INTERCARE – BAOVIET HEALTHCARE INSURANCE – DIAMOND PACKAGE

BAO VIET INTERCARE 

is a premium healthcare insurance of Bao Viet Insurance Company. The product is designed specifically for the group of VIP customers who need healthcare at high-class domestic hospitals in Vietnam such as Viet Phap, Phap Viet (FV), Vinmec … or hospitals in other countries, even global.

  • No health examination is required before registration
  • Access to the system of modern hospitals in direct billing list.
  • Various insurance benefits, suitable for many budget levels and needs
  • Direct Billing Service 24/7: Customers do not waste time collecting claim documents and do not have to pay hospital fees. All have been paid by BaoViet.

1. INSURED PERSONS:

– From 15 days old to 69 years old.

– Children under the age of 18 must participate in a contract with Dad or Mom (their program is not higher than their parent’s)

– Being a Vietnamese or a foreigner living or working in Vietnam for at least 6 months.

2. WAITING PERIOD: (only apply for the first year insurance)

(A waiting period is defined as a time period in which the relevant benefits will not be paid. Bao Viet shall exclude all risks occurring during that time, including but not limited to their related expenses or consequences thereof which arise after the waiting period as specified.)

  • In case of medical expenses incurred for treatment of normal illness/ diseases: all benefits shall take effects after 30 days from the effective date of the policy.
  • In case of medical expenses incurred for treatment of pre-existing conditions, special diseases, any illness/ diseases hereinafter: all benefits shall take effects after 365 days from the effective date of the policy:
  • The following diseases shall not be covered during the first year in any condition: Adenoidectomy, Tonsillectomy, Septoplasty (Deviated nasal septum surgery), vestibular disorders, asthma, middle ear infection (otitis media) surgery, Sinusitis, Degenerative diseases of the vertebral column/joints, Hemorrhoid Surgery, Herniated disc, polyps.
  • Special diseases:
      1. Cancer and tumors of any kind
      2. Diseases of heart, liver (hepatitis A, B, C), pancreas, kidney, lung failure
      3. Diseases related to hematopoietic (blood forming) system including pancreatic failure, acute and chronic leukemia.
      4. Growth hormone deficiency
      5. Diabetes mellitus
      6. Parkinson’s disease.
  • Pre-existing condition: Any medical conditions of the Insured Person which have been diagnosed; or for which symptoms existed that would cause an ordinary prudent person to seek diagnosis, care or treatment; or for which medical treatment was recommended by a medical practitioner, irrespective of whether treatment was actually received or not.

3. INSURANCE BENEFITS:

BENEFIT SCHEDULE – BAOVIET INTERCARE

Issued with the Decision No. 6608/QĐ-BHBV dated September 21 st, 2017 of the Chief Executive Officer – Bao Viet General Insurance Company

————————————————————————————————————————

Area of coverage

Area 1: VIETNAM

Area 2: ASEAN

Area 3:  ASIA

Area 4: WORLDWIDE EXCLUDING USA AND CANADA

Area 5: WORLDWIDE

CORE PLAN: IN-PATIENT TREATMENT DUE TO ILLNESS/ DISEASE/ ACCIDENT (IP)

Unit: VND

IP Select Essential Classic Gold Diamond
Area of coverage Area 1 Area 2 Area 3 Area 4 Area 5
Maximum Annual Aggregate Limit 1.050.000.000 2.100.000.000 4.200.000.000 5.250.000.000 10.500.000.000
1.   Room and Board/day 4.200.000 /day 6.300.000 /day 10.500.000/day 16.800.000 /day 21.000.000 /day
2.   Intensive care unit (max 30 days/ disease) Full cover Full cover Full cover Full cover Full cover
3.   Companion Accomodation /person/day (max 10 days/year) 1.260.000/ day 1.890.000/ day 3.150.000/ day 5.040.000/d ay 6.300.000/day
4.   Hospital Miscellaneous Expenses (charges incurred for medical supplies and services during a in-patient and/or day-patient treatment)

