2 In case of single trip, the rescission of insurance policy after the Company has issued the insurance

policy shall not contain the repayment of insurance premium, except for the case that the VISA of the Insured is not approved

with the evidence from the Embassy in which the Insured shall notify the Company prior to the starting date of the coverage.

2.7.3 In case of annual trip, the Insured or the Company shall be able to use the right to rescind the insurance

policy according to the specified condition as follows:

2.7.3.1 The Company shall rescind this insurance policy by sending the letter of notification for

no less than 15 days in advance by registered mail to the Insured according to the address as lastly notified to the Company. In

this case, the Company shall repay the insurance premium to the Insured by deducting the insurance premium for the period

that the insurance policy is effective by proportion.

2.7.3.2 The Insured shall rescind this insurance policy by notifying the Company in letter and shall

have the right to receive the insurance premium after deducting the insurance premium for the period that the insurance policy

is effective. Then, issue according to the rate of short-term insurance premium according to the table as specified below:

Table of Rate of Short-Term Insurance Premium

Insurance Period (Not Exceeding/Month) Percentage of Full-Year Insurance Premium

1 15

2 25

3 35

4 45

5 55

6 65

7 75

8 80

9 85

10 90

11 95

12 100

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The rescission of this insurance policy according to this condition shall not be done by any parties, but shall be

rescinded for the whole policy only. Any part of the coverage shall not be cancelled during the insurance policy year.

2.8 Arbitration Settlement

In case there are disputes, conflicts, or claims under this insurance policy between the claimant according to the

insurance policy and the Company and if the claimant desires and agrees to settle the dispute by arbitration, the Company

agrees to give consent and make final arbitration decision according to the rules of Office of Insurance Commission regarding

the arbitration.

2.9 Precedent Condition

The Company shall be liable to pay the compensation according to this insurance policy when the Insured or the

representative of the said individual as the case may be has practiced correctly and completely according to the insurance

contract and the conditions of the insurance policy.

2.10 Currency and Expenses that Occur in the Foreign Countries

If the compensation that shall be paid according to this insurance policy is in foreign currency, the Company

shall pay the compensation in Thai Baht by using the foreign exchange rate according to the date as specified in the receipt, the

document for the claim for compensation under the coverage agreements, and/or the addendum

Section 3 General Exclusions

The insurance according to this insurance policy shall not cover the losses or the damages that occur or

continue from the causes or the occurrences in the following period (unless the coverage is specified in the coverage

agreement specifically):

3.1 Suicide, suicide attempt, or self-assault

3.2 War, invasion, malicious action of foreign enemy, or malicious action that is similar to war (whether

there is the declaration or not), or civil war or the war between those who live in the same country, militant, rebellion,

insurrection, strike, commotion, revolution, coup d’etat, martial law declaration, or any incidences that might cause the

declaration or maintain the martial law.

3.3 Terrorism

3.4 Illegal actions of the Insured, confiscation, detention, destruction by customs or other officers, and

the violation of government rules

3.5 Radiation or radioactivity from nuclear or any nuclear wastes that come from the combustion of

nuclear fuel and any processes from the disintegration of nuclear that continuously proceeds by itself

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3.6 Explosion of radioinfluence or the components of nuclear or other hazardous objects that come from

the explosion in the nuclear process

3.7 While the Insured are acting as solider, police office, or volunteer and has joined in the war or the

suppression

3.8 Occurs in the country or the territory not included in the coverage as specified in the Policy Schedule

and the addendum (if any)

3.9 Occurs around the oil rig, and natural gas rig in the sea or underground mine

Section 4 Coverage Agreement

Under the requirements, general conditions and provisions, general exclusions, coverage agreements, and

addendums of the insurance policy and in order to repay the insurance premium that the Insured shall pay, the Company agrees

to provide the coverage for the coverage agreements as follows:

3

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Coverage Agreement

Accidental Death, Dismemberment, Loss of Sight or Total Permanent Disability

Additional Definition

1 Dismemberment means The amputation of the body from wrists to ankles and shall include

the complete impairment of the said organ with the medical

indicators that it cannot function again.

2 Loss of sight means Complete blindness and unable to heal again.

3. Total permanent disability means The disability that occurs and prevents the working in the regular

career and other careers permanently or the inability to perform the

routine activities for 3 types and above by oneself. Hence, the

practice of daily activity means the ability to perform 6 daily tasks,

which are the medical criteria to assess the patients who cannot

perform the said tasks, which are:

(1) Movement ability, such as the ability to move the chair to the

bed by oneself without receiving assistance from other persons or

equipment

(2) Walking or motion ability, such as the ability to walk or move

from one room to another room by oneself without receiving

assistance from other persons or equipment

(3) Dressing ability, such as the ability to wear or remove clothes by

oneself without receiving assistance from other persons or

equipment

(4) Bathing ability, such as the ability to take a shower, including

going in and going out of the bathroom by oneself without receiving

assistance from other persons or equipment

(5) Eating ability, such as the ability to eat by oneself without

receiving assistance from other persons or equipment

(6) Excretion ability, such as the ability to use the toilet for

excretion, including going in and going out of the toilet by oneself

without receiving assistance from other persons or equipment

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Coverage

This insurance covers the losses or the damages that occur from the physical injury of the Insured. For the

accident that occurs during the period of insurance and causes death, dismemberment, loss of sight, or total permanent disability

within 180 days as from the date that the accident occurs or for the injury that the Insured needs to receive the continuous

treatment as a patient in the hospital or the medical health facility and has passed away due to the injury, the Company shall

pay the compensation as follows:

1. 100% of Sum Insured For loss of life

2. 100% of Sum Insured For total disability permanent with clear medical indications that

the Insured is a person with total permanent disability or in case

there are no medical indications but the person has become a person

with total permanent disability for 12 consecutive months as from

the date that the accident occurs.

3. 100% of Sum Insured For both hands from wrists or both feet from ankles or loss of sight

for both eyes

4. 100% of Sum Insured For one hand from wrist and one foot from ankle

5. 100% of Sum Insured For one hand from wrist and the sight of one eye

6. 100% of Sum Insured For one foot from ankle and the sight of one eye

7. 60% of Sum Insured For one hand from wrist

8. 60% of Sum Insured For one foot from ankle

9. 60% of Sum Insured For the sight of one eye

The Company shall pay the compensation according to this item at the highest amount for each list only.

Throughout the period of insurance, the Company shall pay the compensation for the consequence according to

this coverage agreement in the total amount of not exceeding the amount as specified in the Policy Schedule. If the Company

pays the compensation according to this coverage agreement in the amount that does not reach the limit of the sum insured, the

Company shall maintain the coverage until the end of the insurance period in the amount that is equivalent with the remaining

sum insured.

Additional Conditions and Provisions (Shall be enforced only for the Accidental Death, Dismemberment, Loss of Sight

or Total Permanent Disability)

Claim and Submission of Proof of Damage

The Insured, the beneficiary, or the representative of the said individual as the case may be shall notify and

submit the documents or the evidence to the Company within 30 days as from the date for death, dismemberment, loss of sight,

or total permanent disability at its own expense.

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1. In case of dismemberment, loss of sight, or total permanent disability from accident

1.1 Form for claim for compensation as specified by the Company

1.2 Medical report that confirms the dismemberment, loss of sight, or total permanent disability (if any)

1.3 Copy of passport and/or travel evidence of the Insured

1.4 Copy of identification card of the Insured

1.5 Documents or evidence as required by the Company (if any)

2. In case of death from accident


2.2 Death certificate

2.3 Copy of biopsy report

2.4 Copy of daily police report

2.5 Copy of identification card and house registration with the stamp of “Death” of the Insured


2.7 Copy of identification card and house registration of the beneficiary


The non-submission of evidence within the said period shall not cause the Company to deny the liability.

