LOTTE INSURANCE CO., LTD.
1. Product Details and Eligibility
A. Product Details
- You can easily apply for insurance without complicated procedures such as physical examinations. You can just simply apply for it after filling out the application form.
- This insurance product covers damages only during the domestic travel period, so the insurance premium is lower.
- This product is not only for domestic residents but also for overseas residents or foreign tourists entering the Republic of Korea (South Korea, hereinafter referred to as “Korea”) for travel. We are going to cover the risk within Korea according to the policy.
- For groups of 20 or more, we may offer a discount on insurance premiums from a minimum of 5% to a maximum of 15%, depending on the number of people.
- The premium should be paid at once in full before inception.
- This product is non-refundable insurance and there is no money to return to the policyholder when the insurance is expired.
B. Eligibility
- An insurance contract that designates the death of a person under 15 years of age, mentally unsound person, or mentally deficient person as a peril insured shall be null and void. However, if a mentally deficient person has mental capacity when entering into an insurance contract or becomes an insured person of group insurance according to the rules of his/her organization, he/she can subscribe to insurance for death.
- The application may be limited or impossible, and the insured amount may be limited considering the age, occupation, and health status of the insured.
- The insured amount of insurance may be limited according to the insurance company's underwriting guidelines depending on the risk, such as the job and duty of the insured.
2. Coverages
A. Warranty of Insurance Claims per Item and Amount
(Unit: KRW)
Category | Warranty | |
Mandatory Contract | Death caused by injury or disability occurred during travel in Korea | When the insured is injured due to an accident during a domestic trip and becomes dead or disabled as a direct result of the accident |
Optional Contracts (Injury) | Fracture Surgery Coverage | If the insured has surgery for direct treatment purposes of fracture as a direct result of the injury. |
Diagnosis of Fracture Coverage (Excluding broken teeth) | If a fracture is diagnosed as a direct result of injury | |
Diagnosis of 5 Major Fractures Coverage | If the insured one is diagnosed with one of five major fractures as a direct result of injury | |
5 Major Fractures Surgery Coverage | If the insured has surgery for direct treatment purposes for one of the 5 major fractures as a direct result of the injury. | |
Cast Treatment Coverage | If the insured receives cast treatment due to an injury or illness diagnosed by a doctor | |
Death or Disability from Traffic Injuries | When the insured is injured due to a traffic accident and dead or disabled as a direct result of the accident | |
Death from a Drowning Accident | In the case of death due to a drowning accident | |
Death caused by Natural Disaster | In the case of death due to a natural disaster | |
Death or disability caused by injuries by robbery | When the insured is injured by a robber and dead or disabled as a direct result of the robbery | |
Violent Crimes (During daily activities) | If the insured dies in a violent crime accident or damage occurs to the insured’s body in his/her daily life activities. | |
Compensation for Diagnosis of Poisoning by Contacting with a Poisonous Animal (Once a Year) | If the insured is diagnosed with poisoning by contact with poisonous animals as a direct result of injury | |
Death or Disability of Sports Groups | When the insured is injured during an athletic competition conducted under the management of an organization and has died or been disabled as a direct result of injury | |
Ruptured Knee Ligament and Cartilage Damage Surgery Coverage | When the insured has knee ligament rupture or cartilage damage, and surgery is performed for direct treatment as a direct result of injury | |
Traumatic Spinal Injury Surgery Coverage | When the insured has surgery due to traumatic spinal injury for direct treatment as a direct result of injury | |
Joint (Knee and Hip) Damage Surgery Coverage | When the insured has surgery due to damages in the joint of his/her knee or hip for direct treatment as a direct result of injury | |
Achilles Tendon Injury Surgery Coverage | When the insured has an injury in his/her Achilles tendon and surgery is performed for direct treatment as a direct result of injury | |
Optional Contracts (Income Indemnityand other claim) | Income Indemnity for 24-Hour Injuries | If disability occurred to the insured with more than 50% of the payment rate within one year from the date of the accident as a direct result of injury |
Income Indemnity for Traffic Injuries | If disability occurred to the insured with more than 50% of the payment rate within one year from the date of the accident as a direct result of traffic injury | |
Burn Surgery Coverage | In the case of burns to the body due to injury and surgery is performed for the direct purpose of the treatment | |
Burn Diagnosis Coverage | If the insured one is diagnosed with burn as a result of injury | |
Stolen Damage at a Residence | When movable properties are stolen in a residence during a trip | |
Optional Contracts (Hospitalization Allowance due to Injury or Disease) | Daily Compensation of Hospitalization for Traffic Injuries | When hospitalized for treatment due to an injury to his/her body and disrupting his/her living function or ability to work as a direct result of traffic injury |
Emergency Room Admission Coverage (Emergency) | When the insured visits an emergency room for medical treatment as an emergency patient | |