MRI, PET, CT scans X-rays, pathology, diagnostic tests

Full cover Full cover Full cover Full cover Full cover
5.   Pre-hospitalization treatments within 30 days prior to the hospital admission 21.000.000 42.000.000 63.000.000 84.000.000 105.000.000
6.   Post hospitalization immediately following hospital discharge but not exceeding 90 days from the hospital discharge 21.000.000 42.000.000 63.000.000 84.000.000 105.000.000
7.   Home nursing (as prescribed by Doctor) – Maximum limit  per year 21.000.000 42.000.000 63.000.000 84.000.000 105.000.000
8.   Expenses for Surgeons, consultants, operating theatre  anesthetists, medical practitioners Full cover Full cover Full cover Full cover Full cover
9.   Organ Transplantation of Heart, Lung, Liver, Pancreas, Kidney, Bone, Marrow.
Limit per lifetime
630.000.000 840.000.000 1.260.000.000 1.680.000.000 2.100.000.000
10.  In-hospital Specialist Consultation (max. one visit /day and 90 days/year) 4.200.000 /day Full cover Full cover Full cover Full cover
11.  Emergency Accidental Pregnancy treatment immediately after an accident per policy (exl .embryotrophic) Full cover Full cover Full cover Full cover Full cover
12.  Emergency Accidental Dental Inpatient Treatment (treatment received within 24 hours at the emergency room of a hospital immediately following an accident) per policy period 21.000.000 Full cover Full cover Full cover Full cover
13.  Expenses for transportation in emergency case 21.000.000 42.000.000 63.000.000 84.000.000 105.000.000
14.  Emergency Medical Evacuation & Repatriation (including by air) Full cover Full cover Full cover Full cover Full cover
15.  Emergency Ward Treatment Full cover Full cover Full cover Full cover Full cover
16.  Acute mental disorde (in-patient only) N/A 21.000.000 /year

105.000.000 /lifetime

63.000.000 /year

210.000.000 /lifetime

63.000.000 /year

210.000.000 /lifetime

78.750.000 /year

262.500.000 /lifetime

17.  Family visit N/A N/A N/A 01 Round-trip economy ticket 01 Round-trip economy ticket
18.  Daily Allowance per night (Up to 20 nights/year) 105.000 210.000 315.000 420.000 525.000
19.  Daily Allowance per night in public hospitals

(Up to 20 nights/year)

210.000

 

420.000

 

630.000

 

840.000

 

1.050.000

 

20.  Sub-limit applied for special diseases/ critical illnesses /lifetime

(exclusively applied for individuals and families including in-patient, out-patient, emergency transportation and term life)

210.000.000 420.000.000 840.000.000 1.050.000.000 2.100.000.000
21.   AIDS/ HIV

Cover for treatment occurring during the Insured Period, including the subsequent renewal year(s), provided that it manifests itself after the policy has been continuously in effect for a period of five (5) years since the Entry date.

105.000.000/ lifetime 210.000.000/ lifetime 420.000.000/ lifetime 525.000.000/ lifetime 1.050.000.000/ lifetime

OPTIONAL PLANS

1. OUT-PATIENT TREATMENT DUE TO ILLNESS/ DISEASE/ ACCIDENT (OP) – Optional

Unit: VND

OP Select Essential Classic Gold Diamond
Maximum Aggregate Limit for the whole insurance period 31.500.000 63.000.000 84.000.000 105.000.000 168.000.000
Area of coverage Area 1 Area 2 Area 3 Area 4 Area 5
·         General Practitioners and Specialist fees.

·         Prescribed medicines.

·         Laboratory test, diagnostic and treatment prescribed by a physician.

·         Medical aids which are necessary as part of treatment for broken limbs or injuries (e.g. plaster casts, bandages) and mobility aids prescribed by a physician.

·         Physiotherapy, radiotherapy, heat therapy or phototherapy prescribed by a physician.