Additional Exclusions (Shall be enforced only for the Accidental Death, Dismemberment, Loss of Sight or Total

Permanent Disability)

The insurance according to this coverage agreement shall not cover the injuries, the losses, or the damages

due to or those that continue from the cause or the occurrence in the following periods:

1. Action of the Insured while being under any conditions as follows:

(1) While being under the influence of addictive substances or narcotics and is unable to remain

conscious

(2) While being under the influence of liquor with the alcohol level in the body during the examination

equivalent with the alcohol level in blood from 150 milligram percent and above

(3) While being under the influence of liquor and is unable to remain conscious in case there is no

measurement or in case it is unable to measure the alcohol level

2. Receiving diseases and parasites, except infection, tetanus, or hydrophobia that occurs from accidental

wound

3. Miscarriage, except if the miscarriage is the result from the accident directly

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4. Injury that occurs from the Insured who is racing all types of car and boat; horse; all types of ski,

including jet ski; skate; boxing; parachute (except the parachute to save life); and while getting in or getting out or

while riding in the balloon or glider.

5. When the Insured is getting in or getting out or while riding in the aircraft that is not registered for

carrying the passengers and is not the commercial airline

6. When the Insured is driving or performing the duties as the regular officer in any aircraft

7. When the Insured joins in the fight or plays a part in provoking the quarrel

8. When the Insured causes the crime with the serious offense or while being arrested or trying to avoid

being arrested

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Coverage Agreement

Overseas Medical Expenses


Alternative medicine means The diagnosis, medical treatment, or disease prevention by using

Thai medicine, Thai traditional medicine, Chinese medicine, or

other methods that are not the conventional medicine.

Coverage

While the Insured receives the coverage according to this insurance policy, if the Insured receives the injury or

illness abruptly, suddenly, or unexpectedly in which it occurs while the period of insurance is effective in which it results in

the admission in the hospital, medical health facility, or clinic in the foreign countries, whether as inpatient or outpatient,

The company shall pay the compensation for the necessary and reasonable expenses that occur from the medical

treatment according to the medical requirements and the medical standards in the actual amount paid, but not exceeding the

sum insured as specified in the Policy Schedule to the Insured.

The expenses for the medical treatments that are covered are as follows:

1. Doctor fee, such as medical professional fee for general treatment, medical professional fee for surgery and

operation, medical professional fee for anesthetist, dentist fee, and other professional fee.

2. Medication cost; infusion cost; blood and blood component cost, including expenses in separating, preparing,

and analyzing blood transfusion; laboratory and pathology cost; radioactivity diagnosis fee; diagnosis fee by other special

methods, including doctor fee for result interpretation, cost of usage or service providing, medical utensils and equipment

outside the surgery room, medical consumable supplies (Supplies 1), surgery room, and equipment in the surgery room,

excluding the wage for special nurse while admitted the hospital, medical health facility, or clinic.

3. Cost of ambulance in case of emergency for transferring the Insured to and from the hospital or the medical

health facility with the medical reason according to the medical requirements.

4. Cost of take-home medicine according to the medical requirement, but shall not exceed 14 days

5. Room fee for patient in intensive care or standard size of patient room, including cost of food at the hospital

or medical health facility that is provided for the patient and the daily nursing fee

6. Other expenses that are relevant with the medical treatment, such as nursing service fee, medical service fee,

and medical procedure fee

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Additional Conditions and Provision (Shall be enforced only for the Overseas Medical Expenses)

Claim and Submission of Proof of Damage


submit the documents or the evidence to the Company within 30 days as from date of discharge from the hospital or the medical

health facility or the clinic at its own expense.

1. Form for claim for compensation as specified by the Company

2. Medical report that specifies significant symptoms, diagnosis results, and treatments

3. Original copy of receipt that shows the list of expenses or the statement summary sheet with receipt

4. Copy of passport and/or traveling evidence of the Insured

5. Copy of identification card of the Insured

6. Documents or evidence as required by the Company (if any)

The receipt that shows the list of expenses shall be the original copy of the receipt and the Company shall return

the original copy of the receipt that certifies the paid amount for the Insured to claim for the missing amount from other insured.

However, if the Insured receives the compensation from the state welfare or other welfares or from other insurances, the Insured

shall submit the copy of receipt that certifies the amount that is paid from the state welfare or other agencies to claim for the

missing amount from the Company.

The non-submission of evidence within the specified period of time shall not cause the Company to deny the

liability.

Additional Exclusions (Shall be enforced only for the coverage agreement and the Overseas Medical Expenses )

The insurance according to this coverage agreement shall not cover the following expenses:

1. Pre-existing condition

2. Treatment or correction of defects of the body since birth

3. Treatment for recreation or sanitation, recuperation, health check-up, and any other treatments that

are not relevant with the injury or the illness

4. Treatment of diseases or conditions that are relevant with psychosis, stress, and insanity, including the

addiction of addictive substances and genetic disorders

5. AIDS, venereal disease, and sexual transmitted disease

6. Any treatments that are relevant with pregnancy, child birth, miscarriage, pregnancy complications,

infertility problems (including analysis and treatment), sterilization, or birth control

7. Medical treatments that are not the conventional treatment plan, including alternative treatment

8. All types of prosthesis, which are canes, glasses, hearing aid, speech device, and all types of defibrillator

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9. Services or surgeries that involve the unnecessary injury or illness that seeks profit or for the fraud

from the insurance policy

10. Treatment for beauty, which are treatment of acne, blemish, freckle, dandruff, weight loss, and hair

growth; treatment to correct the defects of the body; or cosmetic surgery, except it is the plastic surgery that is done

due to the accident for the said organ to function as normal

11. Expenses that are relevant with the dental or gum service, except to relieve the injury from the

accident. It shall not include dental restoration, braces, crown, root canal treatment, tooth cleaning, tooth filling, dental

implant, or denture or the nursing treatment fee for the treatments that are necessary for making natural sound due to

the dental treatment from accident

12. Vaccination or injection of vaccines to prevent the disease, except the injection of vaccines to prevent

hydrophobia after being attacked by animals and vaccine to prevent tetanus after receiving the injury

13. Expenses for the medical treatment by which the doctor is the Insured or is the father, mother, spouse,

or child of the Insured

14. Actions of the Insured while being under any of the conditions as follows:

14.1 While being under the influence of addictive substances or narcotics and is unable to remain

conscious

14.2 While being under the influence of liquor with the alcohol level in the body during the

examination in blood from 150 milligram percent and above

14.3 While being under the influence of liquor and is unable to remain conscious in case there is no

measurement or in case the alcohol level cannot be measured

15. Receiving diseases and parasites, except the infection of diseases or tetanus or hydrophobia that comes

from the accidental wound.

