4.

Lilt] t DOI Vth ICHACH HANG KM THAM GIA

0 HIEM LIEN KET CHUNG THth HAN 20 NAM —
G PHI MOT LAN — ICE HOACH BAO VE

San phim bao hiem len Ica chung clang phi linh hog dm Clang ty TNHH Manulife (Via Nam)
("Cong Ty") &rye phe chulan theo c8ng van s6 8443/BTC-QLBH ngay 16/07/2018 dm BO Tai
chinh. Khi tham gia San pham bao hiem Lien KM Chung Thai Han 20 Nam — DEng phi met Ian
a
— Ka hoach back ve, nghl khach hang d9c va luu 9 met s6 diem sau:
DQC ky Quy tic, Dieu khoan not khi tham gia San pham bac) hiem Lien Ket Chung
Thai I-Ian 20 Nam —DEng phi met Ian — Ka hoach bao v va lint 9 met se!) nOi dung sau:

1.1 Nglila cfm nhimg t&/cam tir viet hoa &we din giai tai Pita Lac 1 dinh kern Quy tic,
Dieu khoan san phArn.
1.2 Ben mua bao hiem c6 the hay hyp (long trong veng 21 (hai much m6t) ngay ke ta
ngay Ben mua bao hiem nhan &rye H9p DAng, \fa nhO 10 phi bao Hem da (long theo
quy dinh tai Dieu 18 dm Hgp Ding.
1.2 Ben mua bao hiem can phai dong phi bao hiem nhu dugc quy dinh tai Dieu 23.
1.3 Cac truang hyp gied han bao hiemva cac kw 9 khac lien quan den viec chi tra quyen
Igi bao hiem quy dinh tai Dieu 1.5, Dieu 12, Dieu 13 va Dieu 14 dm Hop Deng.
1.4 Cac loai phi duce quy dinh tai Diu 24 dm Hgp Deng.
Vic tham gia cac san pi-1Am bao hiem be try la thong bat buOc. Ben mua bao hiem c6
quyen yeu eau hay b6 cac san phAm bao hiem be try. Ben mua bao hiem can Itru 9 cac
dieu khoan loai tit quy dinh danh rieng cho quyen lgi bao hiem be try.

Khi tham gia bao hiem, phai km gift cac chimg tit lien quan (Mn hcm &Eng bao hiem day

Tillie hien ke khai thong tin trung thuc va thOng bao khi có thay dei cac thong tin lien
quan den I-19p thing bao hiem theo guy dinh tai Dieu 19 va Dieu 26 caa I-19p DEng. Vic
ke lchai thong tin khong trung thyc ve sat khOe va tin sir benh se dan den rh ro khach
hang killing duce Cong ty chi tra quyen Igi bao hiem cfm san
 MIX LIJC
QUY TAC, DIEU ICEMAN
SAN PRAM BAO HIEM LIEN KET CHUNG THOI HAN 20 NAM —
BONG PHI MOT LAN — KE HOSCH SAO YE

A. PHAN NO DUNG

CHU'ONG I: QUYEN LQI BAO HIEM

DIEU 1: QUYEN L()I TRO CAP Y TE 1
1.1 Quyen Igi trq cAp nam vien 1
1.2 Quyen Igi trg cap nam vin tai IChoa Chant See Dc Biet 1
1.3 Quyen Igi troy cAp thu nhap• 1
1.4 Quyen lqi he trg chain s6c sac khoe 1
1.5 Giei Han Va Dieu Kin Chi Ira Chung 2
DIEU 2: QUYEN LO1 BNH Us? NGHIEM TRQNG 2
2.1 Quyen lqi bao him Benh Ly Nghiem Trqng giai doan sam 2
2.2 Quyen Igi bao him Benh LS/ Nghiem Trong giai doan cuOi 3
2.3 Quyen Igi bao him benh 19 theo giei tinh 3
DIEU 3: QUYEN LOI BAO HIEM THUONG TAT DO TAI NAN 3
3.1 Quyen lqi bao him thuang tat do Tai Nan 3
3.2 Quyen lqi bao Hem t6n throng !lei tang do Tai Nan 4
3.3 Quyen lqi bao him Say xucmg do Tai Nan 5
3.4 Quyen lqi bao him bong nghiem trong do Tai Nan 5
DIEU 4: QUYEN LOI BAO HIEM THUONG TAT TOAN BO VA VTNH VIEN 6
DIEU 5: QUYEN LOI SAO MEM TO' VONG 6
5.1 Quyen Igi bAo him tit vong: 6
5.2 Quyen lqi bao hiem tit vong do Tai Nan: 7
5.3 Quyen Igi danh cho nguoi kh8ng hut thutic 1a: 7
5.4 Quyen lqi trg cAp mai tang: 7
DIEU 6:MUC DIEU CH1NH TRONG TRUONG HOP NGUOI DOC BAO HIEM LA TRE EM 8
DIEU 7: QUYEN LOI DUY TR1 HOP DONG 9
DIEU 8: QUYEN LOI DAM BAO HIE.0 LUC HOP BONG 9
DIEU 9: QUYEN WI DAO HAN 10
DIEU 10: QUYEN LOI DAU TU. 10
DIEU 11: BAO HIEM TAM THOI 10
 DIEU 12: GI61 HAN P1-LAM VI BAO HIEM 11
12.1 Doi vori Quyen Igi tir vong• 11
12.2 DM vai Quyen Igi thuang tet do Tai Nan va Quyen Igi tfr vong do Tai Nan 12
12.3 DOi vai Quyen Igi Thuang Tat Toan 139 Va Vinh Vin: 12
12.4 Doi veri Quyen lgi Benh Ly Nghiem Trog 13
12.5 Doi veri Quyen Igi Trg cep Y te 13
DIEU 13: THOI GIAN CHO va THOI GIAN CON SONG 14
DIEU 14: TIEU CHUAN VE SO NGAY NAM VIN DOI VOI MOT SO InNH THONG
THUONG 15
CHDONG II: THONG TIN VE QUit LIEN KET CHUNG VA QUYEN LOI MU TIc 16
DIEU 15: THONG TIN VE CO CAU VA HOAT BONG CUA WS' LIEN ICET CHUNG 16
DIEU 16: CIA TR! TAI KHOAN HOP BONG 16
16.1 Gia Tr! Tai Khoan Ca Ban 16
16.2 Gia tri Tai Khoan Deng Them 16
CHDONG HI: GIAI QUYET QUYEN LOI BAO HIEM — GIAI QUYET MAU THUAN
VA TRANH CHAP — CRAM DIA HOP BONG BAO HIEM 17
DIEU 17: TH1) TUC GIAI QUYET QUYEN LOI BAO HIEM 17
17.1 Thai han nQp yeu eau giai quy6t quyen Igi bao him 17
17.2 Cluirng tCr yeu cu giai quy6t quyen Igi bao him 17
17.3 Thai gian giai quyet quyen led bao him 18
CHDC1NG IV: CAC QUYEN CIJA BEN MUA BAO HIEM 19
DIEU 18: THOI GIAN CAN NHAC 19
DIEU 19: CAC THAY DOI LIEN QUAN DEN HOP BONG 19
19.1 Thay del thong tin clia Help Deng: 19
19.2 Thay dei cu the 11en quan den Ngueri Dugc Bao Hiem 19
19.3 Thay Mi Ben Mua Ban Hiem 19
DIEU 20: TAM ONG To. Gus. TR! TA! KHOAN HOP BONG 20
DIEU 21: ROT GIA TR! TAI KHOAN HOP BONG 21
DIEU 22: CHAM DOT HOP BONG TRU6C THOI HAN 21
CHDONG V: PHI BAO MEM VA CAC KHOAN PHI LIEN QUAN DEN HOP BONG BAO
HIEM 21
DIEU 23: PHI BAO HIEM 21
23.1 Phi Bao Hiem Ca Ban 21
23.2 Phi Bao Hiem Bong Them 22
23.3 Gia han d6ng phi bao him va Met hieu We H9p Deng 22
 DIEU 24: CAC KHOAN PH! LIEN QUAN DEN HOP BONG BAO HIEM 22
CHUQNG VI: QUY DIM! CHUNG 24
DIEU 25: NGHTA VI) CLING CAP VA BAO MAT THONG TIN COA CONG TY 24
DIEU 26: NGEITA VI) ICE KHAI TRUNG THVC COA BEN MUA BAO HIEM VA NGUOI
DVOC BAO HIEM 25
DIEU 27: TRUONG HOP ICE KHAI SAI TUOI VAMOAC GIOI TINH 25
DIEU 28: MIEN TRUY XET 26
DIEU 29: NGUOI THV HUNG 26
DIEU 30: CHAM DOT HOP BONG 27
DIEU 31: GIAI QUYET MAU THUAN VA TRANH CHAP 27

PHU LUC 1- PHAN DINH NGHIA

PHU LIJC 2- DANH SACH BENH Lt NGHIEM TRQNG GIAI DOAN sem VA
SEMI IS THEO GIQI TiNH

PHI; LIJC 3- DANH SACH BENH Lt NGHIEM TRQNG GIAI DOAN CUOI
 QUY TAC, DIEU KHOAN
SAN PRAM BAO MEM LIEN KET CHUNG THth HAN 20 NAM -
BONG PH! MOT LAN - Kt HOSCH BAO
(Ban hanh kern theo Gong van se, 8443/BTC-QLBH ngay 16/07/2018 dm 138 Tai chinh)

A. PHAN NO! DUNG

CHUONG I: QUYEN LQI BAO HIEM

Trong theri gian Hap D8ng c6 hieu lye, cac quyen lgi neu tai Chuang nay se dirge Cling Ty xem
xet chi tra cang veri cac dieu khoan va dieu kien tuong Ong.

DIEU 1: QUYEN LQI TRQ CAP Y TE

1.1 Quyen lqi trq eAp flint vin

Nu Ngueri Dirge Bao Hiem phai Nam Vien, Cong Ty se thanh toan Quyen Igi try cAp
Elam vin la thong phay hai phan tram (0,2%) SO Tien Bao Hiem xac clath tai tiled diem
Oat hanh (nhung 'thong Ian han ba (03) trieu clOng) cho rn6i Ngay Nam Vin. Tuy
Alen, Gang Ty‘se kitting chi tra Quyen Igi try cAp nam vien theo Dieu 1.1 nay cho
(nhang) Ngay Nam Vien da dirge chi tra theo Quyen Igi try cAp nam vin tai Khoa Cham
Sok Dec Bret neu tai Di'eu 1.2.

1.2 Quyen lqi trq cAp nm vin tai Khoa Cham Sec Dc Bi?t

Neu Ngtrai Dirge Bao Hiem phai Nam Vin va dirge di'eu tri tai Khoa Chant S6c Dac
Biet, Cong Ty se thanh toan quyen Igi nay bang 02 (hai) Ian Quyen Igi try cAp nAm vin
tai Dieu 1.1 cho m6i Ngay Nam Vin de diet.: tri tai Khoa Cham Roc Dat Biet.

1.3 Quyen Igi trg cAp thu nh4p:

Neu (i) Coring Ty chAp nhon thanh than quyen Igi quy dinh tai Dieu 1.1 hoc Dieu 1.2 va
(ii) Ngtrai Dirge Bac) Hiem Nam Vin qua 05 (nam) ngay, Cong Ty se thanh toan them
20% (hai mtrai phAn tram) Quyen led try cAp nam vin cho m6i NO), Wain Vin ke tir
Ngay Nam Vin thir 6.

1.4 Quyen Iqi h6 trq cham sec sic khoe

tong Ty se thanh toan vao Tai Khoan Ding Them s6 tien Wang throng 0,2% (kh8ng
phAy hai phan tram) caa S6 Tien Bac Hiem dirge xac dinh tai theri diem phat hanh Hap
Dein (nhtrng kitting lern hcrn ba (03) trieu deng) vao mOi Ngay Niem Him Deng lieu
IchOng c6 bAt Ict Quyen Igi try cap y t6 nag dirge chi tra trong Nam Hyp Deng lien truac
db.

1/27
1.5 Gied Han VI Dieu Kii:n Chi Trit Chung

Ngoai cac quy dinh cy the n8u ten, viec thanh toan cac quyen lei bao hiem &rye quy
dinh tai Dieu 1.1 va Dieu 1.2 cling se ph y thuOc vao Mc gied han va dieu kien chi tra
chung nhu sau:

T6ng se Ngay Nam Vin thi da ma Cong Ty c6 nglila vv chi tra cho tong ca 02 (hai)
quyen lei bao Hem dugc nett tai Dieu 1.1 va Dieu 1.2 kitting vugt qua 1.000 (met
ngan) Ngay Nam Vin cho toan Thai Han Hgp D6ng; va

Trong truemg hop Nguai Dugc Bao Hiem phai Nam Vin tai cat trung tam y te cAp
quan/huyen hoac Mc benh vin không tryc thuec sy quan 19 dm BO Y re, the B'enh
vien/vien/Ichoa hoc bAt cir ca se y h9c co truyen/y hoc d'a'n tOc/dieu &fang va phyc
hM thee nang nao, sO Ngay Nam Vin tOi da ma Cong Ty xem xet chi tra trong
twang hap nay kitting vtrgt qua 05 (Mitt) Ngay Nam Vin cho mOi Ian Nam Vien.

1.6 Cham dfit quyen

Ngoai nhang twang hyp chAm dirt quyen lai bao hiem da neu 41 Hgp Thing, Quyen lgi
try cAp y te' quy dinh tai Dieu 1 nay se chim dirt tai thei diem Nguai Dirge Bao Hiem
dat bay muai (70) Tuoi.
DIEU 2: QUYEN LQ1 BENH Lt NGHIEM TRQNG

2.1 Quyen Iqi bao hiem Benh Ly Nghiem TrQng giai doan seem

a) Neu Nguai Dugc Bao Hiem duce chAn doan la mac bAt ky Benh L9 Nghiem Treng
giai dean sem nao dugc quy dinh tai Dieu 1 dm Phy Lyc 2, Ong Ty se thanh toan
gia tri nh6 hcrn gala:

Hai muai lam phAn tram (25%) S8 Tien Bao Hiem ducrc xac dinh tai thai diem
duct chan dean mac Benh Ly Nghiem Tryng giai doan sem, hoc

Nam tram (500) trieu

cho mot (01) 'An thanh than.

Trong truang hgp Ngtrai Duet Bao Hiem có tham gia nhieu hcm met kip dOng bao
hi8m, tong s8 tien dugc chi tra cho quyen lei bao hiem Berth L9 Nghiem Try/1g giai
doan sam thong vugt qua nam tram (500) trieu dong cho met (01) lan thanh toan.

b) Cac dieu kien sau se dirge Cong Ty tip dyng khi xem xet thanh toan quyen lei bao
hiem neu tai Dieu 2.1 nay:

(i) S6 Ian thanh toan tOi da dugc chi tra Ichong vtret qua bon (09 lAn trong suOt
uteri han Ma H9p DO'ng nay, va Cong Ty se thong chi tra nhieu hcrn met (01)
Ian cho m6i Benh L9 Nghiem Tryng giai doan sem; va

2/27
 Neu co tir hai (02) Benh L9 Nghiem Treng giai Joan sem dirge chAn Joan
trong cling me4 (01) ngay hoc met (01) LAn Tham Kham, Cong Ty chi thanh
toan met (01) Benh L9 Nghiem Trgng giai Joan sem; va

Neu Benh 14 Nghiem Trgng giai Joan sem dugc chAn Joan lien quan den cac
be phan cUa co the dirge xem la co quan cap (bao gom cac co quan sau: tay,
chan, vá, tai, mat, Ong clan trimg, than, phOi, bang trimg, tinh hoan) Cling Ty
chi thanh tan met (01) lAn cho ding met co quan cap de.

2.2 Quyen loi bat) tam Benh 1.4 Nghiern Trong giai doqn eudi

Neu Ngueri Dirge Bao Him dugc chan doan la mac bat k9 Benh L9 Nghiem Trgng giai
Joan cutii nao dtrgc guy di/1h tai Phu Luc 3, C8ng Ty se thanh toan met tram pilau tram
(100%) SO Tien Bao Hiem,thrgc xac dinh tai the' diem dirge chAn Joan mac Benh 14
Nghiem Trgng giai Joan cuoi.

Tnrec khi thanh toan Quyen Igi bao hiem Benh L9 Nghiem Trgng giai Joan cuM, C8ng
Ty se trir di tAt ca cac Quyen lei bao hiem Benh 14 Nghiem Trgng giai Joan sem theo
quy dinh tai Dieu 2.1 a dirge Gang Ty thanh toan tithe do.

2.3 Quyen lqri bao him benh ly theo gioti tinh

Neu Nguai Duqc Bao Him duqc chAn Joan IA mac bat k9 Benh L9 Nghiem Trgng theo
gigi tinh nao dirge quy dinh tai Dieu 2 Phu Luc 2 dm Hip Deng, Cong Ty se thanh toan
them hai mucri lam phan tram (25%) SO Tien Bao Hiem dugc xac dinh tai tiled diem dugc
chAn Joan mac Berth 14 Nghiem Trgng theo giei tinh de.

Quyen lgi neu tai Dieu 2.3 nay se cham dirt ngay khi C8ng Ty chap nhan thanh toan.

2.4 ChAm dirt quyen loi

Ngoai thing trueng hgp cham dal quyen lei bao him dA neu tai Hgp Deng, Quyen lei
bao hiem Benh 14 Nghiem Trial-1g quy dinh tai Dieu 2 nay se cham dirt khi:
'Fling st tien chi tra cho Quyen lgi bAo him Benh L9 Nghiem Tryng giai Joan sem
va Quyen lei bao hiem Benh 14 Nghiem Trgng giai Joan cu6i dat met tram phan
tram (100%) SO Tien Bao Hiem; hoac

Nguai Dugc Bao Hiem dat bay mucri (70) Tuoi.

DIEU 3: QUYEN LOT BAO MEM THIYONG TAT DO TAI NAN

3.1 Quyen lqi bao him thtrung tiqt do Tai Nan

a) Neu Ngtrgi Dugc Bao Hiem bj thucrng tat do Tai Nan, Cong Ty se xem xet chi tra

3/27
 quyen Igi theo t9 le phan tram dm SO Tien Bao Hiem nhu quy dinh dm bang dual day:

T5a chi tra

Mirc chi tra ten du (1
Tinh Trang Thirovg Tat (Y0 SO Tan ( Trau Sing)
Bat) Ham)
Ca hdi tay hoc ca hai chan hoc ca 100% Kitting áp clung
hai mat
+ Met tay va met than; hoac
+ Met tay va met mat; hoc 100% Khong áp ding
+ Met chan Ara met mat.
Met than hoc met tay hoc met mat 50% Khong áp dung
Ca hai tai 50% Khong áp dpng
Met ben tai 10% 100
Tieng noi 50% Khong áp clang
Ngon tay cal 20% cho mei 200
ngOn tay cal
Ngon tay trO 10% cho m6i
100
ng6n tay to
Ngdm tay giaa 6% cho mei 60
ngon tay giaa
Ng& tay áp at 5% cho mOi 50
ng6n tay AID At
Ng& tay (it 4% cho mei 40
neon tay (it
Tat ca 10 ngon chan 30% 300
Tat ca. 05 ng6n chan tren ding 01 ban 15% 150
chan
Ng& chan cal 5% cho mtii 50
ngtin chin cai

(*) Mirc chi fit to' da cho m6i thuang tat dOi vdri mi lan thanh toan quyen lgi nay.

b) Neu ding met Tai Nan gay ra tir hai (02) Tinh Trang Thucmg Tat tar len, Cling Ty sE
thanh toan tong se, Wan can tra cho cac Tinh Trang Thucmg Tat nay.

3.2 Quyen lqi bao ham tin thirong n'ai tang do Tai Nan
a) Neu Nguai Dugc Bac Hiem bi Mn thucrng noi tang do Tai Nan clan den viec phdi phau
thuat ma 6 vang bung hoc nguc, C6ng Ty se chi at mural lam phan tram (15%) SO
Tien Bao Hiem (nht.mg khong lan han 150.000.000 (met tra'm nam muai trieu) Deng)

4/27
 cho rad Tai Nan.
b) Cong Ty to quyan tir choi chi tra Quyen Igi bao hiem Mn thuong nOi tang do Tai Nan
neu ngay sau khi xay ra Tai Nan, Ngtroi Dugc Bao Hiem kitting nam vin lam benh
nhan rthi tra tai benh vien.