3.200.000   /visit 5.000.000   /visit 6.700.000   /visit 7.300.000   /visit 11.800.000 /visit
·   Health check-up/ Vaccination per year N/A N/A N/A 2.000.000 3.000.000

 2. MATERNITY CARE (MA) – Optional

(Applicable only to the Insured Person who is female from 18 to 45 years old)

Unit: VND

MA Select Essential Classic Gold Diamond
Maximum Aggregate Limit for the whole insurance period 21.000.000 31.500.000 63.000.000 84.000.000 105.000.000
Area of coverage Area 1 Area 2 Area 3 Area 4 Area 5
Benefit:

a) Complications of pregnancy and childbirth

BAOVIET shall pay for medical expenses arising from complications during the period of pregnancy and childbirth which need obstetric procedures, the mother’s immediate pre and post-natal expenses in a hospital. Coverage is provided for caesarean sections required on medical grounds and does not include voluntary caesarean sections (or medically required due to a previous elective caesarean section). Complication of pregnancy and childbirth including but not limited to the followings:

Ø  Miscarriage or when the fetus has died and remains with the placenta in the womb;

Ø  Stillbirth abnormal cell growth in the womb;

Ø  Ectopic pregnancy;

Ø  Post-partum haemorrhage;

Ø  Retained placental membrane;

Ø  Therapeutic abortion including abortion cases due to hereditary diseases/congenital malformation of the fetus or to save the mother’s life;

Ø  Preterm labor

Ø  Difficult delivery

Ø  Complications following any of the above conditions.

b) Normal Delivery/ Childbirth

BAOVIET will pay for medical costs arising from normal delivery/ childbirth, including but not limited to the hospital charges, specialist fee, the mother’s immediate pre and postnatal care in hospital, postnatal suture.

Waiting period:

In case of Childbirth:

For individual policy: This benefit shall only be paid after 635 days from the Effective Date of the Policy.

For group policy: This benefit shall be paid after 365 days from the Effective Date of the Policy.

In case of Complications: This benefit shall be paid after 90 days from the Effective Date of the Policy.

3. DENTAL CARE (DC) – Optional

Unit: VND

DC Select Essential Classic Gold Diamond
Maximum Aggregate Limit for the whole insurance period 21.000.000 21.000.000 31.500.000 31.500.000 31.500.000
Area of coverage Area 1 Area 2 Area 3 Area 4 Area 5
Benefit:

1. Routine Dental Care

Ø  Check-up and diagnosis

Ø  Tooth cleaning

Routine dental care including tooth cleaning):1.000.000/ year Routine dental care (including tooth cleaning):

1.000.000/ year

Routine dental care (including tooth cleaning):

2.000.000/ year

Routine dental care (including tooth cleaning):

2.000.000/ year

Routine dental care (including tooth cleaning):

2.000.000/ year

2. Dental Treatment

Ø  Check-up and diagnosis

Ø  Normal filling (amalgam or composite)

Ø  Removal of decayed teeth.

Ø  Removal of impacted, buried or un-erupted teeth

Ø  Removal of roots

Ø  Removal of solid adontomes

Ø  Apicetomy

Ø  Root canal treatment

Ø  Gingivitis, pyorrhoea.

Up to Maximum limit Up to Maximum limit Up to Maximum limit Up to Maximum limit Up to Maximum limit
3. Special treatments, Dentures

New or repair of bridge work, porcelain crowns, dentures

Co-insurance 50% Co-insurance 50% Co-insurance 50% Co-insurance 50% Co-insurance 50%

 4. PERSONAL ACCIDENT (PA)

Unit: VND

PA Select Essential Classic Gold Diamond
Maximum Aggregate Limit for the whole insurance period 1.000.000.000 1.000.000.000 1.000.000.000 1.000.000.000 1.000.000.000
Area of coverage Area 1 Area 2 Area 3 Area 4 Area 5
Benefit:

Cover for Death, Permanent Total & Partial Disablement due to Accident

5. TERM LIFE (TL)

Unit: VND

TL Select Essential Classic Gold Diamond
Maximum Aggregate Limit for the whole insurance period 1.000.000.000 1.000.000.000 1.000.000.000 1.000.000.000 1.000.000.000
Area of coverage Area 1 Area 2 Area 3 Area 4 Area 5
Benefit:

Cover for Death, Permanent Total Disablement due to any cause other than accidents

Waiting period:  Normal illness: 90 days from the Effective Date of this benefit.