16. When the Insured is racing all types of car or boat; horse; all types of ski, including jet ski; skate;

boxing; parachute; playing or racing paramotor, parachute, and glider; while getting in or getting out or transporting

in the balloon; bungee jumping; diving with air tank and underwater breathing respirator (except parachuting and

diving that needs to use air tank and underwater breathing respirator that are done to save life)

17. Injury that occurs while the Insured is getting in and getting out or while traveling in aircraft that is

not registered to carry the passenger and is not the commercial airline

18. Injury that occurs while the Insured is driving or performing the duties as the regular employee in any

aircrafts

19. Injury that occurs while the Insured is joining in a fight or taking part in the provocation for fighting

20. Injury that occurs while the Insured is doing the serious offense or being arrested or escaping the arrest

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Coverage Agreement

Medical Expenses for case follow-up after return to Thailand


Alternative medicine means The diagnosis, medical treatment, or disease prevention by using

Thai medicine, Thai traditional medicine, Chinese medicine, or

other methods that are not the conventional medicine.

Coverage


illness abruptly, suddenly, and unexpectedly in which it occurs during the period of insurance while traveling in the foreign

receives countries and leads to the ongoing medical care or the follow-up in Thailand, the period to request for medical

treatment is as follows:

1. In case the Insured has never received the medical treatment for the said injury or illness in the foreign countries

before, the Insured shall make the request to receive the medical treatment in Thailand within 24 hours as from the date of

returning to Thailand and the ongoing medical care shall not exceed 30 days.as from the date of receiving the first medical

treatment in Thailand

2. In case the Insured has received the medical treatment since being in the foreign countries, the Insured has the

period of 30 days as from the date of returning to Thailand to receive the ongoing medical care in Thailand.

Hence, the Company shall pay the compensation for the expenses that are necessary and reasonable for the

medical treatment according to the medical requirement and the medical standard for the expenses that occur in Thailand

according to the actual amount paid, but shall not exceed the amount of sum insured as specified in the Policy Schedule.

Additional Conditions and Provisions (Shall be enforced only for the coverage agreement for the Medical Expenses for

case follow-up after return to Thailand)

Claim and Submission of Proof of Damages

The Insured, the beneficiary, and the representative of the said individual as the case may be shall notify and

submit the documents or the evidence to the Company within 30 days as from the date of discharge from the hospital or the

medical health facility, or the clinic at its own expense.


2. Medical report that specifies the significant symptoms, diagnosis results, and treatments

3. Original copy of receipt that shows the list of expenses or the statement summary sheet with the receipt



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The receipt that shows the list of expenses shall be the original copy of receipt and the Company shall return the

original copy of receipt that certifies the amount paid for the Insured to claim for the missing amount from other insured.

However, if the Insured has received the compensation from the state welfare or other welfare or other insurances, the Insured

shall submit the copy of receipt that certifies the amount paid from the state welfare or other agencies to claim for the missing

amount from the Company.


liability.

Additional Exclusions (Shall be enforced only for the Medical Expenses for case follow-up after return to Thailand)
















growth; treatment to correct the defects of the body; or cosmetic surgery, except if it is the plastic surgery that is done

due to the accident for the said organ to function as normal







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conscious







16. When the insured is racing all types of car or boat; horse; all types of ski, including jet ski; skate;

boxing; parachute; playing or racing paramotor, parachute, and glider; while getting in or getting out or traveling in

the balloon; bungee jumping; diving with air tank and underwater breathing respirator (except parachuting and diving

that needs to use air tank and underwater breathing respirator that are done to save life)

17. Injury that occurs while the Insured is getting in and getting out or while traveling in the aircraft that

is not registered to carry the passenger and is not the commercial airline


aircrafts

19. Injury that occurs while the Insured is joining in a fight or taking part in the provocation for fighting

20. Injury that occurs while the Insured is doing the serious offense or being arrested or escaping the arrest

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Coverage Agreement

Overseas Daily Hospital Income Benefit

Coverage

While the Insured receives the coverage according to this insurance policy, this insurance shall provide the

coverage in case the Insured needs to be admitted in the hospital or the medical health facility as inpatient during the period of

insurance due to injury or illness that occurs abruptly, suddenly, and unexpectedly according to the medical requirements and

the medical standards.

The Company shall pay the daily compensation to the Insured according to the number of days for the admission

in the hospital or the medical health facility as inpatient in the amount of ............ baht per day or as specified in the Policy

Schedule as from the first date for the admission in the hospital or the medical health facility as inpatient in the foreign countries

by which the compensation shall be paid after being admitted in the hospital. Hence, the Company shall pay the compensation

for a total of up to 30 days per each time of injury or illness as from the first date of receiving the treatment as inpatient in the

hospital or the medical health facility and per each travel or according to the time (if any) that is specified in the Policy Schedule.

If the Insured receives injury or illness abruptly, suddenly, and unexpectedly in which the treatment by surgery

or procedure according to the medical requirements as inpatient is needed, but the Insured does not need to be admitted in the

hospital or the medical health facility due to the medical evolution, the Company shall pay the daily compensation to the Insured

for one day (1 day) for the treatment that occurs by surgery or procedure as follows:

1. ESWL (Extracorporeal Shock Wave Lithotripsy)

2. Coronary Angiogram/ Cardiac Catheterization

3. Extra Capsular Cataract Extraction with Intra Ocular Lens

4. All types of laparoscopic

5. All types of endoscope

6. Sinus Operations

7. Excision Breast Mass

8. Bone Biopsy

9. Amputation at the fingers or toes

10. Liver Puncture/ Liver Aspiration

11. Bone Marrow Aspiration

12. Lumbar Puncture

13. Thoracentesis/ Pleuracentesis/ Thoracic Aspiration/ Thoracic Paracentesis

14. Abdominal Paracentesis/ Abdominal Tapping

15. Curettage, Dilatation & Curettage, Fractional Curettage

Page 21 of 52

16. Colposcope, Loop Diathermy

17. Bartholin’s Cyst (Marsupialization of Bartholin’s Cyst)

18. Gamma Knife

Additional Conditions and Provisions (Shall be enforced only for the Overseas Daily Hospital Income Benefit )



submit the documents or the evidence to the Company within 30 days as from the date of discharge from the hospital or the

medical health facility, or the clinic at its own expense.


2. Medical report that specifies the significant symptoms, diagnosis results, and treatments

3. Original copy of receipt that shows the list of expenses or the statement summary sheet with the receipt





liability.

Additional Exclusions (Shall be enforced only for the Overseas Daily Hospital Income Benefit )















Page 22 of 52


growth; treatment to correct the defects of the body; or cosmetic surgery, except it is the plastic surgery that shall be

made due to the accident for the said organ to function as normal











conscious







16. When the insured is racing all types of car or boat; horse; all types of ski, including jet ski; skate;

boxing; parachute; playing or racing paramotor, parachute, and glider; while getting in or getting out or traveling in

the balloon; bungee jumping; diving with air tank and underwater breathing respirator (except parachuting and diving

that needs to use air tank and underwater breathing respirator that are done to save life)

17. Injury that occurs while the Insured is getting in and getting out or while traveling in the aircraft that

is not registered to carry the passenger and is not the commercial airline


aircrafts

19. Injury that occurs while the Insured is joining in a fight or taking parts in the provocation for fighting

20. Injury that occurs while the Insured is making the serious offense or being arrested or escaping the

arrest

Page 23 of 52

Coverage Agreement

Emergency Medical Evacuation and Repatriation

Coverage


illness abruptly, suddenly, and unexpectedly, which occurs during the period of insurance while traveling in the foreign

countries and it is necessary to transport the Insured by using the appropriate and the necessary method according to the

comment or the suggestion of the emergency service provider in order to perform the appropriate medical treatment or to take

the Insured back to Thailand or the country of domicile, the Company shall compensate for the expenses in the transportation

for emergency medical treatment or the transportation to Thailand or country of domicile to the emergency service provider

according to the actual expenses, but shall not exceed the sum insured as specified in the Policy Schedule. The methods for the

transportation for emergency medical treatment shall be determined by the forms of transportation and the destination by the

emergency service provider, which shall include the cost of vehicle to transport the patient by air, by boat, by land, or other

transportation methods according to the medical requirements and the medical standards.