3.3 Quyen Ivi bac) him gay xtring do Tai Nan

a) Neu Nguai Dugc Baia Hiem bi gay, nirt hoc va xtrcmg do Tai Nan, C6ng Ty se xem
xet chi tra Quyen Igi bao hiem gay xuong do Tai Nan theo ty 14 phan tram dm SO Tien
Bao Hiem nhu quy dinh dm bang dual day:

Tjr le chi tra Mat chi trit tiii da cho

Xtrung hi gay (Y0 SO Tien null io@i tan thircrng
Bao Him) taming (then Bong)
Nut hoc va xuong so (tit phau 30% 300
thuat dau)
Gay xtrong_ham duai 15% 150
:ngham tren
Gay xt_rcL 10% 100
Gay xuong mat 5% 50
Gay cort7ay, co than, mat a chin, 5cY0 50
canh tay tren va canh tay duai
Gay xtrcmg Cm 15% 150
Gay mOi xuang &ran 5% 50
Gay cOt sOng 12% 120
Gay xuong chau 50% 500
Gay xucmg c9t 10% 100
Gay_mOt hoac hai xuong diti 30% 300
Va melt hoc hai xuong banh che 15% 150

Clang Ty se chi tra Quyen Igi bao him gay xtrong do Tai Nan cho cac In Tai Nan
khac nhau. Trong truing hgp xay ra tir hal Tai Nan tra len gay ra cling met loai ton
thuong xuong klieg) va tan thucmg cüa Ian Tai Nan lien try& da dugc Cong Ty chi tra
quyen Lai nity, C6ng Ty se tiep tic chi tra cho tan thuong caa !An Tai Nan ka tiep vâi
dieu kien Tai Nan ke tip xay ra sau Tai Nan lien twat tir da mtrai hai (12) thing tra

Neu cang mot Tai Nan gay ra ten thuong gay tlr hai (02) loai xuong tr& len, C6ng Ty se
thanh toan tong sa tien can tra cho cat quyen Igi nay.

3.4 Quyen Iqi bao htem bong nghiem trung do Tai Nan

a) Neu Nguti Duce Bao Him hi b6ng do Tai Nan, ,Cong Ty se chi tra Quyen Igi bao
hiem bang nghiem tr9ng do Tai Nan theo le plan tram dm SO Tien Bao hiem nhu
quy dinh tai bang dual day.

Tinh trang TS' be chi tra Mitre chi tra

5/27
 •

(% STBH) fel da
Bong cap do ba >= 20% din tidh be mat da 100%
Being c. p do ba >= 15% dien 11th be mat da 75%
Khong di) dung
Bang cap de) hai >= 20% din tich b8 mat da 50%
Bong cep de hai >= 10% din tich be mat da 25%

b) Cong Ty c6 quyen tit eh& chi tra Quyen lgi bat) hiem bong nghiem [Kong do Tai Nan
neu ngay sau khi xay ra Tai Nan, Ngueri Dugc Bao Him kh6ng dugc dieu tri b6ng tai
met bOnh vien.

Lieu Trong myi twang kw, tong girl 14 chi trti cho the guyOn 191 nen kti Didu
- 3.1
din Diu 3.4 kheng virvt gud m01 from ph'dn tram (100%) S'd Tidn Bari Manz.

3.5 Chain dirt quyen Int

Ngoai nhang trueng hap cham dirt quyen Igi bao hiem da n8u tai Flgp Deng, Quyen Igi
bao hiem Thuang Tait do Tai Nan quy dinh tai Dieu 3 nay cham dirt khi Nguai Dugc
Bao Hiem dat bay mucri (70) TOL

DIEU 4: QUYEN LQI BAo witm THIYONG TAT TOAN BQ VA VINH VIEN

4.1 Neu Ngtrai Dugc Bao Hiem bi Thucrng Tat Toan BO VA Vinh Vin, Cong Ty se xem
xet chi tra quyen lgi Thucmg Tat Toan BO Va Vinh V& la tong

se tien Ian hcm gicla SO Tien Baia Hiem va Gia tri Tai Khoan Ca Ban tai theri
diem Cong Ty chap nhan chi tra quyen Lai Thuang Tat Than BO Va Vinh Wen;
va

Gia tn Tai Khoan Bong Them.

Hop Deng chain dirt tai thin diem Clang Ty chap nhan chi tra quyen Igi Thuang Tat
Than BO Va Vinh Vin.

4.2 Chain dirt quyen lai

Ngoai nhang twang hop cham dirt guy& Igi bao hiem da neu tai Hgp Deng, Quyen led
bao hiem Thuang Tat Than BO Va Vinh Vien neu tai Dieu 4 nay cham dirt khi Ngueri
Duot Bao Hiem (tat bay mucri (70) Tuei.

DIEU 5: QUYEN LQI BAO DIEM TtY VONG

5.1 Quyen loi bão him ter vong:

NM Ngueri Dugc Bao Hiem tfr vong, Cong Ty se xem xet chi tra quyen Igi bao hiem tir
vong là teng

(i) SO tien lon han giita SO Tien Bao Hiem va Gid tri Tai Khan Ca Ban tai theri
diem C8ng Ty nhOn dtrgc you eau giai quyet quyen Igi tir vong; vã

6/27
 (ii) Gid tri Tai Khoan Deng Them.

5.2 Quytn lqi bao him tir vong do Tai Nan:

Ngoai quyen Igi tcr vong neu tai Dieu 5.1, neu Nguiai Dugc Bao Hiem tit vong do Tai
Nan truck khi Nguesi Dugc Bao Hiem dat bay muai (70) Thai va thuOic mOt (01) trong
the truemg hgp sau, Gong Ty se xem xet chi tra them:

a) Ba tram phAn tram (300%) S6 Tien Bao Him, nEu Ngueri Duce Bao Hiern bi tfr vong
do tai nan may bay khi dang la hanh khach cep mua ye tren mOt chuyen bay thuang mai;

Hoc:

b) Hai tram phan tram (200%) S6 Tien Bao Hiem, neu Nguai Dirge Bao Him bi tü vong
do Tai Nan khong thuOc truang hgp (a) va thuOc mOt trong cac truerng hop sau:

Nguai Dugc Bao Him bi ta vong do tai non giao th8ng khi dang là hanh khach
co mua ye tren cat Phuang Tien Giao Th8ng C8ng COng; hoac

Nguai Dugc Bao Hiem bi tir vong do tai nan thang may khi dang di chuyen
bang Thang May (ngoai trir nhang nguai dang lam nhiem vii siva chrra/bao tri
Thang May); hoc

Ngtrai Duqc Bao Hiem bi tCr vong do hau qua trgc tiep eüa hea howl xay ra tai
cat Tea Nha Cong Cong.

Hoac:

c) Mott tram phan tram (100%) S6 Tien Bao Hitm, nAu Nguai Dugc Bao Hiem bi ter vong
do Tai Nan kh8ng thuOc hai throng hgp a) vã/hoc b) neu tren.

Trwor khi thank todn Quydn 10 bdo ham Ifr vong do Tai Ngn, Cling Ty se fie
di tit cá Sc giti trj Cu Sc guy en 10 guy clink tgi Dieu 3.1, Dieu 3.2, Dieu 3.3
vet Didu 3.4 de duvc Con Ty thank totin trut do (niu co).

5.3 Quytn lcyi dinh cho nguti không hut thac la:

Neu duqc Cling Ty chi tra Quyen Igi bao hien' tit vong va/hoac Quyen Igi bao hiem ter
vong do Tai Nan quy dinh tai Dieu, 5.1 va/hoac Dieu 5.2, Ging Ty se chi tra them mired
phan tram (10%) SO Tien Bao Hiem neu: (i) died die'm tü vong, Nguai Dugc Bao
Hiem tir dü muel lam (15) Tu6i tit( len; va (ii) dirge xac dinh IA nguai khOng hUt thu6c
la trong suet Theri Han Hgp Deng.

5.4 Quytn lqi trq cAp mai tang:

Khi nhan dugc you cAu giai quyet quyen Igi bao hiem tcr vong theo Dieu 5.1 va/hoac
Dieu 5.2, Cling Ty se chi tra tank cho Nguai Thy Huerng Quyen Igi try cap mai tang la
A .X
so nen nhe tma giCra: (i) 10% SO• Tien
.1
Bao Hiern va (ii) 30 (ba muai) trieu don yeti

7/27
•

dieu kien:
Su kin ter vong xay ra trong died gian Hgp Deng c6 hieu luc và sau met (01) nAtn
ke ta Ngay Hieu Lac Flgp DOng; vã

Nguyen nhan tit vong Ichong thuOc nhang truang h9p duce quy dinh tai Dieu 12.1
vã/hoc Dieu 12.2 dual day.

Lieu V:

> Lieu V trong vide xcic dinh quvdn loi bcio ham tau tai Dau 1, Bib 2, Didu 3, Dili 4,
yet Didu 5 tran day:

So Tien,Bao Him va Tu6i oh Ngtrai Dave Bao Him lam can dr chi tra quyen Igi
theo Dieu 2, Dieu 3 va Dieu 5 la SO Tien Bao Hiem vã Tu8i cita Ngtrai Dugc Bao
Hiem tai then diem xay ra scr kien bao hiem;

SO Tien Bao Him vã Tuoi caa Ngtrai Dugc Bao Hiem lam can cer chi tra guy& Igi
theo Dieu 4 la SO Tien Bao Hiem va Tu8i cüa Ngtrai Dugc Bao Hiem tai then diem
Cong Ty chap nhan thanh toan quyen Igi bao hiem;

Truac Ichi thanh toan Quyen Igi ter vong nhu duge neu tai Dieu 5 tren day, Clang Ty
Se xem xet:
COng: Phi Bao Hiem Rai Ro vã Phi Quan 14( Hgp Deng sau ngay xay ra su kin
tU vong dã bi trer ter Gia Tri TM Khoan Hgp Deng.

Tr& di:

No (neu c6);

Quyen Igi trg cap mai tang ma C6ng Ty dA thanh toan (nu cep);

Ngoai ra, Cong ty së xem xet (i) hoan IM cac khoan phi bao hiem da (long, kitting c6
dugc nep sau ngay yeu cAu giai quyet quyen Igi bao hiem tU vong neu tai Dieu 5 (neu
co) va (ii) thu, hoi/khau tr& tAt ca cac quyen Igi bao hiem phat sinh sau then diem Nguai
Dugc Bao Hiem ter vong ma C6ng Ty a thanh toan (neu c6) !along tinh

DIEU 6: Wit DIEU CHiND THONG TRITONG HOT' DUOC BAO HIEM
LA IRE EM
RAt kE da c6 cac cry dinh neu tren, trong twang hgp Ngtrai Duct Bao Hiem la tre em
clued bOn (04) Tuoi, S6 Tien Bao Hiem vã/hoc mfrc‘chi tra tOi da cüa timg quyen lgi
neu tai Dieu 2, Dieu 3, Dieu 4, Dieu 5 (ngoai ter Dieu 5.3) se dugc dieu chinh tucmg
Ong vai timg do TuOi theo bang dtrai day:

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 Tutpi dm Ngued DIN Bao Hiem Ty 18 dieu chinh

Tit met (01) thang Tuaii den dugi 01 Tuai 20%

Tir 01 Tuoi den clued 02 Tula 40%
Tir 02 Tuai den dual 03 Tail 60%
Tir 03 Tuoi den dueri 04 Tuai 80%

DIEU 7: QUYEN LOJ BUY TR! HOP BONG

Quyen Igi Theri diem chi tra Cfich that chi tra Quyen Igi

Quyen Lgi Huy Vao mei Ngay Ky
Tri Hgp Bong Niem Hop Bong tha
Dinh Ky sau (06), mumi hai
(12) va mired tam
(18)
z z.
Quyen Lai Buy Vao mot Niay Ky
Tri Hgp Deng Niem Hop Bong tit&
Dec Bi8t mtrai sau (16) den
tha hai much (20)
Ban phay narn phan tram
(4,5%) dm Gia Ttl Tell
Khorin Ca Ban Trung Binh.
.
Chi tra vao Tat
Khoan Co Ban
Mot phan team (01%) SO
Tien Sao Hi8m.

GM Tri Tat Khod n Co Ban Trung Binh la gia tri trung binh cita bay muai hai (72) gia
tri Tai Khoan Ca Ban tai bay mteai hai (72) Ngay Nlem Hang Thang gan nhdt, bao
gam Ngety Niem Hang Thang toi thai diem dang xem xit.

Quyen lgi duy tri Hp Dang chi duct chi tra veri dieu kin:

KhOng có giao dich Rut Gia Tri Tai Khoan Co Ban Ice dr NO)/ Hieu Lye Hop
Bang; va

Tang s6 tien Tam Ling Tir Gia Tri Tai Khoan Hgp Being va lai ph& sinh lien
quan den Ichoan tam ang kh8ng wert qua gia trj Tai Khoan Deng Them tai thiM
diem xem xet.

DIEU 8: QUYEN LQI DAM BAO HitU LC HQP BONG

Hyp Bang se clugc duy tri hieu lye cho dU Gia Tri Tai Khoan Co Ban Ichang da de
thanh toan cac Khohn Kick Trir Hang Thang, ved diet] kin:

KhOng c6 bet giao dich Rat Gia Tri Tai Khoan Co Ban ke tir Ngay Hieu Lye Hop
Bang; va

Tai died diem xem xet, (i) tOng so tien Tam Ung Tir Gia Tri Tai Khoan Hgp Bang va lai

9/27
 phat sinh lien quan den viec tam Ong kh8ng vugt gia tri Tai Khoan Deng Them tai theri
diem xem xet va (ii) Hgp Deng khong trong the' gian gia han &mg phi nhu quy dinh tai
Dieu 23.3.(a).

DIEU 9: QUYEN LQI DAC, HAN

Vao Ngay Dar) Han, C8ng Ty se chi tra toan bo Gia Tri Tai Khoan Hgp Deng sau khi
trir Ng (neu c6).

DIEU 10: QUYEN LQI DAU

10.1 Dinh kY hang thang,can cCr tinh hlnh hog dOng dAu tir tren thi tnrang tai chinh, C6ng
Ty se thong bao tren website cim C8ng Ty may lai su6t cong b6 áp dyng cho cac Hap
Deng.

10.2 Sau khi ket th(ic m& nam tai chinh, Cling Ty se danh gia lai ket,qua hoat eking cüa Quy
trong Warn vira qua. Neu hoat Ong dAu tu cüa Quy dat ket qua tot hcrn du Icien, the la Ili
suat &Ong b6 thAp han ket qua flux te, Ging Ty se chi tra phAri lai chenh Itch vao Gia
Tri Tai Khoan Hap Deng trong nam tai chinh tiep theo, sau khi khAu trir cae phi lien
quan (neu ca).

10.3 Trong twang hgp hoat deng Mu tit cüa Quy dat ket qua thAp hcm dir kien, tire IA lai suAt
cong bo cao hcrn ket qua thirc te, Gia Tri Tai Khoan Hgp Deng dm Ben Mua Bao 1-Hem
van gin' nguyen theo mat lai suat ding be) ma Cong Ty n áp dyng.

10.4 !Chong phy thuOc vao le& qua hoat Ong Mu tu cüa Quy, C8ng Ty cam le& ty 1 lai suAt
Mu tu nhu sau:

Mm Hqp Ding Lii sugt cam ket

Tir Nam Hgp Deng dui 1 den Nam Hap 3,0%
Ding di* 5
Tir Nam Hgp DOng thir 6 den Nam Hgp 2,0%
Deng the. 10
Tir Nam Hgp Deng thir 11 tra di 1,0%

10.5 Lai do Cong Ty chi tra se dugc phan b vao gia tri tai khoan tucmg (mg.

DIEU 11: BAO }HEM TAM TH(11

11.1 Trong Mei Min bac hilm tom thei, nu Nguoi Dirge Bao Hiem cüa san phAm bao hiem
chinh tCr vong do Tai Nan, C8ng Ty se chi tra s6 tien nhe han

Tong SO Tien Bao hem cUa sari phim bao hiem chinh ghi tren tat ca he so yeu cAu bao
hiem dang dugc xem xet cüa ding met Nguai Dugc Bao Hiem do; va

200.000.000 (hai tram trieu) ding.

Quyen lgi bao hitm tam died se' dirge chi tra cho nhimg Ngirei Thy Huang co5 ten trong

10/27
 cac HO Su Yeu CAu Bao Him duqc chap thuan chi tra, theo each thirc sau:

Neu Quyen Igi bao him tarn thai la gia tri neu tai diem (a): Cong Ty se
chitrá tirng S6 Tien Bao Hiem tuang irng veri ding HO So Yeu Cau Bao
Hiem,
Neu Quyen lqi bao him tam then la gia tri neu tai diem (b): so tin nay se
dugc chi tra theo ty le phi bao him da clang tuang Ong gala cac HO So
Yeu Cau Bao Hiem.

Neu tong phi bao hiem da thing cüa tAt ca cac HO So Yeu Cau Bao,Hiem dang cher cAp
IOn hcm 200.000.000 (hai tram trieu) (long, Cong Ty se chi trA lai tong phi bao hiem
&mg, kh8ng c6

Tfuerng -hqp Citing Ty chi tra quyen Igi bao him tam tiled, Cong Ty se kh8ng hoan lai
so phi bao hiem da (long.

Thai hp:1,6d° ham tgm that dugc tinh tinh tir khi Cong Ty dang dau xac nhan cid nhan
day do HO Su You Cau Bao Him hyp l va da nhan &rex day &I phi bao hiem dau tien
den Ngay CAp Hqp DOng hoc ngay C6ng Ty ban hanh van ban dr chOi bao hiem hoac
ngay Ben Mua Bao Hiem có van ban yEu eau hay cap H9p Deng, thy ngay nao den
Oink.

11.2 Quynlqi bao him tam thai neu tren se khong có hieu lyc va C'Ong Ty se chi tra lai phi
bao hiem cid dong, kheng tinh lai, sau khi da trir cac khoan chi phi y te \TA chi phi ma
Cling Ty phai thanh toan trong viec danh gia nil no bao hiem neu Ngirgi Dupe Bao
Hiem tcr vong do bat ky nguyen nhan tryc tiep nao sau day gay ra:

Ty tfr, dü trong tang thai tinh tao hay mat tri; hoc

SO- dyng ma tug, chat kich thich, chat gay nghien hoc cac tit u6ng ce, cOn vi pham
phap luat hien hanh; hoc

Cat hanh vi vi pham phap luat hinh sy caa Ngtrai Duqc Bao Hiem, Ben Mua Bao Mem
hoac cda Nguai Thy Huang.
Sr kien dAn den ter vong cüa Nguai Duqc Bao Him xay ra truerc khi Thai han bao
him tam they' bat dau.

DIEU 12: GIOT HAN PRIM VI BAO HIEM

12.1 DM Quyen lqi tik vong:

COng ty së khOng chi tra Quyen Jai bao hiem ter vong theo quy dinh tai Dieu 5.1 nu sy
kien gay ra ter vong cho Ngtroi Duqc Bao Him do lien quan tryc tip den mOt trong
cac nguyen nhan sau:
a) Ty ter hoc c6 hanh vi ty ter trong theri gian 02 (hai) nam ke ter Ngay Bleu Lyc Hyp
Wong, cho clU Ngutri Duqc Bao Hiem c6 bi mat tri hay thong; hoac

11/27
 b) Cac hanh vi vi pham pháp luat hinh sr cüa Ngtrai Dirge Bao Him, Ben Mua Bao
Hiem hoc cOa Ngueri Thu Huang.

12.2 Dei vi5i Quyen Iqi thwung CO do Tai Nan va Quyen byi tie vong do Tai Nan

Ging Ty se" kitting chi tra Quyen Igi throng tat do Tai Nan va Quyen lcri tit vong do Tai
Nan theo quy dinh tai Dieu 3 va Dieu 5.2 neu sr kien bao hiem c6 lien quan trgc tiep
den met trong cac nguyen nhan sau:

Cac truerng h9p neu hi Dieu 12.1; hoc

Do Ngtari Duce Bao Hiem ttr sir dung bat kS, loai thuec kich thich, ma thy, chat gay
nghien, chat dec hoc thu8c khong theo chi dinh dm bac si; hoe

Do chien tranh hoac hanh Ong nao lien quan den chien tranh, du la duce tuyen 1)6. hay
kitting dugc tuyen 66, tham gia ltrc higng vil trang cUa bat k$, nu& nao dang c6 chien
tranh hay he lugng clan ph6ng; hoc

Tham gia danh nhau, au da, bao loan, khai nghia, bao dung clan sg, bieu tinh, dinh cong
hay khung b6; hoc

Ngueti Duce Bao Him hi tai nan hang kitting, trir khi Ngtrai Dugc Bao Him là hanh
kith c6 mua ye tren met chuyen bay throng mai; hoc

Bat k5i ton throng nao cita Nguiri Duce Bao Him xay ra khi c6 tinh can tra hoe
chOng lai viec truy bat dm ngtreti thi hanh phap,luat hoAc do Mu qua Ulm tiep hoc gian
tiep cüa cac hanh vi chay xe qua the do hoc uong rugu bia vtris qua mire quy dinh khi
tham gia giao thong theo hat giao th6ng hien hanh; hoc

Tham gia cac hoat deng the thao chuyen nghiep hoc cac hoat dOng c6 tinh chat nguy
hiem nhir nhay di], leo mil, sari ban, dua xe, dua ngtra, Ian co binh khi nen; hoc

Benh Co can, ngoai trir nhitng tnrong hçp dA duvc ke khai va duce str chap thuan Ma
Ging Ty; hoc
Bat kSt tinh trang ten thtrcrng, being hay thucrng tat nit() cita Nguai dugc Bao hiem la hap
qua dm viec dieu tri benh.

