Type of Insurance: Coronavirus (2019 nCoV), Group Health Insurance, by Southeast Insurance Public Company Limited

Policy No. 35230865-21NBK
Terms of Coverage

  • Coverage for Coronavirus Disease 2019 (COVID-19) infection: 50,000THB/Year (First infection)
  • Coverage for Loss of Life, Dismemberment, Loss of Sight, or Total Permanent Disability (P.A. 1): 5,000 THB/Year (Any acts of the Insured while under the influence of alcohol or addictive drugs, suicide attempts, infected by pathogen, miscarriage, diarrhea, engaging in brawl, terrorism, etc. are not covered by the insurance)
  • The insured students will be covered to March 24, 2022.

Remarks : Benefits, coverage and exclusions shall be in accordance with the conditions stated in the insurance policy for Coronavirus (2019-nCoV) Infection of the insurance company, Southeast Insurance Public Company Limited.

Claims reimbursement for Infection due to COVID-19 (First Infected Only)
Claims reimbursement
The insured or the beneficiary must submit following for claim reimbursement as soon as possible or within 30 days after being Infected due to COVID-19 (First Infected Only)

  1. Completed Claim Form
  2. Medical Report or Medical Certificate which specifies cause, treatment period
  3. Laboratory test results
  4. Copy of Insured’s National ID Card or Passport
  5. Copy of Bank Book (Saving Account)
  6. Other documents requested by the insurance company (if any)

Claims reimbursement for Loss of Life, Dismemberment, Loss of Sight or Total Permanent Disability (PA.1)
Claims reimbursement for Loss of Life
The beneficiary must submit following documents as soon as possible or within 30 days in case of loss of life.

  1. Completed Claim Form
  2. Medical Report or Medical Certificate which specifies cause, treatment period.
  3. Certified true copy of Death Certificate issued by District
  4. Certified true copy of Death Certificate issued by the hospital, in case of being hospitalized before passing away) and all related medical history
  5. Certified true copy of Death Certificate issued by Royal Thai Police, in case of death at accident scene
  6. Certified true copy of Autopsy Report from the local police station where the accident occurred
  7. Certified true copy of Police Report from the local police station where the accident occurred and the Investigation Report
  8. Certified true copy of Passport of the Insured
  9. Certified true copy of Work Permit for foreign worker
  10. Certified true copy of Insurance Certificate
  11. Certified true copy of Passport or ID card of the Beneficiary
  12. Certified true copy of Bank Book of the Beneficiary
  13. Other additional documentation is depending on the loss circumstances and necessity

Claims reimbursement for Dismemberment, Loss of Sight or Total Permanent Disability
The insured or the beneficiary must submit following documents as soon as possible or within 30 days in case of Dismemberment, Loss of Sight or Total Permanent Disability.

  1. Completed Claim Form
  2. Medical Report or Medical Certificate which specifies cause, treatment period.
  3. Medical Certificate confirming the injury, dismemberment, or Total Permanent Disability
  4. Certified true copy of Police Report from the local police station where the accident occurred and the Investigation Report
  5. Certified true copy of Passport of the Insured
  6. Certified true copy of Work Permit for foreign worker
  7. Certified true copy of Insurance Certificate
  8. Other additional documentation is depending on the loss circumstances and necessity

**Download form

Send all required documents by mail to:

Miss Supunnee Suksunwachirakul

Student Affairs Office

King Mongkut’s University of Technology Thonburi

126 Pracha Uthit Rd., Bang Mod, Thrung Khru, Bangkok, 10140 Thailand