The coverage for the expenses that is specified is the expenses for the service that is determined and/or prepared

by the emergency service provider for transportation or medical treatment service and the cost of medical supplies in case of

necessity, which results from the transportation for emergency medical treatment of the Insured as specified in this place.

The emergency service provider shall determine the methods for the transportation for emergency medical

treatment, the forms of transportation, and the destination, which might include the cost of vehicle to transport the patient by

air, by boat, by land, or other transportation method as deemed necessary.

Hence, the emergency service provider is SOMPO Assist.

Additional Conditions and Provisions (Shall be enforced only for the coverage agreement of the Emergency Medical

Evacuation and Repatriation )



submit the documents or the evidence to the Company within 30 days as from the time of occurrence at its own expense.


2. Copy of passport and/or travel evidence of the Insured



liability.

Hence, for the expenses regarding any services that do not receive the approval and are managed by the

emergency service provider that the Insured or the beneficiary has paid in advance for all services in which it cannot be notified

Page 24 of 52

to the emergency service provider, but has the reasonable cause for the expenses that occur and cannot be controlled during the

emergency medical treatment at any places, the Company shall make compensation according to the actual expenses, but shall

not exceed the sum insured as specified in the Policy Schedule.

Page 25 of 52

Coverage Agreement

Repatriation of Mortal Remains

Coverage

While the Insured receives the coverage according to this insurance policy, if the Insured has passed away within

30 days as from the date that the injury or the illness has occurred abruptly, suddenly, and unexpectedly during the period of

insurance while traveling in the foreign countries, the Company shall pay the compensation for the funeral and other necessary

expenses for the management of dead body; such as coffin, embalming, cremation at the place of death, and the transportation

of dead body or cremains to Thailand or country of domicile that is proceeded by the emergency service provider who receives

the authorization from the Company. The expenses will be charged to the Company directly, but shall not exceed the sum

insured as specified in the Policy Schedule.


Additional Conditions and Provisions (Shall be enforced only for the coverage agreement of expenses for transportation

of dead body or cremains to Thailand or Country of Domicile)








liability.

Hence, for the expenses regarding any services that do not receive the approval and are managed by the

emergency service provider that the Insured or the beneficiary has paid in advance for all services in which it cannot be notified

to the emergency service provider, but has the reasonable cause for the expenses that occur and cannot be controlled during the

emergency medical treatment at any places, the Company shall make compensation according to the actual expenses, but shall

not exceed the sum insured as specified in the Policy Schedule.

Page 26 of 52

Coverage Agreement

Overseas Daily Hospital Income Benefit


Family member means Legal spouse of the Insured; father, mother, legal adoptive father or

mother of the Insured or legal spouse; and child, legal adoptive

child, siblings, grandfather, or grandmother of Insured or legal

spouse.

Coverage


the illness that receives the coverage under the coverage agreement for cost of medical treatment that occurs while traveling in

the foreign countries and needs to be admitted as inpatient in the hospital or the medical health facility in foreign countries for

more than 5 consecutive days or in case the injury or the illness is serious and the doctor comments that the transportation for

treatment cannot be made in which there is no family member of full age as the travel companion,

The Company shall provide the coverage for the travel to visit the patient by which the emergency service agency

who receives the authorization from the Company shall be considered from the appropriateness of the travel to visit the patient,

depending on the diagnosis or the suggestion of the doctor and proceed with the procurement of accommodation and economy

class ticket for inbound and outbound as the case may be for any of these cases:

1. Travel companion or friend of the Insured who needs to stay together until the Insured is discharged from the

hospital or travel to Thailand or until the insurance policy is ended, whichever incidence occurs first or

2. Family member or close relative or friend of the Insured who needs to travel from Thailand to stay together

until the Insured is discharged from the hospital and travel back to Thailand or until the insurance policy is ended, whichever

incidence occurs first or

3. Family member or friend of the Insured who needs to travel from Thailand to stay together until the Insured

passes away during the admission as inpatient and the funeral or the pick-up of deceased body is needed.

The Company shall cover for the expenses for travel to visit the patient according to the amount that the

emergency service agency that receives the authorization from the Company has charged to the Company or the amount that

the Insured has paid in advanced in case the emergency service agency who receives the authorization from the Company

cannot be contacted by which the Company shall pay for the cost of ticket in the highest amount that is equivalent to the

economy class ticket. Hence, it shall not exceed the amount as specified in the Policy Schedule.

Page 27 of 52

Additional Conditions and Provisions (Shall be enforced only for the Overseas Daily Hospital Income Benefit)


The Insured, the beneficiary, or the representative of the said individual shall submit the following evidence to

the Company within 30 days as from the date of discharge from the hospital or the medical health facility at its own expense.


2. Boarding pass

3. Medical certificate, receipt, or summary report of medical treatment of the Insured that shows the number of

days of hospital admission

4. Original copy of receipt for the boarding pass of the family member or friend who travels to visit the Insured


liability.

Page 28 of 52

Coverage Agreement

Travel to a Funeral





spouse.

Coverage

While the Insured receives the coverage according to this insurance policy, if the Insured passes away within 30 days

as from the date that the injury or the illness occurs suddenly, abruptly, and unexpectedly during the insurance period while

traveling in the foreign country with no family member of full age as travel companion,

The Company shall provide the coverage for the travel for funeral. The emergency service agency that receives the

authorization from the Company shall proceed with the procurement of accommodation and economy class ticket for the family

member or the close relative who will travel from Thailand to manage the funeral or pick-up the deceased body of the Insured.

The Company shall pay the compensation for the accommodation cost, actual cost of economy class ticket for both

inbound and outbound trips according to the amount that the emergency service agency that receives the authorization from

the Company has charged from the Company or the amount that the Insured has paid in advanced in case of unable to contact

the emergency service agency that receives the authorization from the Company.

Hence, the Company shall pay the compensation for the amount that does not exceed the sum insured as specified in

the Policy Schedule. If the Company provides the coverage under the coverage agreement for travel to visit the patient at the

hospital or the coverage agreement for the delivery or the travel to pick up the child in the same accident, the beneficiary or the

representative shall not receive the coverage under this coverage agreement.

Additional Conditions and Provision (Shall be enforced only for the Travel to a Funeral)

Claim and Submission of Proof of Damages In Case of Unable to Contact the Emergency Service Agency that Receives

the Authorization from the Company

The beneficiary or the representative of the said individual as the case may be shall submit the following evidence to

the Company within 30 days as from the date of discharge from the hospital or the medical health facility at its own expense.


2. Receipt for boarding pass of family member who travels for funeral

The non-submission of evidence within the specified period of time shall not cause the Company to deny the liability.

Page 29 of 52

Coverage Agreement

Personal Liability


Third party means Any non-relative individuals who do not reside with the Insured, the

employee of the Insured during the employment, and the partner of

the Insured.

