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외국인을 위한 보험 서비스 - 개인 보험
개인 보험
사고 및 건강 보험
- Terms and Conditions and Kinds of Coverage
| Type |
Coverage |
Cause of Benefit Payout |
| Basic |
Accident Death and Disability |
Provides a benefit up to the sum assured if accident death or disability occurs within one year of the accident |
| Increased Coverage of Accident Medical Cost |
If receiving a medical care due to an accident, the Insurer provides actual medical cost (including the gap in cost between actual hospitalization room and standard one) paid by the insured within 180 days of the accident, up to the sum assured per accident (Applies 50% of total medical cost if it is not covered by national health insurance. If having entered multiple insurance policies that cover the same cost, a benefit is provided in proportion to the policy provision) |
| Disease Death |
Provides the sum assured if a death or 80%+ disability is caused by a disease. |
| Active Benefit (Fracture and Burn) |
Provides a benefit that equals the sum assured multiplied by payment rate as stipulated by the policy provision if diagnosed as accident fracture/burn (But, tooth fracture is excluded). |
| Selective Ⅰ |
Accident hospitalization cost(1 ~ 180 days) |
Provides a daily hospitalization benefit (the sum assured) up to 180 hospitalization days of the accident if being hospitalized due to the accident. |
| Disease Hospitalization Cost (4 ~ 180 days) |
Provides daily hospitalization benefit (the sum assured) up to 180 days, but starting from the 4th day of hospitalization if hospitalized for more than 4 days due to a disease. |
| Cancer Hospitalization Cost (4 ~ 120 days) |
Provides a daily hospitalization benefit (the sum assured) up to 120 days, but starting from the 4th day of hospitalization if hospitalized for more than 4 days due to the certain cancers as stipulated by the policy provision after the protection starting day (or the day following 90 days of the contract date if new business) (But, providing 20% of the sum assured of daily hospitalization starting from the 4th day of hospitalization in case of cancer in situ, borderline tumor and other skin cancers) |
| Selective Ⅱ |
Cancer Diagnosis |
Provides the sum assured of cancer diagnosis, -but the payment is only one time - if diagnosed as the certain cancer as stipulated by the policy provision after the protection starting day (or the day following 90 days of the contract date if new business) (But, providing 20% of the sum assured -but, the payment is only one time - per cancer if diagnosed as cancer in situ, borderline tumor and other skin cancers) |
| Stroke Diagnosis |
Provides the sum assured if diagnosed as stroke as stipulated by the policy provision, but only one time payment. |
| Acute Myocardial Infarction |
Provides the sum assured if diagnosed as acute myocardial infarction as stipulated by the policy provision, but only one time payment |
| 7 Major Diseases Surgery |
Provides the sum assured of surgery due to 7 major diseases (cardiac disorder, Ischemic Cerebrovascular Diseases, liver disease, hypertension, diabetes, chronic lung disease, gastric & duodenal ulcer) as stipulated by the policy provision. |
| Emergency Treatment Hospitalization Cost |
Provides the sum assured of hospitalization for the purpose of continuous care following necessary emergency treatment (including the case of death) in case of being emergently transferred to the hospital due to the symptoms as stipulated by the policy provision |
| Selective Ⅲ |
Long Term Care |
Provides the sum assured -but, only one time payment - if a psychiatrist or neuro psychiatrist, or medical specialist confirms that "Alzheimer" or "Disability" continues for more than 180 days after the diagnosis of "Alzheimer" or "Disability". |
| CI Diagnosis & Surgery |
Provides the sum assured if diagnosed as the policy provision-prescribed CI (critical cancer, critical stroke, critical acute myocardial infarction, end-stage renal failure, end-stage liver cirrhosis, benign brain tumor) or receiving a critical surgery (Coronary Artery Bypass Grafting, organ transplant) after the protection-starting day (or the day following 90 days of contract date if new business). But, the payment is only one time per each case. |
| Daily Life Liability |
Provide a benefit up to the sum assured if the insured or a spouse living together causes a loss to a 3rd party's body and property and bears a legal liability for such loss, which is caused by accidental event arising from the ownership, use, and management of the house, or daily life (The insured's payment: 20,000 won per accident) |
