Pengertian Manfaat. A. Pasien klinik rawat jalan yang berkonsul- tasi dengan dokter umum Merupakan penggantian biaya konsultasi, sampai dengan biaya harian maksimal untuk datang ke tempat praktek dokter umum, klinik, dan biaya dimana dokter datang ke tempat Tertanggung untuk mendapatkan perawatan, dengan ketentuan sehari satu kali konsultasi seperti yang tercantum dalam Uraian Manfaat. B. Pasien specialis rawat jalan Merupakan penggantian biaya yang ditentukan oleh dokter spesialis, sampai dengan biaya maksimal sehari, untuk mendapatkan perawatan, dengan biaya maksimal sehari satu kali konsultasi seperti yang tercantum dalam Uraian Manfaat. C. Pasien rawat jalan yang memerlukan diagnosa dengan Tes Laboratorium dan X-ray Merupakan penggantian biaya tes laborato- rium dan X-ray atas permintaan dari dokter spesialis atau umum untuk menegak- kan This supplementary cover is applicable only if it is shown in the Schedule or Certificate as “Covered”. This supplementary cover is attached to and forms part of this Policy - additional premium has been paid accordingly. This benefit is only applicable for treatment in Indonesia. The Company will reimburse the REASONABLE AND CUSTOMARY CHARGES incurred by an Insured Person as an out-patient for actual costs of medically necessary services provided by a general or specialist physician {except medically necessary treatment provided within twenty-four (24) hours following an Accident as these are reimbursed under the Emergency Out-Patient Benefit (Accidental only)}, provided that the maximum liability of the Company shall not exceed the limits applicable for such services which are shown in the Schedule of the Policy. 1. Description of Benefits : A. Out-Patient Clinical Consultation with a General Practitioner Reimburses consultation charges, up to the daily maximum for a visit to a physician’s room, clinic and the charges for a visit by a General physician to the residence of the Insured Person to have treatment, subject to a maximum of one consultation per day as mentioned in the Schedule Benefit. B. Out-Patient Specialist Consultation Reimburses the fees charged by a Specialist up to the daily maximum for the treatment of a covered disability, subject to a maximum of one consultation per day as mentioned in the Schedule Benefit. C.
