InterCare

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

Policy Wording

I. Definitions
II. Core plans
III. Optional plans
IV. Exclusions
V. General conditions
VI. Claim Procedures
Emergency Evacuation & Repatriation Services
 I. THUẬT NGỮ/ DEFINITIONS

In this Policy, words and expressions used shall have the following meanings:
Insurer
Shall refer to Bao Viet General Insurance Company established, organized and
operated under the provisions of Vietnamese Law. Bao Viet shall have all the
rights and obligations as set out in the Policy and shall be bound by the terms of
the Policy.
Authorized Assistance Company
Shall refer to the international assistance company authorized by BAOVIET to
conduct medical relief and repatriation services.
Insured
Shall refer to the person whose life and health are the subject matters of the
Policy as shown in the Policy/ Insurance Certificate. The Insured has
completed Application Form and insurance effectiveness has been confirmed
by the Insurer.
Applicant
Shall refer to legal entity in case of group policy; or legally authorized
representative such as the father/mother of a child under age 18; or a spouse/
child of the person over age 18. The Applicant shall apply for cover, sign the
policy and pay the premium.
Dependent
Shall refer to Insured’s legal spouse and unmarried children (including biological
children, recognized illegitimate children, step-children, and legally adopted
children). Such children are from 15 days old to 18 years old or 24 years old if
they are still in continuous full-time education, single and dependant on the
Insured Person for support.
All dependants must be named in the policy as Insured Persons and only
eligible for benefits equivalent to or lower than those of the Policyholder.
Children under the age of eighteen (18) must participate with their father/mother
with the same core plan and any Endorsement.
Beneficiary
An individual or a group nominated by the Applicant/ Insured to be beneficially
entitled to all or part of the benefits specified in the Policy. Beneficiary must be
named in Application Form, Claim Form or the Certificate/Policy. In case there
is no nominated Beneficiary, Bao Viet Insurance shall settle reimbursement
according to the inheritance law governed by Vietnam Civil Code.
Eligible age
The Insured's age at the time the Policy takes effect, referring to the age at the
Insured’s last birthday before the Policy comes into effect.
Group Policy
Shall refer to a Policy of a group of at least 03 employees working in the same
organization/entity or company and joining in the same schedule, and that
organization/entity or company will act as the Policyholder.
Policy
The Policy means the written contract signed by and between Bao Viet and the
Insured/Applicant. Accordingly, the Insured must pay premium and Bao Viet
Insurance shall provide coverage and services specified hereinafter in the
Wording. Application form/ Wording/ Insurance Certificate/ Appendix are all to
be considered as integral parts of the Policy.
Maximum limit/ Sum insured
Shall refer to the maximum limit of the Insurer’s accrued liability for each
Insured for the whole Insured Period as set out in the Insurance Certificate or
the Benefit Schedule attached to the Policy.
Giới hạn phụ/ Sub-limit
Shall refer to the maximum payable amount per each insured section as
detailed in the Benefit Schedule. In any case, total payable amounts after
application of all sub-limits can not exceed the Maximum Limit.
Effective date
The Policy shall come into effect from 00: 01 AM on the Date of Entry or the
Date of Renewal and shall expire at 23:59 on the Expiry Date shown on the
Insurance Certificate or Policy. The validity of Policy shall be considered to be
continous only when the Insured has renewed the current Policy on or before its
expiry date.
Insured period
The Insured Period is stated in the Policy or Insurance Certificate. The Insured
Period is one (01) year. In case of Individual Policy, short-term period and
application for additional benefits in midterm shall not be accepted.
Waiting period
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.
Home country
The country where the Insured Person was born and/or registered as a legal
citizen.
Place of Residence
Any city or province in the Socialist Republic of Vietnam where the Insured
Person declared in the Application Form, or as otherwise agreed and stated in
the Policy or Insurance Certificate.
Area of coverage
Area of coverage is stated in the Benefit Schedule, including which the Insured
Person can be evacuated to in the event of medical emergency when
necessary treatment is unavailable locally and where the customary and
necessary medical expenses incurred by the Insured Person may be
considered payable under this Policy.
Accident
Any sudden and unforeseen event occurring during the Insured Period by an
external, violent and visible force is considered as a cause resulting in Bodily
Injury or Death of the Insured Person and occuring beyond the Insured’s
control.
Bodily injury
Any injury caused solely by an accident during the Insured Period results in the
Insured’s disability or disablement.
Partial permanent disablement
Shall refer to any Disablement listed in Table of Disability Percentage attached
to the Policy or Bodily Injury solely due to accident which permanently and
considerably reduces the Insured person’s working capacity as a result of the
removal or loss/loss of use/paralysis of any part of the Insured person’s body,
provided that such Disablement/Injury is unable to be improved in current
medical practice and lasts 52 consecutive weeks.
Total permanent disablement
Shall refer to any Disablement which entirely and permanently prevents the
Insured Person from attending to any Business or Occupation of any and every
kind, or causes entire loss of the Insured person’s working capacity for any type
of work, provided that such disablement lasts 104 consecutive weeks and is
beyond hope of any improvement thereafter.
Illness, disease
Shall refer to a physical condition marked by a pathological deviation from the
normal healthy state, which manifests itself in symptoms or syndromes
diagnosed by Physicians.
Cấp tính/ Accute condition/illness
A medical condition is characterized by signs and symptoms of rapid onset and
short duration and can be cured.
Chronic condition/illness
 A medical condition determined by a licensed Physician as a General
Practitioner or Medical Specialists or Consultants is long-lasting in its effects,
persistent and cannot be cured.
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.
Special disease
Under this Policy, the following diseases are understood as special diseases:
a. Cancer and tumors of any kind
b. Diseases of heart, liver (hepatitis A, B, C), pancreas, kidney, lung failure
c. Diseases related to hematopoietic (blood forming) system including
pancreatic failure, acute and chronic leukemia.
d. Growth hormone deficiency
e. Diabetes mellitus
f. Parkinson’s disease.
AIDS/ HIV
The Insurer will accept to cover for expenses incurred in treating HIV and
related diseases such as Acquired Immune Deficiency Syndrome (AIDS) and
other related complex/ illness, and/or any consequences/ treatment during the
insured period including renewal period (s), provided that they manifest
themselves after the policy has been continuously in effect for a period of five
(5) years since the Entry date. This coverage will be subject to annual limit(s)
and payable up to 10% of total annual limit(s)/ lifetime/ insured.