| Hole in One Cost |
Provides a cost prescribed by the policy provision (free gift purchasing cost, congratulatory meeting cost, commemor-ative tree planning cost in the golf field, and congratulatory money for the accompanying caddy) up to the sum assured if achieving a hole in one during a golf game * However, a bugle hole in one is not the case of coverage. |
- Premium Table
| (Unit: Thousand Won) |
| Type |
Coverage |
Plan Ⅰ |
Plan Ⅱ |
Plan Ⅲ |
| Basic |
Accident Death and Disability |
₩100,000 |
₩200,000 |
₩300,000 |
| Accident Medical Cost |
₩2,000 |
₩3,000 |
₩4,000 |
| Disease Death |
₩10,000 |
₩15,000 |
₩20,000 |
| Active Benefit (Fracture and Burn) |
₩150 ~ ₩5,000 |
₩150 ~ ₩5,000 |
₩300 ~ ₩10,000 |
| Selective Ⅰ |
Accident Hospitalization Cost |
₩20 |
₩30 |
₩30 |
| Disease Hospitalization Cost |
₩50 |
₩50 |
₩70 |
| Cancer Hospitalization Cost |
₩50 |
₩50 |
₩50 |
| Selective Ⅱ |
Cancer Diagnosis |
₩10,000 |
₩15,000 |
₩20,000 |
| Stroke Diagnosis |
₩10,000 |
₩15,000 |
₩20,000 |
| Acute Myocardial Infarction |
₩10,000 |
₩15,000 |
₩20,000 |
| 7 Major Diseases Surgery |
₩500 |
₩1,000 |
₩1,000 |
| Emergency Treatment Hospitalization Cost |
₩100 |
₩100 |
₩100 |
| Selective Ⅲ |
Long Term Care |
₩10,000 |
₩15,000 |
₩20,000 |
| CI Diagnosis & Surgery |
₩10,000 |
₩15,000 |
₩20,000 |
| Daily Life Liability |
₩5,000 |
₩7,000 |
₩10,000 |
* Could you please send me the price and any concerning of Insurance by email.
Matters You (Policyholder) Must Know
- Special Notes You (Policyholder) Must Know with regard to Insurance Agreement
- Notes with regard to Insurance Agreement
Violation of Duty of Declaration before Agreement
- If you do not notify the Company of the disease you suffered in the past or medical history, the Company may not pay you claims.
- If you verbally notify the insurance planner of your past disease or your medical history, you may be disadvantaged such as not being able to get claims, and therefore you must declare your disease(s) you have or you had or medical history in writing on your application.
- If you buy an insurance through communication means including telephone call by recording your answers to a telemarketer's questions without a written application, you must perform your duty of declaration before agreement and therefore especially you must pay special attention when you answer the telemarketer's questions.
- Matter of Cancellation Refund
- If the agreement is nullified, invalid or cancelled, refund of premium shall be made as follows. However, if a covered accident took place during the term of insurance and compensation for a loss has been already made, no refund shall be made by any means.
- If it is nullified, invalid or cancelled for any reason not attributable to the policyholder, the insured or beneficiary: in case of cancellation, an amount of unearned premium calculated by day for the term of insurance that has not passed shall be refunded.
- If it is nullified, invalid or cancelled for any reason attributable to the policyholder, the insured or beneficiary: for the term of insurance that has passed, an amount of balance after the earned premium calculated at short-term rate (applied to the term of insurance of less than 1 year) is deducted shall be refunded. However, if the agreement is nullified due to an intentional act by the policyholder, insured or beneficiary, no refund of premium received will be made.
- Special Notes for Payment of Claims
- [ Cancer Insurance ]
- If the insured is diagnosed as having a cancer within 90 days of the date of the insurance agreement, the Company will not pay any claims, excluding one of other skin cancers, carcinoma in situ, borderline tumor.
- Firm diagnosis on a cancer must be in principle made by a doctor based on his/her opinion through diagnosis by microscopy on fixed tissues, fine needle aspiration biopsy (organism test using a fine needle) or blood test
- [ Particular Disease ]
- Insurance to cover a particular disease such as a cancer, CI or so forth will pay claims only for any disease listed on the clause or the attached table.
- [ CI ]
- As CI coverage pays only for a particular disease such as one of important cancers, so forth listed on the clause, not every disease, please be sure to confirm what are important diseases.
- [ Operation ]
- In the case of a manipulation not included in the definition of "Operation" on the clause (ex: a manipulation like absorbing with an injector, or absorbing body fluid tissues with an injector or injecting medicine into the body), the Company will not pay any claims.
- Coverage using Operation Classification Table will pay only for any operation listed in the Table.
