平安養(yǎng)老保險(xiǎn)股份有限公司來華人員綜合保險(xiǎn)保障計(jì)劃簡介

1、平安養(yǎng)老保險(xiǎn)股份有限公司來華人員綜合保險(xiǎn)保障計(jì)劃簡介Brief In troduct ion to Pi ng An Annu ity In sura nee Compa ny, Ltd.Comprehe nsivel nsura nce& Protect ion Schemefor Foreig nersstayi ng in Chi na保險(xiǎn)責(zé)任In sura nee coverage在保險(xiǎn)責(zé)任有效期內(nèi)，本公司承擔(dān)下列保險(xiǎn)責(zé)任：Ping An shall un dertake the follow ing in sura nee liabilities duri ng the pe

2、riod of in sura nee:1、身故保險(xiǎn)責(zé)任：被保險(xiǎn)人因意外傷害事故或疾?。ê琒ARS）死亡，本公司按約定保險(xiǎn)金額給付保險(xiǎn)金，保險(xiǎn)責(zé)任終止。1. Death In sura nee: Ping An shall pay the stipulated amount of in sura nee compe nsati on if the In sured dies of any accide ntal injury or disease （in cludi ng SARS）. In sura nee liabilities thus termi nate.2、殘疾保險(xiǎn)責(zé)任：被保險(xiǎn)人因

3、遭受意外傷害保險(xiǎn)事故，并自遭受意外傷害之日起一百八十日內(nèi)導(dǎo)致殘疾，乙方按照平安養(yǎng)老保險(xiǎn)股份有限公司殘疾程度與給付比例表”的規(guī)定比例乘以約定保險(xiǎn)金額給付保險(xiǎn)金。如第一百八十日治療仍未結(jié)束，則按第一百八十日的 身體情況進(jìn)行殘疾鑒定，并據(jù)殘疾程度與給付比例表”給付意外殘疾保險(xiǎn)金”2. Disability In sura nee: If the In sured suffers from any accide ntal injury which results in any disability with in 180 days s ince the occurre nee of the accid

4、e ntal injury, The sum in sured shall be paid by Party B in the amount of agreed i nsured sum specified in the in sura nee policy multiply by certa in proporti on stated in the Disability Degree and Payme nt Proporti on Table of Pi ng An Annuity In sura nee Compa ny, Ltd. If the treatme nt is not fi

5、ni shed on the 180th days, disability iden tificati on shall be con ducted on the basisof the In sured "physical con diti on on the 180th day, an d the In sura nee for Accide ntal Disability shall be paid in accorda nee with the Disability Degree and the Payment Proportion Table .被保險(xiǎn)人因同一意外傷害事故造

6、成殘疾程度與給付比例表”所列殘疾程度兩項(xiàng)以上者，保險(xiǎn)人給付各對應(yīng)項(xiàng)殘疾保險(xiǎn)金之和。但不同殘疾項(xiàng)目屬于同一手或同一足時(shí)，僅給付一 項(xiàng)殘疾保險(xiǎn)金；若殘疾項(xiàng)目所屬殘疾等級不同時(shí)，給付較嚴(yán)重項(xiàng)目的殘疾保險(xiǎn)金。If the same accidental injury results in two or more disabilities listed in the Disability Degree and Payme nt Proport ion Table to the In sured, the In surer shall pay the sum in sured to the sum of

7、the amount to each corresponding disability. However, however if different disabilities take place to the same arm or leg, only one disability insured amount shall be paid;If the disabilities fall into different disability degrees, the disability insured amount for the more serious disability shall

8、be paid.該次意外傷害事故導(dǎo)致的殘疾合并前次殘疾可領(lǐng)較嚴(yán)重項(xiàng)目殘疾保險(xiǎn)金者，按較嚴(yán)重 項(xiàng)目標(biāo)準(zhǔn)給付，但前次已給付的殘疾保險(xiǎn)金（投保前已患或因責(zé)任免除事項(xiàng)所致殘疾程度與給付比例表”所列的殘疾視為已給付殘疾保險(xiǎn)金）應(yīng)予以扣除。If with the disability resulted from this accidental injury and the previous disability taken together, the In sured could draw the in sura nee for the more serious disability, the in su