Coverage

While the Insured receives the coverage according to this insurance policy, the Company shall pay the

compensation in the name of the Insured to the third party for the amount that the Insured shall be liable according to the law

from the accident that occurs during the period of insurance according to the amount of actual loss or damage, but shall not

exceed the sum insured as specified in the Policy Schedule for the result of loss or damage as follows:

1. Death or physical injury of the third party that continues or results from the accident of the Insured

2. Loss or damage of the property of the third party that continues or results from the accident of the Insured

Additional Conditions and Provisions (Shall be enforced only for the coverage agreement of the Personal Liability)

1. Duties of the Insured to Claim for Compensation

In case there is an incidence that might cause the claim for compensation according to this coverage

agreement, the Insured shall:

1.1 Notify the Company without delay

1.2 Transfer to the Company immediately when receiving the writ or the instruction or the order from the

court that is relevant with the matter that the Insured is being prosecuted to be liable according to the law to the third party

according to this coverage agreement

1.3 The Insured shall not perform any actions that shall be an agreement to pay or the liability to the third

party or other individuals or perform any actions that might cause or cause the prosecution or the litigation without receiving

the consent in writing from the Company, except if the Company does not manage the claim in the reasonable period as from

the date of receiving the notification from the Insured.

1.4 Submit the details and provide the assistance as necessary for the Company to agree to make

compensation or litigate any claims or prosecute in the case.

2. Duties of the Insured to Manage the Prevention

The Insured shall prevent or arrange the prevention as deemed appropriate to prevent the accident and shall

comply with the legal provisions and the requirements of the government officer.

Page 30 of 52

3. Duties to Maintain the right of the Company for Subrogation

With the expenses of the Company, the Insured shall perform any actions as deemed necessary or as requested

by the Company, whether before or after receiving the compensation from the Company, to maintain the right of the Company

for the subrogation of claim for the damages from the third party.

4. Rights of the Company

The Company has the right to litigate the case and make compromises in the name of the Insured against any

claims.

5. Average Liability

During the time of occurrence in which there is the coverage from other insurances for the claim for

compensation for the same liability, the Company shall be liable for the damage, cost of prosecution, and other expenses in not

exceeding the proportion of the Company for the amount that shall be paid for the said liability.

Additional Exclusions (Shall be enforced only for the coverage agreement of the liability of the third party)

The insurance according to this coverage agreement shall not cover the liability to the third party that

occurs or continues from the following causes:

1. Loss or damage, including the injury of the individual that is not the third party

2. Loss or damage towards the property of the Insured or those that is in the possession or the control of

the Insured

3. Loss or damage that is relevant with the liability that occurs from the contract that the Insured has

made in which if the said contract does not exist, the liability of the Insured shall not occur

4. Loss or damage that is relevant with the liability that is done with purpose or intention or the illegal

action of the Insured

5. Loss or damage due to the ownership and the possession of all types of vehicle that are driven by

engines, including any machines or vehicles that are pushed or towed by engines, aircrafts, firearms, pets, land, or

buildings or that occurs from the negligence in the supervision.

6. Trading or professional liability or the business defect

7. Loss or damage from the actions of the Insured while being in the state of disorderliness in the mind,

nervous system, and insanity, including while the Insured is taking part in the fight or is taking part in the provocation

of fight.

Page 31 of 52

Coverage Agreement

Rental Vehicle Excess

Coverage

While the Insured receives the coverage according to this insurance policy, if the car that the Insured has rented

for driving while traveling in the foreign countries has an accident and the Insured has the liability according to the law to

compensate for the damage from the accident that occurs to the car that the Insured has rented, the Company shall pay the

compensation for the deductible that the Insured has paid, but shall not exceed the amount as specified in the Policy Schedule.

Additional Conditions and Provisions (Shall be enforced only for the Rental Vehicle Excess)

The Insured shall comply with the following conditions:

1. Must rent the said car from a car rental company that has a car rental business license 2.

The car rental agreement shall determine for the Insured to buy the first class insurance that covers the loss or the

damage to the rental car during the rental period.

3. The Insured shall comply with all item conditions of the car rental company under the rental agreement and

the conditions of the Insured under the insurance contract, including the laws, rules, and requirements of the country.


The Insured, the beneficiary, or the representative of the said individual as the case may be shall submit the

following evidence to the Company within 30 days as from the date that the loss or the damage occurs at its own expense.


2. Boarding pass

3. Contract from the car rental company about the amount of deductible that the Insured shall be responsible

according to the agreement of the insurance contract of the car rental service provider.


liability.

Additional Exclusions (Shall be enforced only for the Rental Vehicle Excess)

The insurance according to this coverage agreement shall not cover

1. Loss or damage that occurs from driving the rental car by violating the conditions of the rental agreement or loss or

damage that occurs outside the territory of the public road or by violating the law, traffic rule, and requirement of the

country

2. Loss or damage that occurs from the wear and tear, the deterioration, the destruction from insects or animal bites,

and the non-evident defects or damages

Page 32 of 52

Coverage Agreement

Emergency Phone Charges

Coverage


illness suddenly or there is the occurrence of emergency that the assistance is needed immediately and contact is needed to

receive the support from the emergency service agency that receives the authorization from the Company, the Company shall

pay the compensation for the expenses in the contact to receive the assistance only for the telephone number that the Company

has notified by mobile telephone. The payment shall be made according to the sum insured as specified in the Policy Schedule.


Additional Conditions and Provisions (Shall be enforced only for the coverage agreement for Emergency Phone

Charges)





2. Boarding pass


liability.

Page 33 of 52

Coverage Agreement

Flight Delay

Coverage

While the Insured receives the coverage according to this insurance policy, if the travel schedule by plane of the

Insured is delayed from the normal travel schedule as specified in the flight schedule for at least 6 consecutive hours as from

the date that is specified in the travel schedule because the plane is unable to enter or leave the airport according to the normal

travel schedule due to the weather that is not convenient for traveling, defects of flight equipment, strike, or protestation of

staff or employee of the airline or the airport or any other causes that are not the liability of the Insured,

The Company shall pay the compensation for the flight delay to the Insured in every 6 hours but shall not exceed

the sum insured as specified in the Policy Schedule.

Additional Conditions and Provisions (Shall be enforced only for the Flight Delay)


The Insured, beneficiary, or representative of the said individual as the case may be shall notify and submit the

documents or the evidence to the Company within 30 days as from the date that the incident occurs at its own expense.



3. Plane ticket or boarding pass or evidence that specifies the travel period

4. Letter, document, or any other evidence with the confirmation from the airline, transportation company,

airport, or authorized person for the travel that specifies the cause of flight delay or the duration of delay



liability.

Additional Exclusions (Shall be enforced only for the Flight Delay)

The insurance according to this coverage agreement shall not cover the flight delay that occurs or

continues from the following causes:

1. The delay from the following causes:

1.1 The Insured does not report to the airline within the specified period

Page 34 of 52

1.2 Strike or protestation of the staff or the employee of the airline or the airport that occurs before or

while the Insured has made a request for this travel insurance

1.3 Delay that occurs from the service cancellation of the airline from the instruction or the suggestion

of the government in that country

1.4 Delay that the Insured has acknowledged before the request for insurance

2. Damage fee that is regained from the airline or the airport

Page 35 of 52

Coverage Agreement

Missed Connecting Flight

Coverage

While the Insured receives the coverage according to this insurance policy, if the Insured has missed connecting

flight in the foreign countries with the confirmation for travel according to the flight schedule at the point that the transshipment

is needed due to the delay of the plane that travels to the transshipment point and there are no flights that can be replaced within

6 hours as from the period that the plane has traveled to the transshipment point per flight,

The Company shall compensate for the missed connecting flight every 6 hours according to the sum insured as

specified in the Policy Schedule, but shall not exceed the sum insured as specified in the table of insurance.