- [ Hospitalization ]
- If the insured who is hospitalized in a medical institution is not absorbed in treatment under the control of a doctor or does not follow the doctors instructions with no right reason during the period of hospitalization, the Company will not pay a part or the whole of hospitalization allowances.
- [ Bodily Injury ]
- If the insured who has a potential disease or physical defect is taken ill due to a minor external affection or his/her symptoms get worse, the Company will not pay accident related claims.
- Summary of Insurance Agreement
| Insurer |
American Home Assurance Company Korea |
| Solicitor |
Branch Office: Agent Office:
Insurance Planner: (Tel. No. : )
|
| Insurance Product |
|
| Term of Insurance |
From . . 200 . to . . 200 . |
| Agreement Related Person |
Policyholder |
|
Insured |
|
| Beneficiary |
The insured or legal successor |
| Premium |
won(Method of Payment : ) |
For a product that is automatically renewed, premium may be raised when it is renewed. Please refer to your application for the details of coverage you have bought, and your premium may change depending on the term of insurance for Special Clause, the period of payment of your premiums, renewal, etc. Please refer to your application for the details of coverage you have bought.
- Policyholder's Rights and Obligations
- Withdrawal of Application
- You, the policyholder may withdraw your application on the date of the application or within 15 days from the date of payment of the 1st premium. If You withdraw your application and the Company accepts it, the Company shall refund the premium received without delay. If you want to withdraw your application, you may withdraw it by filling out in the space of "Withdrawal of Application" on the written application and then submitting it in person or mailing it to a branch office (see Information on the Addresses of Branches When Your Application Is Withdrawn) near you. If withdrawal of your application is accepted, no claim against an accident if occurs will be paid.
- The place where you can submit your withdrawal of application: (Tel: )
- The place near you : (Tel: )
- Cancellation of Agreement
You (the policyholder) may cancel this Policy within one (1) month of the date of your application and within 3 months if the Company did not give you the duplicates of the clauses and your application or not brief you on the important part of the clauses or you did not affix your own handwriting signature on the application when this agreement was made. In this case, the premium paid plus a prescribed interest will be refunded.
- Duty of Declaration before Agreement
You (policyholder) or the insured must declare to the Company only true facts for the questions on the application form when the insurance agreement is made and affix your own handwriting signature on your application. If you or the insured declare to us any untrue facts on the important matters by your intention or gross mistake, the Company may cancel the agreement or restrict the payment of claims for loss in a separate way set forth by the Company.
- Duty of Declaration after Agreement
After an agreement is made, if the insured's occupation or assignment is changed (including the case that a private car driver is changed to business car driver), or if the insured becomes to personally use a bicycle or motor-bicycle, you (the policyholder) or insured must declare such fact to the Company without delay. If you or the insured do not notify the Company of such change and a covered accident occurs, the Company may restrict payment of claims.
- Notification of Changed Address
All post mails for information from the Company will be sent to your address last notified to us and any mail sent to you will be deemed to arrive at you after the time necessary for arrival has passed.
- Notification of Loss
You (the policyholder), the insured or its beneficiary must notify the Company of a covered accident without delay if occurs as soon as you know it. If you or the insure neglect to notify it and a loss increases, the Company will not pay for the increased loss.
- Delay of Payment of Premiums
If you (the policyholder) or the insured default to pay your installment premium after the 2nd installment and thereafter by the due date, the Company shall give you 14 days of grace period. The Company shall pay you for loss or damage incurred during the said grace period. And the Company will notify you that the policy would be terminated in advance 7 days before expiration of the grace period if you do not pay your installment premium during the grace period. Then, if you do not pay the installment by the expiry date of the grace period, the Company shall cancel the agreement on the day following the expiration of the grace period.