Special diseases/Pre-existing diseases/diseases detailed in No.2 of the general exclusion of  this Wording: 365 days from the Effective Date of this benefit

6. OVERSEAS STUDENT PROTECTION

Unit: VND

Education Assistance Select Essential Classic Gold Diamond
Area of coverage Area 1 Area 2 Area 3 Area 4 Area 5
Study Interruptions N/A 50.000.000 70.000.000 100.000.000 150.000.000
Sponsor protection
Terrorism insurance

4. INSURANCE PREMIUM

PREMIUM TABLE – BAO VIET INTERCARE

Issued with the Decision No. 6608/QĐ- BHBV dated  September  21 st , 2017 of the Chief Executive Officer – Bao Viet General Insurance Company

——————————————————————————————————————-

INPATIENT TREATMENT (IP) – Core plan

Unit: VND
Age band Select Essential Classic Gold Diamond
0-18 6.200.000 7.200.000 8.500.000 11.300.000 15.300.000
19-25 6.000.000 6.800.000 8.700.000 11.600.000 22.200.000
26-30 6.400.000 8.300.000 10.300.000 13.700.000 24.800.000
31-35 7.100.000 8.700.000 11.400.000 15.200.000 26.100.000
36-40 9.300.000 10.000.000 13.300.000 17.700.000 27.400.000
41-45 11.200.000 11.500.000 15.700.000 20.900.000 30.000.000
46-50 11.700.000 13.700.000 17.600.000 23.500.000 32.600.000
51-55 17.300.000 19.400.000 20.500.000 25.700.000 39.500.000
56-60 19.600.000 22.000.000 23.300.000 29.200.000 44.800.000
61-64 24.300.000 27.100.000 27.300.000 34.200.000 56.600.000
65-69 28.600.000 39.200.000 44.700.000 55.900.000 77.300.000
70-75* 34.500.000 47.700.000 54.100.000 67.600.000 100.500.000

OUTPATIENT TREATMENT (OP)

  Unit: VND
Age band Select Essential Classic Gold Diamond
0-18 5.800.000 6.600.000 7.900.000 9.000.000 12.100.000
19-25 5.300.000 6.100.000 7.000.000 8.300.000 11.900.000
26-30 5.300.000 6.100.000 7.100.000 8.300.000 11.900.000
31-35 5.300.000 6.200.000 7.300.000 8.500.000 12.200.000
36-40 5.600.000 6.500.000 7.700.000 8.900.000 12.700.000
41-45 5.900.000 6.800.000 8.000.000 9.300.000 13.300.000
46-50 6.200.000 7.200.000 8.300.000 9.700.000 13.900.000
51-55 6.400.000 7.700.000 9.200.000 10.500.000 15.000.000
56-60 7.400.000 8.900.000 10.600.000 12.200.000 17.400.000
61-64 8.400.000 10.300.000 12.100.000 13.800.000 19.700.000
65-69 12.500.000 14.000.000 19.600.000 24.000.000 34.400.000
70-75* 16.200.000 18.200.000 25.400.000 29.300.000 44.800.000
* Renewal only

MATERNITY CARE (MA)

(Additional premium applied for women from 18 to 45 years old) Unit:  VND
Plan Select Essential Classic Gold Diamond
Premium 4.800.000 5.500.000 7.900.000 11.000.000 12.100.000

 

DENTAL CARE (DC)

                                                                                                                                                       Unit: VND
Plan Select Essential Classic Gold Diamond
Premium 6.600.000 7.000.000 8.300.000 8.800.000 9.300.000

 

PERSONAL ACCIDENT (PA)

Territorial scope Annual premium
Area 1 1.000.000
Area 2 1.100.000
Area 3 1.150.000
Area 4 1.200.000
Area 5 1.250.000

 

TERM LIFE (TL)

Territorial scope Annual premium
Area 1 2.000.000
Area 2 2.100.000
Area 3 2.200.000
Area 4 2.400.000
Area 5 2.700.000

 OVERSEAS STUDENT PROTECTION

Plan Select Essential Classic Gold Diamond
Premium N/A 350.000 490.000 700.000 1.050.000

Neccessary Notes about compulsory terms:

Coreplan (Inpatient): is the compulsory clause for customers to participate. (A)
Optional Plan (including Outpatient, Personal accident insurance, Term life, Dental Care, maternity Care): are not required to participate, it is up to your choice tọ join. (B)
Premium’s calculation is as follows: Total Premium = A + B.

In which clause A is required to buy. Clause B can buy or not, or only buy one of the terms: outpatient, maternity, dental, termlife, personal accident.