Lieu Neu Ngueri Duov Bac, Mem tic vong thuac cac Throng hop neu Jai Didu 12.1 va
Dieu 12.2 neu tren, Gang Ty se' chi thanh tad); Gia Tr/ ,Tai Khocin Hop Dong dzroc xcic dinh
veto ngay Gong Ty nhan dirge yeu ceiu gidi quyet quyen 10 bao hiem sau khi,khau (p
cae chi phi thvc é clic, Cling Ty phcit sink lien quan den Hop &Mg, (ii) Quyen 10 tro ccip
mai tang ma Gong Ty cld thanh loan va cac khoan tiq theo quy clink cact Hop Thing.

12.3 Dei vol Quyen loi Tinning T4t ToAn Bet Va Vinh Vin:

Cong Ty se kitting chi tra Quyen 19i Thum& Tat Toan BO VA Vinh Vin neu stx kin
bao hiem xay ra cep lien quan trgc tiep den met trong cac nguyen nhan sau:

12/27
 Cac truong hum nEu tai Dieu 12.1; hoc

Cac Benh CO ngoai tit nhang truemg h9p da duct ke khai va dugc six chap thuAn
cUa Cong Ty.

12.4 DOi vol Quyen Içi 13t'nh L9 Nghiem Trqng

CEng Ty se khong thanh toan Quyen Igi Benh 19 Nghiem Trong quy dinh ti Dieu 2 lieu
sir kien bao hiem to lien quan true tiep den mOt trong cac nguyen nhan sau:

Truemg hgp neu ti Dieu 12.1.(b), Dieu 12.3.(b); hoc

Tg tcr hoac co hanh vi ty ter hoc bet ky truemg hgp W. 9 gay ra ton thuang, cho dü
Nguoi Dugc Bao HiEm to bi met tri hay khong; hoc

NO hoc ph6ng xa ter va khi hat nhan, va khilb5a hoc va nguyen tü, nhigm dee
phOng xa tir viec cal dAt hat nhan va nguyen tit; hoa- c

12.5 P61 veri Quyen lqi Trq cip Y te

Ong Ty se !thong thanh toan Quyen Igi Trg cap Y te nu nhu Ngueri Dugc Bao Him
phai Nam Vin vi mOt trong cat nguyen nhan true tiep sau:

a) Cac truang hgp neu tai Dieu 12.1, tit Dieu 12.2.(b) den Dieu 12.2.(g), Dieu 12.3.(b); hoac

Vic kham sCrc khee dinh kiem tra sire Ichoe thong lien quan den vi'ec dieu tri hay
chen doan benh hoc thucmg tAt cüa Nguai Dugc Bao 1-hem hoc bet k9 dieu trj y te nao
Itheng dap ling cat dieu kien Cen Thiet ye Mat Y Khoa; hoc

Dieu tri khuyet tat be'm sinh, benh bem sinh, benh di truyen, vo sinh, triEt san; hoc

Tet ca cat dieu tri v nha lchoa trir }chi bat buec phai c6 dieu tri do Tai Nan gay ra trong
khi Hop Ding can hieu luc; hoc
PhAu thuat them my, lap mat kinh va kinh khuc xa hoac thiet bi trg thinh ; hoac

Thai San (nhu da dugc dinh nghia tai Luc 1); hoac

Tibh duOng, benh tam than, rOi loan tam 19, rOi loan chuc nang cüa nab; hoac

Bet ky skr dieu tri hay kiem tra lien quan den hei cluing suy giam min dich (AIDS) hoac
nlam vi rat HIV; hoAc
Lam dung thuoc, tluic uOng c6 cn, nghien hoc lam dung chet ma toy va do viEc dieu tri
cat bEnh lay qua dtding tinh dgc; hoa- c
Dieu tri bang thuk &rig y/y h9c c6 truyan hoc the bin phap y hoc dan tee; hoac

13/27
 k) Tiem phOng va tiem mien dich; hok

1) Vic diu tri ck benh 19 th6ng thueng, bao

Dau lung, dau khop, viem kherp, viem co, thoai h6a cOt sting; viem kat mac, 'Ong
thit kh8ng phau thuat;

Viem xoang/da xoang, viem Amygdal kh8ng phau thuat, viem müi hgng, viem ho
hap, viem phe quart, viem tai ngoai va sot sieu vi (di) dung di veil Ngtred Dugc
Bao Hiem tir 16 Tutii lit ten);

Wed loan tien dinh, eel loan tan hoan nAo, thieu nang than hoan tido;

12.6i loon tieu Ma;

Viem da day, viem td trang, hei chi:mg da day tá tang;

Tri khong có phau thuat;

Viem philn phu, nhiem trUng titu 0 phu na;

Suy nhugc c the, suy nhugc than kinh;

Mang thucmg tat khOng nghiem trgng nhu rach da hoc chAn thtrong phan mm,
gay kin hay tat khem nem tay, ngem chan khOng pilau thuat.

DIEU 13: THOI GIAN CHO irk Tad! GIAN CON SONG

Ngoai tr.* trueng hgp neu tai Dieu 12.5 va trueng hgp Nam Vien do Tai Nan, thi:

13.1 BAt k va tAt ca cac guy& Igi dugc quy dinh tai Dieu 1 se chi dugc xem xet va/hok chi
tra nen viec Nam Vin dien ra sau ha mtrai (30) ngay ke tü Ngay Cap Hgp Deng ("thiii
gian chit).

Cling Ty se khOng thanh toan Quyan 19i bao hiem neu tai Dieu 1 trong truemg hcm Ngtrai
Dugc Bao Him bi Benh CO San trong hoc tnrerc thoi gian cho.

13.2 BAt va tat ca cac quyen lgi dugc quy dinh tai Dieu 2 se chi dugc xem xet vã/hoc chi
tra neu:

a) Ngay ma Ngueri Dugc Bao Hiem duce chAn doan hoc dieu tri hoc co bat 14 clau
hi'eu hoc trieu cheng nao cCia:

Benh L9 Nghiem Trgng giai doan sem, hoc

Benh L9 Nghiem Trgng giai doan cuoi, hoc
Benh 1 theo glen tinh.

14/27
 sau chin mired (90) ngay k tit Ngay CAp Hgp Deng; va

b) Ngueri Dirge Bao Hiem vAn con sons it nhAt la ba muai (30) ngay k te ngay Ngfrei
Dtrgc Bao Hiem dirge chan doan mac bat ky Benh L9 Nghiem Trong hoc berth 19
theo gieti tinh nao.

DIEU 14: TIEU CHUAN VE S6 NGAY NAM VIEN DO! VU! MOT SO BENH THONG
TH1U'ONG

Ngoai ti-Cr cac benh 19 thut)c trueng hgp loai ti-Cr nhfr dugc neu tai Dieu 12.5.(1) va giâi
han chi tra dirge guy dinh,tai Dieu I .5.(b), Cong Ty se can cir vao se Ngay Nam Vin ten
da dirge xem la Can Thiet Ve Mat Y Khoa theo bang dueri day de chi tra cho mai Ian
Nam Vien eüa Nguei Dirge Bao Hiem.

SO Tat SO NGAY CHI TRA

NHOM BENH TOI DA
TV
1 Benh lao 30
2 Benh viem gan sieu vi c6 trieu cheng 15
3 Nhem benh ca-xucrng-khep 14
4 Nhem &Oh cilia mat 13
5 Nhem benh dm he mien nhie-m 13
6 Nhom benh cea h'e tim mach 12
7 Nh6m benh u bueu 11
8 Nh6m benh nh1ern trung lchac 11
9 Nhem benh do chart thuong ng0 dc 10
10 Nhem benh cea tai 10
11 Nhem benh dm he than kinh 10
12 NhOm benh dm hello hap 10
13 Mom benh cila he tiel nieu; sinh dye , 9
14 Nhern benh dm he chuyen h6a; nei net 9
15 Nhom benh nhiem ki sinh treng 8
16 NhOm benh dm he tieu h6a 8
17 Nhem benh cea he to mau 8
18 Nhom benh caa da 8
19 Nh6m benh nhiem treng dm he tieu him 7
20 Nhem berth nhiem sieu vi kern set cao 6

Nheng trueng hgp can thiat phai nam vin vi nheng benh 19 nang, Cling Ty se chi tra theo
s6 Ngay Nam Vin thuc te ma dine xem la Can Thiet Ve Mat Y Khoa va c6 sr chi dinh
dm bac si dieu tri. Trong nheng trueng hgp nay, khach hang phai thong bao cho Clang Ty
de dirge tu van va Song dan the we.

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 •
•

CHUONG II: THONG TIN YE QUI LIEN KET CHUNG VA QUYEN LQ1 MU Tir

DIEU 15: THONG TIN VE CO CAU YA HOAT HONG CiJA QUI LIEN ICET CHUNG

QuS, Lien Ket Chung ("Quy") dugc hinh thanh tu Phi Bao them Ca Ban Dugc Phan B6
va Phi Bao Hiem Deng Them Dugc Phan B6 va dugc to ra tCr tAt ca cfic hyp deng bao
him lien ket chung do Cong Ty phitt hanh. Mgc tieu dau tu cfia Quy la nham mgc dich
dgt dugc lei nhufin Mu tu On dinh va sinh led vol kha nang thanh khoan cao.Cac tai san
tfip trung chit yeu vao trai phieu chinh pita, trai phieu do thi, trai phieu doanh‘nghi'ep,
cac ding cc' cüa thi truang tien te va cac kenh dau tu khac.Cong Ty c6 toan quyen quyet
dinh chinh sach dfiu tu va phtrcmg thirc quan l Quy phil hop yeti quy dinh cfia phap
luat.
Cong Ty bao Itru quyen fiy tit& Wan be hoc bAt thAm quyen Mu tu va quyet dinh
cüa Cong Ty cho bAt ky ca nhan hay to chirc nao theo cac dieu kin do COng Ty quyet
dinh.

DIEU 16: GIA Till TAI KHOAN HOP BONG

16.1 Gia Trj Tai Khoin Co Ban

Gia tn Thi Khoan Co Ban s thay d'ei va dugc dieu chinh theo cac giao dich cüa Hep
Deng bao g6m:

(I) Tang sau khi dugc cOng Phi Bao Him Ca Ban Dlige Phan B6 (nu c6);

Tang sau 'chi dugc c'eng lAl phat sinh trong thang de can dr lei suAt cling b6 neu
tai Dieu 10.1;
Tang sau khi dugc cOng Quyen lei duy tri Hyp Deng (neu co);

Giam sau khi trir Khoan }Chau Id: Hang Thang;

Giam sau khi trir khoan rut hr gia tri Tai Khoan Ca Ban ),Ta Phi di kern (nu c6).

16.2 Gia tn Tai Khoan Deng Them:

Gia tit Tai Khoan Deng Them së thay dei va dugc dieu chinh theo cac giao ditch dm
Rep Erong bao gorn:
Tang sau khi Ong Phi Bao Him Deng Them Dugc Phan 136 cüa thang d6 (nu
c6);
Tang sau khi cOng guy& lei M trg chain s6c sire IchOe theo Dieu 1.4 (neu cO);

Tang sau khi dugc Ong Ifii phat sinh trong thang de can dr lei suat c6ng be neu
tai Dieu 10.1;
Giam sau !chi trix Khoan KhAu TnCr Hang Thing (nett gia tri Tai Khoan Ca Ban

16/27
 khong de de chi tra khoan tin nay va Hcfp Wong kitting de diau kin de dugc
dam bao duy tri theo quy dinh tai Dieu 8).

Giam sau khi dugc trCr khoan rat tCr gia tri Tai Khoan Hong Them va Phi di kern
(nau c6);

Hang nam, gia tri TM Khoan Co Ban va gia tn TM Khoan Bong Them se dugc thong
bao den Ben Mua Bao Him theo quy dinh phap 141

CHUCING HI: GIAI QUYET QUYEN LQI BAO HIEM — GIAI QUYET MAU
THUA.' N VA TRANH CHAP — CRAM Dtr HOP BONG BAO HIEM
DIEU 17: THU TUC Gal QUYET QUYEN LQI BAO HIEM

17.1 Thai han nQp yen au giái quyet quyen Iqi bao him

Ben Mua Bao Hiam hoc Nguai Thu Huang c6 nghia vu thong bao cho C8ng ty vstr
kian bao hiem trong thbi gian sem nhat k tir khi Ben Mua BAD Hiorn hoc Nguti Thy
Huang blot dugc sr kian bao hiem va cung cap cac chimg ta theo quy dinh de giai
quyet quyen lgi bao hiem.

Thai han nap don you au giai guy& quyen lyi bao him tad C6ng ty tot da la mat (01)
Mm, ke te ngly xay ra sy kien bao hiem, thai gian mat (01) nam nay thong bao gOrn
then gian tri hoAn do cac tra ngai khach quan va sr kin bat kha khang.

17.2 Ch'ing tie yeu can giai quyet quyen lqi bao him

-Fru& khi thanh toan quyan Igi bao hiam, C8ng Ty phai nhan dugc day de the loai
chang tit hgp 1 dugc quy dinh tai tang quyen Igi Prong (mg nhu sau:

a) Dia vat yen au giii quyet Quyen lqi bao him Tir vong:

Don yeu au giai quyet quyen Igi bao hiem va Giay Uy quyen daqc lop theo mau
ctia Cling Ty; va
Gik chi:mg tir (Ban sao c6 ch(ng tInrc sao y ban chinh eUa cac ca quan c6 tham
quyen); va

H6 so y te, ban sao benh an co xic nhon dm co sa y te diu tri, giAy ra vien, ket
qua xet nghiem, ket qua chAn doan hinh anh, giAy chang nhOn dummy tich, ket
qua giam dinh y khoa, bang Ice chi tiet vien phi, h6a don, don thu8c (neu co); va

GiAy ter chang minh quyan nhan quyan Igi bao him nhu van ban ity quyan, van
ban phan chia di san thin ke, di chile hoc cac grey to xac nhan hgp phap khac;
va cheng minh nhan dan/giay to nhan than dm nguai c6 quyen nhan quyen Igi
bao hiem; va

Trong trading hpp n7r vong do Tai Npn, ngoli cac cheng ta Lieu tren, can phai nap
them:

17/27
 116 so Tai Nan: bien ban tai nan, hen ban kham nghiem hien truang, bien ban
ket bran dieu tra do C8ng an cap quAn/huyen tra len lap; va

Cac bang chirng cho thay có so hien din cUa Ngtr6i Duce Bao Him tren cac
chuyen bay throng mai hole cac Phucrng Tien Giao Th6ng C6ng Ceng hole
Tea Nha C'Ong Cong.

b) 06i vai yeu au gill quyet Quyen Thwang Tht Tohn BO Vh Vinh Van

Cac chimg tir neu tai Dieu I7.2.(a).(i), Dieu 17.2.(a).(iii), va Dieu 17.2.(a).(iy);
va

Ket qua giam dinh tinh trang thucmg tat do 1401 ding y khoa cap tinh hoc ca
quan tucrng duang theo quy dinh cita phap luat cap.

c) 061 vol yeu au gad quyet Quyen lqi Thmaing Tht do Tai Nan

Cac chirng tir neu tai Dieu 17.2.(a).(i), Dieu 17.2.(a).(iii), Dieu 17.2.(a).(iv), Dieu
17.2.(a).(v) va Dieu 17.2.(a).(vi).

d) Doi wed yeu au grail quyet Quyen lvi Benh Ly Nghiem Trong

(i) Cac chirng tir neu tai Dieu 17.2.(a).(i), Dieu 17.2.(a).(iii) va Dieu 17.2.(a).(iv),
Dieu 17.2.(b).(ii).

(ii) KM qua xet nghiem chan doan theo yeu cAu trong dinh nghia Benh L Nghiem
Trong hoc benh ly theo giói tinh Wang (mg dace neu tai Phi Luc 2, Phu Luc 3;
va

e) 'Avert yen cAu giai quyet Quyen lvi Trq cAp Y te

Cac chimg S neu tai Dieu 17.2.(a).(i); Dieu 17.2.(a).(iii); va
Ban giSc giay ra vin (hoc ban sao c6 ding chimg sao y hop 1); va
Gity xac nhan dieu tri tai Khoa Cham Sec Dc Bret trong twang hop yeu eau chi
tra Quyen Igi tro cap nam vin tai Khoo. Cham S6c Dc Biet.

173 Thai gian giid quyet quyen lvi bao ham

Ong Ty se xem xet va chi tra quyen lai bao him (neu duct chap thuan) cham that la
30 (ba maai) ngay ke tir ngay nhan duce day do cat chirng S theo yeu cau. Trong
truong hop S choi chi tra, C6ng Ty se c6 van ban lieu re ly do S chid.

Neu vi bat ky 15, do gi ma quyen Igi bao hiem dug° C6ng Ty chap nhan nhung thong
dug° Gong Ty chi tra trong thai gian quy dinh thi Cling Ty se tra lAi cho then gian,tra
chain tren co sa lAi sat bang I/6i IAi suat tam frng S Gia Tri Tai Khoan Hop Deng
dove clang 136 tren website cüa C8ng Ty.

18/27
 CHUtiNG IV: CAC QUYEN CtJA BEN MUA BAO HIEM

DIEU 18: THOI GIAN CAN NHAC

Trong yang hai math mot (21) ngay k t& ngay nick H9p DOng,,neu Cling Ty chua
nhan dugc yeu cAu giai quyet quyen Igi bao him, Ben Mua Rao Hiem c6 quyen tir choi
tham gia bao hiem bang. each gin van ban thong bao den Cong Ty, kern theo ck h6a
don thu phi bao hiem (neu cat) va be 149p Hong. Sau khi nhan duct day de cac tai li'eu,
Cong Ty se hoan tra lai phi bao him da (long, kh8ng c6 lai, sau khi trir di chi phi kham,
xet nghiem y khoa (neu co).

DIEU 19: CAC TILW DOI LIEN QUAN DEN HQP HONG
19.1 Thay dOi Meng tin ciut Hqp Doing:

Trong thai igian H9p, Deng cOn hieu lye, Ben Mua Bao Hiem c6 the yeu cAu thay doi
lien quan den Hcp Dong phi] hop vai cac quy dinh cea Hap Deng nay va phap ludt. Tat
ca you eau thay doi bao g6m: thay d8i Nguai Thy Huang, thay doi thong tin lien he dm
Ben Mua Bao Hiem, chuyen nhugng hop d8ng, vWhodc tham gia hoc hey b6 ck san
pham bao hiem bo trg phai dugc lap theo mu cua Cong Ty va girl den Cong Ty. Ck
thay di nay se chi c6 hieu lye sau khi dugc Cong Ty chap thuk bang van ban hoc
ban hanh (cat) Xac Nhan Thay Dili Flop Deng.

19.2 Thay di cc the lien quan den Nguiri Dirge Bito Hi&

a) Ben Mua Bao Hiem.phai thong bao bang van ban cho C6ng Ty chdm nhAt trong yang
ba muai (30) ngay ke tir ngay có scr thay dOi, neu Nguai Dugc Bao Hiem:

Di chuyen ra nuac ngoai tir chin muai (90) ngay tar ten; hoc

Thay doi nai cu trU, dia chi lien he, h9 ten, chirng mirth nhan dan; hoc

Thay doi ye nghe nghiep, tinh chat ding viec hoc ye viec tham gia cac hoat
clOng the thao co tinh chat nguy hiern.

b) D6i yeti cac thay del neu ten (cho‘dii Ben Mua Bao Hiem co thong bao hay khong),
C8ng Ty c6 the tip We duy tri quyen Igi bao him cho Nsuoi Dugc Bao Hiem vol cac
dieu kin Ichong thay doi, va/hok thay deli Phi Bao Hiem Rai Ro, vã/hoc Phi Bao
Hiem Ca Ban va/hok SO Tien Bao Hiem; vWhok loai trir mi)t so quyen Igi bao hiem
hoc cham dirt Hgp Deng. Trong tnrong hop cham dirt H9p Deng, COng Ty se chi tra
cho Ben Mua Bao Hiem Gia Tri Hoan Lai tai thai diem do. Gong Ty se khong you cAu
Ben Mua Bao Fliem hoan tra bAt khoan thanh toan nao neu Ben Mua Bk Hiem van
con ng Cong Ty sau khi cla can trir het Gia Tri Hoan Lai.

19.3 Thay del Ben Mua Bin Hi&

a) Chuyin niuronk Hop Hang:

19/27
 S
•

Ben Mua Bao Hiem c6 the chuyen nhugng 1-I9p Deng trong khi Hop Deng van
dang co hieu lye neu co van ban yeti cau va dugc Cling Ty chap thuan bang van
ban thong qua viec phat hanh Xac Nhan Thay Dei Hop Deng. Doi tuong nhan
chuyen nhuong hop Tong phai hi du dieu kien de to thanh Ben Mua Bao Hiem
nhtr quy dinh tai Dieu 6 dm Phy lye 1 dinh kern Hop Deng.