- Major Details of Coverage in the Insurance Agreement
| Kind |
Coverage |
Reason for Payment |
Claims Payable |
| Basic Coverage |
Death or Disability by Sequela due to a boily injury suffered by a covered accident |
If the insured dies due to a covered accident which causes bodily injury within 1 year of the date of such accident, claims shall be paid to the extent of the insured amount. |
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| If the insured suffers disability by sequela due to a covered accident which causes bodily injury within 1 year of the of such accident, claims will be paid pursuant to the payment ratio set forth by the clause within the limits of the insured amount. |
| Active Claims (Diagnosis Fee for Fracture and/or Burn) |
If the insured is injured by a covered accident and the insured's injury is firmly diagnosed as fracture, burn (5% or more of the bodily area or second or higher burn in its depth), intracranial injury accompanied by loss of consciousness and/or some amnesia, and/or internal organ injury accompanied by surgical operation such as laparotomy and/or thoracotomy, the Company will pay to the insured an amount equivalent to the insured amount multiplied by payment rate set forth by the clause, excluding fracture of tooth. |
|
| Selected Coverage |
Death of Disease |
If the insured dies or has 80% or more payment rate of disability by sequela, the insured amount will be paid. If the insured suffers disability in two or more parts of the body listed on Disability Classification Table due to the same disease, payment rate for disability by sequela in each part of the body shall be calculated and no aggregated payment rates will apply but only the higher payment rate apply. For disability not fixed permanently but temporarily appearing after the completed medical treatment, if such disability staying with the insured for 5 or more years, it will be recognized as disability by sequela and an amount equivalent to 20% of the payment rate for that disability will be paid. |
|
| Actual Medical Expense for Bodily Injury in hospital |
If the insured undergoes treatment in a hospital due to a bodily injury, hospitalization and treatment fee will be paid for each injury within the limits of the insured amount as follows:
- Sickroom, hospitalization expenses, operation: an amount equivalent to 90% of the insured's share plus the portion to which the national health insurance does not apply (excluding a difference between the standard sickroom and a higher sickroom) of the allowances payable by the National Health Insurance Corporation in accordance with the National Health Insurance Act, provided that if an amount equivalent to 10% of the insured's share exceeds 2 million won a year, such the exceeding amount will be compensated).
- For hospitalization, an amount equivalent to a difference between the standard sickroom and a higher sickroom actually used by the insured less 50% of such the difference (provided that daily average amount will be within the limits of 100,000won, and such the daily average amount will be calculated by dividing the total amount of differences between the standard sickroom and a higher sickroom actually paid by the insured during the insured's hospitalization by the total days of hospitalization).
|
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| Actual Medical Expense for Bodily Injury (treatment as an outpatient in a medical institution) |
If the insured undergoes medical treatment as an outpatient in a medical institution, as a result of bodily injury he/she suffered, the Company will pay such medical expense less the deductible per each outpatient's treatment within the limits of the insured amount (up to 180 times from the date of the insurance agreement a year).
- Deductible: 10,000won for a clinic, 15,000won for a hospital and 20,000won for a specialized general hospital.
|
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| Actual Medical Expense for Bodily Injury as an outpatient (prescriptions from a medical institution) |
If the insured gets injured and as a result, he/she gets prescriptions from a medical institution as an outpatient, the Company will pay such the medical expense less the deductible per one prescription within the limits of the insured amount (up to 180 cases a year).
|
|
| Hospitalization for 4 days - 120 days due to 7 Most Important Diseases |
If the insured is hospitalized and undergoes medical treatment for 4 or more days in a clinic or hospital set forth by the clause due to a disease or one of the 7 most important diseases (heart disease, cardiovascular disease, liver disease, high blood pressure, diabetes, chronic lower respiratory tract disease, and gastric/duodenal ulcer) described on the clause, claims will be paid for up to 120 days. |
|
| Solatium for Loss Incurred by Job Suspension |
If the insured gets disable completely and continuously within 90 days of the date of a covered accident, and is not able to engage in his/her job, solatium for loss incurred by job suspension will be regularly paid for such period of job suspension (weekly pay) within the limits of 52 weeks. |
|
| Hospitalization Expense due to cancer II (4 days to 120 days) |
Coverage for a cancer will start on the next day of the date when 90 days (including the date of insurance agreement) has passed from the date of the insurance agreement. However, coverage for other skin cancers, carcinoma in situ, borderline tumor, thyroid cancer will start on the date of insurance agreement. If the insured is hospitalized in a clinic or hospital due to a cancer described on the clause for 4 or more days, daily allowance starting on the 4th day of such hospitalization will be paid per day of hospitalization within the limits of the insured amount for up to 120 days. However, for other skin cancers, carcinoma in situ, borderline tumor, thyroid cancer daily allowance starting on the 4th day of hospitalization will be paid in an amount equivalent to 20% of the insured amount. |
|
| Diagnosis Fee for Cancer II (any person above 16 is eligible to buy this coverage) |