9、ra nee shall be paid in accorda nee with the sta ndardfor the more serious disability, but the disability in sura nee which has previously bee n paid (the disabilities took place before buying in sura nee or the disabilities listed in the Proportion Table between the Degree of Disability and the Pay

10、ment which were resulted from exceptions shall be treated as being compensatedalready)shall be deducted.被保險(xiǎn)人不論一次或多次發(fā)生意外傷害保險(xiǎn)事故，乙方均按規(guī)定分別給付意外殘疾保 險(xiǎn)金，但累計(jì)給付金額以不超過約定保險(xiǎn)金額為限。Party B shall respectively pay the in sura nee compe nsati on for accide ntal disability in accordance with the policy, no matter the I

11、nsured suffers from accidental injury for once or several times, however the accumulative payment hereto shall not exceed the stipulated sum in sured.每一被保險(xiǎn)人的意外殘疾、意外身故保險(xiǎn)金的累計(jì)給付金額以其對應(yīng)的意外傷害保險(xiǎn) 金額為限。The accumulative amount of in sura nce for accide ntal disability or death of each in sured shall not excee

12、d the in sured sum set for the corresp onding accide ntal injury.被保險(xiǎn)人自意外傷害保險(xiǎn)事故發(fā)生并導(dǎo)致殘疾之日起一百八十日內(nèi)由于同一原因死亡， 乙方只給付約定意外身故保險(xiǎn)金額與意外殘疾保險(xiǎn)金的差額；超過一百八十日死亡，不論 是否同一原因所致，乙方按約定意外身故保險(xiǎn)金額給付保險(xiǎn)金，保險(xiǎn)責(zé)任終止。If the In sured dies of the same reas on with in 180 days since the occurre nce of accide ntal injury which results in an

13、y disability, Party B shall be liable only for the difference between the stipulated insured amount for accidental death and for accidental disability; if the Insured dies after 180 days, Party B shall pay the stipulated insured amount for accidental death no matter if the death is causedby the same

14、 reas on .,a nd the in sura nce liability shall be term in ated.3、意外傷害醫(yī)療保險(xiǎn)責(zé)任：3. Accide ntal Injury Medical Treatme nt In sura nce Liability被保險(xiǎn)人因遭受意外傷害事故，并自事故發(fā)生之日起一百八十日內(nèi)進(jìn)行治療，本公司 就其實(shí)際支出的合理醫(yī)療費(fèi)用按100%給付意外傷害醫(yī)療保險(xiǎn)金，累計(jì)給付金額以約定的保險(xiǎn)金額為限。被保險(xiǎn)人不論一次或多次發(fā)生意外傷害保險(xiǎn)事故，保險(xiǎn)人均按上述規(guī)定分別 給付意外傷害醫(yī)療保險(xiǎn)金”但累計(jì)給付金額以不超過該被保險(xiǎn)人的保險(xiǎn)金額為限，累計(jì) 給付金

15、額達(dá)到其保險(xiǎn)金額時(shí)，對該被保險(xiǎn)人的該項(xiàng)保險(xiǎn)責(zé)任終止。If the In sured receives any medical treatme nt with in 180 days since the occurre nce of the accide ntal injury, the in surer shall be liable for the full amount of the actual and reas on able expensesfor medical treatment; however the accumulative payment shall not exceed

16、 the stipulated in sured sum.No matter the In sured suffered from accide ntal injury on ce or man y times, the In surer shall respectively pay for the Accidental Injury Medical Treatment in accordance with the foresaid provisions, but the accumulative amount of payment shall not exceed the Insured a

17、mount, where the accumulative amount of payme nt amounts to the in sured 'n sured sum, the said in sura nce liability for the said In sured shall be term in ated.4、住院醫(yī)療保險(xiǎn)責(zé)任:4. Hospitalizati on Medical Treatme nt In sura nce Liability被保險(xiǎn)人因意外傷害事故或于保單生效日后因疾病(含SARS)，經(jīng)醫(yī)院診斷必須住院治療(門診手術(shù)及醫(yī)院無床位原因的觀察室治療視同住

