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UltraCare - AOC Insurance Broker Powered By Docstoc
					InterGlobal in Thailand                           Broker Contact : AOC Insurance Broker
IAG Insurance (Thailand) Limited                  France : contact@aoc-insurancebroker.com - Tél : + 33 1 56 07 07 07 - + 33 6 09 12 32 89
24th Floor, Thanapoom Tower                       Thailand : asia@aoc-insurancebroker.com - Tél : + 66 832 99 42 86
1550 New Petchburi Road                           Website : www.aoc-insurancebroker.com
Makkasan, Ratchtevi
Bangkok 10400
Thailand


                                                                                                                                                                                           UltraCare
UK China Japan Kuwait Qatar Singapore South Africa Thailand UAE Vietnam




                                                                                                                                                                                           Healthcare Plans
UltraCare is the brand name for the international private medical insurance plans developed by InterGlobal Ltd, a company                    registered in England No 3554885.
                                                                                                                                                                                 1t/0111
InterGlobal UltraCare plan




               InterGlobal
               provides...
                ...international private medical insurance for expatriates, frequent travellers and
                international business people all over the world.
                We cover individuals, families and corporate or affinity groups who have a
                need for quality international medical insurance coverage.
                As specialists in international private medical insurance, we can provide you with
                a passport to global protection.
                Wherever you are, you will have the reassurance of knowing that you have access
                to medical assistance, wherever you happen to be.
                                                                                                    InterGlobal UltraCare plan




Wherever you are,                            Why should I buy                               Why choose InterGlobal?
you’re in safe hands                         international health                           We pride ourselves in high quality service
                                                                                            and exceptional cover. All our products are
Life is full of uncertainties. You can’t     insurance?                                     designed to provide total peace of mind and
plan for what is going to happen, but
                                             When you are away from home, you               the level of protection you need backed by
you can ensure that regardless of where
                                             want to know that you and your family,         full international support from our offices
in the world you may find yourself, you’re
                                             or employees, will be able to access good      around the globe, our 24/7 international
covered against almost all eventualities
                                             quality healthcare wherever you are. With      assistance companies and a worldwide
with international health insurance
                                             our plans, you have the flexibility to visit   network of health advisors and hospitals.
from InterGlobal.
                                             any private or public hospital or clinic for    •	 A no claims bonus that allows you
                                             medical treatment.                                 to reduce your premiums every year.
                                             This means that you can relax and use           •	 red24, a 24/7 helpline and rescue and
                                             your time and money to do the things               repatriation service for any security
                                             that you enjoy.                                    related incidents abroad. See page 5
                                                                                                for more information.
                                             Who are InterGlobal?
                                                                                             •	 Emergency medical evacuation
                                             Since 1998, InterGlobal has built an               and repatriation for the entire
                                             excellent reputation for innovative products       family should a member become
                                             and service, recognition of which has come         critically ill.
                                             from being voted “International Private
                                             Medical Insurer of the Year” in 2010 and        •	 The financial bonus on every plan of
                                             “Best International PMI Provider of the            only paying for the first child and having
                                             Year” in 2010.                                     the second, third and fourth go free.

                                             The company, founded in 1998 and                •	 The flexibility of having a choice of five
                                             known for its innovation, flexibility and          plans, plus optional add-on plans and
                                             personal approach to customer service,             choice of currency, payment frequency
                                             has seen great success and growth in               and area of cover.
                                             the highly competitive and growing              •	 Peace of mind of knowing that
                                             international private medical insurance            your health and well-being are
                                             market.                                            being looked after by a financially
                                             We are specialists in international health         secure organisation with a B++
                                             insurance, with the infrastructure, security       (Good) rating.
                                             and expertise to give you confidence in our
                                             products and service.




                                                                                                                                      03
 InterGlobal UltraCare plan




The UltraCare plan
Our UltraCare plans provide private
healthcare insurance cover for
expatriates, frequent travellers and
international business people all
over the world. These great value
plans cover individuals, families and
corporate or affinity groups who
have a need for quality international
private medical insurance cover.
We have five plans ranging from
in-patient medical treatment only, right
through to a full refund for most in- and
out-patient medical treatments. These
plans can be easily extended giving you
additional cover and extra flexibility with
our optional add-on plans.




Choose the right
plan for you



1         UltraCare
          Elite                                           2        UltraCare
                                                                   Plus                                            3        UltraCare
                                                                                                                            Comprehensive
 All the Plus plan benefits with increased                All the benefits of the Comprehensive                     As for the Select plan but with higher
 complementary medicine coverage, annual                  plan but with higher limits. Includes                     limits and cover for primary consultations,
 dental check up and fully paid cancer care.              red24 ActionResponse.                                     dental and wellness benefits, plus red24
 Includes red24 ActionResponse.*                                                                                    ActionResponse.




4         UltraCare
          Select                                          5        UltraCare
                                                                   Standard
 Full in-patient and daycare treatment with               Full in-patient and daycare treatment,
 limited cover for out-patient treatment,                 plus red24 AdviceLine.
 including primary consultations. Includes
 red24 AdviceLine.                                                                                                  All plans include red24 cover.


Please see pages 6 to 9 of this brochure for more information about our plans and benefits.
* Elite plan benefits from ‘no excess or co-insurance’. However it is not possible to add a voluntary excess like you can with the other plans.
Only available for area 2 and area 3.