Congenital disease
Congenital disease, known as “congenital disorder”, “birth defect”, “congenital
anomaly”or “chromosomal abnormality”, is defined as any disease formed on
the fetus during pregnancy due to effects of environmental factors on the fetal
development. The identification of congenital diseases must be performed by a
Physician.
Genetic disease
Shall refer to any disease occurring between blood relatives or caused by
transmission of gene disorders from the parental generation to their offspring,
and/ or inherited from generation to generation between blood relatives. The
identification of genetic diseases must be performed by a Physician.
Emergency treatment
Emergency treatment is defined as the immediate care performed in medical
facilities within the first 24 hours after an accident or the onset of medical
 symptoms which could seriously endanger the insured’s health and life and
require an emergency treatment at the emergency room. The submitted claim
documents must be stamped and certified by the emergency department
(casualty ward).
When the treament is performed at the emergency room because out of hours
services are not availaible, such treatment should be covered under out-patient
benefit.

Serious condition/ Life-threatening condition

Shall refer to a medical condition determined by Assistance Company and/or

BAOVIET constitutes a serious medical condition requiring urgent remedial
treatment to avoid death or serious impairment to the Insured Person’s
immediate or long term health prospects. The seriousness of the medical
condition will be judged within the context of the Insured Person’s geographical
location, the nature of the urgent remedial treatment and the local availability of
appropriate medical care or facilities.
Hospital
Shall refer to any legally authorized establishment for medical care and
treatment which shall:
- Have capabilities and facilities for diagnosis, treatment and surgery,
- Provide certain conditions for in patient, out –patient treatment and use
patient record system in every-day practice,
- Be not primarily a convalescent or nursing home, or a home for the aged,
or a place for alcoholics or drug addicts or the mentally ill, or a leprosy
hospital/institute or a resort (spa)/ sauna/ massage center.
Phòng khám Clinic
Shall refer to any medical facility that provides a full range of facilities, medical
equipment used for the diagnosis / examination and treatment as prescribed by
law. Such clinic must have a legal business license and practising certificate of
each practitioner.
The invoices/ receipts/ bills of treatment expenses incurred in legal clinics must
comply with the regulations and other rules of the Ministry of Finance/ General
Department of Taxation.
Direct billing network
Shal refer to legally licensed medical facilities which have signed an agreement
with Bao Viet Insurance to provide direct billing services. When visiting such
Clinic/hospital, Bao Viet shall guarantee and settle the payment directly with the
medical facility for eligible medical expenses incurred by the Insured Person for
treatment, subject to the coverage and limits stated in the policy/ Certificate of
Insurance. The Insured Person must be responsible to pay any excess of
insured limits at the time of treatment.
Hospitalization
Shall refer to any treatment received when an Insured Person has to stay at
least 24 consecutive hours or overnight in the hospital. In case a hospital
cannot issue an Admission and/or Discharge Form, either medical records or
invoices clearly indicating the period of treatment are accepted as substitute
documents. The in-patient day unit is calculated on a 24-hour and board basis
shown in the Discharge Form or in the breakdown of expenses. In-patient
treatment is accepted to be eligible when the patient stays in a hospital as
defined, not in a clinic or out-patient medical facility.
Eligible expenses
Shall refer to reasonable and necessary medical expenses incurred for the sole
purpose of the Insured’s medical treatment and prescribed by the Physicians
due to sickness, disease, injury or maternity complications within the scope of
coverage.
Full cover
Bao Viet will cover for all eligible medical expenses within the scope of
coverage and total payable amount shall not exceed the maximum limit of the
chosen plan per insured period.
Reasonable and customary charges
Shall refer to charges that do not exceed the general level of charges being
made by other medical services providers of similar standing in the locality
where the charges are incurred, when giving like or comparable treatment,
services, or supplies for a similar illness or bodily injury caused by an accident.
Day-patient treatment
Shall refer to any medical treatment which requires the patient to be admitted to
hospital and normally requires them to occupy a hospital bed during the day,
but not overnight. Hospital discharge form or receipts clearly indicating room
and bed charges are the bases of payment.
Surgical operation
Shall refer to a scientific method to treat an injury or a disease performed by
qualified surgeons through manual operations with medical instruments or
equipment in a hospital including the categories listed hereof and/ or in the
Endorsement as an integral part of Wording/ Policy, such as open surgery,
endoscopic surgery, laser surgery.
Consumable materials
Shall refer to materials, which are used once or several times to assist medical
care and treatment and are not permanently placed in the human body, except
for those which are absorbable in the human body or which may have been
taken out of the human body without affecting its functions (e.g. steel thread)
but it is unnecessary to remove them as they are not eliminated by the human
body.
Out patient
Shall refer to any medical treatment provided to the Insured at a legally licensed
medical facility/hospital/clinic as defined where the Insured is not hospitalized.
Medical examination (visit)
A medical examination (a visit) is when a patient receives physical
examination, laboratory tests, diagnostic imaging, functional exploration or
any other examinations and any drugs prescribed by a Physician at a legally
licensed medical establishment for the purpose of medical diagnosis and
treatment.
- Where a patient is consulted by more than one specialist as requested by the
hospital, such consultation is considered as an examination.
- Where a patient receives a series of examinations at a specialized
department during the day, such examinations will constitute a single
examination.
- Where a patient is required to seek further examinations at more than one
specialized departments at a medical facility as prescribed by Physicians, (s)he