18、院醫(yī)療)，乙方就其實(shí)際支出的護(hù)工費(fèi)(限額100元/天，累計(jì)30天)、救護(hù)車費(fèi)、建病歷費(fèi)、取暖費(fèi)、空調(diào)費(fèi)、床位費(fèi)(限額 300 元/天)、檢查檢驗(yàn)費(fèi)、特殊檢查治療費(fèi)、手術(shù)費(fèi)、藥費(fèi)、治療費(fèi)、化驗(yàn)費(fèi)、放射費(fèi)等合理 醫(yī)療費(fèi)用，按100%給付住院醫(yī)療保險(xiǎn)金”。f the hospitalization is diagnosed to be necessaryof the insured due to any accidental injury, or for any disease (in cludi ng SARS) after the day of in sura nee policy become

19、 effective (Ambulatory Surgery andobservation room treatment due to no bed available shall be treated as hospitalizati on medical treatme nt), Party B shall be liable for the actual and reas on able expe nses for medical treatment including nursing fee (limited to RMB100 Yuan per day for accumulativ

20、e 30 days), ambulanee fee, medical record fee, heating fee, air conditioner fee, bed fee (limited to RMB300 Yuan per day), expe nses for docimasia, special exam in ati on an d treatme nt, operati on, medic ine, treatme nt, laboratory test, radiati on and etc., and shall pay 100% of the costs of hosp

21、italization medical treatment.被保險(xiǎn)人發(fā)生保險(xiǎn)責(zé)任范圍內(nèi)的住院治療，其因同一病因發(fā)生的院前、院后門急診醫(yī) 療費(fèi)用可以按住院醫(yī)療費(fèi)用賠付標(biāo)準(zhǔn)予以賠付。If hospitalizatio n treatme nt which is with in the scope o fin sura nee liability is n ecessaryto the insured , the outpatient and emergency treatment fee before and after hospitalization arise from the same di

22、sease shall be paid in accordanee with the payment standard of hospitalization medical treatme nt.被保險(xiǎn)人不論一次或多次住院治療，本公司均在規(guī)定限額內(nèi)給付保險(xiǎn)金，分項(xiàng)累計(jì)給 付金額達(dá)到其保險(xiǎn)金額時(shí)，該項(xiàng)保險(xiǎn)責(zé)任終止。In surer shall pay the costs of hospitalizati on without reference to the nu mber of times withi n the regulated limits, however in sura nee li

23、ability shall be termi nated once the accumulative payments reached the sum insured.被保險(xiǎn)人在本次投保前發(fā)生重大疾病或慢性病的，保險(xiǎn)人不承擔(dān)給付保險(xiǎn)金的責(zé)任。If the I nsured suffered from critical ill ness or chro nic disease before buying this in sura nee, the In surer shall be released from its liability to make payme nts注：1)以上所有醫(yī)療機(jī)構(gòu)

24、僅限于中華人民共和國大陸境內(nèi)的公立醫(yī)院。2)醫(yī)療費(fèi)用范圍只限于符合當(dāng)?shù)厣鐣踞t(yī)療保險(xiǎn)規(guī)定報(bào)銷范圍的項(xiàng)目和費(fèi)用， 但承擔(dān)乙類藥品的自負(fù)費(fèi)用。Note: 1)All the foregoing medical organizations shall be limited to the public hospitals established with in the board of the People "Republic of China;2)The scope of medical treatment expensesshall be limited to the items an

25、d expenses which can be reimbursed in accordanee with the local regulations on social basic medical in sura nee. However the expe nses for the B-class medic ine shall be paid by in sured.責(zé)任免除Liability Exemption身故及殘疾責(zé)任免除Liability Exemption for Death and Disability因下列情形之一，造成被保險(xiǎn)人身故、殘疾的，本公司不負(fù)給付保險(xiǎn)金責(zé)任：Thi

26、s corporate shall be exempted from the in sura nee liabilities for the death and disability of the Insured for any of the following eireumstances:一、投保人或受益人的故意行為；二、被保險(xiǎn)人犯罪、吸毒、毆斗、酒醉、自殘或自殺；三、被保險(xiǎn)人酒后駕駛或無照駕駛；四、被保險(xiǎn)人懷孕、流產(chǎn)或分娩；五、被保險(xiǎn)人患有愛滋病或其它性病。六、戰(zhàn)爭、軍事行動、內(nèi)亂或武裝叛亂；七、核爆炸、核輻射或核污染；八、專業(yè)人員參與的高風(fēng)險(xiǎn)運(yùn)動及高危競技類活動。發(fā)生上述情形，被保險(xiǎn)人身