04
                                                                                                          InterGlobal UltraCare plan




24/7 worldwide                                     Who are red24?                                Choose from one of two
security assistance                                red24 provides you with access to round       levels of red24 support
                                                   the clock advice and the support of 400
red24 is a 24/7 security assistance service that                                                 There are two levels of red24 cover available
                                                   specialist travel safety advisors worldwide
provides you and your immediate family with                                                      free of charge. Both levels of cover offer
                                                   who aim to reduce the risk of things going
peace of mind during your travels.                                                               access to the 24/7 travel assistance phone
                                                   wrong whilst overseas, and to be at hand
                                                                                                 line, travel safety text alerts, family
                                                   for any security related incident should
                                                                                                 membership* and full access to red24’s
                                                   trouble occur.
                                                                                                 continuously updated website with in-depth
                                                   Our partnership with red24 allows us to       safety information for over 185 countries.
                                                   provide peace of mind to you when facing
                                                                                                 AdviceLine: Tailored information before
                                                   potentially dangerous situations, safe in
                                                                                                 you travel as well as expert advice at the end
                                                   the knowledge that your plan incorporates
                                                                                                 of the phone during any situation. Available
                                                   access to help, advice and evacuation
                                                                                                 on all UltraCare Standard and Select plans.
                                                   should the need arise.
                                                                                                 ActionResponse: Provides all of the
                                                                                                 support of AdviceLine, plus support on
                                                                                                 the ground, including an emergency
                                                                                                 security evacuation service in the event
                                                                                                 of a life-threatening situation affecting
                                                                                                 you or your immediate family. Available
                                                                                                 on all UltraCare Comprehensive, Plus and
                                                                                                 Elite plans.
                                                                                                 *Includes partners and families living in the
                                                                                                 same household.




                                                                                                                                           05
InterGlobal UltraCare plan



Table of benefits - UltraCare
                                                                          Elite            Plus         Comprehensive              Select              Standard
1     Overall limits
      Under the terms and conditions of the plan, we will pay
1.1   reasonable costs up to an overall maximum, for you in           THB 80,000,000   THB 80,000,000    THB 80,000,000        THB 80,000,000         THB 34,000,000
      each plan year (unless a lifetime limit is shown):



2     In-patient and daycare treatment
      (see section 19 for deductibles)

2.1   Accidents and emergencies
2.2   Hospital accommodation
    Intensive care, theatre costs, nursing fees, medical
    expenses and other charges, surgeons’, consultants’,
    anaesthetists’ and medical practitioners’ fees,
2.3
    prescribed drugs, MRI, PET and CT scans, X-rays,
    pathology, diagnostic tests and procedures and
    physiotherapy by a registered physiotherapist
                                                                        Paid in full     Paid in full       Paid in full          Paid in full          Paid in full
      Reconstructive surgery following an accident
2.4
      or following surgery for an eligible medical condition
      Prostheses: artificial body parts surgically implanted
2.5
      to form permanent parts of your body
      Parent accommodation (for an insured parent with
2.6
      an insured child under 18 years of age in hospital)
2.7   Accidental damage to natural teeth
      Psychiatric treatment and psychotherapy for up to
2.8   30 days, available after you have had 12 months                                                      Not covered           Not covered            Not covered
      continuous cover under the plan



3     Out-patient treatment
      (see section 19 for deductibles)

                                                                                                                                                          Up to $510
                                                                                                                                                     paid in each plan
                                                                                                                                                      year immediately
      Consultations to include medical practitioners’                                                                                                following related
3.1   fees, prescribed drugs and dressings, X-rays, pathology,          Paid in full     Paid in full                                                   in-patient or
      diagnostic tests and procedures                                                                                                               daycare treatment
                                                                                                             Paid up to            Paid up to           for a period of
                                                                                                               $8,500                $5,100              90 days after
                                                                                                         *Complementary        *Complementary         leaving hospital
                                                                                                           medicine and          medicine and
      Psychiatric treatment and psychotherapy available
                                                                        Paid up to       Paid up to         treatment,            treatment,
3.2   after you have had 12 months continuous cover under
                                                                       THB 136,000      THB 136,000     traditional Chinese   traditional Chinese
      the plan
                                                                                                           medicine and          medicine and
      Complementary medicine and treatment by a therapist,                                                 physiotherapy         physiotherapy
      when referred by a medical practitioner, consultant                                                    limited to            limited to
3.3                                                                     Paid up to       Paid up to
      or specialist. This benefit covers osteopathic, chiropractic,                                            $1,700                $1,275
      homeopathic and acupuncture treatment only*                      THB 204,000      THB 136,000
                                                                                                                                                        Not covered
3.4   Traditional Chinese medicine*
      Physiotherapy by a registered physiotherapist, when
3.5   referred by a medical practitioner, consultant
      or specialist*
                                                                        Paid in full     Paid in full
3.6   MRI, PET and CT scans
                                                                                                            Paid in full          Paid in full
3.7   Out-patient surgical operations




06
                                                                                                                                                  InterGlobal UltraCare plan