For example: Customer Nguyen Van A is 35 years old. He chooses the Classic program. If he buys only the compulsory clause (coreplan), the premium is: 13,300,000 VND.

If he wants to participate in optional plans and choose only outpatient conditions, the premium is: 13,300,000 + 7,700,000 = 21,000,000 vnd

If he wants to add more benefit like dental care, the premium shall be: 13,300,000 + 7,700,000 + 7,900,000 = 28,900,000 vnd

If he wants to choose IP and PA, the premium shall be: 13,300,000 + 1,150,000 = 14,450,000 vnd

Payment term:

All premiums are payable once annually in advance or before the due date

5. GENERAL EXCLUSION

(Applied to the Insurance Policy and all Endorsements)

The following treatment, items, conditions, activities and their related or consequential expenses are excluded from this Policy:

1. Pre-existing conditions, special diseases as defined and the diseases named in article 02 below shall be excluded in the first year of insurance. This exclusion shall not be applied in the following cases:

+ Group policy with at least 20 people.

+ After Individual and family policies is effective for 12 consecutive months, pre-existing conditions and special diseases shall be covered up to the limit shown in the Benefit Schedule.

2. The following diseases shall not be covered during the first year in any condition: Adenoidectomy, Tonsillectomy, Septoplasty (Deviated nasal septum surgery), vestibular disorders, asthma, middle ear infection (otitis media) surgery, Sinusitis, Degenerative diseases of the vertebral column/joints, Hemorrhoid Surgery, Herniated disc, polyps.

3. Home services or treatments if it is not prescribed by a Physician (except for nursing cost as specified in the Benefit Schedule of this Policy) or treatments received in health hydros, nature cure clinics, spa, sanatorium, or long term care facility or similar establishment. Costs related to treatment at a clinic which fails to comply with definition hereinabove, including but not limited to expenses for medications, tests and/ or treatment indicated by the Physician at such clinic, even though those expenses are incurred in legal clinics, hospitals, drug stores thereafter.

4. Routine medical examinations (in-patient or out-patient), check-ups, cancer screening tests with normai results, medical examination or consultation which are not associated with medical treatment of Illness/ Disease/ Injury, including but not limited to gynaecological examination/ male genital examination, routine laboratory tests, routine check-ups for newborns, immuzination, vaccinations and preventative medicines (excluding vaccinations given after an accident or being bitten or stung by animals or insects). This exclusion is not applied if “Health check-ups” in “Out-patient” Optional plan is applicable.

5. Normal eye tests, cataract, normal hearing test, aging, degradation, any corrective treatment for non-medical/ natural degenerative eyesight and hearing, including the categories listed hereof and/ or in the Endorsement as an integral part of Wording/ Policy such as eyes refraction including myopia, presbyopia and astigmatism, and any corrective surgery for sight and hearing defects;

6. All dental treatment (in-patient and out-patient) except for emergency treatment following an accidental damage to sound, natural teeth. Artificial teeth or denture of any type. This exclusion is not applied if “Dental Care” optional plan is applicable.

7. Any type of treatment for beauty purpose, weight problems (weight increase, decrease, obesity, rickety…), skin pigmentation (hyperpigmentation), treatment for hair loss, cosmetic or plastic surgery and any consequence thereof unless it is re-constructive surgery necessitated by an accident/illness that occurred during the period of insurance stated on the Policy.

8. Psychiatric and behavioral disorders, mental illness/ mental disorders or mental retardation, Attention deficit disorder (ADD),  Autism spectrum disorder (ASD), Alzheimer, sleep disorders, insomania, snoring with unknown causes, asthenia, anxiety disorders (stress) or any of related syndromes/ diseases.

9. Any costs related to family planning, consequence of any abortion due to psychological or social causes, male/ female infertility, artificial insemination, sexual dysfunction / impotence, or sex change, or any related consequence or complication thereof

10. Pregnancy and Childbirth of any type except complication of pregnancy caused by accidents. This exclusion is not applied if “Maternity care” optional plan is applicable.