shall be considered to receive one medical examination only.
Physiotherapy
Shall refer to a method of prevention and treatment using natural or artificial
physical elements such as: water, air, temperature, climate, altitude, electricity,
X-rays, ultraviolet, infrared, ultrasound, radioactive isotopes, massage, fitness –
sports, walking, Tai Chi,...This Wording shall not cover for expenses incurred for
the sole purpose of relaxation, massage, spa, gait training techniques.
Doctor/Physician
Shall refer to a legally licensed medical practitioner recognized by the law of the
country where treatment is provided and who, in rendering such treatment, is
practicing within the scope of his/her licensing and training but excluding a
Doctor who is the Insured Person himself/herself or the spouse, parents,
parents in law or children of the Insured Person. A Doctor/ Physician may be
recognized as a Consultant or a Specialist.
Specialist/ Consutant
Shall refer to a legally licensed Physician (as defined) registered under the
Medical Acts, and given accreditation as a Specialist/Consultant recognized by
the law of the country where treatment is provided.
Medical treatment
Shall refer to the application of surgery, therapy or medical procedure
prescribed by a Physician for the sole purpose of the cure or remission of
illness, disease or injury.
Prescribed drugs/ medicines
Shall refer to medicine/pharmacy sold and used according to Doctor’s
prescription and law regulations, excluding functional food, cosmeceuticals,
cosmetics, minerals, preparations which are not named in the list of drugs for
treatment of the Ministry of Health, tonics and vitamins. However, Bao Viet
shall consider reimbursing the expenses of tonics and vitamins up to 20% of
total expenses of the whole prescription provided that:
- These tonics and vitamins are prescribed by a Physician, and
 - These tonics and vitamins are used to accomodate treatment, and
- The prescription of tonics/vitamins must be accompanied by drugs for
treatment
Health check-up
Shall refer to a variety of screening exams/ tests performed in individuals without
signs or symptoms. This can be perfomed in some following types depending on
the age for early detection of diseases/ illness:
 Vital signs (the measurement of blood pressure, blood lipids, pulse,
respiratory rate, temperature)
 Cardiac (Heart) Screening)
 Neurological examination
 Cancer screening
 Tests for age-appropriate development of reflexes (for children aged 0-6
years)
 Vaccination
Professional sport activities
Shall refer to any sport activities that provide the Insured Person with major and
frequent earnings.
Medical supportive appliances or devices
Any medical appliance/ equipment/ tool/ device which shall:
- Be put/implanted/ inserted into any part of the body in order to maintain a
patient's bodily function including the categories listed hereof and/or in the
Endorsement as an integral part of Wording/ Policy such as stent, heart valves,
balloon catheter, disc, splints, vis, screws, pacemakers
- Be specialized in performing specific procedure or surgery, and used only
once and not comsumable including the categories listed hereof and/or in the
Endorsement as an integral part of Wording/ Policy such as cartilage knives,
planing knives knives/ scalpels, liver ultrasound knives, stapler for hermorrhoids
surgical in Longo procedure , lithotripsy baskets for kidney stone surgery
- Be put outside the body in maintaining its functional mobility or other
functions including the categories listed hereof and/or in the Endorsement as
an integral part of Wording/ Policy such as as crutches, braces, wheelchairs,
hearing aids, prescription glasses, heart assist devices
- Be any other equipment/ tool/ device intended for aesthetic and orthopedic
applications.
Prothesis
Shall refer to any appliance/ equipment/ tool/ device/ material which are artificial
replacement for any body part.
Organ transplantation
Shall refer to the Insured’s transplant surgery of an organ such as heart, lung,
liver, pancreas, kidney or bone marrow performed in a hospital by a Physician
duly qualified to perform such an operation. The cost of acquisition and
 transportation of the organ and all costs incurred by the donor are not covered
under this Wording.
Hormone therapy
Shall refer to any consultation services and medicines prescribed by a Physician
in a legally licensed medical facility to treat Hormone Imbalance related to
common symptoms of Perimenopause and Menopause
Co-payment (co-insurance)
Co-payment - also called co-insurance - is the portion of the bill which the
Insured/ Insurer is responsible to pay for expenses within the scope of coverage
according to the Wording. The Co-payment is a percentage calculation (%) of
the total valid reimbursed amount or of the Sublimits of Out-patient (or In-
patient) benefits, whichever is lower. The covered expenses after co-payment
are paid up to sublimits of relevant benefits in the Benefit Schedule.
Sponsor
Shall refer to an individual specified in the Application Form or the insured’s
father/ mother responsible for paying the insured’s tuition fees for his/her full-
time study in an educational Institution loacated outside Vietnam.
Tuition fees
Shall refer to total costs paid for entering education programs at the educational
institution located overseas as notified in writing by such educational institution
(including fees for laboratory and facilities while attending the programs
mentioned above, but excluding expenses such as textbooks, accommodation)
Study Interruptions
Shall refer to the case where the insured’s studies are interrupted (for more
than 30 days) due to illness or injury resulting in hospitalization within the scope
of cover. The reimbursement for following expenses is subject to the relevant
limits detailed in the Benefit Schedule:
- Fees which must be paid by the Insured to repeat or resume his/her
studies, or;
- Non-refundable tuition fees due to interruptions
Education Assistance
Shall refer to financial assistance provided to the insured person during the time
of studying abroad if his/her father/ mother died as a result of accidents;
Terrorist activities
Shall refer to any act, including but not limited to, the use of force or violence
and/or the threat thereof, of any person or group(s) of persons, whether acting
alone or on behalf of or in conjunction with any organization(s) or
government(s), committed for political, religious, ideological or ethnic purposes
or reasons including the intention to influence any government and/or to put the
public or any section of the public in fear
 II. Core plan: In-patient treatment due to illness/ disease/ accident