Coverage for a cancer will start on the next day of the date when 90 days (including the date of insurance agreement) has passed from the date of the insurance agreement. However, coverage for other skin cancers, carcinoma in situ, borderline tumor, thyroid cancer will start on the date of insurance agreement. If the insured's disease is firmly diagnosed as a cancer, the insured amount will be paid only once during the term of insurance. However, if the insured's disease is firmly diagnosed as carcinoma in situ, borderline tumor or other skin cancer, thyroid cancer 20% of the insured amount will be paid only once during the term of insurance. |
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| Diagnosis Fee for Stroke |
If the insured's disease is firmly diagnosed as stroke specified on the clause, the insured amount will be paid only once during the term of insurance. |
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| Diagnosis Fee for Acute Myocardial Infarction |
If the insured's disease is firmly diagnosed as acute myocardial infarction specified on the clause, the insured amount will be paid only once during the term of insurance. |
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| Diagnosis Fee for Critical Illness (CI) |
If the insured has a disease firmly diagnosed as "critical illness"(important cancer, important stroke, important acute myocardial infarction, end-stage renal failure, end-stage hepatic sclerosis, or benign brain tumor). specified on the clause or undergoes an operation for critical illness specified on the clause after the starting date of coverage (on the next day of the date when 90 days (including the date of insurance agreement) has passed from the date of the insurance agreement. during the term of insurance, the insured amount will be paid only once during the term of insurance. |
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| Operation Fee for One of 7 Most Important Diseases |
If the insured undergoes an operation for one of the most important diseases (heart disease, cardiovascular disease, liver disease, high blood pressure, diabetes, chronic lower respiratory tract disease, and gastric/duodenal ulcer) listed on the clause, the insured amount will be paid. |
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| Operation Fee for Cancer II |
Coverage for a cancer will start on the next day of the date when 90 days (including the date of insurance agreement) has passed from the date of the insurance agreement, (except for a person under 15). However, coverage for other skin cancers, carcinoma in situ, borderline tumor, thyroid cancer will start on the date of insurance agreement. If the insured undergoes an operation for the direct purpose of curing a cancer after the starting date of coverage (90 days has passed from the date of insurance agreement for a new agreement), the insured amount will be paid during the term of insurance. However, if the insured undergoes an operation for carcinoma in situ, borderline tumor or other skin cancer, thyroid cancer 20% of the insured amount will be paid. |
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| Operation Fee |
If the insured undergoes an operation described on the clause due to bodily injury or disease, the insured amount will be paid. |
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| Expense for Treating a Cancer as an Outpatient in a medical institution |
If the insured undergoes treatment as an outpatient in a medical institution for the direct purpose of curing a cancer described on the clause after the starting date of coverage (on the next day of the date when 90 days has passed from the date of insurance agreement for a new agreement), the insured amount will be paid per treatment in the medical institution as an outpatient. However, if the insured undergoes treatment as an outpatient for carcinoma in situ, borderline tumor or other skin cancer, 20% of the insured amount will be paid. |
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| Operation Fee for Plastic Operation (up to 5 million won) |
Because the insured sustains a covered accident that causes external specks or ugly appearance, or functional disability on his/her face or upper or lower limbs, from which he/she wants to recover, if he/she undergoes plastic operation by a specialized plastic surgeon within 2 years of the date of such accident, and if he/she undergoes such plastic operation two or more times on the same bodily part, claims for it will be paid only for the first operation in an amount not exceeding 5 million won (for the face: 140,000won per 1 cm in the diameter of operation; for the upper or lower limbs: 70,000won per 1 cm; and only for 30mm or more size of operation. |
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| Funeral Expense (death of a bodily injury) |
If the insured sustains an injury caused by a covered accident and he/she dies of a cause directly resulting from such injury within one year of the date of such accident, the insured amount will be paid. |
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| Emergency Hospitalization Expense |
If the insured suffers a symptom specified on the clause and is urgently evacuated to a hospital and after first aid, he/she is hospitalized for the purpose of undergoing continuous treatment (including the case of death), the insured amount will be paid. |
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| Solatium for Food Poisoning |
If the insured is hospitalized in a clinic or hospital for 2 days or longer due to food poisoning described on the clause, claims will be paid up to one million won depending upon the length of hospitalization (for hospitalization of 2 to 3 days: 100,000won; for 4 to 9 days: 300,000won; 10 to 19 days: 500,000won; and 20 days or longer: 1 million won.) |
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| Treatment Expense for Fracture or Burn |
If the insured sustains a covered accident and he/she has a fracture or burn (second degree burn in its depth) listed on the clause resulting from such accident according to a specialized medical doctor's firm diagnosis, the insured amount will be paid. |
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| Diagnosis Fee for 3 Most Important Children's cancer Cancers |
If the insured has one of the 2 most important children's cancer cancers (cerebral cancer or leukemia) set forth by the clause according to a specialized medical doctor's firm diagnosis after the starting date of coverage (on the next day of the date when 90 days has passed from the date of insurance agreement for a new agreement), the insured amount will be paid only once during the term of insurance. |