                                                                            Elite                    Plus               Comprehensive                 Select                 Standard
4     Out-patient dental treatment
    Treatment for the immediate relief of dental pain,
    accidental damage to natural teeth and restoring
    natural teeth including X-rays, fillings, extractions,
                                                                          Paid up to            Paid up to 75%           Paid up to 75%
4.1 root-canal treatment, gum treatment, semi-precious
                                                                         THB 51,000               THB 51,000               THB 34,000
    and replacement crowns. This benefit is available after                                                                                          Not covered              Not covered
    you have had 182 days continuous cover under the
    plan (see section 19 for deductibles)
      One dental checkup in each plan year to include                    Paid up to
4.2                                                                                               Not covered              Not covered
      scraping, cleaning and polishing                                   THB 6,800



5     Cancer care
      (see section 19 for deductibles)

      Treatment aimed to cure cancer, including bone                                                                                                                         Covered in the
5.1
      marrow transplants                                                                                                                                                  benefit limit shown
                                                                                                                                                                              in sections 2.
                                                                                                                                                                             Covered in the
                                                                                                                                                                          benefit limit shown
                                                                                                                                                                             in section 3.1
                                                                                                   Paid in full             Paid in full             Paid in full
      Stabilising acute episodes of a cancer which is                                                                                                                    immediately following
5.2                                                                                                                                                                          in-patient or
      diagnosed as a chronic medical condition
                                                                                                                                                                          daycare treatment
                                                                         Paid in full                                                                                      for a period of 90
                                                                                                                                                                           days after leaving
                                                                                                                                                                                hospital
      Consultations, tests, drugs and dressings to maintain                                     Covered in the           Covered in the           Covered in the
5.3   the symptoms of a cancer which is diagnosed as a                                        benefit limit shown      benefit limit shown      benefit limit shown
      chronic medical condition                                                                 in section 7.2           in section 7.2           in section 7.2
                                                                                                                                                                              Not covered
                                                                                                Covered in the           Covered in the           Covered in the
    Palliative and hospice care when cancer is diagnosed
5.4                                                                                           benefit limit shown      benefit limit shown      benefit limit shown
    as a terminal medical condition
                                                                                                in section 8.1           in section 8.1           in section 8.1


6     Wellness benefit
      Adults (18 and over): routine health checks
      including cancer screening, cardiovascular examinations,
6.1                                                                       Paid up to               Paid up to               Paid up to
      neurological examinations, vital sign tests (for example,                                                                                      Not covered              Not covered
      blood pressure, cholesterol checks) and vaccinations               THB 34,000               THB 34,000               THB 27,200
6.2   Children (0-17): well-child tests and vaccinations



7     Chronic medical conditions
      (see section 19 for deductibles)

                                                                        Covered in the           Covered in the           Covered in the            Covered in the           Covered in the
      Stabilising acute episodes of chronic medical
7.1                                                                 benefit limits shown     benefit limits shown     benefit limits shown      benefit limits shown      benefit limit shown
      conditions
                                                                     in sections 2 and 3      in sections 2 and 3      in sections 2 and 3       in sections 2 and 3          in sections 2.
                                                                                                                                                                             Covered in the
                                                                                                                                                                          benefit limit shown
                                                                                                                                                                             in section 3.1
                                                                         Paid up to a             Paid up to a              Paid up to a             Paid up to a        immediately following
      Consultations, tests, drugs and dressings to maintain                                                                                                                  in-patient or
7.2                                                                    lifetime limit of        lifetime limit of         lifetime limit of        lifetime limit of
      the symptoms of a chronic medical condition                                                                                                                         daycare treatment
                                                                       THB 4,080,000            THB 4,080,000             THB 3,400,000            THB 2,720,000
                                                                                                                                                                           for a period of 90
                                                                                                                                                                           days after leaving
                                                                                                                                                                                hospital
      Please note: If a chronic medical condition becomes terminal, cover under the chronic medical conditions benefit will end. We can only cover terminal medical conditions under the
7.3
      terminal illness benefit




                                                                                                                                                                                            07
 InterGlobal UltraCare plan


Table of benefits (continued)
                                                                                                  Elite                            Plus                    Comprehensive                  Select                Standard
 8     Terminal illness
                                                                                              Paid up to a                     Paid up to a                        Paid up to a          Paid up to a
       Palliative and hospice care for a terminal
8.1                                                                                         lifetime limit of                lifetime limit of                   lifetime limit of     lifetime limit of         Not covered
       medical condition
                                                                                            THB 4,080,000                    THB 4,080,000                       THB 3,400,000         THB 2,720,000


 9     Hormone replacement therapy
                                                                                                                                                                                                              Up to THB 10,200
                                                                                                                                                                                                              paid in each plan
                                                                                                                                                                                                              year immediately
                                                                                                                                                                                                              following related
       Hormone replacement therapy for pre- and post-                                          Paid up to                       Paid up to                         Paid up to             Paid up to
9.1                                                                                                                                                                                                             in-patient or
       menopausal symptoms                                                                    THB 10,200                       THB 10,200                         THB 10,200             THB 10,200
                                                                                                                                                                                                             daycare treatment
                                                                                                                                                                                                              for a period of 90
                                                                                                                                                                                                              days after leaving
                                                                                                                                                                                                                   hospital


10     HIV or AIDS
       available after you have had 4 years continuous cover from the date that the benefit was first introduced on your plan (see section 19 for deductibles)