Additional General Conditions and Provisions (Shall be enforced only for the Missed Connecting Flight)



submit the documents or the evidence to the Company within 30 days as from the time of occurrence.


2. Letters, documents, or any other evidence with the confirmation from the airline, transport company, airport,

or the authorized person per trip with the identification of the cause of missed connecting flight

3. Copy of passport of the Insured

4. Copy of plane ticket


liability.

Additional Exception (Shall be enforced only for the Missed Connecting Flight)

The Insured shall not cover the missed connecting flight that occurs or continues from the following

causes:

1. The Insured has missed the connecting flight at the first travel point, whether by any causes.

2. The delay that occurs from the cancellation of the airline by the instruction or the suggestion of the

government of any countries.

3. The Insured does not report to the airline within the specified period of time.

Page 36 of 52

Coverage Agreement

Trip Cancellation of Postpone





spouse.

Coverage

While the Insured receives the coverage under this insurance policy, this insurance shall provide the coverage to

the Insured for the loss or the damage that occurs from the travel postponement or the travel cancellation of the Insured that

occurs within 21 days before the travel date (except the cause in Item 4) and those that occur after the insurance contract is

effective due to

1. The Insured passes away, receives the injury, or illness with the confirmation from the doctor that the Insured

should not travel as planned

2. Family member of the Insured passes away, receives the serious injury, or gets critical illness that prevents the

Insured from traveling as planned

3. Receive the summons as witness at the court or receive any writs from the court

4. When the residence of the Insured that is the permanent residence has received serious damage from fire or

natural disaster within 1 week before the travel date that prevents the Insured from traveling as planned.

For the compensation that the Company shall pay to the Insured according to this coverage agreement which are

deposit money, traveling expense, advanced ticket price, accommodation cost, cost of food that the Insured has paid in advance,

and/or the expenses that the Insured shall be responsible for according to the law only for the loss or the damage that does not

receive the compensation from other sources, the Company shall compensate according to the actual loss or damage that occurs

in not exceeding the sum insured as specified in the Policy Schedule.

Hence, this coverage shall be effective only when the Insured has received the insurance before knowing about

any incidents that might cause the travel postponement or the travel cancellation. Any of the insured shall not be able to

claim for compensation for the coverage agreement of travel postponement or travel cancellation and the coverage

agreement for the reduction of number of travel days (if any) in the same incident.

Additional Conditions and Provisions (Shall be enforced only for Trip Cancellation of Postpone)


Page 37 of 52


documents or evidence to the Company within 30 days as from the date that the incident occurs at its own expense.


2. Receipt from travel agency or airline, accommodation cost, and cost of food that specifies the amount of money

that is charged

3. Medical certificate (in case of travel cancellation or travel postponement due to injury or illness of the Insured,

serious injury, or critical illness of family member)

4. Death certificate (in case of death of the Insured or family member of the Insured)

5. Acknowledgement from travel agency or tour manager or service provider of transportation or accommodation


liability.

Additional Exception (Shall be enforced only for the Trip Cancellation of Postpone)

The insurance according to this coverage agreement shall not cover the expenses for travel postponement

or travel cancellation that occurs or continues from the following causes:

1. Loss or damage that occurs from the control or the regulation of the government

2. AIDS, venereal disease, or sexual transmitted disease

3. Travel cancellation or travel postponement that the Insured knows in advanced before making a request

for this insurance


5. Treatment for mental disorders or all types or mental confusion

6. Illegal action of the Insured or the Insured who is being prosecuted criminally

Page 38 of 52

Coverage Agreement

Trip Curtailment





spouse.

Coverage

While the Insured receives the coverage under this insurance policy, if the number of travel days of the Insured

is reduced after the beginning of the travel and the Insured travels back to Thailand before the schedule due to the following

causes:

1. The Insured receives the injury or illness with the confirmation from the doctor that the continuance to travel

will be harmful to life and the travel should not be continued or

2. Family member passes away or receives the serious injury or gets critical illness that prevents the Insured from

traveling as planned,

The Company shall pay the compensation to the Insured for the expenses that the Insured has paid in advance,

whether partially or as a whole, as the deposit or the advanced booking for the cost of travel or the accommodation cost that is

not used or the fine for the reduction of number of travel days in which the Insured does not receive the compensation from

other sources according to the actual expenses, but shall not exceed the sum insured as specified in the Policy Schedule.

Hence, this coverage shall be effective only when the Insured has received the insurance before knowing about

any incidents that might cause the reduction of number of travel days. Any of the insured shall not be able to claim for

compensation for the coverage agreement for the reduction of number of travel days and the coverage agreement of

travel postponement or travel cancellation and (if any) in the same incident.

Additional Conditions and Provisions (Shall be enforced only for the Trip Curtailment)



documents or the evidence to the Company within 30 days as from the date that the incident occurs at its own expense.


2. Copy of recent plane ticket with receipt

Page 39 of 52


4. Medical certificate in case the reduction of number of travel days is needed due to the Insured receives injury

and illness or in case of death, serious injury, or critical illness of family member

5. Death certificate (in case of death of Insured or family member)



liability.

Additional Exclusion (Shall be enforced only for the Trip Curtailment)

The insurance according to this coverage agreement shall not cover the reduction of number of travel days

that occurs or continues from AIDS, venereal disease, or sexual transmitted disease.

Page 40 of 52

Coverage Agreement

Hijacking


Hijacking of aircraft means Occupy or take control of the plane by using force or violence or

threaten to use force or violence with bad motives of the individual

or the group of individuals

Coverage


coverage to the Insured who becomes the hostage in the hijacking of aircraft that occurs during the period of insurance while

traveling on the plane and the said incidence has occurred for at least 24 consecutive hours.

The Company shall pay the compensation for being the hostage in the hijacking of aircraft to the Insured for

every 24 consecutive hours of being the hostage, but shall not exceed the sum insured as specified in the Policy Schedule.

Additional Conditions and Exclusions (Shall be enforced only for the Hijacking)




1. Form for the claim for compensation as specified by the Company



4. Letters, documents, or other evidence with the confirmation from the airline or the airport or other agencies

that specify the cause and the period of hijacking of aircraft



liability.

Page 41 of 52

Coverage Agreement

Baggage Delay

Coverage


coverage in case the baggage of the Insured is delayed during the period of insurance due to the mistakes or the delivery to the

wrong place or the temporary loss of the carrier for more than 6 hours after the Insured has traveled to the point of baggage

claim at the destination.

The Company shall pay the compensation for the delay of the baggage to the Insured for every 6 hours of the

delay of baggage, but shall not exceed the total sum insured as specified in the Policy Schedule.

Additional Conditions and Provisions (Shall be enforced only for the Baggage Delay)

1. Claim and Submission of Proof of Damage

The Insured, the beneficiary, or the representative of the said individual as the case may be shall notify

and submit the documents or the evidence to the Company within 30 days as from the time of occurrence at its own expense.


1.2 Certification letter from the airline to confirm the delay of the baggage



The non-submission of evidence within the specified period of time shall not cause the Company to deny

the liability.

2. Subrogation

In case the Company pays the compensation according to the insurance policy, the Company shall subrogate

the right of the Insured who receives the coverage from any individuals or organizations only in the part that the Company has

paid the compensation. In this regard, the Insured shall cooperate with the Company in the submission of documents as well as

proceed with necessary actions to prevent the right and shall not perform any actions that shall damage the right of the Company.

The Insured shall not make a prosecution after the loss or the damage occurs to the individual who causes the said loss or

damage.

