How to make an insurance claim?

• Road accident report
• Copy of car registration manual
• Evidence of damages issued by the surveyor
• Copy of the insurance policy schedule
• Copy of the driver license of the individual driving during the accident

• Road accident report
• Copy of car registration manual
• Evidence of damages issued by the surveyor
• Copy of the insurance policy schedule
• Copy of the driver license of the individual driving during the accident

• Road accident report
• Copy of identity card or passport of the car owner
• Copy of police report and the outcome of police proceedings
• Letter of power of attorney from financial institutions,in case the car is under finance
• All keys
• Original copy of the insurance policy / policy schedule
• The application form of transfer request issued by Department of Land Transport Original car registration manual
• Original car registration manual

Third-party vehicle damages

• Evidence of damages issued by surveyor
• Copy of the driving license of the third-party driver
• Car repair quotation or receipt
• Copy of identity card or passport of the car owner

Third Party property damages

• Repair quotation or receipt (for reimbursement)
• Copy of identity card of the property owner

Bodily Injury

• Copy of third party insurance policy certificate (if any)
• Copy of the driving license of the third-party driver
• Copy of identity card or passport of the injured person
• Copy of police report
• Original medical invoice(s)
• Medical certificate

Death

• Copy of identity card or passport of the deceased
• Copy of death registration certificate
• Copy of identity card of the legitimate heir
• Copy of bank book of the claimant or legitimate heir

Bodily Injury

• Copy of police report
• Copy of identity card or passport of the injured person
• Original medical invoice(s)
• Medical certificate (if any)

Death

• Copy of death registration certificate
• Copy of identity card of the legitimate heir

Permanent disability

• Disabled card

The company shall pay compensation as per the sum insured stated in the schedule and/or the renewal insurance certificate. By claiming for compensation, the insured person, the beneficiary or the representative of the said person, whichever the case may be, must furnish all necessary evidence as required at their own expense to the company.

The insured must submit the following documents within 30 days commencing from the discharge date or the outpatient treatment date:

• The company’s completed claim form
• Medical reports that state the symptoms, the results of diagnosis and medical treatment
• Certified true copy of an ID card or passport of the insured person
• Original receipt showing medical expenses or summary statement with receipt
• Other documents requested by the company as necessary (if any)

The company will compensate the actual medical expenses incurred which are deemed reasonable according to medical necessity and medical standard, but not exceeding the sum insured stated in the insurance policy.

The original receipt must be presented. If the company does not reimburse the full medical expense, the company will return the original receipt, certifying the amount paid, so that the insured person can claim the remaining amount from other insurers (if any).

However, if the insured has received partial reimbursement from the government, other welfare/benefit schemes or other insurers, the insured must submit a copy of the receipt and the original statement with a certified amount paid by the government or other authorities to claim the remaining amount from the company.

Roojai Care Card in MyAccount is a special privilege for Roojai personal accident insurance customers. You can receive medical treatment for accidents according to the sum insured in the policy. The steps are as follows:

• Choose a hospital from over 400 network hospitals across Thailand.
• Show your Roojai Care Card and your ID card or passport when you visit a hospital or medical clinic
• Allow for the hospital to check the insurance policy information in the system.
• Wait for the hospital to send medical treatment details to the company.
• The company will review the insurance claim and inform the hospital of the compensation details.
• Sign all necessary documents from the hospital and pay any outstanding balance that is outside the sum insured specified in the policy (if any).

1. The cashless hospitalization(IPD/OPD) option will be available only in Roojai network hospitals and for medical treatment of accident happened 60 days after the policy effective date. The policyholder doesn’t need to pay upfront when discharged from the hospital.
2. For accidents during the first 60 days of the policy effective date, medical expenses must be paid in advance, and request reimbursement afterwards.
3. The customer can present his/her digital Roojai Care Card with an ID document at the hospital for treatment eligibility confirmation. It is not eligible for overdue payment.
4. If the treatment is received in a facility outside the Roojai hospital network, only the reimbursement option is available.

The company will pay compensation in accordance with the sum insured stated in the policy schedule. The insured person must submit the following documents at their own expense within 30 days of diagnosis by a physician that the Insured suffers from total permanent disability or permanent dismemberment.

• The company’s completed claim form
• Attending physician’s summary certifying the insured person has suffered from permanent disability or permanent dismemberment.
• A copy of an ID card or passport of the insured
• Other documents requested by the company as necessary (if any)

In case of any injury causing the insured person to be hospitalised, the company shall pay the daily income compensation during hospitalisation in the amount indicated in the policy schedule. By claiming for compensation, the insured person, the beneficiary or the representative of the said person, whichever the case may be, must submit the following documents to the company within 30 days commencing from the inpatient treatment date as required at their own expense:

• The company’s completed claim form
• Medical reports that identify the conditions of requiring prolonged hospitalization
• Certified true copy of the insured’s ID card
• Photo of the insured and the injured body part
• Other documents requested by the company as necessary (if any)

If the insured person, or representative of such person, depending on circumstances didn't claim for compensation benefits and then the insured died from an accident, the beneficiary, or representative of such person, depending on circumstances, must submit the following documents or evidence at their own expense to the company within 30 days from the date.

