Prime Care Plus Insurance

Customer Age    : 30 Years Old

Chosen Plan        : Plan 4

Monthly Premium     : Rp844.800,-

Additional Insured    : None

Contact AIA Customer Line:

• Call : 1500980
• Email : id.customer@aia.com

Claim Document

Death Benefit:

1. Original Policy (as applicable);
2. Valid Identity Card of You, Additional Insured (if applicable), Beneficiary (if applicable) and the claim applicant;
3. Claim form for Death Benefit which has been filled correctly and completely by You/the Beneficiary and by the Doctor;
4. Photocopy of the Family Card;
5. Original Death Certificate issued by a competent authority;
6. Other documents as stipulated in the Policy

The Documents for requesting the payment of the Insurance Benefits as specified above shall be submitted no later than ninety (90) days from the day of the Death

Daily Cash Benefit or Daily Cash Benefit in ICU:

1. Claim form which has been filled correctly and completely by You;
2. Claim Form for Outpatient-Inpatient benefit which has been correctly and completed by the Doctor;
3. Original receipt (or legalized copy) and billing details issued by Hospital;
4. Valid Identity Card of You, the claim applicant and Additional Insured;
5. Other documents as stipulated in the Policy

Waiver Of Premium:

1. Original Policy (as applicable);
2. Valid Identity Card of You and the claim applicant;
3. Statement from You/the Beneficiary on the causes of Total Permanent Disability;
4. Statement from an authorized Doctor which certifies that You have become Total Permanent Disabled; and
5. Other documents as stipulated in the Policy

The Documents for requesting the payment of the Total Permanent Disability Benefit as specified above shall be submitted no later than 240 (two hundred forty) days from the date of occurrence of Total Permanent Disability.

Return of Premium benefit:

1. Original Policy (as applied);
2. Form of insurance benefit payment duly and appropriately completed;
3. Valid Identity Card of You and the applicant.
4. Other documents as stipulated in the Policy

The Return of Premium benefit shall be paid to an account requested by You or the account which is used for Premium payment.

1. The Daily Cash Benefit, Daily Cash Benefit in ICU and/or Waiver Of Premium Benefit contained of this Policy shall not be paid due to:
   
   • Pre-Existing Conditions;
     
     • For You and/or Additional Insured aged 18-55 (eighteen to fifty five) years old at the Policy Effective Date, Pre-existing Condition is valid for 12 (twelve) months from the Effective Date of the Provision or the date of the Latest Policy reinstatement, whichever occurs later;
     • For Additional Insured aged 5-17 (five to seventeen) years old at Policy Effective Date, Pre-existing Condition is valid as long as the Provision are applied.
   • Routine health checks or check-ups that have nothing to do with the Illness;
   • Congenital Illness, disability or Abnormality since birth;
   • Sexually transmitted diseases (STDs) and/or all illnesses caused by sexual disorder.
   • Mental and/or psychiatric disorders or treatment done by a Psychiatrist;
   • Care or treatments directly or indirectly related to pregnancy, childbirth, abortion, sterilization, or attempts to gain fertility;
   • Care or treatments associated with Acquired Immune Deficiency Syndrome (AIDS), AIDS Related Complex or Human Immunodeficiency Virus (HIV) infection;
   • Alternative or experimental treatments;
   • Plastic or cosmetic surgery, dental care and treatment, except for reconstruction surgery as well as dental treatment and care of natural teeth due to Illness or Injury caused by Accident, which is deemed necessary by a Doctor;
   • Medical treatments done by non-Doctor;
   • Injury suffered before the Effective Date of the Policy;
   • You and/or the Additional Insured intentionally injures your/him/herself or attempts to commit suicide or any other acts toward the similar purpose of suicide; whether or not done in a sane or insane state of mind;
   • You and/or the Additional Insured is/are under the influence of or involved in the abuse of narcotics, psychotropic drugs, alcohol, toxicants, gas or similar substances or drugs (unless the usage of such drugs or substances are recommended by a Doctor).
   • You and/or the Additional Insured deliberately doing or participating in a brawl, crime, or crime/ violation of laws, or an attempted crime/ attempted laws violation, whether actively or not.\
   • Insurance crime committed by the party who has or jointly having interest in this insurance protection;
   • You and/or the Additional Insured prepares for or participates in an agility, speed competition and so forth using a motor vehicle on land, water or air or likewise;
   • Is consequent on You and/or the Additional Insured engaging in a sport in a professional capacity or where You and/or the Additional Insured would or could earn income or remuneration from engaging in such sport or results from hazardous pursuits or hobbies engaged by You and/or the Additional Insured;
   • You and/or Additional Insured’s direct or indirect involvement in a war (whether declared or not), invasion by other countries, operations that are hostile or resemble a war (whether declared or not), terrorism, civil war, rebellion, civil commotion or riot as part of or constitutes a general resurrection, resurrection of the military, resistance, revolution, military or armed force, or martial law, involvement in military actions/ activities;
   • You and/or Additional Insured’s involvement in an aircraft flight or the like, unless You and/or the Additional Insured is as a passenger in an airline having a fixed and regular flight schedule, and having aviation business licenses;
   • Ionizing radiation or radioactive contamination from nuclear fuel or nuclear waste from nuclear fusion or nuclear weapon material;
2. Death Benefit contained in this Policy shall not be paid if You and/or the Additional Insured dies due to :
   
   • Acquired Immune Deficiency Syndrome (AIDS), AIDS Related Complex or Human Immunodeficiency Virus infection;
   • Insurance crimes committed by those who have or jointly having interest in this insurance coverage;
   • Intentionally attempting to injure him/herself or committing suicide or other acts towards the similar purpose of suicide in the period of 2 (two) years from the Effective Date of Policy; or
   • Intentionally doing or participating in a fight, crime/law violation, or an attempted crime/law violation, whether actively or not.