Additional Exclusions (Shall be enforced only for the Baggage Delay)

The insurance according to this coverage agreement shall not cover the delay of the baggage that occurs

or continues from the following causes:

1. Luggage that is transported under the cargo permit

Page 42 of 52

2. Luggage that is confiscated by the customs or other official agencies

3. Expenses that the airline has paid to the Insured

4. Delay of the baggage while being in Thailand or after the travel of the Insured has ended as specified in

the travel evidence

Page 43 of 52

Coverage Agreement

Damage or Loss of Baggage and/or Personal Belongings


1 Baggage Means Baggage that the Insured carries for traveling.

2. Personal property Means Property that the Insured carries for traveling.

3. Souvenir Means Object that is the symbol or the memorial of incidence, place, or

thing that are distributed or given as memorial.

4. Jewelry Means Object, such as ring, bracelet, necklace, bangle, earrings, pendant,

and watch that is worn as decoration on the body.

5. Valuable object Means Jewelry that is made from gold, silver, or other valuable metal;

wool; watch; and gem, diamond, or valuable stone, including gold

or silver ornaments.

6. Robbery Means Theft by using physical force to hurt or threat at the moment in

order to

1) Provide the convenient for the theft or to take away the property

or

2) Deliver the property or

3) Seize the property or

4) Cover the offense or

5) Release from being arrested

Hence, theft means ill-gotten of the property of other persons or

those that belong to other persons.

7. Gang robbery Means Robbery that is done by 3 persons and more.

8. Pair or set Means Any property that looks identical or are the component parts or are

used together.

Coverage

While the Insured receives the coverage according to this insurance policy, if the baggage and/or the personal

property of the Insured is lost or damaged due to any incidences during the period of insurance:

Page 44 of 52

1. While the baggage and/or personal property of the Insured is under the care of hotel staff or other residences

that the Insured has stayed or the transport company, the loss or the damage shall be accepted in writing from the authorized

person or

2. Robbery, Gang robbery, or any other actions that involve force or threat from the individual towards the

Insured in order to take the baggage and/or personal property

3. Theft in the room of the hotel with the evidence of break-in in the room that the Insured has registered to stay

as the hotel guest,

The Company shall pay the compensation for the loss or the damage of the baggage and/or personal property for

the single limit or the pair or set that receives the damages or the pair or set that receives partial damage but cannot function

again.

The payment shall be made according to the actual amount of loss or damage in the highest amount of not

exceeding the sum insured as specified in the Policy Schedule.

Additional Conditions and Provisions (Shall be enforced only for the Damage or Loss of Baggage and/or Personal

Belongings)

1. How to Pay Compensation and Limitation of Company Liability

The Company has the right to pay the compensation by any methods as follows:

1.1 Pay in cash according to the actual value while the loss or the damage of the property has occurred in

which the depreciation of the property has been considered. The limitation of amount per single limit or each pair or set shall

not exceed 5,000 baht and shall not exceed the total sum insured as specified in the Policy Schedule or

1.2 Repair according to the actual loss or damage or

1.3 Procure the similar property as replacement

2. Duties of Insured for the Claim for Compensation

When the loss or the damage occurs, the Insured shall practice as follows:

2.1 The Insured shall notify the hotel or the carrier or the police officer in the locality about the damages as

soon as possible, except if the Insured is unable to perform such action due to the necessity or is in an incidence that causes the

Insured to be unable to make such notification.

2.2 The Insured shall follow all procedures for the baggage and the personal property of the Insured to be

taken care of.

2.3 The Insured shall be responsible for the deductible towards the loss or the damage in the sum insured as

specified in the table of policy for each loss or damage and every loss or damage.

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2.4 The Insured, the beneficiary, or the representative of the said individual as the case may be shall notify

and submit the documents or the evidence to the Company within 30 days as from the time of occurrence at its own expense.

2.4.1 Letters, documents, or other evidence that are issued by the carrier or the hotel by specifying the

details of damage in case the damage is in the control of the hotel staff or other residences that the Insured has stayed or the

transport company.

2.4.2 Property irregularity report that is issued by the carrier and the hotel executive by specifying the

details of damage in case the damage is in the control of the hotel staff or other residences that the Insured has stayed or the

transport company.

2.4.3 Notice or daily report of the police officer in the locality that the incidence has taken place in

case of robbery, being threaten, or being treated with violence in order to steal the baggage and/or the personal property inside

the baggage.

The non-submission of evidence within the specified period of time shall not cause the Company to

deny the liability.

3. Other Insurances and Average Liabilities

In case the damage has occurred and it is found that the Insured has made the insurance for the same damage

with other insurance companies, whether it is done by the Insured itself or other individuals that are done in the name of the

Insured, the Company shall average the compensation to be not exceeding the average according to the amount that the

Company has received the insurance per the total sum insured, but shall not exceed the sum insured that the Company has

received in the insurance.

4. Subrogation

In case the Company pays the compensation according to the insurance policy, the Company shall subrogate

the right of the Insured that receives the coverage from any individuals or organizations only in the part that the Company has

paid the compensation. In this regard, the Insured shall cooperate with the Company in delivering the documents and proceeding

with the necessary operations to prevent all rights and shall not perform any actions that shall damage the right of the Company.

Additional Exclusions (Shall be enforced only for the Damage or Loss of Baggage and/or Personal Belongings)

The Insurance according to this coverage agreement shall not cover:

1. The deductible as specified in the Policy Schedule (if any)

2. The loss or the damage that occurs from the seizure of property or the detention of property under the

customs law, the forfeiture of property by the government, the transportation, the illegal goods, or any actions that

contradict the law

3. The loss or the damage of the property as follows:

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(1) Pets; jewelries; valuable objects; arts or antiques; alcoholic drinks; stock certificates; bills of

exchange; promissory notes; traveler’s cheques; travel tickets and tour tickets; drafts; credit

cards, debit cards, and ATM cards; cash; bank notes; coins; or souvenirs

(2) Baggage of the Insured that is sent in advance, not going together with the Insured

(3) Property in the bag that is not the baggage, which are wallets, handbags, or bags with general

usage that is different from the baggage, except those that are in the baggage

(4) Equipment that is rented or the equipment for rent

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Coverage Agreement

Damage or Loss of Travel Documents


Robbery means Theft by using physical force to hurt or threat at the moment in

order to

1) Provide the convenience for the theft or to take away the

property or

2) Deliver the property or

3) Seize the property or

4) Cover up the offense or

5) Release from being arrested

Hence, theft means ill-gotten property of other persons or those that

belong to other persons.

Pillage means Robbery that is done by 3 persons and more.

Coverage

While the Insured receives the coverage according to this insurance policy, if the documents that are relevant

with the travel, which are passport, travel ticket, traveler’s cheque, and cash, including credit card of the Insured that occurs

from the damage or the loss due to robbery or pillage, the Company shall pay the compensation as follows:

1. Fee for making the new documents that are relevant with the travel, including the necessary accommodation

cost if the travel postponement for the outbound trip is needed because of not receiving the travel documents within the date of

traveling back as specified in the Policy Schedule.

2. Cash

3. Liability to the loss of credit card from the cause that receives the coverage and is illegally used by other

individuals apart from the card holder by which the Company shall provide the coverage for the amount of damage that occurs

after the Insured has reported the loss to the Company that issues the credit card and does not receive the coverage by the

Company that issues the credit card.

Hence, the Company shall pay the compensation for the actual damage, but shall not exceed the sum insured as

specified in each list in the Policy Schedule.