• The company’s completed claim form
• Certified true copy of the insured person’s death certificate
• Certified true copy of autopsy &dissection report
• Certified true copy of daily police report, investigation report, judgment in case of lawsuit (certified true copy by the police officer handling the case)
• Certified true copy of the insured person’s ID card or passport and house registration stamped “deceased”
• Certified true copy of the beneficiary’s ID card or passport and house registration
• Other documents requested by the company as necessary (if any)

The company will compensate only one item of loss which has the highest payable amount. During the policy period, the total compensation will not exceed the sum insured stated in the insurance policy. If the company has not paid the full sum insured, the company will continue to provide coverage until the end of the policy period for the remaining sum insured.

The company shall pay compensation as per the sum insured stated in the schedule and/or the renewal insurance certificate after which, the cancer insurance coverage under this policy will be terminated. The insured person, or representative of such a person, depending on circumstances, must submit the following documents or evidence at their own expense to the company within 30 days of getting the results of a medical diagnosis.

• The company’s completed claim form
• Medical reports that identify symptoms, the results of diagnosis and medical treatment
• Certified true copy of the insured’s ID card or passport
• Laboratory biopsy results
• Other documents requested by the company as necessary (if any)

If the insured person, or representative of such person, depending on circumstances didn't claim for compensation benefits and then the insured died from cancer, the beneficiary, or representative of such person, depending on circumstances, must submit the following documents or evidence at their own expense to the company within 30 days from the date.

• The company’s completed claim form
• Certified true copy of the insured’s death certificate
• Certified true copy of autopsy &dissection report
• Certified true copy of daily police report, investigation report, judgment in case of lawsuit (certified true copy by the police officer handling the case)
• Certified true copy of the insured person’s ID card or passport and house registration stamped “deceased”
• Certified true copy of the beneficiary’s ID card or passport and house registration
• Medical report with the main symptoms, diagnosis results, and the medical history before decease.
• Other documents requested by the company as necessary (if any)

*Please remember to read the full policy terms and conditions.

Skin cancer means any skin cancers, except malignant melanoma at stage II or above classified by the American Joint Committee on Cancer.

The cancer insurance policy has extended the coverage of skin cancer, during the period in which this policy becomes effective and after the waiting period of 90 days from the policy start. If the insured person gets a medical diagnosis of having skin cancer as defined in the insurance coverage document for the first time, the company shall pay compensation as per the sum insured stated in the schedule and/or the renewal insurance certificate. The insured must submit the following evidence at their own expense to the company within 30 days of getting the results of a medical diagnosis.

• The company’s completed claim form
• Medical reports that identify symptoms, the results of Diagnosis and medical treatment
• Certified true copy of the insured’s ID card or passport
• Laboratory biopsy results
• Other documents requested by the company as necessary (if any)

If the insured person gets a medical diagnosis from a physician or specialist with coronavirus disease 2019 (COVID-19) for the first time and later suffers a coma due to COVID-19, the company will pay compensation according to the sum insured stated in the insurance policy. Terminal illness in this event, as diagnosed by a physician, is a serious incurable illness that causes coma, severe chronic obstructive pulmonary disease or end-stage lung disease. The insured must submit the following evidence at their own expense to the company within 30 days of getting the results of a medical diagnosis.

• The company’s completed claim form
• Medical reports that state the symptoms, the results of diagnosis and medical treatment
• Certified true copy of the insured’s ID card or passport
• Other documents requested by the company as necessary (if any)

If the insured person dies after a coma caused by COVID-19 and no compensation has been claimed, the company will pay compensation to the named beneficiary according to the sum insured stated in the policy. The following documents must be submitted to Roojai within 30 days from the date of the insured person’s death:

• The company’s completed claim form
• Certified true copy of the insured person’s death certificate
• Certified true copy of autopsy &dissection report
• Certified true copy of daily police report, investigation report, judgment in case of lawsuit (certified true copy by the police officer handling the case)
• Certified true copy of the insured person’s ID card or passport and house registration stamped “deceased”
• Certified true copy of the beneficiary’s ID card or passport and house registration
• Other documents requested by the company as necessary (if any)

If the insured suffers from terminal illness caused by COVID-19 and at least one other condition, the company will pay benefits for only one condition.

If the insured person gets a medical diagnosis of having coronavirus disease 2019 (COVID-19) for the first time and needs to be treated either as an in-patient or out-patient in a hospital or medical facility, the company will pay compensation based on the actual amount the insured person paid, not exceeding the sum insured stated in the insurance policy. The following reimbursement documents must be submitted to Roojai within 30 days from the date of leaving the hospital or medical facility:

• The company’s completed claim form
• Medical reports that state the symptoms, the results of diagnosis and medical treatment
• Certified true copy of the insured ID card or passport
• Original receipt showing medical expenses or summary statement with the receipt
• Other documents requested by the company as necessary (if any)

The receipt listing the medical expenses must be the original receipt. If the company does not reimburse the full expense, the company will return the original receipt, certifying the amount paid, so that the insured person can claim the remaining amount from other insurers (if any). However, if the insured has received partial reimbursement from the government, other welfare/benefit schemes or other insurers, the insured must submit a copy of the receipt with a certified amount paid by the government or other authorities to claim the remaining amount from the company.

• The company will return all premiums already charged to the insured person if symptoms of the coronavirus disease 2019 (COVID-19) appear within the 14 day waiting period from the policy effective date.
• Each coverage under the insurance policy will be terminated if the company pays the full sum insured as stated in the policy for the coverage. The company will continue to cover the insured person until the end of the policy period for the remaining sum insured (if any).