Ging Ty kh6ng chju trach nhiem ve tinh hieu lye hay tinh day dm bat Ick y'eu
cau chuyen nhugng nao. Sau khi chuyen nhuong, nguai duce chuyen nhugng se
tiep nhAn cac quyen va nghia vy dm Ben Mua Bao Hiem theo quy dinh dm Hop
Deng.

b) Thaa thutin chi dinh Ben Mua Bao Ham mai cita Hap Bang trong Throng hop Ben
Mua Bao Higm hien tai vong/cham dirt hoat &Mg

Trong then gian Hop Deng c6 hieu lye, nett Ben Mua Bao Hiem bj tir vong (truerng hop
Ben Mua, Bao Hiem la ca nhan) hoc cham dirt boat dOng (truerng hop Ben Mua Bao
Hiem la to chive):

Neu Nguesi Dugc ,Bao Him tir di: 18 Tuei Ye len va et!: au cac dieu kin cüa
Ben Mua Bao Hiem theo quy dinh trong Hap Deng nay va cac quy dinh caa
phap luAt, thi Ngueri Duce Bao Hiem sè trer thanh Ben Mua Bao Hiem meti ctia
Hap Deng.

Neu Ngueri Dugc Bao Hiem dual 18 Tuta thi ngueri. giam he hop phap cüa
Nguai Dugc Bao Hiem se tra thanh Ben Mua Bao Hiem meri neu dap ang cac
dieu kin dugc quy dinh tai Hop Deng.

Sau khi dugc sy chap thuan eUa Cons Ty, Ben Mua Bao Him mai se tie() nhan fat ca cac
quyen va nghla vy phat sinh tir Hop Wong.

DIEU 20: TAM UNG Tic GIA TR! TAI KHOAN HOP DONG
Trong then gian Hop Deng con hieu lyc va bat dau ta Nam Hop Deng thit hai (02), Ben
Mua Bao Him co the yeu au Ging Ty tam &rig tir Gia Tri Tai !Oman Hop Deng neu
tong gia tri tam img kh6ng vugt qua tam =raj phAn tram (80%) Gia Tri Tien Mat Thyc
Tra elm Hap Deng tai thai diem yeu cau tam img va khong thap han mac tei thieu do
C'Ong Ty quy dinh vao tang uteri diem.
Ben Mua Bao Him co trach nhiem thanh toan lai cho cac khoan tam img Us gia tri Tai
Khoan Hop Deng.
Ben Mua Bao Hiem c6 the hoan tra gia tri tom irng va lai phat sinh vao bat cir liw nao
neu khoan thanh toan moi Ian dap img mac thanh toan eel thieu do Cong Ty quy dinh
tai tang thai diem.
Gang Ty c6 quy'en khau trir cac khoan tam irng (cOng lai) tnrac Ida chi tra bat kjr quyen
Igi bAo hiem nao theo Hop Deng nay.

20/27
 e) Mac ldi suat cho cac khodn tam Ung, mire tam img t6i thieu va mac thanh toan t6i thieu
se theo quy dinh dirge clang tai tren website eüa Cling Ty.

DIEU 21: RUT CIA TR1 TAI KHOAN HOP HONG

Trong theft gian Hop Deng con hieu lue va sau thai gian can nhac neu tai Dieu 18, Ben
Mua Bao Hiem có the you eau rat Gid Td Tai Khoan Hop Ding va chili Phi Rat Gia Tri
Tai Khoan Hop Dong theo quy dinh tai Dieu 24 neu dap img cac dieu kith sau:

S6 troll yêu cAu cUa m6i 'An rat Icheng vuot qua thug cita (1) gia tri TM Khoan Bong
Them va (ii) tam muai phan tram (80%) gia tri Tai Khoan Ca Ban, sau khi tra di Phi
Rat Gia Id TM Khoth va Nq (nu c6); va
S6 lien t6i thieu cüa tn6i Ian rat va so du con lai trong Tai Khoan Co Ban sau kin rat
khong thap ban mac quy dinh caa Cong Ty.

Vic rat Gia Tri TM Khoth Hgp Deng se dirge tru tien thuc hith tit TM Khoan Bong
Them. Neu se tien yeu cau rat vtrqt qua gia tri TM Khoan Bong Them, phan vuqt qua
se tiep tie duqc rat dr TM Khoan Ca Ban.

SO Tien Bao Hiem cüa Hop DOng se bi dieu chinh giam neu se du can lai trong TM
Khoan Ca Ban sau khi rat thAp han SO Tien Bao Hiem. SO Tie'n Bao Him sau khi dieu
chinh Ichong tháp han SO Tien Bao Hiem toi thieu do C8ng Ty quy dinh.

DIEU 22: CHAM Der HOP BONG TRUtfC THOT HAN

Trong thoi gian Hop Deng can hith hp, Ben Mua Bao Him c6 the yeu cau chAm dirt
Hap Wing truck thai han bang each gai yéu cau bang van ban cho Cong Ty. Ngay
cham dirt Him) Bong la ngay COng Ty nhth &roc you cau bang van ban day da va hqp
IA tir Ben Mua Bao Hiem.
Khi chAm dirt Hop pang truac then han, neu Hop Deng da c6 Gia Tri Tien Mat Thuc
TM, Ben Mua Bao Hiem së nhdrt throe Gia Tri Tien Mat Thot,Tra dirge xac dinh tal
ngay cham dirt Hop Deng. Neu Hqp Deng chtra c6 Gia Tri Tien Mat Mac Tra, Ben
Mua Bao 1-hem se kh6ng nhArt throe bAt kji khoan tien nao.

CHVONG V: PHI BAO HIEM VA CAC ICHOAN PHI LIEN QUAN DEN HOP HONG
BAO mtm

DIEU 23: PHI BAO HIEM

23.1 Phi Ban ThEm Co Ban

Phi Bao Hiem Ca Ban dm Hop Deng dirge Ben Mua Bao Hiem (long me4 Ian vao theri
diem you cau bao hiem.
Phi Bao Hiem Ca Ban thing vao, sau khi trir Phi Ban DAu, se dirge phan be vao Tai
Khoan Co Ban.

21/27
23.2 Phi Ban Them Deng Them
Trong thai gian Hcip Bang yel hieu lirc, ngoai Phi Bao Him Ca Ban, Ben Mua Bao
them c6 the a tu them bang each &Mg Phi Bea Hiem Bong Them. Phi Bao Him
Bang Them clang vao, sau khi trir Phi Ban DAu, se dirge phan b6 vao Tai Khoan Being
Them.
Quy dinh ye Phi Bao Hiem Bong Them toi thieu va tói da se dirge C6ng Ty thOng bao
tren website cüa Gong Ty hoc thong bao cho Ben Mua Bao Him bang van ban, tin
nhan, thu din tü hoc cac hinh thirc van ban Ichae.

233 Gia h3n dang phi ban him va Mitt hi0 life Hcrp Hang

Thai gian gia han clang phi bao him la 60 (ati mirth) ngay dirge bat Mu Ice tir ngay gia
tri Tai Khoan Hop Deng sau !chi trir Ng (neu co) Ichong dii de thanh toan Khoan KhAu
Tr& Hang Thang.

Trong tiled gian gia han &mg phi bac) him, Hgp Deng van co hieu lirc.

H9p Bang mat hieu luc neu sau Thai gian gia hgn thing phi bao him neu teen ma Gia
Ili TM Khoan Hqp Bong tru Ng (nu c6) kheing JO de thanh toan Khoan KhAu Trir
Hang Thang.
Trong theri gian Elgp Bang mat hieu hie, khong co bat Khoan Khali Trir.Hang Thang
hay lchoan phi nao phat sinh ding nhu khong co bAt quyen Igi bao hiem nao dirge
chi tra.
Ltru Dau 23.3 nay khong áp dyng trong truing hgp Hp Ding dirge dam bio day In
theo guy dinh tgi Dilu 8.

DIEU 24: CAC !MOAN PHI LIEN QUAN DEN HOP HONG BAO MEM

Cac loai phi dirge neu tai Dieu nay du tuan tha guy dinh Qua san phAm da dirge BO Tai
Chinh phe chuAn.

La phi dirge IchAu trir if, Phi Bao Him Cu Ban vã Phi Bao Him Bong Them trirec
Phi 1d6 phan bo vao tai khoan hop dang. Mac phi áp dung nhtr sau:
Ban 2+
NArn Hgp Bang 1
Dim
% Phi Ban Him Ca Ban 24% 0%
% Phi Bao Hiem Hong Them 5% 5%

22/27
 Phi Quan LS, Hop Deng se duoc, khau trit hang thang vao Ngay Ky Niem Hthg Thang
tit gia tri Tai Khoan Ca Ban. Phan Phi Quan Ly Hop Wong vucyt qua gia tri Tat Khan
Ca Ban se dugc tiep toc kha'u tar tit gia tri Tai Khoan Deng Them.

Phi Trong nam 2018, Phi Quart Ly figp Dang la 31.000 (ba muai mot ngth) d6ng/H9p
Quin 1)&1g/thing va sE to clOng tang 2.000 (hai ngan) clang/Hop ang/thang m6s i narn
Ly ducmg, lich sau do. Tuy nhien, trong m9i truang h9p, mac dieu chinh khong vuot qua
Hop mac t6i da 60.000 (sau moth ngan) dong/Hop Dling/thang.
Doting
Ceng Ty c6 quy6n thay doi Phi Quan LS, Hop D6ng hoc mac tangyta Quail LS, H9p
Wong sau khi c6 so chap thuan caa BO Tai Chinh. Neu c6 so thay d8i, C8ng Ty se gni
thong bao cho Ben Mua Bao Him ba (03) thang tritac khi ap dung mac Phi Quart LS,
Hop Ding mai.

Phi Bao Him Rai Ro dugc khau frit hang thing vao Ngay KY Niem Hang Thing tit
gia tri Tai Khoan Ca Ban. Phan Phi Bao Him Rai Ro vugt qua gia tri Tai Khoan Ca
Phi Ban se &roc tip Wc kith tra tit gia tri TM Khoan Deng Them.
Batt
Him Phi Bao Hiem Rai Ro dugc xac dinh theo tuOi, gieri tinh, tinh trang sac kh6e NIA nghe
Riii Ro nghiep dm Ngueri Dugc Bao Him. Phi Bao Him Rai Ro c6 the thay idol sau khi
duct BO Tai Chinh chap thuan. Trong twang hop nay, C8ng Ty se' girl thong bar)
bang van ban cho Ben Mua Bao Hiem 03 (ba) thang truErc khi áp dung.

Phi Hay B6 Hop Ding Truec Han dugc tinh theo ty le pith tram (%) tren Phi Bao
Hi Ca Ban cho Tai Khoitn Ca Ban, va Wen Gia Tri TM Khoan Deng Them cho Tai
Phi Khoan Deng Them. Mat phi ap dung nhu sau:
Huy116
Hop 1 2 3 4 5 6 7+
Nam Hop [Yang
Wong
TM Khoth Ca Ban 8% 6% 4% 2% 1% 1% 0%
Trutt
(% Phi Bao Hiem Ca Ban)
Hon
Tai Khoan Deng Them 50/
(% GTTK Deng Them)

Phi Rat Gia Tri TM Khoan Hop Bong duoc tinh theo ty le phan tram (%) tren s6 tien
Phi nat. Mac phi ap dung nhu sau:
Rut
Gia Tri Nam Hcop Diing 1 2 3 4 5 6 7+
•
Tai Tai Khoth Ca Ban
Khofin .x rat) 8% 6% 4% 2% 1% 1% 0%
(% So Den
Hop
T ai Khoan Deng Them 5%
.
•
Bong x
(% So Oen rat)

23/27
 Phi Rut Gia Tri Tai Khoan Hgp Deng se dace khAu till vao so nen ,yeu cau nit truerc
khi C8ng Ty chi tra sO den it nay. Trong tritii Nam Hgp Deng, d8i \Teri lan rut tien
au den, Citing Ty se mien Phi RCA Gia Tri Tai Khoan Hop &nig cho Idman tien rut
len den 0,2% So Tien Bao Hiem (nhung kh8ng qua 3 trieu den). Phan tien rut vugt
qua se tien neu teen se chin Phi Ritt Gia Tri Tai Khoan Hey Deng theo bang tren.

Phi Quan Ly Quy la 1,5% (Met phay nam phA'n tram) cim Gia Tri Tai Khoan ligp
Deng. Phi Quan Ly Quy dugc quy dinh eft the trong Trans Hgp Deng hoc Thong
Phi bao dm Cong, Ty (neu c6). Phi Quan LY Quy se dugc khau trir truac !chi C8ng Ty
Quint Gong b6 lai suat theo quy dinh tai Dieu 10.1.
Ly Quy
Phi Quan Ly Quy co the dugc thay dAi neu dugc sir chAp thuan dm Bi) Tai Chinh.
C8ng Ty se gin th8ng bao cho Ben Mua Bao Hiem ha (03) thang truerc 'chi ap dung
mirc Phi Quan Ly Quy meri.

CHLIONG VI: QUY DINH CHUNG

DIEU 25: NGITIA VU CUNG CAP VA BAO MAT THONG TIN CI:JA CONG TY

25.1 KM giao ket Hgp Deng, Ceing Ty c6 trach nhiem cung cap day dC thong tin lien quan
den Hop Wong, giai thich day du cat dieu kien, dieu khoan bao hiem elm Ben Mua Bao
Hiem. Trong truerng hgp C6ng Ty cung cap thong tin sai str that nham giao ket Hyp
Deng thi Ben Mua Bao Hiem c6 quyen don phircmg chArn dirt Figp Deng, yeu cau Mfg
Ty hoan tra than 68 s8 phi da &Mg sau khi trir di cac khoan ROt Gia Tri Tai Khoan Hop
Deng va Ng (neu co) va/hoac,yeu eau C6ng Ty bei thuems cac thiet hi ma Ben Mua
Bao Hiem phai ganh chit' (nen c6) phat sinh lien quan den vi"ec C8ng Ty cung cAp
th6ng tin sai sly that.
25.2 Con Ty khong duct chuyen giao th6ng tin ca nhan do Ben Mua Bao Hiem/Ngueri
Ducrc BA° Hiem cung cap cho bat Icy ben thir ha nao khác, trir cac twang hyp sau day:

Thu thap, sir duns, chuyen giao theo yeu cau dm co quan nha ntrem có tham quyen hoc
cho muc ditch tham dinh, tinh toan phi bao hiem, phat hanh hgp ding bao hiem, thu phi
bao hiem, tai bao hiem, trich lap ,dfr phOng nghiep vi, giai quyet chi tra quyen lgi bao
hiem, nghien ciru thiet ke san pham, phOng chong true Igi bao hiem, nghien ciru, danh
gia tlnh hinh tai chinh, kha nang thanh toan, mire di) day dit von, yeu cau von.
Cac trtrimg hyp khac dugc Ben Mua Bao HiemiNgueri Dugc Bao Hiem &mg Y bang
van ban, val dieu kien:
Ben Mua Bao Hiem/Nguari Duqc Bao Hiem phai clugc th8ng bao ye num dich
chuyen giao thong tin va dugc quyen lua chon giirra Ong y hoc khong clang 9
veri viec chuyen giao do; va
Vic Ben Mua Bao Hiem/Ngutri Duce Bao Hiem tir ch6i cho phep chuyen giao

24/27
 thong tin cho ben thir ba ngoai diem (a) neu tren khong dugc sir clung lam 19 do
de tir chOi giao ket Hgp Deng.

DIEU 26: NOMA. VU KE KHAI ,TRUNG THVC CtJA BEN MUA BAO THEM VA
NGIAM DUtIC BAO DIEM

26.1 Ben Mua Bao Hiem va/hodc Nguai Dugc Bao Hiem c6 nghia 141,phai ke khai trung
thgc va cung cap day cac thong tin theo yeu cau COng Ty de Cong Ty danh gia
lcha nang chap nhian bao hiem hoc chi tra quyen Igi bao hiem theo Hgp Deng hoc cac
san pham bao hiem be trg (neu có). Viec C8ng Ty co5 hoc khOng có yeu cAu kiem tra y
th sê Icheng dugc sir clang lam 19 do de mien trg nghia vg kE khai trung thgc cim Ben
Mua Bao Hiem va/hoc Ngutri Dugc Bao Hiem.

26.2 C8ng Ty s'e don phucrng chAm dirt ligp Deng hoc Ichong chAp nhdn yeti cAu khoi phgc
hieu Igc H9p Deng trong twang hgp Ben Mua Bao Hiem va/hok Ngtrai Dugc Bao
Hiem co 9 vi pham nghia vv cung cAp th6ng tin theo Dieu 26.1 neu tren ma neu biet
dugc nhang thong tin nay Cong Ty CIA !dieing chap nhan bao hiem. Trong twang hcrp
nay Cong Ty se IchOng giai quyet bat 14 quyen lgi bao hiem nao va se hoan tra Gia Tri
Tien Mt Thgc Tra sau khi da khau trir Sc khoan quyen Icri bao hiem dA dugc thanh
toan. C6ng Ty se Ichong yeu cau Ben Mua Bao Hiem hoan tra bat 14 khoan thanh toan
nao neu Gia Tri Tien Mt Thgc TM nith.hcm cac khoankhAu trir neu tren. Tai thai diem
Gong Ty phat hien hanh vi gian clOi (neu có), bAt quyen Igi bao hiem nao dd dugc
chAp thudn nhtmg chua dugc chi tra thi ck quyen lçxi bao hiem de deu ngay Idp tirc bi
hey be va C6ng Ty se thông c6 nghia vg tiep tgc chi tra.

26.3 Trong truimg hgp Ben Mua Bao Hiem va/hodc Nguari Dugc Bao Hiem vi pham nghia
vi ke Ichai thong tin ti Dieu 26.1 nhung viec vi pham nay thong lam anh htrang tai
quyet dinh chap thuk bao hiem hodc quyet dinh khoi phgc hieu hrc Hgp Dong theo quy
dinh cUa Cong.Ty tai timg then diem, Cong Ty van se chi tra quyen lgi bao hiem neu co
sr kien bao hiem xay ra theo quy dinh cüa Hgp Deng. Trong twang hgp nay, C6ng Ty
co the thu them khoan phi bao hiem hoc dieu chinh SO Tien Bao Hiem giam Wang img
voi mirc rid ro (neu co) theo quy dinh ye thAm dinh bao hiem.

DIEU 27: TRIYONG HOP KE KHAI SAI TUOI VA/HOAC GIOT TIM!

27.1 Trong trugng hqp k8 khai sai tuoi vanioac giai tinh cüa Nguai Dugc Bao Hiem, Cong
Ty c6 the tinh toan va dieu chinh lai khoan Phi Bao Hiem Rid Ro, Phi Bao Hiem Co
Ban va/hoc So Tien Bao Hiem phai thu theo Tuôi dung va/hoc gigi tinh dung tinh
Ngay Hieu Luc Ho Bong den ngay phat hien ra viec ke Ichai sai. Hop Deng, gia tri Tai
Khoan Co Ban va cac th8ng tin cua Ngtrai Duct Baa Hiem trong Hgp acing s'e dugc
dieu chinh tucmg img va phü hgp.

27.2 NM Tuei thgc cua Ngugi Duce Bao Hiem khong nam trong them tu'ei c6 the dugc bao
hiem theo quy dinh alai-19p Wong, Cong Ty c6 quyen hey be Hgp Dong va hoan tra Lai
cho Ben Mua Bao Hi'em Cia Tri Tai Khoanylcip Deng hoac s8 phi bao hiem oda dOng,
thy theo gia tri nao Ian hcm tinh tai thed diem Cong Ty c6 thong bac) ye viec ke khai
thong chinh 'Mc de, khong co lai, trir di cac quyen Igi bao hiem da thanh toan, cac

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 khoan rut tir Gia Tri Tai Khoan Hgp, Ding, the khoan Ng va the chi phi thuc te phat
sinh trong viec danh gia rüi ro bao hiem cim Nguoi Dugc Bao Him.

DIEU 28: MIEN TRUY XET

28.1 Ngoai trir truang hop kê khai sai v Tu61 va/ho4 giai tinh nhu quy dinh tai Dieu 27
hoc c6 9 cung cap thong tin khong trung thtrc hoc killing day du nhu dtrgc quy dinh
tai Dieu 26, trong khi H9p Wong van con hieu Itrc, viec Ben Mua Bao Hiem va/ho4
Nguiri Dugc Bao,Hiem ke khai khong chinh xac hoc bet sot cac thong tin trong Ho Sa
Yeu Cau Bart Hiem hoac cac nth don, ban ké khai lien quan den viec tham dinh vá
chap thuan bao hiem cita COng Ty se, khong lam cho Hgp Deng bi hity bit neu Hgp
Deng da c6 hieu hic it that hai muai bon (24) thang ke tir Ngay Cap Hgp Deng hoc Ice
tir ngay khoi phyc hieu lye hgp dong gan nhat, thy thuec vao ngay nao den sau.

28.2 Dieu khoan nay se kitting ap dung trong truang hgp Ben Mua Bao Hiem vã/hoc Ngueri
Dugc Bao Hiem co 9 khong Ice khai hoc khong cung cap day du va trung thuc nhang
thong tin ma neu biet &Km cac thong tin de, Gong Ty se tarn hoan hoc tir chei bao
hiem.