11. Any treatment and/ or surgery in connection with birth defects, hereditary illness (including recessive genetic disorders)/ congenital anomalies/ conginental malformations/ conginental disorders, genetic deformities/ diseases, and any related complications or consequence thereof; surgical treatment indicated before the inception date, including the categories listed hereof and/or in the Endorsement as an integral part of Wording/ Policy such as congenital heart disease, Down syndrome, cleft lip and palate, hydrocephalus, anal stricture, phimosis, congenital deviated septum.

12. Costs of providing, maintaining, fitting or replacing any prostheses or medical supportive appliances or devices as defined.

However, devices implanted inside the body such as pacemakers, aerosols, stent or Longo knife for hemorrhoid surgery, etc. are covered up to 70% of the total cost (Bao Viet shall pay 70%, the insured shall pay 30%).

13. Chronic supportive treatment of renal failure, including dialysis (artificial blood filtering). BAOVIET will, however, pay for the cost of renal dialysis incurred:

  • immediately pre and post operation.
  • in connection with acute secondary failure when dialysis is part of intensive care.

14. Treatment involves ligament reconstructive surgery (this exclusion is not applied after 12 months of continuous cover under this Policy).

15. Any treatment in connection with sexually transmitted diseases such as syphilis, gonorrhea, genital disfunction (sexual malfunction/ sexual disorder),

16. Willful misconduct of the Insured Person or the Beneficiary.

17. Violation of law, regulations and other rules leading to the enforcement of judgements and/or violation of traffic regulations and/or violation of labour laws by the Insured Person aged 14 or over. The Insured drives any kind of transportation whilst having a blood alcohol content higher than the limit specified in traffic laws and the Insured is affected by alcohol, wine, beer, or substances or stimulants which may result in any accident or illness/ disease.

18. Accident risk occurs in period of insurance but Consequences of accidents that occur outside the Insured Period applicable for medical expenses.

19. Treatment for alcoholism, drug or substance abuse or any addictive condition of any kind and any injury or illness arising directly or indirectly from such usage, abuse or addiction.

20. The Insured Person’s act of fighting (unless such act can be proved that it is only a defense against an attack), participation in or training for any professional sport activities or any form of professional race or competition.

21. Aviation acitivities other than as a licensed fare-paying passenger. Participation in military demonstration or training, fighting in armed forces.

22. Treatment and expenses directly or indirectly arising from or required as a consequence of: war, riots, invasion, acts of foreign enemy hostilities or warlike operations (whether war be declared or not), civil war, mutiny, civil commotion assuming the proportions of or amounting to a popular uprising, military uprising, insurrection, rebellion, military or usurped power or any act of any person acting on or on behalf of or in connection with any organization actively directed towards the overthrow or to the influencing of any government or ruling body by force, terrorism or violence.

23. Disaster risks such as earthquakes, volcanoes, tsunamis, radioactive contamination, epidemics officially declared by the authorities (including SARS, H5N1, Ebola)

24. Hormone replacement therapies for the growth period, or the pre-menopausal or menopausal period of women.

25. Treatment directly or indirectly arising from or required as a result of chemical contamination or contamination by radioactivity from any nuclear fission, or from the combustion of nuclear fuel, asbestosis or any related condition.

26. Examination, testing, treatment and use of drugs without indication or diagnostic conclusions of the participating Physicians/ doctors; herbal medicines of unknown origin; oriental medicine private clinics/facilities. Treatment which is experimental in nature and/ or not scientifically recognized and/or any free treatment received at any hospital.

27. General Out-patient Services other than an emergency Out-patient treatment following an accident. This exclusion is not applied if “Out-patient Treatment” optional plan is applicable.

28. Treatment outside the area of coverage of the plan which is selected and declared on the Policy Schedule.

29. Functional foods, minerals, supplements and organic substances for nutrition or for diet available naturally, cosmetic and pharmaceutical products.