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| Special Education and Training Expense |
If the insured becomes the disabled (the crippled, visually handicapped, hearing-impaired, or speech-defect person) set forth by the clause resulting from injury or disease caused by a covered accident, the insured amount will be paid. |
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| Children's Legal Liability |
If the insured has a legal liability because an accidental accident involving his/her child(ren) causes damage to a third person's body or property during the insured's owning, using and managing a housing or daily life, claims will be paid within the limits of the insured amount(deductible: 20,000won per accident). |
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| Daily Life Legal Liability |
If the insured himself/herself or his/her spouse living together with the insured has legal liability resulting from an accidental accident that causes damage to a third person's body or property during the insured's owning, using and managing the housing or daily life except in the case of owning, using or managing other than the housing), claims will be paid within the limits of the insured amount(deductible: 20,000won per accident). However, for the legal liability arising directly based on the insured's job duties, no claims will be paid. No claims will be paid for the legal liability arising based on the insured's real estate other than his/her housing listed on the insurance certificate (insurance policy) owned, used or managed by the insured. |
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| Long Term Nursing Care II |
If the insured's serious condition of "Dementia" or "Unable to Move" continues for 90 days or longer according to psychiatrist or neuropsychiatrist's verification after his/her disease is diagnosed as serious condition of "Dementia" or "Unable to Move" by such the specialist, claims will be paid within the limits of the insured amount only once during the term of insurance. "Serious condition of Dementia" means the disease firmly diagnosed as organic dementia and the insured remains in the condition of "disorder of cognitive function" thereby. |
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| Expenses on Hole in One |
If the insured makes hole in one in a golf game, the expenses set forth by the clause (for buying gift souvenirs, a congratulatory party, planting a commemorative tree in the golf course, and congratulatory money given to the caddy for the golfer) will be paid to the extent of the insured amount. |
|
| Traffic Accident Aids Expense |
If the insured causes a third person or third persons to suffer a bodily injury due to a sudden, accidental accident arising while driving his/her own car (except for a motor bicycle set forth by the provisions of Article 2 of Enforcement Ordinance of Automobile Management Act) during the term of insurance, the Company will pay for the actual money paid by the insured to back up Mutual Agreement to reduce criminal liability in the traffic accident within the limits of_____won per victim.
- For death of the victim : 30 million won
- If, due to a "traffic accident where the insured violated important laws and regulations", the victim is diagnosed as having an injury which it takes 42 days or longer to cure:
| 42 to 69 days |
70 to 139 days |
140 days or longer |
| 10 million won |
20 million won |
30 million won |
- If the insured causes a heavy injury or injuries "in a general accident":
If the insured has other agreements that cover the same risk as that in this agreement and if the aggregated amount of claims calculated pursuant to such other insurance agreements respectively as if there were no other insurance agreements exceeds the amount of backup money for Mutual Agreement to reduce criminal liability in the traffic accident, then the liability of the Company hereunder will after the application of any Average Condition be limited to their ratable proportion of such Loss. In other words, each of the insurance companies involved in the same risk agreements will only pay its contribution in ratable proportion against the said aggregated amount. In the case that the insured is prosecuted by the prosecutor because he/she causes other persons to suffer heavy injury or injuries or he/she causes injury of grade 1, grade 2 or grade 3 set forth by Article 3 of Enforcement Ordinance of Automobile Loss Compensation Guaranty Act. |
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| Home-Care Electronic Appliances (4 important home appliances) |
* The Company will pay actual repair charge, if the home appliances specified on the policy in use in the insured house are out of order, up to max. the amount on the policy. "The insured house" means a house for living located at the address on the policy. Any loss incurred within 30 days after coverage starts will not be paid for. The insured house means any house at the address for the purpose of living listed on the insurance certificate (insurance policy)) within the limits of the amount described on the insurance certificate (insurance policy), except for any loss incurred within 30 days after coverage starts. |
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| * A claim per accident will be the market price of the repaired product or actual repair charge, which is lower within the limits of the insured amount listed on the insurance certificate (insurance policy). |
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* The Company may pay for repairs at its own decision or replace the malfunctioned product with another new product having the same performance * Repairing expense will include prices of parts and labor, and delivery charge if transportation charge is incurred for repairs of the malfunctioned product (except for portable small products which can be carried by hands). |
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* Insurable Electronic Products
- Electronic home appliances legally purchased in Korea,
- A product of less than 9 years from the date of manufacture, and
- Products used for home.