Emergency Room Admission Coverage (Non-Emergency) | When the insured is not an emergency patient but he/she visits an emergency room for medical treatment | |
Daily Compensation for Hospitalization with Food Poisoning | When hospitalized continuously for at least four days for the direct purpose of the treatment of food poisoning after food poisoning has been diagnosed and confirmed | |
Optional Contracts (Disease) | Deaths Caused by Diseases and High Degrees of Disability for more than 80% | If the insured dies during the insurance period due to disease according to the policy, loses a part of his/her body, or permanently loses his/her function resulting in disability equivalent to 80% or more of the payment rate prescribed in the terms and conditions |
Specific Infectious Diseases | In the case of being diagnosed with an infectious disease and receiving treatment; | |
Optional Contracts (Coverage for medical expensesactually paid) | Injury Benefit | In the case of medical expenses incurred due to hospitalization or outpatient treatment (outpatient and prescription preparation) at a medical institution |
Disease Benefit | ||
Injury for Non-benefit | In the case of non-benefit medical expenses incurred by hospitalization or outpatient treatment (outpatient and prescription preparation) at a medical institution | |
Disease for Non-benefit | ||
3 Major Non-benefits | When medical expenses incurred with the three major non-benefit medical expenses in the case of hospitalization or outpatient treatment to treat injuries or diseases at a medical institution | |
Optional Contracts (Compensation for Cost) | Damage to Carry-on Items During Travel | In the case of damage to a carry-on item(s) due to an accident (excluding loss) during the insurance period |
Fines(Ⅱ)(Property) | When a fine is imposed in connection with Article 151 (Penalty) of the Road Traffic Act(Korean Law) due to an automobile accident while driving a motor vehicle | |
Fines(Ⅲ)(Person) | When a fine is imposed for causing injury to another person's body in a car accident while driving a motor vehicle | |
Support for Settling Traffic Accidents | When money for criminal settlement is paid by injuring another person's body in a car accident while driving a car | |
Coverage of Appointing a Lawyer for a Car Accident (Excluding Simple Indictment) | When the insured has to pay the cost of appointing an attorney by injuring another person's body in a car accident while driving a motor vehicle | |
Hole-in-one Coverage (1 time only) | In the case of a hole-in-one during a golf game | |
Abduction, Kidnapping, Hostage of Youth | When the insured one is detained for abduction, kidnapping, illegal detention, etc. by others and is not rescued or released within 72 hours after reporting to an administrative agency | |
Financial Fraud | When an accident is filed with the police as financial fraud using information and communication network and is classified as a scam such as phishing, smishing, memory hacking, or other telecommunications financial fraud among voice phishing or cyber financial crimes; | |
Cyber Threats | When reasonable and inevitable costs are required for the insured to respond to cyber threats. | |
Optional Contracts (Liability for Compensation) | Liability for Compensation During Travel | When the insured has damage by taking legal liability for damage to another person's body or property due to an accident during a domestic trip |
Compensation for Liability Caused by Pet (Person·Animal) | When the insured is legally liable for the physical damage to another person or his/her animal due to an sudden accident caused by the animal owned by the insured. |
B. Calculation Method of Claim amount
- Coverage for death, diagnosis, and surgery expenses: The full insured amount is paid.
- Disability, Compensation for income: The amount according to the certain rate of insurance subscription will be paid depending on the degree of disability.
- Theft: Actual cost within the insured amount
- Daily allowance for hospitalization: When included in the policy, the insured amount declared in the policy will be paid per day of hospitalization but limited to maximum 180 days.
- Coverage for medical expenses: The medical expenses actually paid within the insurance coverage amount will be paid according to the terms and conditions. (Deduction amount will be applied)
- Coverage for Cost and Liability: Compensated not to exceed the insured amount
C. Limitations on Insurance
- The coverage begins when the company accepts the subscription of the contract and receives the first insurance premium.
- If several contracts have been signed to cover medical expenses, the company may compensate proportionally according to the relevant insurance terms and conditions.
- Insurance payments may be limited depending on the contents of general and special terms and conditions, and please refer to the general and special terms and conditions for details.
- Exclusions (Examples)
- Intentional accident by the insured one However, when the insured hurts himself/herself while he/she is unable to make free decisions due to mental deficiencies, etc.
- When an incident happens by the intention of the beneficiary (the beneficiary of claim) or the intention of the contractor.
- Pregnancy, childbirth (including cesarean section), and postpartum period of the insured one
- In the case of war, acts of foreign enemies, revolution, civil war, or riots.
- Intentional accident by the insured one However, when the insured hurts himself/herself while he/she is unable to make free decisions due to mental deficiencies, etc.
3. Basics of Calculation for Insurance Premium
- Insurance premiums paid by policyholders consist of insurance premiums of risk for insurance payments in the event of an accident and additional insurance premiums for the insurance company's business expenses.