30. Medical expenses and treatment for the person who is not eligible to join into this Policy.

6. CLAIM PROCEDURE

GENERAL GUIDELINES:

a. Proof of Claim (applied for the Core and Optional plans)

When making a claim request, the Insured and/or his/ her legal Beneficiary must submit to Bao Viet Insurance the following documents in English or Vietnamese within 01 year from event of insurance or inform Bao Viet within sixty (60) days from the end date of a referral to treatment period/ Discharge date or Date of Death:

  • Claim form (issued by Bao Viet Insurance) filled in and signed  by the Insured or the Claimant who is the Heir/ Beneficiary/ Nonimated receiver named on the  Certificate/  Legally authorized representative of the Insured (except in case where the Insured is the child whose claim forms shall be completed by his/ her legal parents/ guardians). In case of group policy, this form must be signed and stamped by the organization/entity or company acting as the Policyholder unless otherwise agreed.
  • In case of accidents:
  1. Accidents in daily life: The accident report is required without the local authorities’ confirmation.
  2. Labour accidents: The accident report is required with confirmation from the organization/entity or company
  3. Traffic accidents (no other parties involved but excluding death case): The accident report is required without the local authorities’ confirmation; a driver license if the accident occurs when the Insured is driving a vehicle with an engine displacement of more than 50cc;

Traffic accidents (other parties involved): The accident report is required by the law, the related reports and documents of police, a driver license if the accident occurs when the Insured is driving a vehicle with an engine displacement of more than 50cc;

  • Records of treatment procedure:  medical prescriptions, medical books, hospital discharge notes, treatment records, indication and results of tests, X-ray, CT scan, certificate of operation (in case of operation/ surgery) and other documents related to the medical treatment. If th orginal versions are not available, the copy versions certified by Bao Viet may be accepted. In all circumstances, Bao Viet reserves the right to require originals for checking and/ or reconcilement.  Medical recors/ prescirptions must be stamped by the medical facilities unless otherwise agreed.
  • Records of payment procedure: VAT (red) invoices, bills, receipts in forms approved by the Ministry of Finance, General Department of Taxation and enclosed with detailed and breakdown of charges. In respect of these payment records, only the originals are acceptable and shall be considered as the property of Bao Viet Insurance after the claims are reimbursed. The invoices/ bills/ receipts for medication/ treatment expenses must be issued within 30 days since the date of the prescription/ treatment and must indicate the same dosage prescribed by the Physician. Bao Viet shall not accept receipts/ bills (non-VAT invoces) issued for cumulation purposes in each claim case as valid payment proofs;
  • In case of Death: Original or certified copy versions  of Declaration of Death and the legal confirmation of the beneficiary or beneficiaries (in case there is no beneficiary nominated by the insured) with authorities’ notarization
  • In case of study interruptions: the insured must submit a doctor’s certificate of disability and impossible continuation of the insured’s studies due to an illness or accident, together with valid official receipts/ documents of foreign educational institutions evidencing the payment of the said repeat or non-refundable tuition fees. The amount stated on thesereceipts will be used as the basis for calculating any reimbursement as detailed in the Benefit Schedule. When a family member deceases, the insured must submit the death certificate and relevant documents for claim settlement.
  • Others if required by Bao Viet

b. Claim reimbursement and direct billing procedure

  • Pay first, claim back:

When visiting the legal hospitals/ clicics which are not in the list of Medical Providers for Direct Billing Services, the Insured must pay all the incurred costs, and then submit the documents to Bao Viet Insurance to claim eligible expenses within the scope of coverage.

  • Timebound:

Bao Viet Insurance shall have responsibility in claim processing and settlement within 15 (fifteen) working days from the date of receiving all sufficient and valid documentation and information. In particular:

  • The claim receipt notification shall be sent within three (03) working days from the date of receipt of all required documentation and information.
  • The requirement for additional documents (if necessary) shall be sent within five (05) working days from the date of receipt of documentation and information.
  • The settlement notice shall be sent within ten (10) working days from the date of receipt of all required documentation and information.
  • The claim reimbursement shall be transferred (or settled) within fifteen (15) working days from the date of receipt of all required documentation and information.
  • The request for returning original claim documents in case of claim rejection must be sent within sixty (60) days after Bao Viet sent the settlement notice.
  • Bao Viet Insurance’s examination of documentation and other information relevant to the Insured Person’s claim should be performed within ninety (90) working days from the date of receipt of all required documentation and information.
  • Additional documents should be submitted by the Insured within thirty (30) working days from the date of receipt of documentation.
General claim information

All documents and materials required by Bao Viet Insurance to support claim settlement process shall be provided free of charge to Bao Viet before any claim payment is made.

In case medical information/ documentation is insufficient, it shall be the Insured’s responsibility to provide additional information/ documentation which is necessary and reasonable for claim reimbursement and Bao Viet shall not bear the cost of obtaining such information/ documentation.