The Benefits mentioned in this Policy are provided to the Insured Person for medical and emergency
transportation expenses following an illness/accident in the scope of insurance as specified in this Policy.
Upon receipt of Proof of Claim, BAOVIET will pay the Benefits incurred under the Policy based on the
policy sub-limits up to the Maximum Limit shown in the Certificate of Insurance. The Benefits are limited to
the actual, customary, necessary and reasonable expenses.
The legal representative of the Insured Person shall have the right to act for the Insured Person who is
incapacitated or deceased. Benefits are payable to the Insured Person, his legal representative or
executor or to the licensed providers of the insured medical treatments and/or care and/or services to the
Insured Person. BAOVIET may appoint independent claim administrators to settle claims on its behalf.
Hereunder is explanation for major benefit in the Benefit Schedule. For more details of Sum Insured for
each benefit in different plan, please see Benefit Schedule.
1. Room & board
BAOVIET shall pay hospital charges for your hospital accommodation provided as part of your day-patient
or in-patient treatment, including all your own meals (must be provided by your admitted hospital and
according to the standard of hospital accommodation where you are admitted). BAOVIET does not pay for
personal items such as telephone calls, newspapers, guest meals or cosmetics.
BAOVIET does not pay for hospital accommodation if they incur for the purpose of treatment which would
normally be provided as out-patient.
BAOVIET does not pay for hospital accommodation if the treatment is considered as out-patient in
medical terms.
2. Intensive Care Unit
BAOVIET shall pay hospital charges for treatment in an intensive care unit (ICU), high dependency unit
(HDU), or coronary care unit (CCU) which gives constant monitoring during day-patient or in-patient
treatment.

3. Companion Accomodation
Bao Viet will pay for hospital accommodation costs for a parent who is legal guardian to stay with an
insured child, under the age of 18, when the child is receiving in-patient treatment.in a hospital. This
benefit is only applied to the father or mother/ legal guardian staying overnight with the child during in-
patient treatment in a hospital, provided that the child is covered under this policy.

4. Hospital Miscellaneous Expenses

If the Insured Person is in hospital confinement, BAOVIET shall also pay for reasonable and customary
charges for hospital services or materials that are medically necessary, including but not limited to the
following costs:
a) Drugs and medicine consumed whilst in hospital confinement;
b) Dressings, ordinary splints and plaster casts;
c) Laboratory examinations;
d) Electrocardiograms;
e) Basal metabolism tests;
f) Physical therapy;
g) X-ray therapy, radium therapy, radium and isotopes;
h) X-ray examination;
i) Intravenous infusions;
j) Administration and the cost of blood or blood plasma.

Pathology, X-rays, MRI, CT and PET scans, diagnostic test or similar tests
These tests must be indicated by the attending doctor to essentially help determine or assess the
insured’s condition and carried out in a hospital as part of charges for hospitalization.
BAOVIET also pays hospital charges for treatment provided by therapists (such as physiotherapy) if it is
needed as part of the insured’s day-patient or in-patient treatment in a hospital.
5. Pre-hospitalization treatment
BAOVIET shall pay for Doctor Consultations and Diagnostic procedures necessarily taken and directly
relating to an eligible medical condition that required immediate hospitalization, and the findings of the
diagnosis are the basis for the attending doctor to conclude that the hospitalization treatments are
necessary, provided that such diagnosis are performed within 30 days prior to the hospital admission.
6. Post-hospitalization treatment

BAOVIET shall pay for follow-up treatment prescribed by the attending doctor immediately following
discharge from a hospital where Hospitalization treatments were received. Follow-up treatment includes
consultations with a Physician, lab tests, examination, prescribed medicines and shall be performed within
90 days from the hospital discharge.
7. Home nursing
BAOVIET shall pay for the nursing care services of a legally licensed nurse in the Insured Person’s abode
when prescribed by a Physician for medical as distinct from domestic reasons immediately following a
covered In-Patient stay in the hospital. Cover will be limited to a maximum period of days as stated in the
chosen Plan and subject to the minimum in hospital stay of 7 days.
8. Surgical operation
BAOVIET shall pay for medical expenses for day-patient or in-patient surgical operations as defined,
including charges for medications, consumable materials, necessary equipments not included in
exclusions, surgical procedure, operating theatre, surgeon, anesthetists fees for the purpose of carrying
out anesthesia and normal costs for pre-surgical assessment, normal post-surgical care and re-operation.
Surgical charges do not include diagnostic procedures.
9. Organ Transplatation
BAOVIET shall pay for hospital charges of surgical transplant of heart, lung, liver, pancreas, kidney or
bone marrow to an Insured Person performed in a hospital by a physician duly qualified to perform such
an operation.
The cost of acquisition of the organ and all costs incurred by the donor are not covered under the Policy.
10. In-hospital Specialist Consultation
BAOVIET shall pay for specialist consultation during hospitalization, subject to one visit per days and 90
days/year as the limit as defined in the Benefit Schedule.
11. Emergency Illness/Accident Cover
BAOVIET shall pay for treatment taken within 24 hours at an emergency ward of a hospital following an
emergent accident or illness as the definition of Emergency Ward Treatment. Limit per policy period is
stated in the Benefit Schedule.
12. Emergency Accidental Pregnancy Treatment
If an Insured Person who sustains a complication of pregnancy by an Accident giving rise to emergency
treatment, a benefit equal to the actual, necessary and reasonable charges made by the hospital for such
emergency treatment shall be payable up to maximum limit stated in the Benefit Schedule. This benefit
excludes any costs of childbirth/baby delivery and any associated consequences of Accident (e.g.
embryotrophy, etc.)
13. Emergency Accidental Dental Treatment
If an Insured Person who sustains injury by an Accident giving rise to emergency dental treatment to
wholly sound natural teeth at any hospital within twenty-four (24) hours from the time of Accident, a
benefit equal to the necessary and reasonable charges made by the hospital for such treatment shall be
payable up to the maximum limit stated in the Benefit Schedule.
A sound natural tooth has no decay, no filling on more than two surfaces, no gum disease associated with
bone loss or being loose, no root or canal therapy.
This benefit is not applied for dental implants, crowns or dentures.
14. Expenses for Transportation in Emergency Case
BAOVIET will pay for Ambulance cost in case of emergency to transport an Insured Person from the
place of incident to the nearest hospital or transfer from a hospital to another one following the indicatiion
of the attending physician.
Limit of this benefit is stated in the Benefit Schedule.
15. Emergency Medical Evacuation & Repatriation
Chi tiết tại mục Dịch vụ chung - Quy tắc bảo hiếm
Please refer to the information in General Services
16. Family visit
Shall refer to the visit of one relative in case the insured must be hospitalized and undergo surgery
outside his/her home country or permanent residence for more than seven (7) consecutive days while the
insured is moving abroad alone for studying or travelling or working. This benefit is payable subject to the
approval of BaoViet Insurance.

