來華留學(xué)生綜合醫(yī)療保險(xiǎn)

1、來華留學(xué)生綜合醫(yī)療保險(xiǎn)ComprehensiveMedicalInsurancePlanofForeignStudentsinChina留學(xué)生綜合保障計(jì)劃簡介BriefIntroductiontotheComprehensiveInsurancePlanofForeignStudents保險(xiǎn)責(zé)任InSuranceLiabilitieS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ThiScompanyShallundertaktheetheperiodofinSurance身故保險(xiǎn)責(zé)任：被保險(xiǎn)人因意外傷害事故或疾病險(xiǎn)金，保險(xiǎn)責(zé)任終止。ollowinignsancleiabilitiesdingA死

2、亡，本公司按約定保險(xiǎn)金額給付保OSSoThiScompenSation(including殘疾保險(xiǎn)責(zé)任:companyitheAiShallnSInSaytheStieddieSanceulatedamountofinSofanyaccidentalinanceyordiSeaSe被保險(xiǎn)人因遭受意外傷害事故，并自遭受意外傷害之日起一百八十日內(nèi)導(dǎo)致殘疾，本公司按照平安意外殘疾附加責(zé)任條款所附“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。1.2DiSabilityInSuranceanIftheInSurSeudffefrrSoamnyaccidentalinjurwyhichre

3、SultSinanydiSabilitywithin18d0aySSincetheoccurrenocfetheaccidentalinjury,thiScompanyShallbeliablefortheagreedamountofinSurmultiplyintgheproportSitoinpulateidntheProportiTonablbeetweetnheDegreeofDiSabilaintdythePaymentattachedtoPingAnSAdditionalLiabilityClauSeforAccidentalDiSability.被保險(xiǎn)人不論一次或多次發(fā)生意外傷害

4、保險(xiǎn)事故，本公司均按規(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。ThiScompanyShallreSpectivelypaytheinSurancecompenSationforaccidentaldiSabilityinaccordancewiththeStipulationnSomattertheInSurSeudffefrrSoamccidentalinjurfyoronceorSeveratlimeS,howevertheaccumulativepaymentheretoShallnotexceedtheStipulatedamountofinSurance.

5、被保險(xiǎn)人自意外傷害事故發(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，本公司只給付約定保險(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，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。IftheInSurdeideSoftheSamereaSonwithin18d0aySSincetheoccurrenceofaccidentalinjurwyhichreSultiSnanydiSability,thiScompanyShalleliableonlyforthedifferencebetweentheStipulatedamounto意外傷害醫(yī)療保險(xiǎn)責(zé)任：被保險(xiǎn)人因遭受

6、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。住院醫(yī)療保險(xiǎn)責(zé)任：被保險(xiǎn)人因意外傷害事故或因疾病含，經(jīng)醫(yī)院診斷必須住院治療，本公司就其實(shí)際支出的護(hù)理費(fèi)（限額10元0/天）、床位費(fèi)（限額10元0/天）、手術(shù)費(fèi)、藥費(fèi)、治療費(fèi)、化驗(yàn)費(fèi)、放射費(fèi)、檢查費(fèi)等合理醫(yī)療費(fèi)用，按10給0%付“住院醫(yī)療保險(xiǎn)金”，累計(jì)給付金額以約定的保險(xiǎn)金額為限。5團(tuán)體高額醫(yī)療費(fèi)用保險(xiǎn)責(zé)任：被保險(xiǎn)人因疾病含或意外傷害住院治療而導(dǎo)致的在保險(xiǎn)期間發(fā)生的合理且必要的醫(yī)療費(fèi)用以及在保險(xiǎn)期間內(nèi)發(fā)生并延續(xù)至保險(xiǎn)合同到期日后一個(gè)月內(nèi)的合理且

7、必要的住院醫(yī)療費(fèi)用（包括床位費(fèi)（限額10元0/天）、藥費(fèi)治療費(fèi)、護(hù)理費(fèi)、護(hù)工費(fèi)（限額10元0/天）、檢查檢驗(yàn)費(fèi)、特殊檢查治療費(fèi)、救護(hù)車費(fèi)和手術(shù)費(fèi)），在累計(jì)超過起付線（人民幣6萬元）時(shí)，本公司對起付線以上至封頂線（人民幣萬元）的部分按給付住院醫(yī)療保險(xiǎn)金。butlimitedtoRMB400,000Yuan.注：以上所有醫(yī)療機(jī)構(gòu)僅限于中華人民共和國大陸境內(nèi)的公立醫(yī)院。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:Alltheforegoingmedicalorganizationsshallbelimitedtothepublichospi