                                                                                        Paid up to a lifetime            Paid up to a lifetime            Paid up to a lifetime      Paid up to a lifetime
       Treatment for HIV or AIDS and related medical
10.1                                                                                          limit of                         limit of                         limit of                   limit of              Not covered
       conditions
                                                                                          THB 3,400,000                     THB 3,400,00                    THB 3,400,000              THB 3,400,000


11     Emergency local ambulance
       Costs of appropriate ambulance transport needed
11.1 because of an emergency or medical necessity to                                           Paid in full                     Paid in full                       Paid in full           Paid in full           Paid in full
       the nearest available and appropriate local hospital



12     Organ transplants
       (see section 19 for deductibles)

       Transplants of kidney, liver, heart, lung or heart and lung
                                                                                             Paid up to                       Paid up to                       Paid up to               Paid up to               Paid up to
12.1 and any related treatment that you need as a result
                                                                                           THB 17,000,000                   THB 17,000,000                   THB 17,000,000           THB 17,000,000           THB 17,000,000
       of a covered medical condition


13     Nursing at home
       Primary care services of a registered nurse in your
                                                                                              Paid up to                       Paid up to                         Paid up to             Paid up to              Paid up to
13.1 home immediately after, or instead of, in-patient or
                                                                                             THB 340,000                      THB 340,000                        THB 170,000            THB 170,000             THB 102,000
       daycare treatment
13.2 Please note: The benefit for nursing at home does not apply to terminal medical conditions. We can only cover terminal medical conditions under the terminal illness benefit



14     Compassionate emergency visit
     Costs you have to pay for an economy class return ticket
     from a country within your area of cover to visit a
     close family member, if their medical condition
14.1                                                                                           Paid in full                     Paid in full                       Paid in full           Paid in full           Not covered
     results in them being placed on a critical list, or their
     death. You are limited to one return journey in each
     plan year


15     Hospital cash benefit
                                                                                             THB 17,000                       THB 17,000                       THB 17,000                THB 17,000              THB 17,000
       Cash payment made to you for each night where you
15.1                                                                                     paid for each night,             paid for each night,             paid for each night,      paid for each night,    paid for each night,
       receive treatment as a non-paying patient
                                                                                         up to THB 510,000                up to THB 510,000                up to THB 510,000         up to THB 510,000       up to THB 510,000




08
                                                                                                                                                 InterGlobal UltraCare plan




                                                                              Elite                  Plus               Comprehensive                 Select                 Standard
16     Evacuation and repatriation
     The costs to transport you to the nearest centre where
     appropriate medical facilities are available. We will only
     pay this benefit, including treatment received, if you
16.1
     suffer from a medical condition; (a) that means you
     need to be placed on a critical list, or (b) for which, in
     our opinion, appropriate treatment is not available locally
       Economy class return ticket following your evacuation,
16.2
       to the country where you live
                                                                                                                                                                              Paid in full
     Costs of your dependants, a close family member
                                                                                                                                                                           when relating to
     or business colleague having to accompany you for                     Paid in full            Paid in full             Paid in full             Paid in full
                                                                                                                                                                           in-patient and
     a medical evacuation. This benefit will only become
                                                                                                                                                                         daycare treatment
     available under the conditions detailed in clause (a) of
     benefit section 16.1 above and must be pre-authorised
16.3
     by us
     We will provide cover for the following:
     • return economy flight
     • overnight accommodation to include breakfast
     • return taxi from the airport to the hotel
     • return taxi from the hotel to the hospital once a day


17     Mortal remains
     If you die outside of your home country, we will
     pay the costs of preparing and transporting your body,
17.1 mortal remains or ashes to your home country, or                      Paid in full            Paid in full             Paid in full             Paid in full             Paid in full
     we will pay the costs of preparing your body or mortal
     remains for local burial or cremation



18     Emergency medical treatment outside area of cover
       (see section 19 for deductibles)

       Emergency medical treatment outside of your                         Paid up to              Paid up to               Paid up to               Paid up to
18.1                                                                                                                                                                         Not covered
       area of cover                                                     THB 2,380,000           THB 2,380,000            THB 2,060,000            THB 1,360,000


19     Deductibles
       Out-patient medical treatment standard excess
19.1 on benefit sections 3, 5, 7 and 10 (applied for each                      Nil                 THB 1,800                THB 1,800                THB 1,800                THB 1,800
       medical condition in each plan year)
                                                                                                  Only applied if          Only applied if          Only applied if          Only applied if
     In-patient, daycare and out-patient medical                                               you have chosen a        you have chosen a        you have chosen a        you have chosen a
     treatment excess on benefit sections 2, 3, 5, 7, 10,                                     voluntary excess. This   voluntary excess. This   voluntary excess. This   voluntary excess. This
19.2                                                                           N/A
     12 and 18 (applied for each medical condition in each                                    replaces the standard    replaces the standard    replaces the standard    replaces the standard
     plan year)                                                                                excess as shown in       excess as shown in       excess as shown in       excess as shown in
                                                                                                   section 19.1             section 19.1             section 19.1             section 19.1
       Out-patient dental treatment co-insurance on
19.3                                                                           Nil                    25%                      25%                       N/A                      N/A
       benefit section 4.1 (applied to each claim)