Claims are only settled to the Insured or his/ her Beneficiary/ Legally authorized representative according to the law.

Direct billing services (applicable for plans which provide direct payment services)

When visiting Clinic/ Hospital which is in the list of Medical Providers for Direct Billing Services, the Insured should follow steps described below:

  • Show BaoViet Care Card issued by Bao Viet Insurance and ID card, or Passport or Birth Certificate (in case the Insured is a child aged below 15) in the hospital/ clinic;
  • Ensure to check the claim form provided by the Hospital/ Clinic after treatment and sign on that form in order to confirm all information related to the Insured’s treatment, make a deposit to the hospital/ clinic (if required);
  • Pay the remaining costs which are not within the scope of coverage or exceed the benefit limits.

Special notes:

  • If the Insured is indicated to receive acupuncture or orthopedic care where (s)he is treated by chiropractic, acupuncture, homeopathy, (s)he has to submit the doctor’s indication or referral forms.
  • If laboratory tests and X-rays are performed, the Insured has to submit their results.
  • In case documentation is insufficient, Baoviet or the policy administration shall have the right to require additional information/ documentation or another claim form to complete claim settlement.

c. Self-insurance/Other Insurance/Thirty party claim

The Policy will not provide the insured benefits other than on a proportional basis if the Insured Person has any other effective Insurance that entitles him/her to the Medical Expenses benefits upon the occurence the insured event.

BAOVIET must be informed without delay of circumstances where a claim against a Third Party can be made. The recipients of benefits shall at the request and at the expenses of BAOVIET, permit and authorize BAOVIET to exercise any rights and remedies for the purpose of enforcing all reasonable and necessary action of obtaining indemnity from other parties whom BAOVIET is entitled or shall become entitled under the subrogation agreement between the Insured and BAOVIET.

EMERGENCY

1. Request for Assistance, Emergency Evacuation

In case of emergency, the Insured Person or his/her representatives as soon as practicable shall call BAOVIET’s Hotline:

Place Address Telephone No. Email
Hanoi, Vietnam 104 Tran Hung Dao, Hoan Kiem District, Hanoi (84 – 24) 39368888

(84 – 24) 39369550

(84) 904 832 888

(84) 906 633 757

Fax: (84–24) 38245157

tpa.hanoi@baoviet.com.vn

 

Ho Chi Minh City, Vietnam 233 Dong Khoi, District I,

Ho Chi Minh City

(84-28) 38274128

(84) 904 832 888

Fax : (84-28) 35202666

 

tpa.hochiminh@baoviet.com.vn

Da Nang city, Vietnam 97 Tran Phu, Hai Chau District, Da Nang city (84-236) 3822855

Fax: (84) 363822234

tpa.danang@baoviet.com.vn

In order for BAOVIET to determine the assisting method, the Insured Person shall provide the following information upon contact:

  • Name of the Insured Person, No. of the Policy and the expiration day of the insurance period.
  • Telephone number and contact address.
  • Summary of the actual situation of the Insured Person in need of assistance.
  • Name, address, telephone number of the Hospital to which the Insured Person is transferred.
  • Name, address, telephone number of the treating Physician and Family Physician (if any).

Medical expert team of the Assistance Company is entitled to directly contact with the Insured Person to understand his or her health situation. If the Insured Person fails to execute that obligation, the Insured Person will not receive medical assistance in any forms unless there are reasonable causes to prove their inability to execute.

2. Life-threatening situation

In a life-threatening situation, the Insured Person or his representative should always try to arrange for emergency transfer to a hospital near the place of incident through the most appropriate means, and notify the Assistant Company and BAOVIET as soon as practicable.

3. Hospitalization prior to notice the emergency Assistance Company

In any case of illness or bodily injury requiring hospitalization, the Insured Person or any person acting on his behalf must inform to BAOVIET/the Assistant Company within 24 hours from the time of admission. Failure to do so may entitle BAOVIET/Assitance Company to invoice the Insured Person for a part of the supplementary cost that has arisen out of the delay.

ITC_Table of benefit

ITC_ application form

ITC_ Premium

ITC_Wording 6608

Ask & Reply

Customer Rate
No rating !