17. Accute Mental Disorder

BAOVIET shall pay for In-patient treatment in recognized psychiatric unit of a Hospital in acute
circumstance of mental disorder. All treatment under this Benefit must at all times be administered under
the direct control of a registered psychiatrist. The initial consultation with a Medical Practitioner (not a
psychiatric specialist), which results in a psychiatric referral is also covered (as per schedule attached).
IP1 (Select) program will not include this benefit.
18. Daily Allowance Benefit
BAOVIET will pay in-patient cash benefit shown in the Benefit Schedule per night up to maximum 20
nights per policy period.
19. Lifetime limit
Shall refer to the maximum amount payable to the Insured stated in the Benefit Schedule or Insurance
Certificate/ Policy during the insured’s lifetime from date of policy inception to the date of death of
the insured or the date of expiration.

III. OPTIONAL PLANS

OPTIONAL PLAN 1: OUT-PATIENT TREATMENT DUE TO ILLNESS/ ACCIDENT

This optional benefit shall cover for out-patient treatment due to illness/accident as follows:
1. General Practitioners and Specialist fees.
2. Prescribed medicines.
3. Laboratory test, diagnostic and treatment prescribed by a physician.
4. Medical aids which are necessary as part of treatment for broken limbs or injuries (e.g. plaster
casts, bandages) prescribed by a physician.
5. Physiotherapy, radiotherapy, heat therapy or phototherapy prescribed by a physician.
6. Health check-up/ Vaccination

OP Select Essential Classic Gold Diamond

Maximum limit/ policy period 31.500.000 63.000.000 84.000.000 105.000.00 168.000.000

0

Area of coverage Area 1 Area 2 Area 3 Area 4 Area 5

 General Practitioners and 3.200.000 / 5.000.000 6.700.000 / 7.300.000 11.800.000 /

Specialist fees. visit /visit visit /visit visit

 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.

 Health check-up/ Vaccination Not Not Not

2.000.000 3.000.000
per year applicable applicable applicable

OPTIONAL PLAN 2: MATERNITY CARE (MA)

(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 21.000.000 31.500.000 63.000.000 84.000.000 105.000.000

the whole insurance preriod

Benefit:
a) Complications of pregnancy and childbirth
BAOVIET shall pay for medial 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:
 Miscarriage or when the fetus has died and remains with the placenta in the womb;
 Stillbirth abnormal cell growth in the womb;
 Ectopic pregnancy;
 Post-partum haemorrhage;
 Retained placental membrane;
 Therapeutic abortion including abortion cases due to hereditary diseases/congenital malformation of the
 fetus or to save the mother’s life;
 Preterm labor
 Difficult delivery
 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.
Note: In case of delivery packages at Hanoi obstetrics and gynecology hospital, National Hospital of
Obstetrics and Gynecology and other public hospitals (with similar issues or facts), the expenses of these
packages will be covered up to up to sub-limits of relevant benefits in the schedule without expense
breakdown.

OPTIONAL PLAN 3: DENTAL CARE (DC)

(Applicable only if Out-patient Treatment benefit is selected)
Unit: VND

DC Select Essential Classic Gold Diamond

Maximum Aggregate Limit for the 21.000.000 21.000.000 31.500.000 31.500.000 31.500.000
whole insurance preriod

Area of coverage Area 1 Area 2 Area 3 Area 4 Area 5

Benefit:
1. Routine Dental Care
 Check-up and diagnosis Routine Routine Routine Routine Routine
dental care dental care dental care dental care dental care
 Tooth cleaning (including (including (including (including (including
tooth tooth tooth tooth tooth
cleaning): cleaning): cleaning): cleaning): cleaning):
1.000.000/ 1.000.000/ 2.000.000/ 2.000.000/ 2.000.000/
year year year year year

2. Dental Treatment Up to Up to Up to Up to Up to
 Check-up and diagnosis Maximum Maximum Maximum Maximum Maximum
 Normal filling (amalgam or limit limit limit limit limit
composite)
 Removal of decayed teeth.
 Removal of impacted, buried or un-
erupted teeth
 Removal of roots
 Removal of solid adontomes
 Apicetomy
 Root canal treatment
 Gingivitis, pyorrhoea.