20     red24 security services
                                                                                                                                                 Included on your         Included on your
                                                                                                                                                plan. Please contact     plan. Please contact
20.1                                                                                                                                               red24 or visit           red24 or visit
       AdviceLine - 24/7 personal security information and              Included on your       Included on your         Included on your         www.red24.com/           www.red24.com/
       advice for all travel safety queries                            plan. Please contact   plan. Please contact     plan. Please contact          interglobal              interglobal
                                                                          red24 or visit         red24 or visit           red24 or visit
                                                                        www.red24.com/         www.red24.com/           www.red24.com/
                                                                            interglobal            interglobal              interglobal
20.2                                                                                                                                                     N/A                      N/A
       ActionResponse - 24/7 international rescue and response
       service for a potentially life-threatening, non-medical event




                                                                                                                                                                                             09
 InterGlobal UltraCare plan


UltraCare premiums Valid from 1 January 2011
These premiums apply to all new and renewing plans from 1 January 2011. We will review these premiums every year. Premiums may also be
reviewed periodically.
Working out your premium
Working out the premiums to pay is easy.
1.   Choose the UltraCare plan you want based on the cover you need (Elite, Plus, Comprehensive, Select or Standard).
2.   Choose the area of cover you need. (See the areas of cover below).
3.   Read across the premium table based on your current age and that of any dependants.
4.   Choose how often you want to pay the premiums (every month, every three months or every year).
5.   Choose an excess option (if available and if you need one) and adjust the premium based on the information below.
The premiums for any children (aged 0 to 17) on the plan apply to the first child only (second, third and fourth children are free).
If you are over 74 we will give you a quote for your renewal premiums.
Due to admininstration costs, the total premiums you pay every month or every three months via credit card will be higher than if you pay
the premiums every year (7.5% if you pay every month and 5% if you pay every three months). The premiums shown are rounded to the
nearest decimal place so they are easier for you to use.


Areas of cover

Area 2: Worldwide, not including the USA.

A list of countries and areas is available on our website at www.nzihealthcare.com.
Please see the eligibility section in the plan guide for restrictions on US citizens.


Excesses (deductibles)
The currency of your excess is based on the currency of your plan.
UltraCare Elite plan only
This plan does not have an excess. You cannot choose a voluntary excess.

                                                                                   ExCESS (DEDUCTIBLE) OPTIOnS            PREMIUM CHAnGE
                                                                                   THB 3,400                                 5% discount

UltraCare Plus, Comprehensive and Select plans only                                THB 6,800                                 10% discount
                                                                                   THB 17,000                                15% discount

You may choose a voluntary excess that is applicable to in-patient,                THB 34,000                                20% discount
daycare and out-patient treatment claims of:                                       THB 68,000                                25% discount
                                                                                   THB 170,000                               30% discount
                                                                                   THB 340,000                               40% discount


                                                                                   ExCESS (DEDUCTIBLE) OPTIOnS            PREMIUM CHAnGE
UltraCare Standard plan only                                                       THB 34,000                                   -10%
For the Standard Plan: You may choose a voluntary excess (applied per              THB 68,000                                   -20%
condition, per year) that is applicable to in-patient and daycare treatment
                                                                                   THB 170,000                                  -30%
claims of:
                                                                                   THB 340,000                                  -40%




10
                                                                                                           InterGlobal UltraCare plan


UltraCare premiums (continued)
Co-insurance (deductibles)
Co-insurance (applies to UltraCare Plus and Comprehensive plans).
You must pay 25% of all out-patient dental claims. The total amount we will pay to you for an eligible claim for out-patient
dental treatment will be 75% of the limit shown on your table of benefits. You cannot remove this co-insurance.


No-claims discount
Your plan premiums depend on your age and will increase as you get older. Your premiums will also increase in line with medical inflation.
As long as no claims are made by the planholder or any dependant on the plan, we will give no-claims discounts on renewal premiums.
These are based on the amount of time the plan has been claim free. If the planholder or any dependant covered under the plan has one
or more claims paid during a plan year, the no-claims discount will be lost until the plan has been claim free for at least one plan year.
The following discounts will apply once the plan has been claim free for the amount of time shown:
•		For	less	than	one	plan	year	-	no	discount
•		For	one	plan	year	-	10%	premium	discount	
•		For	two	plan	years	-	15%	premium	discount	
•		For	three	or	more	plan	years	-	20%	premium	discount	
The maximum no-claims discount is 20%.
If a claim relating to a previous plan year is made and we have already given a no-claims discount, we can recover the extra premium due
for the plan year to which we gave the no-claims discount.
Any claims made for the wellness benefit or optional add-on plans will not affect the no-claims discount. The no-claims discount does not
apply to the premiums of any optional add-on plans you may have chosen.


Paying your premiums
It is important that the planholder keeps payment of premiums up to date and tells us immediately about any changes to payment details.
Full payment details and information on unpaid or late payments can be found in the plan guide. If premiums are not paid on time, we will
suspend all claims until the premiums are up to date.
For yearly premium payments, you can choose to pay by:
•		credit	card;
•		banker’s	draft	or	cheque;
•		bank	transfer.
Monthly and quarterly premiums may only be paid by MasterCard or Visa.
Cheques and bank drafts should be made payable to IAG Insurance (Thailand) Ltd.
Please make sure that you give your full name and quotation or plan number as the reference for your bank transfer.