DIEU 29: NGIAII THIJ HVONG

29.1 Ngtrai Thy Huimg dugc Ben Mua Bao Hiem chi dinh trong don yeu cAu bac) hiem hoc
dirge thay 461 va chap thuan bed Cling Ty trong (cac) Xac Nhan Thay Doi Hgp Deng.
Ngtrai Thy Huerng dugc huang the quyen I9i ciia 1-19p Bong neu va khi duqc Ging Ty
don 9 chi tra cac suyen Igi bao hiem trong truong hgp Ngtrai Dugc Bao Hiem ,tir
vong. Tat ca cac quyen Igi khac ciia Hgp Being trong thai gian Nguai Dugc Bao Hiem
con sting so dugc thanh toan ,cho Ben Mua Bao Hiem hoc theo them thuan khac gicta
Cong Ty va Ben Mua Bao Hiem.
29.2 Neu khong co Nguai Thy Huang nao dugc chi dinh hoc tAt ca Nguiyi Thy Huang du
cla tir vong/ chant dirt hoat <long clang theri hoac truerc khi Noted Dugc Bao Hiem tir
vong, quyen lgi bao him tfr vong sê dugc chi tra cho Ben Mua Bao Hiem hoc ngtrai
thira Ice hgp phap dm Ben Mua Rao Hiem.

29.3 Neu c6 tir hai Ngubi Thy Htremg ter Len thi:
guy& lgi bao hiem tir vong se dugc chia d&i cho tAt ca m9i Nguai Thy Huang, trir khi
c6 quy dinh khac trong Hgp Deng hoac trong van ban chi dinh Nguiri Thy Huang dang
co hieu lye áp dyng; hoc
nu c6 bAt ky Ngued Thy Huang nao dä Ut vong/cham dirt hoat Ong riling theri hoc
try& khi Ngueri Dugc Bao Hiem tir vong, phan quyen Igi bao hiem cim Ngtrai Thy
Huerng de se dugc chia deu cho flitting Nguai Thy Huang can Lai, trir khi c6 quy dinh
khac di trong Hgp Deng hoc trong van ban chi dinh Ngtrai Thy Huang dang co hieu
lye áp dyng.
29.4 Bat Ice cla ca the quy dinh khac tai H9p Deng nay va trir truang hgp COng Ty chap
thuan khac bang van ban, trong tnrang hyp Ben Mua Bao Hiem la to chac:

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 Quyen Igi bao him tir vong se dugc chi tra cho Nguai Thy Huemg. Cac quyen Igi lien
quan den Mt GikTri Tai Khoan 1-lap DOng, tam (mg t& Gia Tri Tai Khoan Hap Deng,
cham dirt Hey Deng truac thai han va quyen lgi dao han Don së dugc chi tra cho
Ben Mua Bao Hiem. Tat ca cac quyen Igi bar) him con lai khac duce quy dinh tai Hap
Deng nay se duce chi tra cho Ngueri Dugc Bao Hiem;

Neu khong c6 Nguai Thy Fluan4 nao dugc chi dinh hap le, quyen lgi bao him tit vong
se dugc chi tra cho ngtrai thira ke cilia Nguei Dugc Bao Hiem; va

Trong m9i twang hap, viec thay del Nguai Thy Huang phai dugc Ngueri Dugc Bao
Hiem (long

29.5 Cong Ty se khong chiu trach nhiem ve tinh hap phap cling nhtr tranh chap (nu c6) cim
Ben Mua Bao Hiem hoc nhirmg nguai lien quan den viec chi dinh thay doi Nguoi Thy
Huang.

DIEU 30: CHANI DeT MR HONG

Hap Deng se cham dirt ngay khi c6 bAt Icy sy kien nao dual day xay ra:

Ngtrai Dugc Bao Hiem hr vong; hoc

Gong Ty chAp nhan thanh toan Quyen Igi Thuang Tat Than B6 Va With VIM; hoc

Hap Deng mAt hieu luc theo quy dinh tai Dieu 23.3.(b); hoc

Ben Mua Bao Him yeu eau chAm dirt Hap Deng truac thoi han; hoac

Nguai Dugc Baia [Hem lien quan Ithong cOn dap irng cac diet' kin a ter thanh Ngtrai
Duce Bao Hiem nhu dugc quy dinh cilia Hap Bong; hoc

Hgp Deng dao

DIEU 31: MAI QUYET MAU THUAN VA TRANH CHAP

31.1 Hap Deng dugc dieu chinh va giai thich theo phap Mat dm nu& COng Him Xa HOi
Chili Ngliia Viet Nam.

31.2 Neu c6 bAt Icy tranh chAp nao khong the giai quyat th8ng qua thucmg lugng thi tranh
chap d6 se cluqc dua ra tea An ea tham quyen nai Ben Mua Bao Hiem Cu trill hap pita])
hoc nai Cong Ty co try ser chinh de phan xir.

27/27
 B. nw Luc _ PHAN DINH NGHIA
(Dinh kem San phcim biro hilin Lien Kit Chung Thoi Hgn 20 Nam — Dong phi meit ldti — KI hogch Move
&egg phe duyet So cong van sO 8443/BTC-QLBH ngiry 16/07/2018 new B6 Tai chinh)

1. Cling Ty: la Cong Ty TNHH Manulife (Viet Nam), cOng ty bao him nhan tho &roc thanh lap
va hoat dOng theo phap lust Viet Nam.

2. Hqp D6ng Bao Him ("Hqp Thing"): la them thuan bang van ban giaa Ben Mua Bao Him va
Cong Ty, trong do ghi nhan quyen Ira nghia vu cüa the ben trong qua trinh thuc hien hop ding
bao him. Hop Bong bao g6m cac tai lieu sau:

146 So You CAu Bar) Him;

TrangH9p Wong;
e bao hiem chinh, san pham bao hiem 1)6 try (n6u c6) da
Quy tdc, dieu khoan san phatn
&roc BO Tai Chinh phe chuan;
(Cac) Xac Nhan Thay Doi Hop Wong (nal co);
(Cac) van ban sin doi, 66 sung Hop Bong (nu co).

3. HO So Yen Ciu Bao Him: IA van ban you au bao him theo mu cüa COng Ty, Won, do ghi
cac nOi dung de nghi tham gia bao hiem va thong tin do ngliti de ngh1 tham,gia bao hiem cung
cap de C6ng Ty danh gia riff ro, lam can ca chap nhan bao hiem hoac ta ellen bao hiem. Ho So
Yeu Clu Bao Him do Ben Mua Bao Hem, Ngtrai Dugc Bao Hiem va,cac ben lien quan den
viec yeu cAu bao hiem caa Ben Mua Bao Hiem ke khai, ky ten va cung cap cho Cong Ty.

4. Trang Hop DOng (Giay Cluing Nha'n Bao Diem): IA van ban do Ging Ty cAp cho Ben Mua
Bao Hiem, trong do the hien mOt se th8ng tin co ban cna Hop Wring VA IA mOt phAri thong tach
roi cua Hop Bong.

5. Xfic Nhfin Thay Dai Hop,DOng: la van ban do C8ng Ty phat hanh nham Tuve dich xac nhan
cac thay diff co lien quan den Hop Bong.

6. Ben Mua Bao Haim: là t6 °him dugc thanh lap va hoat dOng hop phap tai Via Nam hoc cá
nhan ffr dri muai tam (18) Tu6i tit len, dang sinh song tai Via Nam va co n5ng lye hanh vi clan
str day dia; la nguti ke khai, ky ten tren don yeu cAu ban hiem, thuc,hien cac quyen va nefia vv
quy dinh trong Hop Bong va &roc ghi nhan la Ben Mua Bao Hiem trong Trang Hop Wing,
hoc Xac Nhan Thay Del Hop DOng (neu c6).

7. Ngutri Dutrc Bao Hien!: la ca nhan ma tinh man va/hoac sat kh6e cUa ca nhan do IA d6i
Ming &roc Cong Ty chap nhan bào hiem, va duce ghi nhan trong Trang Hop Dring IA Ngtred
Ducc Bao Hiem twang Ung veri san pham bao hiem chinh.

Vao thei diem yeu cAu bao hietn, trir truErng hop ducc quy dinh kit di tai cac san pham bao
hiem b6 tit el,' the, Nguti Duce Bao 1-hem phai:

(i) con song va c6 mM quan he &roc bao hiem vai Ben Mua Bao Hiem,

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dang hien dien Lai Viet Nam,

trong dO Tuai tir mOt (01) thang Thai den sau mtroi lam (65) Tu6i.

Ngurbi Thn throng: là (cat) ca nhan hoc tó chirc dugc Ben Mua Bao Him chi dinh d nhan
guy& Igi bao hiem. Ngtriai Thy Huemg dugc ghi ten trong HO So Yeu Cau BA° Him hoc Xac
Nhan Thay Dai Hop Bang (neu co).

SO Tien Bao Him: IA sei tin duce Cong Ty chap nhan bao hiem theo quy dinh tai Hop Deng
va &roc ghi tren Trang Hop Wong hoc Xac Nhan Thay Doi Hop Bong (neu co).

Tutu: la tuai cUa Ngtrai Dirge Bao Him tinh theo ngay sinh nhat vaa qua tnracc (ii)Ngay Hiatt
Luc Hop Wong hoc (ii)Ngay Niem Hop Don trong cat Nam Hop Bong tier) theo.

Ngity

11.1 Ngay CAp Hop Hang: là ngay Hop Dang &roc Cong Ty chap thuan va phat hanh theo
HO So You Cau Baia Hiem hop le caa Ben Mua BA° Him. Ngay Cap Hop Dang throe
ghi nhan trong Trang Hop Ding hoc Xac Nhan Thay Doi Hop Wong (nu cep).

11.2 Ngity Hien Lye Hap Hang: IA ngay Hop pang bat du co hie'u lye va &roc ghi nhan tai
Trang Hop Bong hoae Xac Nhan Thay Doi Hop Wing (neu co).

11.3 Ngly 19.r Mem Hap DOng: IA ngay k9 niem tyang img hang ram dm NO), Hieu Lye
Hop Bong trong su8t Thai Han Hop Bang. Neu nam thong co ngay nay thi ngay cued
cOng dm thing do se la Ngay Niem Hop DOng.

11.4 Nny Ky Niem Hang Thang: IA ngly tuang Ong hang thang cOa Ngay Hieu Lye Hop
Deng. Truang hop thang kitting cO ngay tucmg Ong thi ngay lien truck do se duce áp
dung.

11.5 Nam Hop Deng: IA khoang then gian ,01(met) nam duang lich kt tit Ngay Hieu Lac
Hop Bang hoac Ngay KS/ Niem Hop Deng.

11.6 Ngay Dan Han Hop Diing: la ngay‘ cuOi cimg elm Thai Han Hop DOng va duac ghi
nhan tai Trang Hop Wong neu Hop Bang con hieu bat den thai diem dn.

Thad Han Hop DOng: IA hai muoi (20) nam tinh tir Ngay Hieu Lye Hop Bang.

Phi Rao Him Ca Ban: IA khoan phi &mg cho san phem chinh va duce ghi trong Trang Hop
Dan hoc Xac Nhan Thay Doi Hop Bang (neu c6).

Phi Ban Hiem BO Trq: IA khoan phi dOng cho (cac) sari pham bao hiem be trg Nth duce ghi
trong Trang Hop Bang hoc Xdc Nhan Thay DOi Hop Deng (neu co).

Phi Ha° Hiem Deng Them: IA khoan hi do Ben Mua Bao Hiem clang them ngoai Phi Bao
HIS Co Ban theo quy dinh elm Hap Bong. Trong twang hop khach hang có chi dinh ye viec
dong Phi Bao HIS BO Tra, Phi Bao Hiem DOng Them se la khoan phi do Ben Mua Bao Hiem
dang them ngoai Phi Bao Hiem Co Ban va Phi Bao Hiem B6 Trg.

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•

Phi Bao HIS Ca‘Ban Dirge Phan I36: la phAn con lai dm Phi Bao Hitm Ca Ban sau khi
khau trir Phi Ban Dau.

Phi Bao HIS Bong Them Dirqc Phan BO: la phan con lai dm Phi Bao Him Dang Them sau
khi khAu trir Phi Ban Dau.

Phi Ban Diu: la Ichoin phi dugc khAu trir tir Phi Bao Hiem Co Ban va/hoc Phi Bao Hiem
Deng Them truck khi Phi Bao Hiem Co Ban va/hoc Phi Bao Hiem Dong Them duct phan be
vao titi khoan Hgp Deng.

Phi Bao HIS Rüi Ro: la khoan phi dugc khAu trir hang thang de dam bao chi tra quyen loi
bao hiem theo quy dinh cüa san pham bao hiem chinh.

Phi Quin Ljr Hop Hang: la khoan phi dugc khAu trir hang, thang d Cons Ty that hien cac
ding viec an thiet lien quan den viec quan 19, duy tri Hop Deng va cung cap cac thong tin lien
quan den Hop Deng cho Ben Mua Bao Hiem.

Phi Quin L Quy: la khoan phi chi tra cho heat dOng quan 19 va dlu tu cUa Quy Lien Ket
Chung.

Khoan 1ChAu Trir Hang Thang: la khoan ben dugc Citing Ty khAu trir hang thang, bao gem
Phi Bao Hiern ROi Ro va Phi Quan L9 Hop Deng.

Phi Huy Ba Hçp Hang Trirat Han: la khoan phi ma Cong Ty se thu khi Hop Deng bi chAm
dirt trutc thai han.

Phi Rut Gia Tri Tai Khoin Hçp Hang: la khoan phi ma Ben Mua Bao Hiem phai chiu khi
yeu eau nat mOt phan tir Gia Tri Tai Khoan Hop Deng.

Ng: la bAt Icy khoan phi, phi bar) hiem hoac khoan tien nao ma Ben Mua Bao Hiem an phai
(long de duy tri hieu lye Hop Deng hoc phai thanh toan cho Cong Ty theo cac dieu khoan va
dieu kin cüa Hcrp Deng, bao gem ca cac Khoan Khau Trir Hang Thang den han, cac khoan
tam (mg tir Gia Tri Tai Khoan Hop Deng, va cac khoan khac cOng \red lai tich 10y phat sinh ten
cac khan tien nay. Tat a cac khoan tien nay se dugc coi la con ng Clang Ty va se dugc Ging
Ty khAu trir tnrec khi thanh toan bat IcY quyen lgi bao hiem nao theo Hop Deng nay.

Ili Khan Co. Ban: la tai khoan dugc hinh thanh tir Phi Bao Hiem Co Ban. Gia tri Tai Khoan
Co Ban dirge xac dinh theo quy dinh tai Dieu 15.2.(a) cUa Hop -Deng.

Tai Khofin Hang Them: la tai khoan &roc hinh thanh tir Phi Bao Hiem Bong Them. Gia tri
Tai Khoan Bong Them dugc xac dinh theo quy dinh tai Dieu I5.2.(b) cUa Hop Deng.

Gia Tri Tai Khan Hqp Hang: la teng cUa gia trj Tai Ithoan Ca Ban va gia tri Tai Khoan
Bong Them.

Gia Tri Hoin Lai: la gia tri thu dtrgc sau khi lay Gia Tri Tai Khoan Hop Deng trir di Phi Huy
BO Hop Hong Tnrec Han. Gia Tri Han Lai dugc tinh toan phü hop yeti co sar k'y thuat cüa san
phAm dä dirge BO Tai Chinh phe duyet.

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V.

30. Gia Tri Tien Mat Thgc Ira: la gia tri thu dugc sau khi lAy Gia Tri Hoan Lai trir di cac khoan
Ng (nu c6).

31. Thircrng Tat Toll] BO VA Vinh Vin:

Thuang Tat Toan BO VA Vinh Vin la trueng hop:

a) Ngued dugc bao him hi mAt, liêt hoan toan va Wong the phgc hOi dugc chirc nang dm:

Hai tay, hoac;

Hai chan, hoac;
Met tay va met chan, hoac;
Hai mat, hoac;
Met tay va met mat, hoac;
Met chan va met mAt.

Trong truong hgp nay, mitt hoan toan va kh6ng the phgc 1161 dugc chirc nang cUa (i) tay dugc
tinh tfr co tay tra len, (ii) chan dirge tinh tir mat ca than tret len, (iv) mat dirge hit: là mAt han
mat hoac mu hoan toan.

Vic chang nhan Ngued dirge bat) him hi mat hoan toan be phan ca the (tay, chan hoac mat)
c6 the dirge thgc hien ngay sau khi sir kien bao hiem xay ra.

Vic ch(mg nhan bi lit hoan toan va không the phgc hii chirc nang cüa cac be phan ca the phai
dugc thgc hien khong sem hcm 180 ngay ke tir ngay xay ra sg Men ban hiem hoac tü ngay benh
19 dtrgc chAn doan xac dinh.

Hoc:
b) Ngtrei dtrgc bao hiem bi thuang tat tir 81% theo xac nhan cüa ca quan y tEl Hai &Ong giam
dinh Y khoa cap tinh tre

32. Tai Nan: nghia IA met sir kin hoac met chuOi str kian lien tuc, Ichach quan xay ra do tac tong
cüa mOt lye, men vat bAt net tir ben ngoai len ca the caa Ngueri Dugc Bao Iliam va gay ra
thuang tat hoac tCr vong cho Ngtrai Dirge Bao Hiem. Sy kin hoac chtuii six kien neu trait phai
là nguyen than trgc tiep, duy nhat va kh0ng lien quan den bAt nguyan nhan nao lchac gar ra
thuang tat hoac tit vong cho Ngutti Dirge Bao Hiem trong vOng chin muai (90) ngay ke tir
ngay xay ra str ki0 hoac chuoi sg kien do.

33. Phircrng Tien Giao Thong Cong COng: la cac phuang tien van chuyen theo lich trinh thueng
xuyan, theo nhilng tuyen duange da dtrgc xac lap va danh cho cac hanh Ichach c6 mua ve, nhu:
xe bu/t, o to' cher khach tuyen co dinh, tau hem, tau thuy che khach, pha cher lchach, tau din va
dirge van hanh bei cac dart vi dirge cap gray phép kinh doanh van tai hanh lchach hgp phap.

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Phtro4 Tien Giao Thong Cong COng kh8ng bao gOm taxi, may bay tu nha'n ck loai, xe thue,
hoc bat Icy pluming tin thue nao sir dung cho myc dich di lai ca nhan.

34. Thang May: nghia là thang may &vac sir dung cho mix dich van chuyen hanh kith, thong
bao grim thang may hoat dOng trong ham m6 hay tai cac &ring trinh thy dyng hoic, nha rieng.

35. Tea Nhi Ging COng: bao gem nha hat, rap chieu phim, truang h9c, trung tam y ta, benh vien,
sin van dOng, nha thi dau, cac trung tam the thao, va trung tam thuong mai.

36. Tinh Trang Thmmg Tat: nghia la Si Icy tinh trang nao dugc liet ke dual day xay ra del vai
Nguai Dugc Bao Him do hau qua cüa Tai Nan:

Doi vol tay/chan: tay/chan bi mit hoan toan hoic liet hoan toan va vinh vien. Mitt hoan toan
va vinh vien dói yeti tay dugc hieu la tinh trang cut hoan toan ta c6 tay ter len, hok mat
hoan toan va vinh vien dei vol chan dugc hieu la tinh trang cut hoan toan ta mat ca chan trot
len;

D6i vat mAt hoc tai: mat hoan toan va vinh vien chac Mang cim thi 19c hoc thinh lye;

Si vâi ngan than hoac ng6n tay: bi cut hoan man tit ca ck dat dm nein;

Dei vol tieng n6i: mAt hoan toan va vinh vin tieng mil, dAn den khOng n6i dugc nen phai
giao tie!) bang chit viet hoc hinh.

37. Banh Co San: nglith IA tinh trang benh tat hoc ten thucmg cith Nguai Dugc‘Bao Hiern d'A dugc
bac si kiem tra, chin doan hay dieu tri truac Ngay Hieu 1,9c Hop [Yong. H6 so y te, tinh trang
tien sir benh dirge km gift tai cac co ser y té dugc thAnh lap hop phap hoc cac thong tin do
Nguai Dugc Bao Him tu ke khai dugc xem IA bang chi:mg day cla va hgp phap ye Benh Co
San.

38. Be'nh LST Nghiem Trong: là cac benh, tinh yang y te hoc phAu thuat dirge quy dinh cv the tai
Phu Lye 2 va Phu L9c 3 dinh kern Hop Deng.

39. Benh Vien: IA (i) benh vien eva ca chU "benh vien" trong ten g9i va tren con &Au chinh thac
hoc (ii) (ck) trung tam y te cap quan/huyen tit len, dirgc thanh lap hop pithy va th9c hien
dieu tri theo phuong phap thy y de cham s6c va dieu tri cho nhang ngueri bi benh hoc bi
thucmg, va cO dU cac thiet bi chuyen mon de tien hanh viec chin doan, co y tá chain s6c 24/24
va c6 bac si trim thuang xuyen. Benh Vien do phai dugc co quan nha ntrac c6 thim quyen aip
gtay phep hoat dOng hop phap. Trong twang hop phat hien tmc Igi hok co dau hieu truc Icti
caa B'enh Vien, C8ng Ty c6 quyen kh8ng chi tra chi phi y te lchi Ngtrai Dugc Bao Hiem diêu tri
tai the Benh Vien nay. Danh sach (ck) Benh Vien Citing Ty khOng chi tra hoc giâi han chi tra
se ducc C8ng Ty cap Elicit tren trang th8ng tin then tir cUa C8ng Ty.