3. Special Treatment, Dentures

Co- Co- Co- Co- Co-
New or repair of bridge work, porcelain
insurance: insurance: insurance: insurance: insurance:
crowns, dentures.
50% 50% 50% 50% 50%

OPTIONAL PLAN 4: PERSONAL ACCIDENT (PA)

This additional benefit shall cover for death or permanent disablement due to accident within 24 hours of
a day.
The benefits described herein shall be payable, as stated in the Table of Disability Percentage below:

Accidentally bodily injury results in % relevant Sum Insured

Death 100%

Total Permanent Disablement:

- Total and unrecoverable loss of sight in both eyes
- Full and incurable mental disorders
- Loss of two arms or two hands
- Loss of an arm and a foot or an arm and a leg or a hand and a foot 100%
- Loss of two legs or two foots

Partial Permanent Disablement

- Permanent and total loss of hearing in both ears 70%
- Permanent and total loss of hearing in one ear 20%
- Total loss of speech (Dumb) 50%
- Permanent and total loss of sight of one eye 50%

Loss by physical severance or permanent and total loss of use of:

 - One arm from shoulder 50%
- One leg from hip 50%
- Both phalanxes of the great toe 10%
- One phalanx of the great toe 03%
- Any other toe 02%
- Both phalanxes of the thumb 25%
- One phalanx of the thumb 10%
- Index finger 15%
- Middle finger 10%
- Ring finger or little finger 08%
- Removal of lower jaw by surgical operation 25%
- Loss of part of a finger The amount payable per phalanx
lost shall be calculated at one
third of the percentage specified
above for the finger concerned.

Amount payable shall be

- Any partial permanent disablement of limbs not specified in this assessed according to the
table seriousness of the disability as
compared with that of these
actually specified.

The benefit shall be payable for death or permanent disablement as a consequence of the accident,
occurring within 24 calendar-months from the date of the incident, provided that the cause of such
accidental death or disablement arises within the insurance period.

Exclusions applied for Personal Accident benefit:

BAOVIET shall not be liable for paying benefits in the Endorsement in case Insured Person participate in
any following dangerous or hazardous activities and any reason arising from tsunami, volcano or
earthquake.

a. Aqualung diving f. Hurling

b. Boxing g. Ice hockey
c. Climbing (with the rope) h. Parachuting
d. Hang gliding i. Any race
e. Yachting beyond 5 kilometers of a coastline j. Show jumping
k. Skydiving
OPTIONAL PLAN 5: TERM LIFE
(TL)
a) Scope of Cover:
This benefit shall cover for death or total permanent disablement due to any reason other than
accidents and exclusions specified in this Policy within the insurance period.
b) Validity of Insurance:
In case of Death due to normal diseases: This benefit shall be effective after 90 days from the day of
premium payment (unless otherwise agreed). In case of continuous contract renewal, this benefit shall
be immediately effective after the Insured Person pays the premium for the subsequent period.
In case of death due to special diseases or pre-existing conditions or excluded diseases listed in
article 2 of General Exclusion or Maternity, this benefit shall only be effective for the Insured Person
who continuously participate in the contract from the second year onwards.
This benefit shall not be applied for Insured Person aged 70 years old or over.
c) Benefit:
In case of death or total permanent disablement under the scope of insurance, BAOVIET shall pay
total Sum Insured stated in the Insurance Certificate or Insurance Schedule.

OPTIONAL PLAN 6: OVERSEAS STUDY PROTECTION (OSP)

This optional benefit will cover for the students studying abroad as the Insured with details of coverage as
below:
a. Study Interruptions:
When this benefit is included in the Policy and during the policy period, the insured’s studies are
interrupted (for more than 30 consecutive days) as a result of:
- The hospital confinement for more than 30 days due to illness or injury within the scope of cover.
- The death of a family member such as father, mother or siblings of the Insured.
Bao Viet will cover for following expenses subject to the relevant limits detailed in the Benefit Schedule:
- Fees which must paid by the Insured to repeat or resume his/her studies after recovery, or
- Non-refundable tuition fees due to interruptions that has already been paid in advance to the
educational institution located overseas
In the case of a claim, 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 these receipts 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.
This plan will not cover for Study Interruptions as a result of:
- change of plan of the Insured or his/her family member for any reason;
- financial status of Insured and his/her family member;
- any business or contractual obligation of the Insured or his/her family member;
 - the tuition fee is refunded or paid from another source

b. Sponsor protection:
When this benefit is included in the Policy and during the policy period, the insured’s sponsor is involved
in an Accident or illness and as a consequence suffers death or total permanent disablement, Bao Viet
will pay a allowance as financial support for overseas education and living expenses up to the limit
specified in the Benefit Schedule.
Note: This Policy will only pay for a claim either under section a - Study Interruptions or section b -
Sponsor protection, but not both for the same risk.
This benefit will not be applied for risks incurred when the Insured's sponsor is engaged in any of the
following activities or occupations: diving, mining or underground jobs; working at heights ofover 30m
above ground level, working at a sawmill; working in factories manufacturing explosives, weapons,
ammunition, crude oil, gas, oil, cement, stone; construction workers on the construction site; quarry
workers, asbestos workers, nuclear power/ atomic energy jobs, space research.
c. Terrorism insurance
This benefit will be applicable in the event of Terrorist activities as defined excluding nuclear, chemical,
biological terrorism or any related causes/ risks which contribute concurrently or in sequence to the loss.

IV. 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:
a. immediately pre and post operation.
b. 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 occur 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.
 V. GENERAL CONDITIONS