                                                                                                                                            11
 InterGlobal UltraCare plan


Thai baht (THB) UltraCare premiums
THB 1,800 standard excess per medical condition, per plan is applicable to out-patient claims only.
The Elite Plan has a nil excess. The Standard Plan is in-patient only.
   Age band              Elite                    Plus                Comprehensive                Select                  Standard

      0-17                                       62,007                   48,507                   44,281                   30,910
     18-25                                       74,970                   59,231                   53,922                   39,334
     26-29                                       86,742                   68,827                   62,623                   45,284
     30-34                                       98,833                   78,744                   71,515                   51,553
     35-39                                      110,605                   88,343                   80,344                   57,504
     40-44                                      125,321                  100,303                   91,157                   65,116
                     Not available
     45-49                                      146,687                  117,771                  107,023                   76,124
     50-54                                      185,650                  149,567                  135,942                   95,954
     55-59                                      227,172                  183,540                  166,776                  117,322
     60-64                                      283,855                  229,795                  208,683                  146,431
     65-69                                      340,220                  275,859                  250,461                  175,350
     70-74                                      678,596                  552,115                  501,188                  348,794


Standard excess per medical condition – nil

      0-17              86,188                   68,098                   53,247                   48,600
     18-25             104,003                   82,284                   64,970                   59,130
     26-29             120,448                   95,232                   75,526                   68,702
     30-34             137,339                  108,532                   86,434                   78,483
     35-39             153,785                  121,482                   96,993                   88,196
     40-44             174,342                  137,669                  110,150                  100,089
                                                                                                                         Not available
     45-49             204,191                  161,171                  129,364                  117,540
     50-54             258,622                  204,032                  164,341                  149,352
     55-59             316,629                  249,706                  201,710                  183,269
     60-64             395,815                  312,057                  252,590                  229,367
     65-69             474,556                  374,058                  303,260                  275,323
     70-74             947,268                  746,271                  607,142                  551,124

* Child rate is for the first child only (second, third and fourth are free - except for the Personal Accident Optional Add-on for
  which each additional child is charged the table premium).




12
                                                                                                            InterGlobal UltraCare plan




Optional add-on plans                            Personal accident                                Who can be covered
We also offer three optional add-on plans,       You may need to pay for more than just           by an UltraCare plan?
giving you extra flexibility and cover for       medical treatment if you suffer an injury. Our
                                                                                                  Our plans are available to people of all
things that might be important to you:           optional personal accident add-on plan will
                                                                                                  nationalities and their dependants, except:
                                                 give a lump sum payment for loss of sight,
                                                 loss of limbs, permanent total disablement         •	 Citizens of the USA residing in
Travel insurance                                 or death as a result of an accident.                  the	USA;
If you take a lot of trips away from the                                                            •	 People who are governed by
country where you live, travel insurance is
essential. This yearly plan covers emergency
                                                 Maternity                                             exchange controls or local licensing
                                                                                                       regulations;
medical treatment, lost, damaged or              If you are planning to have a baby, you
                                                                                                    •	 Where cover is illegal under local
delayed baggage and personal belongings,         want to know that you can access the
                                                                                                       laws;	or
travel cancellation, missed departure, hijack,   best healthcare available. Our optional
theft and accidental loss of money               maternity plan will cover most maternity           •	 Anyone who is older than 74 at their
or passports.                                    medical needs, including care during normal           UltraCare plan start date.
                                                 pregnancy and childbirth and cover for
                                                 complications. This plan is not available
                                                 with the UltraCare Standard plan.                Pre-existing medical
                                                                                                  conditions
                                                                                                  We underwrite our plans on a 24 month
                                                                                                  moratorium basis. This means that any
                                                                                                  pre-existing medical conditions that have
                                                                                                  existed in the two years before your plan
                                                                                                  starts will not be covered until you have
                                                                                                  been free of symptoms or treatment for
                                                                                                  two years after the start date of the plan.
                                                                                                  For a full definition of pre-existing medical
                                                                                                  conditions and an explanation of our
                                                                                                  moratorium, please see the UltraCare
                                                                                                  plan guide.



                                                                                                  Transfers
                                                                                                  If you already have a health insurance
                                                                                                  plan with another provider, we may be
                                                                                                  able to continue your cover with the
                                                                                                  same underwriting terms. Please be
                                                                                                  aware that our policy terms, conditions
                                                                                                  and benefits may be different from those
                                                                                                  offered by other insurers.




                                                                                                                                                13
Table of benefits - optional maternity add-on plan
                                                                                                                                                       Area 2

Under the terms and conditions of the plan, we will pay reasonable costs up to an overall maximum for each pregnancy, in each plan year:           THB 68,000,000