27、故的，本公司對該被保險(xiǎn)人保險(xiǎn)責(zé)任終止，并在扣除手續(xù) 費(fèi)后退還該被保險(xiǎn)人的未滿期保險(xiǎn)費(fèi)。1. any inten ti onal act of the appliea nt for in sura nee or the ben efieiary;2. eriminal aet, addietion to nareotie, fighting, drunkenness, self-injury or suieide of the in sured;3. driving while intoxieated or driving without lieense;4. pregnancy, misear

28、riage or ehildbirth of the insured;5. AIDS or other VD of the insured;6. War, military action, civil rebellion or armed revolt;7. Nuclear explosi on, radiati on or polluti on;8. High-risk sports a nd athletic activities by the professi on als;If any of the foregoing eireumstances happens resulting i

29、n the death of the Insured, the in surer shall end the in sura nee liabilities and return the unearned premium after thededueti on of the commissi on charge.醫(yī)療責(zé)任(意外傷害醫(yī)療、住院醫(yī)療)免除Liability Exemption for Medical Treatment (accidental injury medical treatment and hospitalization medical treatment)因下列情形之一

30、造成被保險(xiǎn)人支出的醫(yī)療費(fèi)用，本公司不負(fù)給付保險(xiǎn)金責(zé)任：The in surer shall be exempted from the in sura nee liabilities for any of the followi ng eireumsta nces:一、投保人、受益人對被保險(xiǎn)人故意殺害、傷害；二、被保險(xiǎn)人故意犯罪或拒捕、自殺或故意自傷；三、被保險(xiǎn)人毆斗、醉酒，服用、吸食或注射毒品；四、被保險(xiǎn)人酒后駕駛、無照駕駛及駕駛無有效行駛證的機(jī)動交通工具；五、被保險(xiǎn)人因整容手術(shù)或其他內(nèi)、外科手術(shù)導(dǎo)致醫(yī)療事故；六、被保險(xiǎn)人因矯形、整容或康復(fù)性治療等所支出的費(fèi)用；七、被保險(xiǎn)人支出膳食費(fèi)、電話費(fèi)等

31、；八、被保險(xiǎn)人未遵醫(yī)囑，私自服用、涂用、注射藥物；九、戰(zhàn)爭、軍事行動、暴亂或武裝叛亂；十、核爆炸、核輻射或核污染。十一、在中國大陸地區(qū)以外發(fā)生的醫(yī)療費(fèi)用。十二、被保險(xiǎn)人懷孕、流產(chǎn)或分娩；十三、普通疾病門診醫(yī)療費(fèi)用。1. intentional killing or injure the insured by the applicant or the beneficiary;2. crim inal actor arrest resista nee, suicide or inten tio nal self-injury of the in sured;3. fighti ng, drunke

32、nn ess,drug tak ing, addict ion or injecti on of the in sured;4. driving while intoxicated or without license or driving motor-driven vehicle without valid driving certificate of the insured;5. medical accident occurred during the cosmetic operation or other physician or surgery operations of the in

33、sured;6. the expensesfor orthopaedic, cosmetic operation or rehabilitating treatment of the insured;7. the expe nsesfood and teleph one of the in sured;8. tak ing, coati ng or injecti ng drugs not in con formity with doctor 'dvice;9. war, military act, rebellion or armed revolt;10. n uclear expl

34、osi on, radiati on or polluti on;11. the medical expensesoccurred from out of the board of the People 'Rvpublic of China;12. pregnancy, miscarriage or childbirth of the insured;13. out-patie nt treatme nt expe nsesof com mon disease.保險(xiǎn)費(fèi)In sura nee Premium保障責(zé)任保險(xiǎn)金 額（元）RMB6 69 歲（留學(xué)生）6 45 歲（外籍專家及外教）46 69 歲（外籍專家