1. Validity of Insurance and Renewal

The insurance coverage shall come into effect from the date specified on the Policy Schedule or
Insurance Certificate. All premiums will be payable on or before the Effective Date (except for other
agreement). If payment is not received, the Insurance will be void from the very first date of the period for
which the premium has not been received unless otherwise 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 detailed in No.02 of the General Exclusion of this Wording: all benefits shall take effects
after 365 days from the effective date of the policy.
The renewal premium will increase if the Insured Person enters a new age group (as classified in the
Premium Table) on the date of renewal. Based on the loss experience, BAOVIET is entitled to adjust the
benefits or the renewal premium or the Lifetime limit.
The policy shall be renewed subject to Terms & Conditions in the Wording updated at the renewal date
and other special conditions applied to particular renewal policy of the Insured.
2. Termination
The Policy will expire at the first due date following the 70th birthday of the Insured. In case of continuous
renewal, the Policy will expire at the first due date following the 75th birthday of the Insured, unless
otherwise agreed in writing by BAOVIET.
If any claim shall in any respect be false or fraudulent or if fraudulent means or devices are used by the
Insured Person or anyone acting on his behalf to obtain benefits hereunder then the Certificate of
Insurance shall be cancelled immediately and all benefits and premiums are forfeited.
In case of group policy: If the Insured Person is working for the Company/ Organization/ Policy holder
whose representative makes a request to cancel the Policy by giving thirty (30) day written notice in
advance, a refund will be given on the pro rata basis calculated by taking the number of days remaining in
the policy period divided by the number of total days of the policy, subject to no claim paid.
In case of individual/ family policy: The Insured Person may reasonably terminate the Policy at any date
subject to no claim paid and thirty (30) day written notice in advance. The refund will be 80% of
the remaining period of insurance premium on short-term basis.
3. Change of Benefits
The maximum limits of benefits can be revised upon the renewal of the policy only.
The renewal with higher limits of benefits or addition of optional benefits is subject to Insurer’s acceptance
confirmation. The increase of limits as well as new optional benefits shall not be considered to be
continuously renewed and waiting period must be applied as specified.

4. Eligibilty
The Policy is designed for all Vietnamese and foreign people who lives legally in Vietnam including
Vietnamese students studying abroad.
The maximum age for enrolment is 70 for all new enrollment and 75 for renewal policy.
Dependant must be covered under the same plan including the plans and all endorsements as the
Policyholder and subject to acceptance by BAOVIET.
Newborn children attaining 15 days of age from the date of birth or the date of hospital discharge,
whichever is later, shall be eligible for insurance, subject to satisfactory evidence of good health and
acceptance by BAOVIET following the submission of an Application form.
Children under the age of 18 must participate with their father/mother and are only eligible for benefits
equivalent to or lower than those of the Policyholder under both plans and any endorsements.
People suffering from a mental illness or permanent disability from above 80% will not be covered by
BAOVIET.
5. Examination
Bao Viet Insurance shall have the rights to examine the Insured Person through the medical
representatives whenever such examination is reasonably required within the duration of any claim. In
addition, Bao Viet Insurance shall have the rights to request an autopsy in case of death, where this is not
forbidden by law or traditional customs.
6. OBLIGATIONS & NOTIFICATIONS OF CHANGE
The Applicant/ Insured person is obliged to:
(1). Complete Bao Viet’s Application Form with all truthful information.
(2) . Authorize Bao Viet Insurance acting on behalf of the Insured to copy records from the hospitals/
medical facilities for claim-handling
The Insured is obliged to notify Bao Viet immediately if either of the following applies:
(1). Any change of current address, occupation or job.
(2). Any condition of disability, illness, defect or physical disabilities arising before or after joining into
the Policy
(3). Any other valid insurance plans/policies currently applied to Insured Person
In case the Policy Holder, the Applicant/ Insured Person provides dishonest information and/ or does not
comply with the provisions and conditions of this Wording, Bao Viet shall refuse to settle any
reimbursement.
7. Short Period Premium
The Short Period Premium is:
For period not exceeding 1 week 1/8 of annual premium
For period not exceeding 1 month 1/4 of annual premium
For period not exceeding 2 months 3/8 of annual premium
For period not exceeding 3 months 1/2 of annual premium
For period not exceeding 4 months 5/8 of annual premium
For period not exceeding 6 months 3/4 of annual premium
For period not exceeding 8 months 7/8 of annual premium
For period exceeding 8 months full annual premium
8. Clerical Error
Clerical errors by BAOVIET shall not invalidate insurance otherwise validly in force, nor continue
insurance otherwise not validly in force.
9. Notice of Transfer
BAOVIET shall not be bound to accept or be affected by any notice of any transfer or mortgage related to
this Policy.
10. Subrogation
By accepting any payments of benefits under this Policy, the Insured Person agrees that BAOVIET shall
be subrogated to all claims, demands, actions and rights or remuneration of the Insured Person against
any third party or any insurer to the extent of any and all payments made or to be made hereunder by this
Policy.
11. Arbitration
Any difference in respect of medical opinion in connection with the treatment of an accident or illness shall
be settled between two (02) medical experts appointed in writing by the parties to the dispute. Any
difference of opinion between the two medical experts shall be referred to an umpire who shall have been
appointed in writing by the two medical experts at the outset. Should the two medical experts fail to agree
despite the mediation of the umpire, then the decision of the umpire shall be final and binding.
12. Legal Proceedings
No action in law or in equity shall be brought to recover under the Policy prior to the expiration of sixty
(60) days after proof of claim has been furnished or after the expiration of thirty (30) days from which
BAOVIET made the decision on the settlement of the claim. Nor shall any such action be brought at all
unless commenced within two years from the date of such claim.
The parties herein agree that the Law of Socialist Republic of Vietnam shall govern and control in the
event of any conflict or dispute between the parties with regard to the Insurance Policy.
13. Premium Payment
All premiums are payable once annually in advance or before the due date shown in the Debit Note of
BAOVIET or appointed Broker. The prevailing rates of exchange of some Banks at the time of payment
shall be applied.
For renewals, the annual premiums are payable within a period after the renewal date according to
payment terms specified in the Policy.
If premium is not paid within the period specified above, the temporary Certificate of Insurance will be
cancelled.
14. Currency conversion
The Parties agree that, according to this provision, premium and claim sums basing on the regulations of
the Policy can be paid in different currency with defined currency in the Policy. The selling exchange rate
of Vietnam Foreign Trade Bank will be applied at time of settling premium or handling claim.
In case of premium adjustment, the exchange rate is also applied as above.
This regulation of currency exchange must be in compliance with the Socialist Republic of Vietnam Law.