Section 1 - Normal pregnancy and childbirth
Delivery costs, antenatal checkups, postnatal checkups, examinations, hospital accommodation costs and nursing charges
This benefit covers no more than three routine antenatal ultrasound scans (one in each trimester) during the term of a normal
uncomplicated pregnancy. If any more ultrasound scans are needed, your treating doctor must provide full reasons in the medical section
of the claim form. This benefit also covers 12 routine antenatal visits during the term of a normal pregnancy. If any more antenatal
visits are needed, your treating doctor must provide full reasons in the medical section of the claim form, so we can consider cover.
This benefit covers the following for the newborn child
• one consultation charge to cover a physical examination, vitamin K, hepatitis B and BCG vaccine
• one hearing test
• routine blood tests for PKU, congenital hypothyroidism and G6PD                                                                                     Paid up to
• accommodation costs for no more than four nights for the newborn child, if the mother is admitted and not suffering                                THB 340,000
   any complications.
Co-insurance
You must pay a co-insurance for each claim under section 1. You can choose to have either:
• no co-insurance;
• 10% co-insurance;	or
• 20% co-insurance.
The total amount payable for a claim under section 1 will be either 100%, 90% or 80% of the benefit limit shown depending on the
co-insurance you have chosen and the area of cover of your plan

Section 2 - Complications in pregnancy during the antenatal period and childbirth
Treatment for a medical complication which happens during the antenatal period or childbirth due to a medical condition. This
benefit does not cover any complication arising during the antenatal, childbirth or postnatal period in a pregnancy resulting from                    Paid in full
assisted conception. This will be limited to the amounts shown in section 1 above

Section 3 - Birth defects and congenital abnormalities
Investigation and treatment of birth defects and congenital abnormalities, including birth trauma, which are diagnosed in the                         Paid up to
first six months from birth. This benefit is available for each pregnancy for 12 months from the date of diagnosis                                   THB 34,000

Section 4 - Terminating a pregnancy
Terminating a pregnancy when medically necessary                                                                                                      Paid in full

Section 5 - Newborn child accommodation
Hospital accommodation costs for a newborn child to stay with its mother when she is receiving treatment as an in-patient in a
                                                                                                                                                      Paid in full
hospital for a medical condition covered under this plan

Section 6 - Emergency local ambulance
Costs of appropriate ambulance transport needed because of an emergency or medical necessity to the nearest available and
                                                                                                                                                      Paid in full
appropriate local hospital

Eligibility
• Cover under this plan is only valid if your UltraCare Elite, Plus, Comprehensive or Select plan is in force
• Available to female members only
• The minimum age at entry for this plan is 18. The maximum age at entry is 44. Once you have reached the age of 46 during your plan year, your cover will not be renewed
• Cover becomes available for treatment received 12 months after the start date of this plan.

Nil Co-insurance                                                                                 20% Co-inurance
18-34                                                                 THB 72,991                 18-34                                                           THB 44,917
35-44                                                                THB 100,713                 35-44                                                           THB 61,932

                                                                                                 You must pay a 20% co-insurance for each claim under section 1. This will be
10% Co-inurance                                                                                  limited to a maximum of 68,000 in total and allows a maximum benefit of THB
18-34                                                                 THB 56,147                 272,000 after you have paid the 20% co-insurance.
                                                                                                 Optional maternity add-on plan premiums can be paid every year.
35-44                                                                 THB 77,471                 The co-insurance you choose will apply for teh first 24 months continuous
                                                                                                 cover under this plan.
You must pay a 10% co-insurance for each claim under section 1. This will
be limited to a maximum of THB 34,000 in total and allows a maximum benefit
of THB 306,000 after you have paid the 10% co-insurance.

14
Table of benefits - optional personal accident add-on plan
Worldwide cover
The optional personal accident add-on plan does not provide cover for sickness or disease

Overall limit
Under the terms and conditions of the plan, if you suffer bodily injury during the plan year, due to any one or more accidents,                                           THB 1,000,000 paid for each unit
we will pay up to an overall maximum for each unit of:                                                                                                                  (maximum of 5 units: THB 5,000,000)

Section A – Accidental death benefit
If you are aged 18 and over and die because of an accident and your death is within 12 months of the accident, this benefit
                                                                                                                                                                           THB 1,000,000 paid for each unit
will be paid to your personal representative

Section B – Accidental death benefit
If you are aged between one day and 17 years and die because of an accident and your death is within 12 months of the
                                                                                                                                                                            THB 100,000 paid for each unit
accident, this benefit will be paid to your personal representative

Section C – Total loss of sight of one eye
Total loss of sight of one eye                                                                                                                                              THB 200,000 paid for each unit

Section D – Total loss of sight of both eyes
Total loss of sight of both eyes                                                                                                                                           THB 1,000,000 paid for each unit

Section E – Permanent disablement
If you suffer a permanent disablement because of an accident within 12 months of the accident which results in the loss of,
                                                                                                                                                                            THB 300,000 paid for each unit
or permanent loss of use of one or more feet, hands, legs below the knee or arms below the elbow
If you suffer a permanent disablement because of an accident within 12 months of the accident which results in the loss of,
                                                                                                                                                                           THB 1,000,000 paid for each unit
or permanent loss of use of one or more legs above the knee or arms above the elbow

Section F – Permanent total disablement
If you suffer a permanent total disablement because of an accident within 12 months of the accident which:
• entirely prevents you from taking part in any business or occupation that you are suited to through education,
  training or experience;                                                                                                                                                   THB 200,000 paid for each unit
• lasts 12 months; and
• is not expected to improve after 12 months

Eligibility
• Cover under this plan is only valid if your UltraCare plan is in force
• You must be aged 18 to 74 when joining this plan
• We provide cover for managerial, clerical and administrative occupations only. If you regularly take part in any occupation, sport, pastime or other activity which puts you at greater risk of a bodily injury caused by
   an accident, the planholder or your plan administrator must tell us. We will tell the planholder or plan administrator if we agree to cover you and let them know any extra premium that will apply.
Accumulation limit
• We will not pay any compensation higher than THB 10,000,000 for multiple members, from all sources for any one location or conveyance.


