Health Insurance Product from Panin Dai-ichi Life in Indonesian RupiahMEDICA is an insurance product with hospital income family benefit and life cover (due to sickness and accident). This product return 100% premium paid plus underwriting surplus (if available) at the end of tenth year (if available).FEATURE100% return of premium, without claim(s) consideration Fast & easy process. Applicants will only need to fill out health questionnaires 24 Hours worldwide, hospital of your choice Cover all diseases according to the policy. Double claim benefit. Sum assured is still payable in addition to health benefit from employer and/or other insurance policy.Protection for 10-year periodBENEFIT Hospital Income Family benefit which terms and conditions as below: Daily hospitalization income benefits up to IDR 2 Mio and maximum benefit 90 days/ year. Unit cost is IDR 200 thou. ICU/ ICCU benefit up to IDR 4 Mio and maximum benefit 45 days/ year. Life cover positioned as condolences benefit due to sickness and/or accident. Waiver of Premium due to Total Permanent Disability (TPD). Policy holder premium is waived up to maturity in addition to other insurance benefitENTRYAGE(YEARS)BENEFIT OPTIIONS (Choose One)Information1 Unit 3 Units5 Units 10 Units A: Rp 200,000/dayA: Rp 600,000/dayA: Rp 1,000,000/dayA: Rp 2,000,000/dayA. Compansation for hospitalization max 90 days/yrsB: Rp 400,000/dayB: Rp 1,200,000/dayB: Rp 2,000,000/dayB: Rp 4,000,000/dayB. Compansation for ICU hospitalization max 45 days/yrsC: Rp 10,000,000C: Rp 30,000,000C: Rp 50,000,000C: Rp 100,000,000C. Compansation for funernal due to accident D: Rp 20,000,000 D: Rp 60,000,000 D: Rp 100,000,000 D: Rp 200,000,000 D. Compansation for death due to accident ANNUAL PREMIUM 18 - 40 Rp 2,400,000 Rp 7,200,000 Rp 12,000,000 Rp 24,000,000 • Premium amount is based on entry age and will not changein insurance period • For decision there arechoices from 1 unit to 10 units 41 - 50 Rp 3,600,000 Rp 10,800,000 Rp 18,000,000 Rp 36,000,000 51 - 55Rp 4,800,000Rp 14,400,000Rp 24,000,000Rp 48,000,000RISIKO Legal Risk Risk due to changes on regulations related to the insurance.Company Risk Risks arising if the company is liquidated.REQUIREMENTS & PROCEDURES Policy Holder Age 21 – 55 Years (Last Birthday)Have Commonwealth Bank AccountFill out Application FormCopy Customers IdentificationOther Supporting DocumentsFEE AND CHARGES Policy Cancelation Fee Policy cancelation fee is free look at the moment. Fee charged is only for policy printing or IDR 100.000Surrender Fee 100% from total premium paid on T ≤ 1, 95% from total premium paid on 1 < T ≤ 2, 85% from total premium paid on 2 < T ≤ 5, 50% from total premium paid on 5 < T ≤ 8, 25% from total premium paid on 8 < T < 10 DISCLAIMERThis insurance product issued by PT Panin Dai-ichi Life and distributed/ marketed by PT. Bank Commonwealth (Commonwealth Bank) to its customer. This product is not issued by Commonwealth Bank consequently Commonwealth Bank doesn’t responsible for any obligation and doesn’t provide any assurance of this Insurance Product. This Insurance Product is not included in Deposit Guarantee Program of Government of Republic Indonesia (LPS). Commonwealth Bank also not undertakes for any risk of the Insurance Policy issued by PT Panin Dai-ichi Life in related to the Insurance Product. The Commonwealth Bank’s logo usage is entirely for cooperation reason between Commonwealth Bank and Panin Life in regard to the marketing process of the Insurance Product. Commonwealth Bank is not an agent of PT Panin Dai-ichi Life or a broker of Commonwealth Bank customers. The fund placed will not be included in and / or not will be secured by a deposit guarantee program by LPS.Call CommBank can be accessed through 1500030 or (6221) 2935 2935 for international access. We serve customer 24 hours a day 7 days a week (including public holiday).