Falcon Insurance

CONTACT FALCON i Smart Health O-A

A Full set of Health Insurance Plan that cover both Inpatients and Outpatients
No cash advance payment needed with Falcon's VIP Care Card
Nationwide hospital network

Coverage	Sum Insured (THB)
Coverage	Standard Plan	Plan 1	Plan 2
1) In-Patient medical expenses caused by illness or accident (IPD)
- Maximum Coverage per year	400,000	800,000	1,000,000
- Maximum Coverage per each illness or accident	40,000	80,000	100,000
1.1) Room and Board and General Nursing Services (Combined not exceeding 365 days)
- Daily Room and Board per day (Maximum 365 days)	4,000	5,000	6,000
- Daily Charges for Intensive Care Unit per day (Maximum 15 days)	8,000	10,000	12,000
1.2) Other coverage benefits for inpatient medical treatment due to injury or illness
1.2.1) General medical expenses (Including the expenses incurred by continuing medical	Actual Cost	Actual Cost	Actual Cost
treatment within 30 days after discharged)	Actual Cost	Actual Cost	Actual Cost
1.2.2) Emergency Treatment (within 24 Hours after accident including follow up	Actual Cost	Actual Cost	Actual Cost
within 15 days)	Actual Cost	Actual Cost	Actual Cost
1.2.3) Surgical Treatment	Actual Cost	Actual Cost	Actual Cost
1.2.4) Physician's Daily Hospital (1 time/day, Maximum 365 days)	Actual Cost	Actual Cost	Actual Cost
2) Out-Patient medical expenses per day (OPD) (1 time/day)	1,500	1,500	2,000
Maximum 30 times/Year	45,000	45,000	60,000
3) Loss of life, Dismemberment for Total Permanent Disability caused by general	100,000	100,000	100,000
accident (P.A.1) (Including Murder or assault)	100,000	100,000	100,000
4) Funeral Benefits or Funeral expenses due case of death of injury or illness	10,000	10,000	10,000
Total Premium per year (Includes duty stamp)
Entry Age Band	Standard plan	Plan 1	Plan 2
50 – 59 years old	32,070	35,400	43,670
60 – 65 years old	38,490	43,090	52,580
66 – 70 years old	48,620	55,419	66,690
71 – 80 years old (Renewal Only)	48,620	55,419	66,690

Insurance Underwriting : year 2021 - year of birth = Insurance year
Example : 2021 - 1955 = 66 years old

Conditions:
1. Eligibility of Applicant for Non-Immigrant Visa O-A :
1.1 Applicant must intend to apply for Non-Immigrant Visa O-A in Thailand.
1.2 Applicant must be aged 50 - 70 years (can be renewed up to 80 years old subject to satisfactory of claim experience).
2. This insurance will not pay the benefits for any sickness during the first 30 days from the first policy commencement date of this
insurance policy.
3. This insurance will not pay the benefits during the first 120 days from the first commencement date of this insurance policy for the
following diseases : Benign, Malignant tumor, Cancer, Cystic mass, Hemorrhoids, Hernias, Pterygium, Pinguecula, Cataract,
Tonsillectomy or Adenoidectomy, Stones, Varicose Veins, and Endometriosis
4. Funeral benefits or any funeral expenses (only in case of death from illness) can only apply after 180 days from the
first policy inception

Major Exclusions of Personal Health and Accident Insurance:
This insurance does not cover the cost of treatment or losses arising from injury or illness (including complications thereof) symptoms or
conditions arising from the following :
1. Pre-existing conditions, congenital abnormalities, growth development abnormalities, and genetic disorders.
2. Any cosmetic surgery or beautification treatment including treatment of acne, freckles, dandruff, weight reduction and weight gain, hair loss.
Reconstructive surgery is also excluded unless injury is sustained as a result of an accident.
3. Services in connection with infertility, pregnancy, childbirth, abortion or miscarriage, or any causes related to pregnancy, sterilization or
investigation of sterilization.
4. AIDS, related or sexually transmitted diseases (STD).
5. Treatment to relieve symptoms commonly associated with aging, menopause or precocious puberty, sexual dysfunction of sex change.

Remarks:
This insurance does not cover the cost of treatment or losses arising from injury or illness (including complications thereof)
symptoms or conditions arising from the following:
1. The Company reserves the right to reject any application or accept with exclusions (if any), according to underwriting standard of Company.
2. This insurance is based on year-to-year basis (Not an automatic renewal guarantee).
3. This document is not an insurance contract, all conditions shall be referred to definitions General Conditions and Exclusions of the original
Personal Health and Accident Insurance Policy.
4. The English language used in this document is merely a translation of Thai Version.

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