Premiums - subject to stamp and tax

Yearly premiums - child rate
Per unit: THB 100,000                                                                                                                                                                   THB 1,062

Yearly premiums - ages 18-74
Per unit: THB 1,000,000                                                                                                                                                                 THB 1,784




                                                                                                                                                                                                                       15
InterGlobal UltraCare plan



Table of benefits - optional travel add-on plan
Worldwide cover
Under the terms and conditions of the plan, cover is provided for trips you make of no more than 180 days at a time during the plan year. We will pay reasonable costs up to the
limits shown for each benefit below:

Section A - Medical benefits and limits
If you suffer a medical condition during a trip, we will pay for:
• In-patient, daycare and out-patient medical treatment                                                                                             Paid up to
                                                                                                                                                 THB 136,000,000
• accommodation and travel costs, if medically necessary to return to the country where you live because you cannot return                      in each plan year
    as originally booked
                                                                                                                                             *Dental treatment limited
• accommodation and travel costs for an insured parent to stay with an insured child under the age of 18 because of an eligible                   to THB 68,000
    medical condition up to 30 days                                                                                                                for each trip
• dental treatment for the immediate relief of dental pain*


Section B - Loss of deposits, cancellations or curtailments
We will pay you or your representative for the loss of irrecoverable deposits, pre-payments and other costs paid or contractually
due to be paid for travel or accommodation if your trip is cancelled, or curtailed as a direct result of one of the following:
• your death
• a medical condition suffered by you
• the death of or a medical condition suffered by:
  - the person you are travelling with, or had arranged to travel with
  - a close family member                                                                                                                      Paid up to THB 204,000
                                                                                                                                                     for each trip
• if you, the person you are travelling with or the person you had arranged to travel with must attend jury service or attend as a
  witness under subpoena in a court of law
• compulsory quarantine restriction of you, the person you are travelling with or the person you had arranged to travel with
• a listed natural disaster or similar force majeure causes that happens after a trip is booked
The amount we will pay for cancellation claims is limited to the scale of cancellation charges as defined in the booking conditions
relating to your trip


Section C - Travel delays
Cash payment made to you for each full 12 hours you are delayed because of strikes, industrial action, adverse weather conditions,    THB 3,400 paid for each full 12 hours up to
mechanical breakdown, or failure of aircraft, sea vessels, train or other licensed public transport                                           THB 10,200 for each trip


Section D - Missed departures and travel disruption
We will pay you for additional accommodation and travel costs you have to pay to connect with your group or tour, or to transport
                                                                                                                                                Paid up to THB 68,000
you to your final destination if you have missed your original departure because of severe weather conditions, damage to or
                                                                                                                                                     for each trip
breakdown of the licensed public transport that you were travelling in to your point of departure


Section E - Hijack
                                                                                                                                         THB 6,800 paid for each full 24 hours
Cash payment made to you for each full 24 hours you are unable to reach your destination because your transport is hijacked
                                                                                                                                           up to THB 102,000 for each trip


Section F - Baggage and personal effects
We will pay you for the intrinsic value of, cost of repairs to or re-issue of, whichever is less, property that is lost, damaged or
stolen which you take on a trip, you buy during a trip or you send in advance up to 24 hours before the departure date shown
on your itinerary.
                                                                                                                                               Paid up to THB 136,000
We will pay up to$510 for any one, pair or set of articles, including losses from vehicles hired or owned by you                                     for each trip
if the articles were secured in a locked boot or glove compartment. The most we will pay for all cameras and photographic
equipment, telescopes and binoculars, antiques, jewellery, watches, furs and precious stones and articles made of, or containing
gold, silver or other precious metals is $510 in total


Section G - Delayed baggage
If your baggage is delayed or misdirected by a carrier on the outward journey for 12 or more hours from the time of your arrival,                Paid up to THB 6,800
we will pay you for the costs of essential toiletries and clothing                                                                                   for each trip




16
                                                                                                                               InterGlobal UltraCare plan




Section H - Loss of money
                                                                                                                                  Covered up to THB 34,000
We will pay you for theft or accidental loss of cash, traveller’s cheques, postal or money orders, owned or held by you
                                                                                                                                        for each trip


Section I - Loss of passport, travel documents
We will pay you for the cost of replacing a passport or travel documents owned or held by you, if they are lost or stolen.
                                                                                                                                  Covered up to THB 34,000
We will also pay you for additional accommodation and travel costs that you have to pay during your trip to replace the lost
                                                                                                                                        for each trip
or stolen passport


Deductibles
Standard excess for each claim                                                                                                           THB 1,800

Eligibility
• Cover under this plan is only valid if your UltraCare plan is in force
• You cannot be older than 74 when joining this plan




Optional travel add-on plan premiums
Yearly premiums
                   Single                                         Couple                                        Family                 One parent family

                 THB 7,800                                      THB 15,600                                   THB 19,500                   THB 11,700




                                                                                                                                                             17

				
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