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| Lawyer's Legal Service Fee |
In the case that because of illegal use of personal information, you paid for lawyer's legal service with the Company's prior consent (except in the case where there is a sufficient reason that you cannot get such consent), the Company will pay for the amount of money actually paid to the lawyer up to the insured amount listed on the policy. |
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| Legal Action Related Costs |
In the case that because of illegal use of a third party's personal information, legal action is brought to the court against the insured, the legal costs (including cost of documents prepared, submission cost, and/or other related costs) including lawyer's remunerations already paid with the company's prior consent for court trial will be paid for by the Company. |
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| Monetary Loss |
In the case that because of illegal use of personal information/illegal use of a payment card, etc., any monetary loss incurred by the insured will be paid for by the Company within the limits of the insured amount on the policy. |
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| Making up for the lost income/other incidental expenses |
In the case that because of illegal use of personal information, a legal action is brought against the insured, the insured's lost income, travel expense, communication costs, etc. resulting from the insured's presence at the legal action under a presence order, etc. will be paid for by the Company within the limits of the insured amount on the policy. |
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| Traffic Accident Injury Indemnity |
If the insured suffers a bodily injury (except for damage to artificial hand, artificial leg, artificial eye, denture, etc.), will pay for a loss incurred by such injury resulting from the one of the following accidents:
- An accidental injury while the insured is driving an automobile,
- An accidental injury while the insured is riding on an automobile or other transportation in operation
- A traffic accident caused by collision or contact with the insured by an automobile or other transportation
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- Details of coverage you actually bought and the insured amount are specified on the application. For the details of coverage you bought, please be sure to see the application
- The above illustrated clauses are only some quoted and summarized from What Causes of Loss Are Not Covered to which you have to pay special attention, and therefore for [What Causes of Loss Are Covered] and [What Causes of Loss Are Not Covered] by coverage, please be sure to demand briefing on them and confirm them through the clauses.
- Special Notes with regard to Payment of Claims
Special notes with regard to payment of claims are only a part excerpted from the insurance clauses, and therefore please be sure to refer to the appropriate clauses.
- Notes for Basic Agreement
- The Company will not pay for a loss resulting from one of the following causes whether direct or indirect:
- Intentional act by the policyholder or insured,
- Intentional act by the beneficiary,
- The insured's self injury, suicide, attempted suicide, penal offense, or violence (except in the case that the insured's act is considered to be from his/her legal defense, emergency evacuation or justifiable act),
- The insured's disease (if you buy a special clause, death of disease will be covered), unsound mind, any injury caused by the insured's psychological disease,
- The insured's pregnancy, delivery (including Caesarean operation), abortion or surgical operation, or other medical treatment,
- Damage to the insured's physical auxiliary equipment and tools,
- The insured's execution of a sentence
- War, foreign country's military power, revolution, etc. or other similar situation,
- Nuclear fuel material or material contaminated by such nuclear fuel material, or radioactivity, explosiveness or similar accidents.
- The Company shall not pay for a loss incurred while the insured is doing one of the following acts for his/her job, duty or club activity:
- Professional mountain-climbing, glider's operation, skydiving, scuba diving, hang gliding or other similar dangerous activity,
- Motorboat, automobile, or motorcycle race, demonstration or entertainment (including training for it) or test driving,
- While a crew, fisher, ferryman or a person whose official duty is to ride a boat is riding a boat.
- For other important details such as the policyholder's rights and obligations, and matter of payment of claims, please be sure to refer to the insurance clauses
- You must declare true facts of your occupation, the condition of your health, etc. to the Company. If you fail to declare true facts intentionally or by gross mistake, the Company may not pay for a loss suffered by the insured. And what you declared to an insurance solicitor verbally will be ineffective.
