Travel insurance general terms of coverage
DEFINITIONS
ACCIDENT/ACCIDENTAL refers to sudden, unintended and unforeseen mishap caused by external, violent and visible means.
INSURED refers to a natural person or legal entity that purchases an Insurance Policy, and in some cases, an insured can be a policy owner as well as an insured person.
EFFECTIVE DATE refers to the date of premium payment or the date of arrival in Myanmar(after passing immigration counter stationed at the arrival airport) whichever is later.
MEDICAL EXPENSE refers to the services fee that an Authorized Hospital or Medical Center charges Insured that are considered Normal and Customary while he/she is their Inpatient.
MEDICAL PRACTITIONER refers to a person who has a medical degree, is licensed or registered in the country which they operate and is accredited by a medical board or equivalent organization to render medical services, except of Family Members.
LOSS OF SIGHT refers to a physical condition where the Insured is completely blind and cannot be cured.
PERIOD OF INSURANCE refers to the period of cover shown in the Policy Schedule and/or Certificate of Insurance for which the appropriate premium has been paid.
PERMANENT DISABLEMENT refers to Injury which:
- falls into one of the categories listed in the Scale of Permanent Disablement Benefits
- having lasted for a continuous period of twelve (12) calendar months from the date of the Accident entirely prevents the Insured from engaging in gainful employment of any and every kind and from which there is no hope of improvement.
PREMIUM refers to the amount paid by an insured to an insurer under an Insurance Policy as consideration for the obligations assumed by the insurer.
REASONABLE AND CUSTOMARY CHARGES refer to charges or fees which are generally prevailing and of normal standard for the medical condition concerned in the country and city where the insured is treated.
THE COMPANY refers to Myanma Insurance.
TRAVELING ROUTE refers to the journey within the Republic of the Union of Myanmar.
TRIP refers to the period between the Commencement of Cover and Expiry of Cover.
COVID-19 Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
SCOPE OF COVER
- PERSONAL ACCIDENT BENEFITS
- ACCIDENTAL DEATH
The Company will pay the sum insured as stated in the Schedule of Benefit, if the Insured sustained Accident during the Trip which results in Death within 90 days from the day the incident occurred.
-
PERMANENT DISABLEMENT
The Company will pay the sum insured as stated in the Schedule of Benefit, if the Insured sustained Accident during the Trip which results in Permanent Disablement. The disablement must be certified by a Medical Practitioner.
| Table of Benefits | Scale of Compensation | |
|---|---|---|
| 1 | Accident Death | 100% |
| 2 | Permanent Total Disablement | |
| 2a | Loss of Sight (both eyes) | 100% |
| 2b | Loss of two limbs | 100% |
| 2c | Loss of one Limb and one eye | 100% |
| 2d | Permanent Total and absolute disablement as certified by Medical Practitioner | 100% |
| 3 | Permanent Partial Disablement | |
| 3a | Loss of Sight on one eye | 50% |
| 3b | Loss of one limb | 50% |
| 3c | Loss of all toes | 20% |
| Two Phalanges | 5% | |
| One Phalange | 2% | |
| More than one toe, each | 1% | |
| Loss of hearing (both ears) | 50% | |
| Loss of hearing (one ear) | 15% | |
| Loss of Speech | 50% | |
| Loss of four fingers and thumb of one hand | 40% | |
| Loss of four fingers | 35% | |
| Loss of thumb – both phalanges | 25% | |
| Loss of thumb – one phalange | 10% | |
| Loss of Index finger
i) One Phalange ii) Two Phalanges iii) Three Phalanges |
4% 8% 10% |
|
|
Loss of Middle finger i) One Phalange ii) Two Phalanges iii) Three Phalanges |
2% 4% 6% |
|
|
Loss of ring finger i) One Phalange ii) Two Phalanges iii) Three Phalanges |
2% 4% 5% |
|
|
Loss of little finger i) One Phalange |
2% |
|
|
ii) Two Phalanges iii) Three Phalanges |
3%
4% |
|
|
Loss of Metacarpals i) First or second (additional) ii) Third, fourth or fifth (additional) |
3% 2% |
|
| Any other part permanent partial disablement | As assessed by Medical Practitioner appointed by us |
MEDICAL AND EVACUATION BENEFITS
EMERGENCY MEDICAL EXPENSES
The Company will reimburse to the Insured or authorized Hospital/Medical Center up to the limit specified in the Schedule of Benefit and Medical Expense Sub-limit Section which is reasonably and customary charges incurred whilst as a direct, sole and independent result of Accident suffered by the Insured.
The insured shall seek treatment in authorized Hospitals or Medical center only. In case of Medical Emergency, the insured shall however be allowed to seek initial treatment in any nearest private hospitals at the time of emergency. Medical Emergency describes an acute injury that poses an immediate risk to the insured’s life or long-term health.
EMERGENCY MEDICAL EXPENSES DUE TO COVID-19
The Company will reimburse to the Insured or to the authorized hospital / Medical Center up to the limit specified in the Schedule of Benefit which is reasonably and customary treatment charges incurred whilst overseas as a direct, sole and independent result of Covid-19 infection suffered by the Insured.
Repatriation of the Dead Body
In the event of death, the Company will take charge the costs of transferring or repatriating the dead body to his/her usual country of residence.
The Insured will not be transported from one hospital to the other without getting the attending doctor to approve the medical report. This assistance is not a first-aid, it is secondary assistance.