VI. CLAIM PROCEDURE

I. GENERAL GUIDELINES :
1. 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:
o 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.
o In case of accidents:
a) Accidents in daily life: The accident report is required without the local authorities’ confirmation.
b) Labour accidents: The accident report is required with confirmation from the organization/entity or
company
c) 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;

o 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.
o 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;
o 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
o 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.
o Others if required by Bao Viet
2. - Claim reimbursement and direct billing procedure
a. 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.
b. 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.
c. 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.
d. 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.
3. 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.
II. 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 (84 - 24) 39368888 tpa.hanoi@baoviet.com.vn

Dao, Hoan Kiem
(84 - 24) 39369550
District, Hanoi
(84) 904 832 888
(84) 906 633 757
Fax: (84–24) 38245157

Ho Chi Minh City, 233 Dong Khoi, (84-28) 38274128

Vietnam District I,
(84) 904 832 888 tpa.hochiminh@baoviet.com.vn
Ho Chi Minh City
Fax : (84-28) 35202666

Da Nang city, 97 Tran Phu, Hai (84-236) 3822855 tpa.danang@baoviet.com.vn

Vietnam Chau District, Da
Fax: (84) 363822234
Nang city

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.

Emergency Evacuation & Repatriation Services

This document is part of the policy wording

GENERAL SERVICES

The following service will be provided in case of Emergency Evacuation

1. Medical service provider referral
The Assistance Company authorized by BAOVIET shall provide to the Insured Person, upon request, the
name, address, telephone number and, if available, office hours of physicians, hospitals, clinics, dentists
and dental clinics within the territorial limit of the chosen plan (collectively “Medical Service Providers”).
The Assistance Company authorized by BAOVIET shall not be responsible for providing medical
diagnosis or treatment. Although the Assistance Company shall make such referrals, the final selection of
Medical Service Provider shall be the decision of the Insured Person. In such cases, the Assistance
Company authorized by BAOVIET will exercise care and diligence in selecting the Medical Service
Providers.
2. Arrangement of appointment with local Physicians for treatment
(Only applicable to the insured person travelling out of Vietnam)
The Assistance Company authorized by BAOVIET will assist the Insured Person by arranging for
appointment with a local Physician for examination or treatment.
3. Arrangement for hospital admission
(Only applicable to the insured person travelling out of Vietnam)
If the medical condition of the Insured Person is of such gravity as to require hospitalization, The
Assistance Company authorized by BAOVIET will assist the Insured Person with arrangements hospital
admission upon request.
4. Arrangement and payment for emergency medical evacuation
After inspecting the situation of the Insured Person, the Assistance Company authorized by BAOVIET
shall immediately inform to BAOVIET whether the Insured Person’s situation is of such gravity as to
require emergency.
After receiving BAOVIET’s agreement on authorization for emergency evacuation, to which the Insured
Person shall be evacuated and the means or method by which such evacuation will be carried out, the
Assistance Company shall arrange for emergency transportation to move the Insured Person in critical
condition to the nearest hospital in the area of coverage as specified in the Insurance Certificate with
reasonable treatment.
BAOVIET shall pay for the medically necessary expense of such transportation and communication and
all usual ancillary charges incurred in such services so arranged by it and extended to cover for economy
class airline return ticket for one other person to travel with the Insured Person as an escort.
5. Arrangement and payment of repatriation following Emergency medical evacuation
After inspecting the situation of the Insured Person, the Assistance Company authorized by BAOVIET
shall immediately inform to BAOVIET about the arrangement for repatriation of the Insured Person.
After receiving BAOVIET’s authorization on means and method by which such repatriation will be carried
out, the Assistance Company shall arrange for repatriation of the Insured Person in the area of coverage
of the insurance plan. For any medical expense of subsequent In-Hospital treatment in the Hospital
Miscellaneous expenses of the policy, BAOVIET shall pay for the expenses necessarily and unavoidably
incurred in the services so arranged by it.
6. Arrangement and payment of repatriation of mortal remains
The Assistance Company appointed by BAOVIET after receiving BAOVIET’s authorization will arrange for
transporting the Insured Person’s mortal remains from the place of death to the insured’s residence of the
Socialist Republic of Vietnam or his/her Home Country in the Territory Scope of chosen Program or
arrange for local burial at the place of death as requested by the Insured Person’s family and with
BAOVIET’s approval. BAOVIET will pay for all expenses reasonably and unavoidably incurred in such
transportation or alternatively pay the cost of burial at the place of death so arranged by The Assistance
Company.
7. Delivery of essential medicine
(Only applicable to the insured person travelling out of Vietnam)
The Assistance Company authorized by BAOVIET after receiving BAOVIET’s authorization will arrange to
deliver to the Insured Person essential medicine, drugs and medical supplies that are necessary for
his/her care and/or treatment but which are not available at his/her location. The delivery of such
medicine, drugs and medical supplies will be subject to laws and regulations applicable locally. BAOVIET
will pay for the costs of such medicine, drugs or medical supplies and any delivery costs thereof.
8. Guarantee of medical expenses incurred during hospitalization & Monitoring of medical
condition during hospitalization.
Outside Vietnam:
Upon request, the Assistance Company shall assist the Insured Person to arrange for hospital admission
and with authorization and on behalf of BAOVIET, to provide guarantee of hospitalization expenses
incurred during his/her hospitalization. The Assistance Company authorized by BAOVIET will also monitor
the Insured Person’s medical condition with the hospital’s attending physician; subject to any and all
obligations in respect of confidentiality and relevant authorization.
Inside Vietnam:
If the Insured Person is treated in the hospitals which already have a direct billing agreement with
BAOVIET, all medial expenses entitled to insurance cover will be paid directly to the hospital by
BAOVIET.
If the Insured Person is treated in hospitals which have not a direct billing agreement with BAOVIET, the
Insured Person should settle any incurred expenses on leaving the hospital.