Vi nnic dich caa Hop Deng nay, the co sâ sau day kh6ng dirgc xem la Benh Vien:

(a) NhA an clueing, nha duOng Ido; va

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 Nai chaa tri danh cho nhang ngtrai nghien rugu, nghien ma thy hoc floral bi b'enh tam
than; va

Nai dieu tri benh phong; va

PhOng kham, bao gèm ca pluing kham troc thuOc Benh Vien va/hoc troc thuac trung tam y
th cac cap.
40. Nam Vin: la viec Nguai Dugc Bao Him phai nhap vien de dieu tri x te dei yeti benh hoc
chan thuon4 ti mOt Berth Vien nhu la met berth nhan nei fit theo you cau cüa Bk Si theo cac
dieu kien Can Thiet Ve Mat Y Khoa.

41. NO)/ Nam Vien (hoc dugc g9i tat la "Ngay"): De duce tinh la inert Ngay Nam Vien cho viec
chi tra quyen Igi bao hiem theo quy dinh dm Hop Deng nay, Nguai Dupe Bao Hiem phai Nam
Vien du hai maul b8n (24) gia lien we.

42. Thai San: nghla la viec sinh dé, say thai, nao, pha. thai, dieu tri vo sinh, dieu tri throe va sau
khi sinh de hay bat 14 benh tat 6m dau nao hoc ton thucmg nao lien quan den cac sr kien nay.

43. CAn Thiet ye Mat Y Khoa: nghia la dich vi y te hoac dieu tri y te:

Phu hop vai cac chan doan va th8ng 14 ve than tri y ta aM veri benh hoc chan thaang lien
quan, va

PhÜ hop vai tieu chuAn ve hanh nghe y duce, va

Co tinh chat bat buOc va phai thoc hien tai Benh Vien, va

Kitting nham moc dich tha nghiem, chAn doan, nghien ciru, phOng ngira hok tam soat, va

Co se Ngay Nam Vien la hop 19 va ph!! hap \red thong le dieu tri cho benh hoc chan
thucrng lien quan.

Tay thuOc vao, phe duyet caa BO Tai Chinh, Ging Ty c6 toan quyen áp dong va dieu chinh cac
dinh mac ve s6 Ngay Nam Vien dirge xem IA Can Thiel ye Mat Y Khoa vao tang thai diem.

44. Khoa Cham Soc Dac Bret: la met khoa hoc met be phan cüa Benh Vien, ma khong phai la
khoa, phOng hau phau hay khoa, ph6ng h8i sac, cap dm va:

(a) duce Benh Vien thanh lap nhAm chain s6c va dieu tri tich eve 24/24 gia; va

chi danh rieng cho cac benh nhan mac benh nang ma the chac nang quan tong cim ca the
dang bi de doa dei hei str theo del, quan sat lien toc do Bac ST chi dinh; va

cung cap tat ca cac trang thiet bi, thu6c men va cac phuang tien cap cau can thiet ngay ben
canh cM cep the can thiep ngay.

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45. LAn ThAm Kham: la met Ian Noxell Duce Bao Him den kham tai co ses y tt va dirge bac si
chi dinh lam cac xet nghiem, chan doan va ke don thuoc dieu tri lien quan den benh, then
chimg benh hoc thuang tich.

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 C. PHU LUC 2

DANH SACH BENH Lt NGHIEM TRQNG GIAI DOAN SQM VA

BENH IA? THEO 6101 TINE!

(Dinh kem San phcim bac ham Lien Kit Chung Thai Hgn 20 Nam — Deng phi inOt lcin — ICE hogch be° ve
dupv phe duvet So tong van sA 8443/B7U-QLBH nggy 16/07/2018 can BO Tea chinh)

DIEU 1: DANH SACH BENH Lt NGHIEM TRQNG GUI DOAN SOM

1.1 PhAu thuAt cAt u tuyen yen

Nguai Dirge Bao Him trai qua phAu thuat cat be u tuxen yen do benh lam tang áp lye nicli
SO, c6 nhung r6i loan ye nei tret hac hoc di chfrng than kinh do u tuyen yen gay chen ep
cac mo nao birth thuang.

Co sr hi'en din cüa khOi u tren the chart doan hinh anh nhu chyp ditn toan cat lerp (CT
scan) hay cOng hugng tr (MRI).

Loai trir truerng hgp pith thuat cat u tuyen yen eel kich think tir 8mm trey xuong

Pfau thuat phai dirge xac nhan IA can thiet ye mat y khoa beri cat bac sy chuyen khoa.

1.2 Mu 1 (m0t) mitt

Mat thi lye hoan toan, vinh vin va không hOi phyc cazt I (melt) mat do benh hoac chart
thucrng

Chan doan phai dirge xk nhan bai bk sy chuyen khoa ve Mat

1.3 Ung thu giai doan serm bao gam Ung thu kheing xam Ian / Ung ttor bieu mo ti chO,
Ung thu tien liet tuyen giai don sam, Ung thu man (long lympho man tinh giai
doan seem.

- Ung thu khOng xam ran / Ung thu bleu mo tai ch.?)

Ung thu bieu m8 tai chQ caa v6, ifs cung, buOng trImg, ong dan to:mg, am hO, am dao, c6 tfr
cung, dai trang, true tang, duong vat, tinh !loan, phoi, gan, da day, müi hau hay bang quang.

Ung thu bieu mo tai cM dirge dinh nghia la sr ty pith tri'en ck te bao ung thu bieu m6
mrat ncri, chua xam Ian/ hay pha Hay mo xung quanh. Xam Ian co nghia IA sir tit nhiem
va/hoac tich eye pha v"6 mo binh thuerng vugt qua ming day. Chan doin ung thu bieu mo
tai cho phai luon luon can dr vao ket qua chan doan te bao hgc. Han nqa, chan doan ung thu
bieu mo ti cho phai luon luon dirgc chan doan xac dinh clya tren quan sat vi the Mau mo da
dirge co dinh. Cac chart dok chi clua vao lam sang khong dap (nig dinh nghia nay.

1/1
 D6i vai ung this bleu mo tai ch6 nun ce te cung: chart (loan phai dip vao xet nghiem
vi the cac mau mo co QM-1h tcr sinh thiet hinh non cO tit cung hay qua sinh thiet khi
thut hien soi ci tfr cung va ket qua sinh thiet co sr hien din 16 rang cita ung thu bieu
mo tai ch8. Khong chap nhan !chi chan doan chi Oa vao ket qua pap smear va cha'n
doan lam sang khOng dap ung tieu chuan chan doan cho loai ung thu nay. DM vai tan
sinh trong bleu mo caa co t cung (Cervical Intraepithelial Neoplasia CIN), loai tit
truang hop CIN I, CIN II va CIN III (loan san Ong nhtrng IchOng c6 bang chimg ung
thu bleu mo tai cht tren ket qua sinh thiet )
DM veri ung thu tai ch6 cM te cung: khoi u duqc phan logi TisNOMO dot vei phuang
phap xep hang ung thu theo h thtng TNM.
Doi vai ung thu tai ch cua bueng khoi u cOn nguyen trong vo b9c, kitting co
khoi u tren be mat buOng . treng, duce phan loai TlaNOMO a61 vai phuang phap xep
hang ung thu theo he thOng TNM hoc FIGO IA doi vOi phucmg phap xep hang
FIGO (phuang phap dm Lien Doan San Pho Ithoa Quoc îé - The Federation
Internationale de Gynecologie et d'Obstetrique);
Doi vai ung thu tai ch6 cua 8ng clan treng: Ichoi u giei han a lap niem mac dm eng
dan trang va duce phan loai Tis del veri phucmg phap xep hang ung thu theo he thong
TNM.
fMi veri ung thu tai ch6 cita am dao: khai u phai duct phan loai Tis del vài phumig
phap xep hang.ung thu TNM va t6 bao ung thu chi a lap te bao ben ten cita long am
dao ( te bao bieu m'O' ) va kh8ng phat trien vao cac 16p sau hon cM am ciao.

Loai trir ung thu tai cM cUa da (bao g6m u melanin Ara u kh6ng melanin ), cM he thrang
duerng mat.

- Ung Thu tin Bet tuyen giai don seem : La cac ung thu Wen liet tuyen c6 kat qua m8
h9c phan loai TI a hay Tlb theo phan loai TNM.

- Ung thy mini &mg lympho min tinh giai door' son . La cac ung thu mau dong
lymph° man tinh nhei han giai doan 3 theo phan loai Rai . Loai trir ung thu giai doon 0
theo phan loai Rai.

Loai trir bat kj, nheng sang thuong tien ac tinh hoc giap bien ma Ichong duet a cap ben tren.
1.4 Pilau thuit gan

Nguai Duot Bao Him do benh hoc tai nan can thiet phai phau thuat cat be it nil& toan be
thity trai hoc toan be thity phai cUa gan.

Loai trir phau thuat cac benh 19 hay fel loan tai gan c6 nguyen nhan lien quan den bia rucru,
thuoc \TA hien tang gan.

1.5 Phu thuit cAt bo 1 ben phii

La phau thuat cat be hoan toan I (met) ben phoi

j do berth hoc tai nan.

Loai trCr truemg hqp chi cat be mM phan cM phOi.

2/2
I

1.6 Thu thuat tao hinh van tim, tach van tim, thay the van tim qua da

Nguai Duct Bao Him trat qua thit thuat don gian de tao hinh van tim, tach van tim bang
bong, thay the van tim qua da vai nhang clang ea hok be phan can thiet. Ton thtrcmg van tim
duct xac dinh beri cac bac sy chuyen khoa tim mach va bang sieu am tim.

Loai trir tat ca cac phucmg phap phau thuat chinh sira khac.

1.7 Phu thu4t huyet kited xoang hang

Nguidi Duerc Bao Him trai qua phau thuat clan tau huyet kh6i xoang hang. Chan doan xac
dinh benh va yeu cdu phau thuat phai dugc xac nhan beri bac sy chuyen khoa Tai MOi 1-Igng.

1.8 Bong trung binh

Bonf dO II (hai) chiem tói thieu 20% din tich be mat co the, phai dtrgc dieu trj tai benh vien
va can phai gay me toan than de phau thuat cat Igc mo hoai tit. bed ck bk sy chuyen khoa.

1.9 Cey may diet' hint nhip tim hoc may khir rung tim duel da

La tinh trang cAy vinh vin dtrai da may dieu hOa nhip tim hoac may khir rung tim cho nhang
truerng hgp bj thi loan nhip tim nghiem trgng ma kh8ng the di'eu tri bang cac phucmg phap
thong thuerng khac. Viec cay nay that sty cAn thiet ye mat y khoa, có nhieu lgi ich va hieu qua
cho benh nhan va dugc xac dinh bet bac sy chuyen khoa tim mach.

Loai trir bat Icy twang hgp cAy may tao nhip tim tam that.

1.10 Hp Ito% hie tinh mach chit

Phu thuat dat krOi Igc tinh mach chit cho nhang truang hgp benh nhan co ghi than tinh
trang thuyen the ph6i tai phat Phau thuat nay that str can thiet va dugc xac dinh beri bac sy
chuyen khoa.
DIEU 2: DANH SAC BENH LI? THEO GIOI TINH

2.1. Cac benh 1ST daub rieng cho nam Ung thy titn het tuyen, Ung Bur phei hoi:ic
ung thtr gan

La khei u ác tinh (lac trung beri sr/ phat then kh8ng the kiem sok va Ian rOng cüa nhirmg th
bao ac tinh va so xam Ian vao mo. Cac ung thtr neu tren phdi dugc bac sy giai phau benh hgc
chart dok xfic dinh clua tren quan sat vi the mu m6 da dugc c6 djnh. ChAn doan nay chi
dugc dva tren tieu chuan ác tinh dugc chAp than sau met nghien cim cau true mo hgc hok
hinh thai cita Ichoi u, mau m6 hok mau )(et nghiem bj nghi nger. Cha'n doan lam sang khong
dap Ong tieu chuan chan doan ung thu.

Loai trir cac truerng hcfp sau:

3/3
•

Tat cA cac khEi u dirge phan loai m6 h9c theo he thEng TNM 6 mire TI (bao Om TI a,
TI b) hoac sem hcm hoac tinh tang tien ung thu hoac ung thu Ichong xam Ian hoac ung
thu tai chit;
Tat ca ung thu di can den tien liet tuyen; va
Tat ca khiti u bi xam lin tir the cdu tit hoac ca quan xung quanh.

2.2. Dinh nghia the B6nh I anti rieng cho nit gieri

2.2.1. Ung thy biiu mei (Carcinoma) ti ch6 cüa vU, c6 tfr cung, tir cung, bung trtirng,
Ong dAn Mtn hoc am do

Ung thu Neu ma tai chit cila c6 tir cung dirge dinh nghia la mEt sg tg pith trien cac th bao ung
thu bieu m6 6 met nai, chtra xam Ian vao ma binh thuang. Xam Ian có nghia la skr tham nhigm
vã/hoc tich cue pha vemô binh thuang vugt qua mang day. Chan doan ung thu bieu mit phai
Mon Mon can cir vao ket qua chan doan te bao hgc.

DEi vOi ung thu bieu mo tai ch6 cUa et) tic cung,: chen doan phai dga vao xet nghiem vi
the cac mau mo co dinh tir sinh thiet hinh non co tir cung hay qua sinh thiet khi thyt hien
soi c6 tir cung. Chan doan lam sang kh6ng dap (mg tieu chuan chan,doan cho loai ung thu
nay. Loai trir trueng hgp CIN I, CIN II diti voi tan sinh trong Neu m6 cUa cit ter cung
(Cervical Intraepithelial Neoplasia - CIN).

DEi vai ung thu tai ch6 cua tir cung: khEi u dugc phan loai TisNOMO del voi phuang
phis) xep hang ung thu theo 4 th8ng TNM hay giai doan FIGO 0 doi vâi phuang phap
xep hang FIGO — (pluming phap dm Lien Doan San Phy Khoa Quiec TE - The Federation
Internationale de Gynecologie et d'Obstetrique).

Si vai ung thu tai ch6 cita bulk-1g trUng: khEi u con nguyen trong ve b9c, khong c6 !MEI
u tren be' mat bang trUng, dugc phan loai TlaNOMO dEi vai phucing phap xep hang ung
thu theo h thEng TNM hoac FIGO IA diti vai phucmg phap xep hang FIGO (phucmg
phap Goa Lien Doan San Phy Khoa QuEc Te - The Federation Internationale de
Gynecologie et d'Obstetrique).

Si vai ung thu tai chit ctia o'ng da'n trUng: khoi u glen han a lOp niem mac ctia ling clan
trUng \fa dugc phan loai Tis doi vai phuang pith!) xep hang ung thu theo he th6ng TNM.

Si \lad ung thu t4i chit cila am ciao: Ichoi u phai dirge phan loai
X
Tis or& vai phircmg phap
xep
X
hang ung thu TNM hoac FIGO 0 dEi vai phuang phap xep hang FIGO (phucmg phap
dm Lien Doan San Phy Khoa QuEc Te - The Federation Internationale de Gynecologie et
d'Obstetrique).

2.2.2. Cac biOn chirng ola thai

Doug man nOi mdch Ian lea (D.I.C): la sr phat sinh to huyet (fibrin) trong clang mau
gay ra do skr tham gia cUa cac chat vai you tó hodt hod mo kluti Oat eye mau &Mg. Sty sir
dung qua mat cila cac yeu to d8ng mau gay ra tinh tang xuat huyet nghiem frog.

4/4
 Banh gai nhau nut: la giai doan cutil oh mot thai k9 thoai hod trong do gai nhau mang
dm to thanh nhfing tUi gAn vao met than gai nhau chinh giong nhu hinh chum nho.

Loan tam thAn Mu san: là tinh trang tam than dugc gay ra trgc flap ta sinh de va dac
trtmg boi su mat sang suOt, hoang twang, ac mOng, ao giac va 9 nghl" hai ban than va con.
a
Nguai dugc bao him can phai dugc nhdp vin dieu tri tam than.

Tfr saw la sir ter vong cüa bao thai ctia Nguoi dugc bao him tir tuan thir hai muai chin
cUa thai tra di.

2.2.3. Di Tat 13Am Sinh

Quyen Igi nay se dugc Cong Ty chi tra trong twang hgp con ctla Ngtrai Dtrgc Bao Hiem
nirr duce chan doan mic mOt trong cac benh sau:

HOi chiing Dao (Down): la str sal l'ech nhierm sic the dac bit, dugc xac dinh là thira
nhiem sac the 21 va d4c trung bbi tinh trang giam twang Igc co, tat dk nh6, tat dau
ngan, ch6m bet va chain phat trien cã v tam than va the ,chat. Chan doan se dugc dtra
tren tieu chuan HOi chang Dao (Down) hien dang duct chap nhan va do Bac if xac nhan.

Tat gai sling &IL là tinh trang &zing Ichuyet cUa cOt song do khiem khuyet caa eing thin
kinh hau qua la thoat vi mang thy - thy song hoac thoat vi mang nab. Loai trir tat gai
song doi an.

Tfr chtleng Pha-I8 (Fallot): la mot benh 19 tim bAm sinh vai tinh trang tic nghen &rang
chay ra cüa tam that phai toan bo hoac nghiem twig, phi dai tam that phai va met khiem
khuyet vach tam that lam cho mau bi Idler Oxygen tit tam that phai di qua Ong mach phoi
va trgc tiep de vao dOng mach chi).

Bit thyt quint va dO khi quan - thile quart: la sty phat trien bat thuang cila clop thgc
quan gan ma ket thtic bang mot titi kin hoac tact thanh clutng do thOng yeti khi quan.

Nao üng thiiy: IA tinh trang tich lily qua mire dich nab thy trong ck nao that.

vong sinh: la sty tü vong cOa daa con ctla Ngtrai &rot bao him trong yang ba
muai ngay sau khi sinh.

2.2.4. Phan thuat Owe hOi

Phau thuat phuc hei dirge dinh nghia la:

Phu thuat tao hinh Itan do tai la viec trai equa cu0c, phau thuat de tai to hinh clang
cUa ck cau true cia ca the bi khiem khuyet, mat di, hu ton hay bien clang do tai flan dugc
Bac si" pilau thuat thgc hien.

Ghep da do tai nan gay ra bong là viec trai qua viec ghep da cho ck cAu truc be mat bi
khiem khuyet do tai nan gay ra being, hoac chiu ghep da do bi bOng it nhat 10% dien tich
be mat ca the tinh theo "quy tac sO 9" dm so de be mat Lund & Browder.

5/5
A

D. PHI) LTJC 3

DANH SACH EttNH NQHIEM TRQNG GIA1 DOAN COOT

(Dinh kem San phan boo hilm Lien Kit Chung Then Hg n 20 Nam — Dong phi mgt ldn — KI hogch bcio
ye citegv phe duyet theo cong van so 8443/BTC-QLBH ngity 16/07/2018 dig BO Teti chinh)

DIEU 1: DINH NGHIA

Chet Nang Sinh Hoktt Hang Ngay: bao g6m

Tam rim: la kha nang tam trong ban hoc dual voi hoa sen (bao gem) ca viec vao va ra
IchOi b8n tam hoc nha tam) hay tam/rira bang cac phuang tien khac.

Thay quan áo: la viec mac va cal cac m6n quail do, day deo, chan tay gia hay cac phg
kin lap vao sau phau thuat.

Chuyen ch6: la viec di chuyen tir gitrOng sang ghe ngai hoac xe Ian va ngugc lai.

Di chuyen: la kha Kiang di chuyen trong nha, tü phong nay sang pheing khac ten mat
bang.

V sinh: la kha Wang sir Ong phimg v sinh, hoc kiem sok eh& nang ciia met va
bong dal de duy tri ye sinh cá nhan.

An Ong: la viec tkr an Ong cac thirc an da duce chuan bi.

DIEU 2: DANH SACH BtNH Lt NGHIEM TRQNG GIAI DOA! CUOI

2.1. Btnh Alzheimer / Sa set tri tut tram trong

Giam sat hay mat Icha nang tu duy do NMI Alzheimer hoc rei loan thgc the lido khong hen
phgc va dugc chan doan dga tren cac bang chang lam sang va cac xet nOiem v birth anh.
Benh clan den tinh trang suy giam tram trong kha nang tri tue va xã hoi, can phai dugc giarn
sat lien We. ,Benh phai dugc chan doin xac dinh bai bac sy chuyOn khoa than kinh va dugc
Cong Ty chap thuan..

Logi trir nhang twang hgp

oi loan than kinh hay tam than

R61 loan nao khong do tan thuang thgc the nhu ti
Tem thuang nao lien quan den rugu, bia

2.2. Pilau thuat Ong mach chii

La pilau thuat cat 68 va thay the dOng mach chit hay met phan dOng mach chili bi benh bang
manh ghep. Trong dinh nglila nay, Ong mach chit la dOng mach chi) nggc va dOng mach chi)
bung, kh8ng bao g8m cac nhanh ciia Ong mach chg. Phau thuat nay dugc xac dinh la cAn
thiet ve mat y khoa boi bac sy chuyen khoa.