It refers to a figure that predicts the probability of future accidents based on insurance accident statistics that have occurred over a certain period of time in the past. In particular, certain probabilities such as death or disease of an individual at a certain point in time are predicted and applied to the calculation of insurance premiums, and generally, if the expected risk rate is high (low), insurance premium rises (becomes lower)
Some of the insurance premiums are set as business expenses in anticipation of various expenses required for insurance companies to sign, maintain, and manage insurance contracts. The term means the proportion of business expenses among insurance premiums.
4. Examples of Insurance Premiums by Coverage
- The example of the insurance premium below is based on the age of 28 for women at the time of subscription, 5 days for insurance, and a lump sum payment.
Type | Insurance Subscription Amount | Deduction Amount (It should be paid by the policyholder) | ||
Hospitalization | Outpatient | |||
Disability from Injuries | 10,000,000 KRW | None | ||
Coverage for Actual Medical Expenses | Injury Allowance | 10,000,000 KRW | 100,000 KRW | 20% |
Disease Allowance | 5,000,000 KRW | 50,000 KRW | 20% | |
Injury for Non-benefit | 10,000,000 KRW | 100,000 KRW | 30% | |
Disease for Non-benefit | 5,000,000 KRW | 50,000 KRW | 30% | |
Diagnosis of Burn Coverage | 100,000KRW | None | ||
Burn Surgery Coverage | 100,000 KRW | None | ||
Diagnosis of Fracture Coverage (Excluding broken teeth) | 300,000 KRW | None | ||
Fracture Surgery Coverage | 300,000 KRW | None | ||
Diagnosis of Five Major Fractures Coverage | 300,000 KRW | None | ||
5 Major Fractures Surgery Coverage | 500,000 KRW | None | ||
Cast Treatment Coverage | 100,000 KRW | None | ||
Daily Compensation for Hospitalization due to Food Poisoning | 10,000 KRW | None | ||
Daily Compensation for Hospitalization due to Traffic Injury | 10,000 KRW | None | ||
Violent Crimes (During daily activities) | 10,000,000 KRW | None | ||
Insurance Premiums | 15,840 KRW | |||
Note 1) When the deduction amount (20% of losses) (It should be paid by the policyholder) of outpatient treatment (Benefits covered by National health care system) is less than KRW 10,000 or KRW 20,000 (Which can be different from the grade of hospital ) then KRW 10,000(or 20,000) will be deducted. Note 2) When the deduction amount (30% of losses) (It should be paid by the policyholder) of outpatient treatment (Non-benefits) is less than KRW 30,000, then KRW 30,000 will be deducted.
5. Matters Concerning Refund from Cancellation
A. Standard to Calculate Refund from Cancellation
- If the policyholder cancels the insurance contract during the insurance period, the unexpired premium of this insurance will be paid as a cancellation refund.
B. Standard to Calculate Unexpired Premium
- In the case of reasons without the responsibility of the policyholder, the insured, or the beneficiary: the full amount of insurance premiums paid to the company in the case of invalidation, and the insurance premiums calculated for the period not elapsed in the case of cancellation.
- In the case of reasons with the responsibility of the policyholder, the insured, or the beneficiary: the balance after deducting the premium calculated at the short-term rate (the rate applied for a period of less than one month) for the already elapsed period. However, if the insurance became invalidated due to the intention or gross negligence of the policyholder, the insured, or the beneficiary, the insurance premium shall not be refunded.
6. Q&A
- Q: Is suicide, or self-harm compensated?
- A: In the event of payment of insurance money due to intentional action by the insured one, such as suicide or self-harm, insurance money shall not be provided. (However, if the insured one hurts him/herself while he/she is unable to make a free decision due to mental and physical loss, etc., insurance money will be paid.)
- Q: Who has the right to receive insurance money in the event of death?
- A: An insurance beneficiary designated by the policyholder. When an insurance beneficiary is not designated, the heir of the insured one shall be the insurance beneficiary.
- Q: Is it possible to apply for insurance by another person without the consent of the insured one?
- A: In the case of a contract covering the death of a person as the reason for insurance payment, the insured one's written consent is required until the contract is concluded.
- Q: Can I receive multiple compensations from each insurance if I have several insurances?
- A: There is a difference depending on the compensation method by risks. In the case of compensation with a fixed amount, each can be compensated separately, but compensation for actual expenses will become proportional to the compensation.
- Compensation with fixed amount: Coverage for death and disability, etc.
- Compensation for actual expenses: Coverage for actual medical expenses, liability for compensation, etc.
- Q: What is the compensation for the accident that occurred after a foreign tourist boarded an aircraft to leave the country after finishing a trip in Korea?
- A: The company will not compensate for the accident that occurred after boarding the aircraft to leave the country even if it is an accident that occurred during the insurance period.
- Q: Does it cover miscarriage due to a traffic accident that occurs during a trip in Korea?
- A: If you have miscarried as a result of a traffic accident, the company will cover it.
- Q: What is the compensation for death during the activities in a hang-gliding club?
- A: The company does not compensate for any damage caused during club activities. However, if you subscribe to cover the risk of the exercises above, the company will compensate you.