- Notes for Individual Clause with regard to Injury Related Coverage
If the insured suffers two or more kinds of fractures due to the same accident, the aggregated amount of claims for such fractures will be paid.
- Notes for Individual Clauses for Disease Related Coverage
- In disease related coverage, the Company will not pay for the following losses:
- In addition to medical examination, vaccination, sterility operation, Caesarian section not based on any disease, social disease, alcoholic toxication, or intake or use of habitual drug or hallucinogen,
- Rest cure to treat fatigue, weariness or metal and physical weakness, or
- Plastic surgery for beautiful face, normal deliver, or dental treatment.
- In the case of stroke or acute myocardial infarction, if the insured is firmly diagnosed as having such disease as set forth by the clause, the Company will pay the insured amount only once during the term of insurance.
- In the cancer diagnosis fee coverage, coverage for a cancer will start on the next day of the date when 90 days (including the date of insurance agreement) has passed from the date of the insurance agreement
- "Cancer" in this agreement means a disease classified into a malignant neoplasm in the 5th Korean Standard Classification of Causes of Death by Disease. However, disease or precancer focal coming under Classification No. 44 (Other Skin Malignant Neoplasm) will be excluded.
- In cancer diagnosis fee coverage, for carcinoma in situ, borderline tumor or other skin cancer, only 20% of the insured amount will be paid.
- For hospitalization due to a cancer, allowances will be paid within the limits of 120 days per one hospitalization.
- If the insured is hospitalized to treat the same cancer two or more times, it will be regarded as one-time hospitalization and allowances will be paid by adding all the days of such many-time hospitalization.
- In operation fee for one of the 7 most important diseases, if the insured undergoes two or more kinds of operation, operation fee only for one operation will be paid.
- For all the disease related coverage, if the insured underwent diagnosis or treatment due to the existing disease within 5 years of the date of application, no claims will be paid.
The above illustrated clauses are only some quoted and summarized from What Causes of Loss Are Not Covered to which you have to pay special attention, and therefore for [What Causes of Loss Are Covered] and [What Causes of Loss Are Not Covered] by coverage, please be sure to demand briefing on them and confirm them through the clauses.
- Notes for Individual Clauses with regard to Liability Related Coverage
- In the clause to cover liability, the Company will not pay for a loss resulting from one of the following causes whether direct or indirect:
- Intentional act by the policyholder, the insured or their legal representative (director(s) if it is a corporation or other organization(s)),
- War, foreign military exercise, revolution, civil war, incident, riot, commotion, or other similar disaster,
- Fermentation, natural generation of heat, or natural combustion of the subject-matter of insurance, or
- Nuclear fuel materials or radioactivity, explosiveness, other hazardous character or their character of the materials contaminated by nuclear fuel materials.
- The policyholder or insured must notify the Company of any covered accident if occurs without delay and make efforts to prevent and reduce a loss. If the policyholder or the insured neglects to notify the Company of such accident and the loss increases thereby, the Company will not pay for the increased loss.
- In the clause to cover liability in daily life, if the insured has other agreements with other insurers that cover the same risk as that in this agreement, the liability of the Company hereunder will be limited to ratable proportion of loss against the aggregated amounts of claims by those insurances(Average Condition).
- In the clause to cover liability in daily life, the Company will not pay for liability directly resulting from the execution of the insured's job duties.
- In the clause to cover liability in daily life, the Company will not pay for liability resulting from the real estate owned, used or managed by the insured other than the housing specified on the insurance certificate (insurance policy).
The above illustrated clauses are only some quoted and summarized from What Causes of Loss Are Not Covered to which you have to pay special attention, and therefore for [What Causes of Loss Are Covered] and [What Causes of Loss Are Not Covered] by coverage, please be sure to demand briefing on them and confirm them through the clauses.
- Special Notes for Insurance Agreement Related Matters
- Loaning System by Insurance Agreement
As this product is an extinctive, full life-time insurance, no maturity repayment, as well as no loaning based on the "insurance agreement" will be available.
- Special Clause for Payment of Installment Premiums
When the Company pays claims, if there is outstanding premium, the claims less the entire outstanding premium will be paid.
- Conversion of Insurance Agreement
If the insured wants to cancel this agreement and make a new insurance agreement, premium may get higher as he/she gets older and therefore you will need enough information on the conversion of insurance agreement
- Business Expense
The premium paid by you (the policyholder) is composed of risk premium for payment of claims if a covered accident occurs and additional premium for the insurance company's expense.
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