1/2
 Loai tra nhang truing hop: di'eu tri bang phumig phip khong pilau thuAt, tao hinh mach
mau, ky thuat thyc hien trong leng dOng mach, icy thot (fat Ong thOng deng mach xuyen da
(stent).

2.3. Thiel" man bat sin

La tinh trang suy thy man tinh, keo dai clugc xac dinh bang ket qua sinh thiet, gay ra thiau
man, giam bach can, giam tieu can can phai truyen san pham mau va can phai dieu tn bang
mOt trong cac phtrang phap san:

Thu& kich thich thy

Thu6c erc che mien dich
Ghep thy.
Chan doan thieu man bat san phai duce bac sy chuyen khoa huyet hoc xac nhan.

2.4. 119i chfrng Apallic

foal ter toan thA vang v6 nAo vai phan than nAo Ichong bj anh huemg. H'Oi chang Apallic phai
&rem chan doan xac dinh ben bac sy chuyen khoa than kinh va benh phai keo dai it nhat meg
(01) thang.

2.5. Viem mang nao nhiem khuan

La viem ming nao do vi khuan dua den nhang di chang than kinh nghiem Yong !coo dai it
that 90,ngay Ice tir ngay &rem chan doan. Chan doan phai clugc xac dinh beri bac sy chuyen
khoa than kinh va c6 vi khuan trong dich nao thy.

Loai thy benh viem mang nal) do virus.

2.6. U nao lanh tinh

La kluei u trong Wei SQ khong phai ung thu, gieti flan trong nao, mang nAo hay day than kinh so
va dap ang tat ca cac dieu kin san:

Nguy hiem den tinh mang;

DA gay ton thuang cho nao;
Da qua phau thuat lAy u hoc dA gay ra di cluing than kinh vinh vin net' khong the phau
thuAt;
Phai &roc chart doan xic dinh beri cac bac sy chuyen khoa than kinh va c6 sir hien dien
caa kh6i u tren cac chan doan hinh anh nhu chyp ellen toin cat lOp (CT scan), cOng hueng tir
(MRI) hoc cac ky thuat chan &tin hinh anh tin cay lchac.

Loai trir cac u dang nang, u hat, di dang mach man nao, Ichoi mau ti, cac u thy& yen, hoc
OA song.

2.7. Phan thuat nao

2/2
 •••
4

LA phau thuat ma hOp s9 de dux hien phau thuat nhu mo nao sau khi dirge gay me toan than.

Loai tra cac twang hap sau:

Phau thuat khoan hi hp Sc;

Phau thuat nao qua xucmg Sam;
Phau thuat dirge trg gigp bed nOi soi hoc bat IcY nhang phAtu thuat xam Itn tti thieu khac;
Phan thuat nao do tai nan.

2.8. Ung dna' de da tinh mang

Ung thu có nghlia la khoi u dc thing beri sir tang truang khong kiem sok va Ian rOng cüa
nhang té bao dc tinh va xam Ian ck mo. Ck loai ung thu bao g6m Carcinoma,
Melanoma, Leukemia, Lymphoma va Sarcoma.

Chan doan phai dirge xac nhan bai bk s9 chuyen khoa.

Loai trir cac twang hgp sau:

Cac sang thucmg dugc mo ta IA lanh tinh, tin ac tinh, khong chk chan, giap bien, kh8ng
xam lAn, ung thu tai chi:, (carcinoma in-situ (Tis)) hoc u dugc phan loai Ta;
Ung thu da dang melanin dc tinh co chieu sau nh6 hcm hoc bang 1 cm tra khi u Ia bet
hay kern theo di can hach bath huyet hoc di can xa. Ung thu da kh6ng phai là u
melanin, khong c6 di can hach bach huyet hoc khong di can xa.
Ung flux tin Iit tuyen dirge phan loai là Tla hoc Tlb, khong c6 di can hach bach huyet
hoc kh6ng di can xa;
Ung thu tuyen &lap the nhu hoc the nang hoac ca hai c6 duang kinh Ian nh'A't cüa khOi u
nhO hcm hoc bang 2 cm va dirge phan loai la Ti, khong c6 di can hach bath huyet hoc
khong di can xa;
Ung thu mau clang lympho man tinh nhO hcm giai doan 3 theo phan loai Rai;
U me dm duang tieu h6a (GIST) ac tinh va u carcinoid ac tinh nh6 hcm giai doan 2 theo
phan loai AJCC.

2.9. Ire'nh ca tim

Benh ca tim dugc chulAn doin xac dinh ben bac sy chuyen khoa tim mach, sac trung bai sg
suy giam Vinh vin chat nang tarn that clugc xac nhan bang sieu am tim. Benh dan den ten
thuang thgc the Vigh vien ttrang ang vari it nhat la Mt 3 dm bang phan loai suy tim cüa
Hip hei Tim mach New York (NYHA) theo ck tieu chuan nhu sau:

Nhom 3: Han ch & . van dOng the lye nhieu. Mk cla benh nhan }thee khi nghi ngai nhtmg
chi can van Ong nhe da c6 trieu chang ca nang.
Nligin 4: Khong van dOng the lye nao ma khong gay kh6 chiu. Trieu chirng suy tim xay
ra khi nghi ngai.

3/3
 Loai trir benh ca tim lien quan den sa dung rugu, bia.

2.10. Hein me
Hon me kdo dal it nhAt 96 gier. ChAn doan phai dap ang tAt ca cac dieu kin sau:

Khong dap (mg vgi kith thich ben ngoai trong vOng it nit& la 96 gia;
Can cc!, cac bin phap h8 trg de duy tri skr song;
Tan thucrng nal.) an den di ChUng than kinh vitt vin dtrgc danh gia it nhAt 30 ngay sau
khi bi h6n me.
Loai trimh6n me do sir dung rugu, bia, thuoc hoc chat gay nghien.

2.11. PhAu thuat nOi tAt dting mach vanh

La phAu thuat tim ha a saa chaa hoc dieu tri dung mach vanh bang manh ghop n6i tit.
Loai trir phau thuat tax) hinh mach mau, dt gia da mach mau (stent) hay cac k thuat th6ng
long clang mach , hoc dieu tri bang keyhole hay laser.

2.12. Viem nao do virus

La tinh trang viem,ctia nhu mo nao (ban cau dal nao, than nao hoac tieu nao) do nhi8m virus,
gay ra di chang than kinh nghiem tong va vinh viôn keo dai it nhat 6 (sau) min va dugc bac
sjl chuyen khoa than kinh xac nhan.

Loai tra viem nao do nhi8m HIV.

2.13. 13?nh ph6i giai &mit cad

Benh gay ra suy h6 hap man tinh, chAn doan phai dap ang tAt ca cac d'Au hieu sau:

Ket qua do the tich khi the( ra ging sat trong giay dAu tien (FEV I) Von luon dyed 1 (m0t)
lit va can phai dieu tri lien tgc liu phap cung cap Oxy do tinh trang giam Oxy matt;
KM qua phan tich khi mau clang mach cho thAy áp lac Oxy ban phAn lac nghi th
55mmHg tr6 xuong (Pa02 < 55mm Hg) va c6 trieu chang kh6 the; khi nghi ngoi.
Chan doan phai duct xac nhon bai bac sy chuyen khoa ho hap.

2.14. Wa1th suy gan giai doan cutoi

La suy gan giai dean cuoi c6 tAt ca cac dau hieu sau:

Yang da keo dai;

CO twang;
Benh nao do gan.
414
 •
4

Loai air b'enh gan tha Oat do sir dung rugu, bia hay chat gay nghien.

2.15. Viêm gan sieu vi tOi cep

Benh viem gan sieu vi lam hoai t& nhu mO gan dan tai hi cluing suy gan t6i cap. Benh dugc
chAn doan xac dinh lchi c6 tAt cá cac dau hieu sau:

Giam nhanh kich thuk gan dugc xk nhan bang sieu Am bung;
Hoai ta toan b'0 cac thity lien quan, chi con khung luai cUa gan;
Suy giam nhanh cac 'cat nghiem chirc nang gan;
Vang da dam;
Benh nao do gan.

2.16. Nhai man ca tim

La ch'et ingt phan ca tim do khong cung cAp du mau nuoi. Chan doan phai dap Ong tat ca cac tieu
chuan sau va phai nhat quan yeti trtramg hop nhai mau co tim cAp:

Benh sCm cna con dau nut dian hinh;

Cac thay d6i mei tren din tam do;
Tang cac men (enzyme) tim car gia tri chAn clan nhu:
. Men CPK-MB tang cao;
. Troponin T> 1.0 ng/ml;
. AccuTnI > 0.5 ng/ml hoc ngtiang tucrng duang cUa Tropinin 1.

Loai trir cat twang hgp sau:

flgi chi:mg mach vanh cap khac bao Om can dau that nut, thieu mau ca tim;
Nhi mau ca tim Bong dc hieu;
Tang the men tim hoc Troponin T hay Troponin I sau Ichi thgc hien the tha thuat xuyen
da hay cac tha thuat nei mach tha tim bao gom thU thuot chip hinh Ong mach vanh, tar)
hinh deng mach vanh.

2.17. Thay the van tim

a
La phau that tim ha thay tha hay saa chea cac bAt thuang dm van tim. Cac bat thuang tha
van tim phai can dr vao ket qua tir the thuat th8ng tim hoc sieu am tim va viec thoc hien
dieu tri nay phai can thiet ve mat y khoa do bac sy chuyen khoa tim mach chi dinh.

2.18. Suy than

Suy than khong 118i plow man tinh tha ca 2 (hai) than, can phai dugc dieu tri bang tham ph'a'n
phk mac, chay then nhan tao vinh vin hay ghap than.

Chan doan phai doge xac dinh Nisi bac sy chuyen khoa.

5/5
2.19. Mat kha nAng sOng d0c letp

La mat kha nang thuc hien tói thieu ba (03) trong sau (06) Chirc Nang Sinh Hogt Hang Ngay
(có hay khong sir dung thiet bi 116 try) do benh hoc than thuang gay ra trong thei gian lien
tkic it nhat sau) (06)thdng. Benh duct chan doan xac dinh bei bac sy chuyen khoa do cong ty
chi dinh.

Logi tit benh kh8ng do ton thuang thuc the nhu nhang benh ve than kinh hay tam than.

2.20. Cam

Mit kha nang noi hoan toan va thong 1181 phoc do benh hay Mn thucmg day thanh am trong
tinted hai (12) thing lien Ale. Cac bang chung y te phai do bac sy chuyen khoa Tai Mi Hong
xac nhan.

Logi tifr moi tinh trang cam al lien quan den tam than.

2.21. Chan thacmg SQ nAo nghiem trong

Chan thuang so nao do tai ngn có di chimg than kinh nghiem trong va vinh vin trong thin
gian it nhat 3 (ba) thing ke tü ngay xay ra tai nail. Di chUng nay lam mat hoan tok va vinh
vin kha' nang thuc hien 61 thieu 3 (ba) trong 6 (sau) Chat Nang Sinh Hogt Hang Ngay.Benh
ducc chan doan xac dinh bed bac s9 chuyen khoa than kinh.

2.22. Ghep cif quan chinh

La sr suy giam khong có kha nang 118i, plthc cüa cac ca quan nhu tim, ph6i, gan, then hay
tüy xucmg va viec cAy ghep la can thiet ye mat y khoa. Chan doan phai duce the nhen bai
bac sy chuyen khoa va phai có phau thOt &Ay ghep tim, ph8i, gan, then hay thy xuong.

2.23. Benh nang thy than

La benh then tien hien do di truyen, ride trung tbei su hien din cac nang trong thy then, teo
tieu quan then va xa boa cac Ong ke then dan den cac bieu hien lam sang nhu thieu mau, tieu
nhieu va mat Natri, tien trien tai suy than man tinh.

Chan doan phai duce xac dinh bang sinh thiet then.

2.24. Benh t bao than kinh van Ong

La tinh trang thoa1 hOa tien trien cdc be ve nao thy sting va ck te bao simg truk dm thy seng
hoc cac te bao than kinh ly tam cUa hanh .nao dan den di cheng than kinh vinh vin, bao gem
benh teo ca thy song, lit hanh nao tien trien, va xa cling cOt ben nguyen phat.

Wenh dugc chan doan xac dinh bai bac sy chuyen khoa than kinh.

2.25. Benh xacieng rai rac

6/6
 •
I

Ld benh 19 do skr pha hay chat myelin 6 m8 than kinh nao. Benh phdi dugc bdc sy chuyen
khoa than kinh chan doan can dr vdo lam sang, benh six theo dOi chat the tien trien NT& hOi
phuc cUa benh.

Cac ket qud chan dodn hinh anh nhu chip cOng hugng tir (MRI), chip din toan cat lop
(CT) hoc cac ket qua chan dodn hinh anh clang tin cay Ichdc phai xac nhan cho chin doan.

Phiti c6 cdc dau hieu t6n thuang than kinh vinh vin, kdo dai lien tyc trong khoang thigi
gian it nhat sau (06) thdrig.

Loai ti-Cr cdc nguyen nhan gay ton thuang than kinh khac nhu b'enh Lupus ban do he thong
(SLE) N/A nhie'm HIV.

2.26. Lo3n cluung ea

La nhern benh thodi h6a ca di truyen dc trung bgi yeti va teo ca tin trien.Loan throng ca
phdi ducrc bac s9 chuyen khoa than kinh chan dodn.Benh phai gay ra tinh trang mat hoan
todn \TA vinh vin MIA nang thgc hien toi thieu ba (03) trong sdu (06) Chat Nang Sinh Hoat
Hang NO)/ (c6 hay Ichong dung cu ho trg) trong thoi gian it nhat sau (06) thang lien tic.

2.27. Benh Parkinson nguyen phat

Benh Parkinson tg phat phai do bac sy chuyen khoa than kinh chan dodn xitc dinh vgi tat cd
cdc dau hieu sau:

Benh kitting the kiem seat dugc bang thu8c;

Co dau hieu cüa tinh gang t8n thucmg than kinh ti&n triM;
Mat hoan toan va vinh vin kha nang thgc hien fa thieu ba (03) trong sdu (06)
Chat Nang Sinh Heat Hang Ngay (c6 hay thong c6 dung cu ho ti-c) trong thogi
gian it nhat sau (06) thdng lien we.

Loai ti-Cr benh do thuOc, dOc chat hay cdc nguyen nhan khdc

2.28. Benh s6t bai liet ( Poliomyelitis )

Ld tinh trang nhiem virus gay sot hal liet clan den Lit ca the chi hay ca h6 hAp Ice° dai it nil& ba
(03) than. Virus gay sot bai lit phai dugc xdc dinh la nguyen nhan gay benh.

2.29. Berth tang ap lue Ong mach phai nguyen phát

Tang áp Igc dOng mach phoi nguyen phat di kern vgi phi di tam that phdi dang k yeti chin
dodn dugc )(de dinh qua dui thuAt thong tim. Benh dAn den ton thucmg thgc the vinh vin
kh8ng h6i phuc tuang (mg vgi nhain 4 cga bang phan loai suy tim cUa Hip ha Tim mach
New York (NYHA) theo the tieu chumn nhu sau:

7/7
 •

Nh6m 1: KhOng han che van d'Ung the Wt. Van dung the lye thOng thuang thong gay
met, kho the( hoac hal hOp
Nh6m 2 : Han cha nhe van dOng the' lye. Benh nhan khoe manh khi nghi ngai. Van dOng
the lye thong thuerng dan den met, h6i hop, kh6 the, hoac dau nggc
Nheim 3 : Han elle van dOng the lye nhieu. Mac dA benh than khOe khi nghi ngai nhtrng
chi can van ging nhe da c6 trieu chgng co nang.
Nhom 4 : Kitting van dOng the lye nao ma thong gay kh6 chiu. Trieu chgng suy tim xay
ra khi nghi ngai.

2.30. Bong !fang

LA bang dO III (ba) chiem toi thieu 20% din tich b mat ca the. Ch'an doin phai dugc xac
nhan bed bac sy chuyen khoa.

2.31. B011 Lupus ban 40 h thOng (SLE) c6 kern viem thin do Lupus

La benh IY tu mien da ca quan dac trung bai sr phat than dm the tu khang the trgc tiep chOng
lai Mc tkr khang nguyen khac nhau.

06i vai dieu, khoan nay, benh Lupus ban de he' thong dugc glad han trong nhang the Lupus
ban de he thong lien quan den than (Benh viem than do Lupus nhom III, IV hoac V dva ten
ket qua sinh thiet than theo TO Chirc Y ia The Gioi).

Loai air Mc dang khaz nhu Lupus ban de hinh dia hoac cac clang Lupus chi co rei loan huyet
hgc hoac kherp.

Phan loai Lupus theo TO Chat Y Te The Giai (WHO):

Nh6m 1: Viem eau than thay d6i t6i thieu

Nhom Viem eau than gian mach don thuan
NhOm III: Viem cau than 6, eve b6
Nh6m IV: Viem câu than Ian tem
Nhom V: Viem cau than mang.

2.32. DOt guy (Tai hien mach man Mao)

Tai biOn mach mau nao bao 6m nhei mau nhu mo nao, xuat huyet ,nao va xuat huyet dueri
nhen, huyet khOi va huyet tac mach mau nao gay ra khiem khuyet chgc nail& than kinh
nghiem tr9ng va vinh vin. Khiem lchuyet nay phai duct bac s9 chuyen lchoa than kinh xac
nhan it nhAt 6 (sau) tuan sau khi d'Ut quy va phai c6 caz ket qua cüa chgp Ming twang tir
(MRI), chip din tan cat lap (CT) hoac cac k9 thuat hinh anh dang tin My phi) hap vai chan
doan Ma b'enh dOt quy mai.

Loai trir cac tnrong hgp sau:

8/8
 Can thieu mau nao thoang qua;
Ton thucmg nao do tai nan hoc do chart thtrang, nhijm thing, viem mach, benh 19 viem
nhiem;
Benh mach matt anh huang den mat hay than kinh thi giac ;
ROi loan thie.0 man caa he tien dinh.

Khiem khuyet chk nang than kinh vinh vin la skr tOn tai .suet thtfi gian song vai cac dau
hieu lam sang nhu te, ha, yeu cgc be, loan van ngon, mat ngon nfl, chang khó nuot, suy
giam thi hit, kh6 khan khi di, thieu ph8i hop, run, co giat, sa sat tam than, me sang, hen me.

2.33. Benh him ngheo giai doyn cued

La benh 19 ma theo quan diem dm Bk sy chuyen khoa va dugc skr ding 9 dm bac syCüa
Cong Ty rang benh 19 nay chac chan se gay tit vong trong \tong 6 (sau) thang.

Loai trir berth hiem ngheo lien quan den nhigin HIV.

2.34. Benh za ging c'Ot ben teo ea

La tinh,trang khiem khuyet than kinh duct xac dinh chac chin yea cac dau hieu dai clang lien
quan den cac eel thy song va cac trung tam van Ong tai nao va vai skr yeu va teo cüa cac ca
tir chi. Benh phai dugc bac sy chuyen khoa than kinh chart doan xac dinh va có the xet
nghiem than kinh-ca thich hgp xic nhan than doan nhtr Dien ca do (EMG).

2.35. Viem tyy man tai phat

C6 tren ba (03) dgt viem tliy lam roi loan chat nang caa tuy gay ra chimg kern hAp thu can phai
clang lieu phap men (enzyme) thay the.

Berth phai dugc bac sy chuyen khoa tieu h6a chan doan va phai &rot xac /than bang kat qua
elm) mat tuy ngugc dong qua mai soi (ERCP).

Loai tit viem tuy man tai phat gay ra do sir dung rugu, bia.

2.36. Benh Creutzfeld —Jacob

Benh Creutzfeld — Jacob hay Nan the dm berth Creutzfeld —. Jacob kern theo di chi:mg than kinh
lam mat hoan toan va \firth vien kha nang thgc hien ten thieu 2 (hai) trong 6 (sau) Che Nang
Sinh Hoat Hang Ngay nhu duct quy dinh trong hgp ding.

Loai trir nhang benh gay ra do dieu tri bang hormon tang truang.

2.37. Benh viem can ea hoyi tfr (Necrotising faseiitis)

Benh duce chAn doan xac (firth dkra tren nhang ti8u chu'An sau day:

9/9
 Co cac trieu chi:mg lam sang thong thtrang cüa benh viem can ca hoai ta;
Vi khuan dugc xac dinh la nguyen nhan gay ra b'enh viem can ca hoai tir;
Hay hoai Ian rOng ca va cac m6 mArn khac den den mAt hoan toan va vinh vin chirc
nAng cüa nhang viing ca the 61 anh huang.