Additional Conditions and Provisions (Shall be enforced only for the Damage or Loss of Travel Documents)

1. The Insured shall report the loss of credit card to the Company that issues the credit card.

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2. The Insured shall report the damage or the loss to the authorized police officer in the locality that the incidence

occurred within 24 hours as from the time of occurrence.

3. The Insured shall not abandon the property in public without supervision or leave in any vehicles or the loss

that results from the omission or the negligence of the Insured in supervision.


The Insured, the beneficiary, or the representative of the said person as the case may be shall submit the following

evidence to the Company within 30 days as from the date that the loss or the damage occurs at its own expense.


2. Confirmation letter for the loss that is issued by the hotel executive with the details of loss or damage

3. Notice or daily report of the police officer in the locality that the incidence occurs

4. Proof of currency exchange or purchase of traveler’s cheque (if any)

5. Boarding pass


liability.

Additional Exclusions (Shall be enforced only for the Damage or Loss of Travel Documents)

The Insurance according to this coverage agreement shall not cover:

1. The actions of the Insured while being under any of the conditions as follows:

(1) While being under the influence of addictive substances or narcotics and is unable to remain conscious

(2) While being under the influence of liquor with the alcohol level in the body during the examination in

equivalent with the alcohol level in blood from 150 milligram percent and above

(3) While being under the influence of liquor and is unable to remain conscious in case of no measurement

or in case the measurement for alcohol level cannot be done

2. The damage or the loss occurs while the Insured is taking part in the fight or provoking the fight.

3. The loss that occurs from mistake, forgetfulness, and negligence of the Insured in the care and the

prevention as deemed appropriate for the safety of the passport.

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Coverage Agreement

Damage or Loss of Notebook Computer


Notebook computer means Computer and full set of carrying bag, including components or

accessories that are the standard equipment of notebook computer.

Handheld computer, including tablet PC, tablet computer, or any

other portable devices, shall not be included in this category.

Intrinsic value means Value of property as from the date that the loss or the damage

occurs with the depreciation of the property.

Coverage

While the Insured receives the coverage according to this insurance policy, if the notebook computer of the

Insured that is carried during the travel is lost or damaged from any of these incidences while traveling:

1. Mistake of the transport company or the hotel staff while the Insured has left the notebook computer and the

hotel staff or the transport company agrees to keep in its own protection

2. Theft with the evidence of breaking into the hotel room that the Insured has registered to stay as the hotel

guest

3. Robbery, threatening, or violent action to steal the notebook computer,

The Company shall pay the compensation for the repair work or the procurement of notebook computer in the

same or similar model in case the Company considers that it cannot be repaired. In case the Company cannot procure the

notebook computer in the same or similar model, the Company shall pay the compensation in cash according to the intrinsic

value of the notebook computer, but shall not exceed the sum insured as specified in the Policy Schedule.

Additional Conditions and Provisions (Shall be enforced only for the Damage or Loss of Notebook Computer)

1. The Insured shall notify the hotel or the carrier or the police officer in the locality about the loss or the damage

as soon as possible.

2. In case the Company has paid the compensation according to the insurance policy, the Company shall

subrogate the right of the Insured that receives the coverage from any individuals or any organizations only in the part that the

Company has paid the compensation. In this regard, the Insured cooperates with the Company to submit all documents and

takes necessary actions to protect all rights and shall not perform any actions that shall damage the rights of the Company.

3. While the damage occurs and it appears that the Insured has made an insurance for the same loss or damage

with other insurance companies, whether it is done by the Insured itself or by other individuals in the name of the Insured, the

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Company shall average the compensation in not exceeding the average according to the amount that the Company has received

the insurance per the total sum insured, but shall not exceed the sum insured that the Company has received the insurance. It is

agreed that in this compensation payment, the Company shall not use the order of insurance for before and after as the allegation

for participating in the average compensation.





2. Confirmation letter for the loss that is issued by the hotel executive or the executive of the carrier by

specifying the details of loss or damage

3. Notice or daily report of the police officer

4. Original copy of receipt or evidence document that specifies the date of purchase, model, and the serial

number of the notebook computer


liability.

Additional Exclusions (Shall be enforced for the Damage or Loss of Notebook Computer)


1. This coverage agreement does not cover the deductible (if any)

2. Seizure or confiscation of property under the law, the forfeiture of property by the government, the transportation

of illegal goods, or other actions that contradict the law

3. Loss or damage to the property that receives the compensation from the hotel or the carrier

4. The Insured forgets the notebook computer in any vehicles or public places or the loss that occurs from the

negligence of the Insured in the care and the prevention as deemed appropriate for the safety of the notebook computer

5. Loss of product or product sample that is not the personal notebook computer of the Insured

6. Loss of information that is recorded in the tape, program, diskette, record card, or other things by the same token

7. Loss or damage that occurs from the breakdown or the defect of the mechanical system of the property or any

parts of the property

8. Loss or damage towards any parts of the property by self-combustion, breakdown or defect of electrical system,

or the self-combustion

9. Damage that occurs from the general wear and tear according to the useful life; the laceration, erosion, rust, or

stain; harm from animals or insect bite; being destroyed by animals; restoration; scratching; friction; or color fading

10. Damage from scratch and/or decoration for beauty, such as deletion of scratch

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Coverage Agreement

Golfer Benefits


Golf equipment means Golf club and golf bag

Coverage

While the Insured receives the coverage according to this insurance policy,

1. If the golf equipment of the Insured that is contained in the golf bag for traveling of the Insured in which the

Insured has carried from Thailand is lost or damaged from any incidences while traveling:

1.1 Mistake of the transport company or hotel staff while the Insured has left the golf equipment and the hotel

staff or the transport company agrees to keep in its own protection

1.2 Theft with the evidence of breaking into the hotel room that the Insured has registered to stay as the hotel

guest

1.3 Robbery, threat, or the use of violent force to steal the golf equipment,

The Company shall compensate for repair work for the damage or the loss of golf equipment or procure the same or

similar model or compensate in cash according to the intrinsic value of the property at the time of occurrence in case the

replacement cannot be done, but shall not exceed the sum insured as specified in the Policy Schedule.

2. If the Insured can make hole-in-one in the competition that is official and non-official under the rules and

regulations of the compensation that is arranged in any 18-hole standard golf course that is open for the general people to join

in the competition and the player, course manager, and competition organizer have signed the name to verify the hole-in-one,

the Insured has the right to receive the prize money according to the amount as specified in the Policy Schedule.

Additional Conditions and Provisions (Shall be enforced only for the Golfer Benefits)


The Insured, the beneficiary, or the representative of the said individual as the case may be shall submit the following

evidence to the Company within 30 days as from the date that the loss or the damage occurs at its own expense.


2. Photograph and receipt that shows the list of golf equipment that is damaged

3. Property irregularity report that is insured by the carrier and the hotel executive by specifying the details of loss or

damage in cause the loss or the damage is in the control of the hotel staff or the transport company

4. Notice or daily report of the police officer in the locality that the incidence occurs

5. Boarding pass

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6. Letter with the signature of golf course manager or the competition organizer

7. Score card (in case the Insured can make hole-in-one in the competition)

The non-submission of evidence within the specified period of time shall not cause the Company to deny the liability.

Additional Exclusions (Shall be enforced only for the Golfer Benefits)


1. Damage of the golf equipment due to the erosion or the deterioration of the equipment

2. Loss or damage of the golf ball

3. Damage that occurs from the search, detention, arrest, confiscation, or possession by the customs officer,

immigration office, police officer, soldier, or operational officer in the airport