2.38. Viem da khop clang thAp Ong

La tinh tang htly hoai kherp tiAn trien man tinh Ian rOng gay ra cac bien clang nghiem tong anh
huang tti thieu 3 (ba) kh6p IOn (nhu khap ban chan, ban tay, c8 tay, goi, hong). Chan doan xac
dinh viai tat ca cac dau hieu sau:
Cang khop bu8i sang
Viem lchap doi xi:mg
Hien din cac not clang thAp
Tang ham lacing cac y8u to dang thAp
Bang chtmg X-quang cUa cac hien clang nghiem trong.

Benh phai dugc bac sy chuyen khoa khap hoc chart doan xac dinh.

2.39. Lang xtrcmg Ong

Lang xtrang la benh thoai hoe caa b0 xuang lam cho giam se lucmg t6 chic xtrang. Chan dok
benh nay bao g6m :

Chi se mat do xuang T- score theo dinh nghlia dm TO chat Y th the gigi (WHO) nhO hon
—2.5
Co it nhAt 3 (ba) len gAy xuang diii, xucmg c6 tay hay miring cOt sOng do bi bang xucmg
Tinh trang gAy xuang nay lam cho Nguai Duqc Bao Hiem mat hoan toan va vinh vien
kha nang thuc hien it nhAt 3 (ba) trong 6 (sau) Chac Nang Sinh Hoat Hang Ngay.

2.40. Xcr cirng bi he thOng (Systemic Scleroderma)

La benh m6 lien ket he thong gay ra Mn thuang xa cang Ian rOng tien then a da, mach mau va
cac ca quan nOi tang. Benh phai phai dugc xac dinh dip tren it nhat 2 (hai) trong so nhang tieu
chuan sau day:

Ton thuang tai phei:

KM qua do kha nang khuyet tan khi CO qua mang phe nang mao mach
(DLCO) < 70% gia tri tien doan

KM qua do the tich khi tha ra gang sue trong giay Mu tien (FEV1), dung
tich song ging the (FVC), dung tich toan phoi (TLC) < 75% gia tri tien
dodn
Ton thuang tai than: DO Ice au then (GFR) < 60m1/min
Ton thuang tai tim: CO trieu chüng suy tim sung huyet, roi loan nhip tim cen phai dieu tri
hay viem mang ngoai tim gay ra tran dich mang ngoai tim lacing tir trung binh tOi Wang.

Loai tnt nhi'mg b'enh sau:

10/10
 Xa cfrng bi khu tit (Xo cling bi tirng dam, timg dai);
Benh viem can mac bach cau áì toan (Eosinophilic fasciitis);
Hei ch(rng CREST.

Benh phai dugc Bac si chuyen khoa Ichap hgc chA'n doan xac dinh.

2.41. Tinning TAt Toan BA \la Vinh Vin

a)La so mAt hoAc het hoAn toan va Vinh vin dm:

Hai tay; hoc

Hai chan; hoc

Met tay va met chan; hoc

Thi lye hai mAt; hoc

MOt tay va thi lye met mat; hoc

Met chan vA thi lye met mat.

Di yeti dieu khoan nay, (i) mat hoan toan va vinh vin doi vol my dugc hieu IA tInh trans cut
hoan toan tir co tay tra len, hoc (ii) mat hoan toan va vinh vien dei yeti chan &roc hieu la
fifth trang cut hoan toan tir mat cá chan ft& len, hoc (iii) mAt hoan toan thj lye dugc hieu IA
mat han hoc mu hoan toan va kh6ng the phyc hei dugc chirc Wang nhin oh mat.

Hoac: •
b).Bi thucmg tat dat ty 14 tren 80% theo quy dinh ve tieu chuan thucmg tat di hieu lye vao then
diem xay ra tai rip hoc berth tAt.

Tat ca cac tinh trang liêt hoan toan va vinh vin va/hoac throng tat neu tren phai dugc giarn
dinh vA xac nhAn bai hei dong y khoa cap tinh/thanh phô true thuec trung wing hoc co quan
tuang throng theo quy dinh cüa phap lust. Vic giam dinh nay phai duct thut hien sau 180
(met tram tam mucri) ngay tinh tir ngay xay ra Tai Nan hoac benh tat.

2.42. BOh nhtnye cif ( Myasthenia Gravis )

La r61 loan to min mac phai ctia qua trinh clan truyen than kinh - co dan den yeu va ma ca.
Benh phai dap (mg tAt cá cac tieu chuan sau:

Sy hien din yeu ca thuang xuyen thuec nhom III, IV hoc V cila Bang phan loai lam
sang cáa Hip hei benh Nhugc ca Boa K9;
Chan doan xac dinh va phan It* benh phai dugc xac nhAn bed bac sy chuyen khoa than
kinh.

Bang phan loai lam sang cim Hip hei benh Nhugc co Boa KS,
 Mt I: Yu cac co mat, c6 the sup mi, khong yeti cac nh6m co khac
Nhom ILYeu cac co mat,6 moi mac do, you mac dO the cac nit co khac
Nhom III: You cac co mat 6 mai mat do, yeu mat do vira Mc nheim co khac
Nhaim TV: Yeti Mc co mat a mai mire do, yeu milt do ndng cac nh6m co khac
a
Nheim V: Can ddt nOi khi quan duy tri duemg tha.

2.43. Berth Crohn

La benh viern xuyen thanh dueng nut man tinh, tinh trang viem keel dai lien Am mac dii dd dugc
dieu trj tich cut Chan doan xac dinh v6i tat ca the clAu hidu sau:

Hinh thanh nhang ch6 hap gay ra tac ruOt can phAi nhAp vin;
Hinh thanh Mc 18 do gift cac quai ruOt;
CAn phai cat it nhAt 1 (loan ruOt.

Chan doan phai dugc xac nhan bed bac sy chuyen khoa tieu h6a (logic chgng minh bang ket qua
giai phAu benh va/hodc bai ket qua fled soi dai trang hay dai trang sigma.

2.44. Hed chitin Eisenmenger

LA benh tim gay ra tang ap loc dOng mach ph& tram gong va lam dao chieu luOng mach mau.

ChAn doan phai dugc xac nhdn b6i bac sy chuyen khoa bang sieu am tim va th8ng tim.

2.45. Suy tuyen thuvng than man tinh ( Benh Addison)

LA rói loan tu mite'n man tfnh gay ra pha hUy dan dan tuyen thugng than can phai dugc dieu tri
bang corticoid suot den.

Chan doan phai dugc xac nhdri bed bac sy chuyen khoa nOi tiet dugc ding ty chAp ththn va ket
qua xet nghiem kich thich ACTH.

Chi chap nhan benh suy tuye'n thugng th'An do nguyen nhan tg min, loai tnt berth do Mc nguyen
nhan khac.

12/12
(Ducfc phe chuAn theo -QLBH ngay 16 Mang 07 nam 2018 caa BO Tai
hint)

1.1 Bien phi chuAn

(Dan vi: phdn ngan)
Ke Hoach Bao Ve Ke Hoach Bao Ve
Turn TuOi
Nam Nit Nam Nit
0 155,0 148,5 36 402,2 367,0
156,8 151,1 37 440,9 381,0
2 158,6 153,7 38 479,6 395,0
3 160,4 156,3 39 518,3 409,0
4 162,2 158,9 40 557,0 423,0
5 164,0 161,5 41 593,0 459,4
6 164,3 163,2 42 629,0 495,8
7 164,6 164,9 43 665,0 532,2
8 164,9 166,6 44 701,0 568,6
9 165,2 168,3 45 737,0 605,0
10 165,5 170,0 46 749,6 640,5
11 167,0 172,9 47 780,7 676,0
12 168,5 175,8 48 800,0 711,5
13 170,0 178,7 49 800,0 747,0
14 171,5 181,6 50 800,0 782,5
15 173,0 184,5 51 800,0 786,0
16 176,2 189,0 52 800,0 789,5
17 179,4 193,5 53 800,0 800,0
18 182,6 198,0 54 800,0 800,0
19 185,8 202,5 55 800,0 800,0
20 189,0 207,0 56 800,0 800,0
21 195,8 213,7 57 800,0 800,0
22 202,6 220,4 58 800,0 800,0
23 209,4 227,1 59 800,0 800,0
24 216,2 233,8 60 800,0 800,0
25 223,0 240,5 61 800,0 800,0
26 235,7 251,5 62 800,0 800,0
27 248,4 262,5 63 800,0 800,0
28 261,1 273,5 64 800,0 800,0
29 273,8 284,5 65 800,0 800,0
30 286,5 295,5 66
31 301,9 307,0 67
32 317,3 318,5 68
33 332,7 330,0 69
34 348,1 341,5 70
35 363,5 353,0
1,2 Bleu phi trQi (EM Loading)
Ltru y: nham mac dich trinh bay ngan gem Bietu phi troi tha the san pham, cac bang sau
day chi dugc trinh bay tai tang 5 tail mOt
(Dan phein ngan)
Phan tram tSr lO tit vong bo sung
TuOi Ngued dugc bao hiem nam Ngued dugc bao him ncr
25% 50% 75% 100% 25% 50% 75% 100%
0 40,50 81,00 121,50 162,00 39,50 79,00 118,50 158,00
5 45,00 90,00 135,00 180,00 44,00 88,00 132,00 176,00
10 45,50 91,00 136,50 182,00 47,50 95,00 142,50 190,00
15 47,50 95,00 142,50 190,00 53,00 106,00 159,00 212,00
20 54,00 108,00 162,00 216,00 62,50 125,00 187,50 250,00
25 66,00 132,00 198,00 264,00 76,50 153,00 229,50 306,00
30 76,50 153,00 229,50 306,00 84,50 169,00 253,50 338,00
35 122,00 244,00 366,00 488,00 124,50 249,00 373,50 498,00
40 87,00 174,00 261,00 348,00 148,50 297,00 445,50 594,00
45 149,00 298,00 447,00 596,00 109,50 219,00 328,50 438,00
50 292,50 585,00 877,50 1,170,00 171,50 343,00 514,50 686,00
55 320,00 640,00 960,00 1,280,00 200,00 400,00 600,00 800,00
60 352,00 704,00 1,056,00 1,408,00 206,50 413,00 619,50 826,00
65 330,00 660,00 990,00 1,320,00 233,00 466,00 699,00 932,00
1.3 He s6 dieu chinh thiri han báo him dm?' chuin
Chi tieu rai ro du6i chuen theo sirc Ichee / nghe nghiep (Per mule loading) c6 the et, thtri
han bang dai han Mari han &Mg phi.

Doi \Teri san ;them d6ng phi mOt Fan, COng ty dieu chinh lai phi trOi bang he s6 chi lieu rUi
ro dutri chuan nhan menh gia va thu phi mOt Ian.

Dan it phdn n an)

Thai He s6 chi tieu rili ro cludri chuen
1-wn 1 2 3 4 5 6 7 8 9 10
1 1,30 2,70 4,00 5,30 6,70 8,00 9,30 10,70 12,00 13,30
2 2,60 5,30 7,90 10,50 13,10 15,80 18,40 21,00 23,70 26,30
3 3,90 7,80 11,70 15,50 19,40 23,30 27,20 31,10 35,00 38,80
4 5,10 10,20 15,30 20,40 25,50 30,60 35,70 40,80 45,90 51,00
5 6,30 12,60 18,90 25,20 31,40 37,70 44,00 50,30 56,60 62,90
6 7,40 14,90 22,30 29,80 37,20 44,60 52,10 59,50 67,00 74,40
7 8,60 17,10 25,70 34,30 42,80 51,40 60,00 68,50 77,10 85,70
8 9,70 19,30 29,00 38,70 48,40 58,00 67,70 77,40 87,10 96,70
9 10,80 21,50 32,30 43,00 53,80 64,50 75,30 86,10 96,80 107,60
10 11,80 23,60 35,50 47,30 59,10 70,90 82,70 94,60 106,40 118,20
11 12,90 25,70 38,60 51,40 64,30 77,20 90,00 102,90 115,70 128,60
12 13,90 27,80 41,70 55,60 69,50 83,40 97,20 111,10 125,00 138,90
13 14,90 29,80 44,70 59,70 74,60 89,50 104,40 119,30 134,20 149,10
14 15,90 31,80 47,80 63,70 79,60 95,50 111,50 127,40 143,30 159,20
15 16,90 33,90 50,80 67,70 84,60 101,60 118,50 135,40 152,30 169,30
16 17,90 35,80 53,80 71,70 89,60 107,50 125,40 143,30 161,30 179,20
17 18,90 37,80 56,70 75,60 94,50 113,40 132,30 151,20 170,10 189,00
18 19,90 39,70 59,60 79,50 99,30 119,20 139,10 159,00 178,80 198,70
19 20,80 41,70 62,50 83,30 104,20 125,00 145,80 166,70 187,50 208,30
20 21,80 43,60 65,40 87,10 108,90 130,70 152,50 174,30 196,10 217,80
 BANG Tt LE pHi BAO HIEM RU RO

1. Bang tt le phi bao him rid ro tü vong hoc thutng t toin b vi vInh van
BAng tST1 phi ban hi6'm tin ro tit vong hoc thucmg tat toan bO va With vin áp dung cho
NDBH co sire khOe chuAn (don vi: phAn ngan)

Ttai Nam NW Tu'ai Nam Nit Lai Nam Nit

2,63 1,88 35 2,17 1,70 70 41,37 23,16
--- 45,43 25,53
1,03 0,84 36 2,32 1,82 71
0,99 0,80 37 2,49 1,96 72 50,08 28,47
3 0,97 0,78 38 2,68 2,13 73 55,34 31,99
4 0,93 0,77 39 2,90 2,32 74 61,10 36,05
5 0,88 0,75 40 3,15 2,53 75 67,25 40,56
6 0,83 0,73 41 3,42 2,75 76 73,70 45,45
7 0,78 0,71 42 3,71 2,98 77 80,37 50,68
8 0,75 0,70 43 4,03 3,20 78 87,32 56,32
9 0,74 0,69 44 4,37 3,44 79 94,76 62,57
10 0,75 0,68 45 4,73 3,68 80 102,94 69,67
11 0,81 0,70 46 5,12 3,92 81 112,09 77,83
12 0,92 0,73 47 5,53 4,19 82 122,41 87,25
13 1,07 0,77 48 5,97 4,48 83 133,84 97,90
14 1,24 0,82 49 6,46 4,79 84 146,12 109,62
15 1,42 0,87 50 7,00 5,13 85 158,98 122,29
16 1,59 0,92 51 7,63 5,50 86 172,21 135,82
17 1,72 0,96 52 8,33 5,92 87 185,73 150,18
18 1,82 1,00 53 9,13 6,38 88 199,53 165,38
19 1,88 1,03 54 10,01 6,85 89 213,69 181,54
20 1,90 1,06 55 10,96 7,33 90 228,43 198,85
21 1,90 1,08 56 11,97 7,80 91 244,11 217,68
22 1,88 1,10 57 13,04 8,25 92 261,43 238,69
23 1,84 1,12 58 14,18 8,70 93 282,13 263,41
24 1,80 1,15 59 15,42 9,20 94 309,97 295,23
25 1,75 1,17 60 16,80 9,80 95 351,86 341,02
26 1,72 1,20 61 18,36 10,54 96 420,99 413,88
27 1,71 1,24 62 20,12 11,49 97 541,00 537,24
28 1,70 1,28 63 22,09 12,63 98 745,15 743,96
29 1,72 1,32 64 24,27 13,92 99 1.000,00 1.000,00
30 1,75 1,37 65 26,62 15,29
31 1,80 1,42 66 29,13 16,71
32 1,87 1,47 67 31,79 18,13
33 1,95 1,54 68 34,65 19,59
34 2,05 1,61 69 37,81 21,23
2. T5 I phi bao ham rill ro khi aim vin
Ty 1'e bao him rüi ro nam vien qua dem dued day dupe áp dung cho NDBH c6 six lchoe
chuan (dun vi: phan ngan).

Tutu' Tyr io Tuai TS, 10

0 2.736 35 2.180
1 2.736 36 2.202
2 2.605 37 2.246
3 2.677 38 2.301
2.457 39 2.347
2.017 40 2.403
2.016 41 2.436
2.039 42 2.481
8 2.036 43 2.525
9 2.041 44 2.559
10 2.036 45 2.606
11 2.026 46 2.578
12 2.057 47 2.642
13 2.064 48 2.660
14 1.982 49 2.666
15 2.006 50 2.685
16 1.994 51 2.761
17 2.008 52 2.826
18 2.014 53 2.890
19 2.001 54 2.967
20 1.970 55 2.974
21 1.955 56 3.166
22 1.969 57 3.366
23 1.972 58 3.575
24 1.987 59 3.789
25 2.000 60 4.010
26 2.009 61 4.954
27 2.028 62 5.978
28 2.038 63 7.073
29 2.056 64 8.261
30 2.066 65 8.708
31 2.085 66 9.348
32 2.113 67 9.988
33 2.132 68 10.645
34 2.161 69 11.285
3. Bing tt I bio hiem red ro benh 15, nghiem trong giai don Mu va giai doan cuOi
Bang tY le bao him red ro benh ly nghiem tong giai don Mu va giai doan cu6i dueci day
duce áp dung cho NDBH c6 sirc kh6e chuen (dun vi: phan ngan).

Tali Nam Nit Tit& Nam Nit

0 2,19 1,36 35 2,07 3,27

1 1,62 1,13 36 2,24 3,61
2 1,18 0,91 37 2,56 3,94
3 1,06 0,85 38 2,89 4,27
4 0,97 0,76 39 3,22 4,55
5 0,85 0,66 40 3,60 4,81
6 0,75 0,56 41 4,00 5,14
7 0,73 0,47 42 4,52 5,49
8 0,70 0,46 43 5,16 5,92
9 0,70 0,46 44 5,74 6,40
10 0,73 0,46 45 6,44 6,93
11 0,75 0,47 46 7,12 7,47
12 0,76 0,52 47 7,82 7,94
13 0,76 0,54 48 8,39 8,39
14 0,79 0,58 49 9,01 8,79
15 0,79 0,59 50 9,67 9,16
16 0,79 0,66 51 10,42 9,45
17 0,76 0,68 52 11,35 9,70
18 0,75 0,70 53 12,44 9,90
19 0,73 0,73 54 13,67 10,11
20 0,70 0,76 55 15,11 10,37
21 0,73 0,83 56 16,75 10,79
22 0,73 0,92 57 18,62 11,35
23 0,76 0,99 58 21,02 12,14
24 0,79 1,06 59 23,27 13,10
25 0,83 1,18 60 25,66 14,32
26 0,87 1,24 61 28,14 15,60
27 0,92 1,34 62 31,12 16,90
28 0,99 1,45 63 34,20 18,22
29 1,09 1,55 64 36,70 19,54
30 1,20 1,72 65 42,57 23,47
31 1,32 1,88 66 47,54 26,40
32 1,46 2,15 67 53,81 29,47
33 1,63 2,48 68 60,72 32,67
34 1,82 2,85 69 68,41 36,27
4. Bang q 4 blio him riii ro benh I nghiem trong giai don du vi giai don Si vi
benh IS} nghiem trçng theo tinh
Bang ts, 14' bac) hiem tin to b101111Y nghiem.trong giai dean clau vi giai dean cu6i clued day
ducc ap clang cho NDBH c6 stic khOe,chuan \fa bao Om phi WO hiern rui to cho bye'nh 1'
nghiem tong theo giei tinh (don vi: phan ngan).

TuOi Nam Nee Tudi Nam NIT

0 2,20 1,47 35 2,10 3,74

1 1,63 1,24 36 2,27 4,08
2 1,19 1,02 37 2,59 4,41
3 1,07 0,96 38 2,93 4,74
4 0,98 0,87 39 3,27 5,02
5 0,86 0,77 40 3,67 5,28
6 0,76 0,67 41 4,08 5,61
7 0,74 0,58 42 4,61 5,95
8 0,71 0,57 43 5,27 6,39
9 0,71 0,57 44 5,86 6,87
10 0,74 0,57 45 6,58 7,39
11 0,76 0,58 46 7,27 7,94
12 0,77 0,63 47 7,99 8,42
13 0,77 0,65 48 8,58 8,87
14 0,80 0,69 49 9,23 9,28
15 0,80 0,70 50 9,91 9,65
16 0,80 0,77 51 10,69 9,95
17 0,77 0,79 52 11,64 10,21
18 0,76 0,89 53 12,77 10,42
19 0,74 0,93 54 14,05 10,64
20 0,71 0,97 55 15,54 10,90
21 0,74 1,08 56 17,24 11,33
22 0,74 1,21 57 19,16 11,90
23 0,77 1,32 58 21,61 12,70
24 0,80 1,44 59 23,92 13,67
25 0,84 1,61 60 26,37 14,90
26 0,88 1,70 61 28,91 16,19
27 0,93 1,82 62 31,95 17,51
28 1,00 1,96 63 35,09 18,84
29 1,10 2,08 64 37,64 20,17
30 1,21 2,26 65 43,60 24,11
31 1,34 2,41 66 48,69 27,11
32 1,48 2,66 67 55,12 30,26
33 1,65 2,98 68 62,19 33,54
34 1,85 3,33 69 70,07 37,22
5. TS7 le phi brio him rili ro tir vong vi thucrng tht do tai nail nfing cao hp dung cho NDBH
co sat khoe chain: 1,47 phan ngan.