8、talsestablishedwithintheboardofthePeoplesRepublicofChina;Thescopeofmedicaltreatmentexpensesshallbelimitedtotheitemsandexpenseswhichcanbereimbursedinaccordancewiththelocalregulationsonsocialbasicmedicalinsurance.HowevetrheexpensesfortheB-classmedicineshallbepaidbythemselves.責(zé)任免除LiabilityExemption身故及殘

9、疾責(zé)任免除LiabilityExemptionforLossofLifeandDisability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：ThiscompanyshallbeexemptefdromtheinsuranceliabilitiesforthelossoflifeanddisabilityoftheInsuredforanyofthefollowingcircumstances: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、

10、戰(zhàn)爭、軍事行動(dòng)、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(dòng)及高危競技類活動(dòng)。發(fā)生上述情形，被保險(xiǎn)人身故的，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)。anyintentionalactoftheapplicantforinsuranceorthebeneficiarcriminalact,addictiontonarcotic,fighting,drunkennessself-injuryorsuicideoftheinsured;drivingwhileintoxicatedordrivingwithoutlicenseofth

11、einsured;pregnancy,miscarriageorchildbirthoftheinsured;AIDSorotherVDoftheinsured;War,militaryaction,civilrebellionorarmedrevolt;Nuclearexplosion,radiationorpollution;High-srpiosrktsandathleticactivitiesbytheprofessionals;IfanyoftheforegoingcircumstanceshappensresultinginthedeathoftheInsured,thiscomp

12、anyshallendtheinsuranceliabilitiesandreturntheimmatureinsurancepremiumafterthedeductionofthecommission.醫(yī)療責(zé)任（意外傷害醫(yī)療、住院醫(yī)療、高額醫(yī)療費(fèi)用）免除LiabilityExemptionforMedicalTreatment（accidentalinjurymedicaltreatment,hospitalizationmedicaltreatmentandmajomredicalexpenses因下列情形之一造成被保險(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：Thiscompanys

13、hallbeexemptefdromtheinsuranceliabilitiesforanyofthefollowingcircumstances: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(dòng)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)人支出的掛號費(fèi)、膳食費(fèi)、陪住費(fèi)、取暖費(fèi)、交通費(fèi)等；八、當(dāng)?shù)厣鐣踞t(yī)療保險(xiǎn)或公費(fèi)醫(yī)療管理部門規(guī)定的自費(fèi)項(xiàng)目和藥品；九、被保險(xiǎn)人未遵醫(yī)囑，

14、私自服用、涂用、注射藥物；十、戰(zhàn)爭、軍事行動(dòng)、暴亂或武裝叛亂；十一、核爆炸、核輻射或核污染。十二、首次投保前的既往癥、精神疾病、艾滋病、性病、先天性或遺傳性疾病及其并發(fā)癥；十三、在中國大陸地區(qū)以外發(fā)生的醫(yī)療費(fèi)用。1.intentionaklillingorinthebeneficiary;uretheinsuredbytheapplicantor4.drivingwhileintoxicatedorwithoutlicenseordriving2.criminalactorarrestresistance,suicideorintentionalself-injuryoftheinsured;

15、3.fightindgru,nkenness,drugtakinga,ddictionorinjectionoftheinsured;otor-drivenvehiclewithoutvaliddrivinedicalaccidentoccurreddurincertificateoftheinsured;thecosmeticoperationorotherphysicianorsurgeryoperationsoftheinsured;theexpensesfororthopaedic,cosmeticoperationorrehabilitatingtreatmentoftheinsur

16、ed;registrationfee,expensesforboard,accompanyingaccommodation,heatingandtrafficoftheinsured;itemsanddrugsatprivateexpensestipulatedbythelocaldepartmentsinchargeofthesocialbasicmedicalinsuranceormedicaltreatmentonpublicexpense;taking,coatingorinjectingdrugsnotinconformitywithdoctorsadvice;war,militar

17、yact,rebellionorarmedrevolt;nuclearexplosion,radiationorpollution;previousdisease,mentaldisease,AIDS,VD,congenitalorhereditarydiseaseandthecomplicationsbeforethefirstapplicationforinsurance;13.medicaltreatmentexpensesoccurredoutoftheboardofthePeoplesRepublicofChina;注：未盡事宜以學(xué)生平安一年定期保險(xiǎn)條款、平安意外殘疾附加責(zé)任條款、平安附加學(xué)生意外傷害醫(yī)療保險(xiǎn)條款、平安附加學(xué)生幼兒住院醫(yī)療條款團(tuán)體咼額醫(yī)療費(fèi)用保險(xiǎn)()款的規(guī)定為準(zhǔn)。oteothermattersthatarenotstipulatedinthisplanshallbegoernedbythePingAnsOne-YearFixedInsuranceClausefortheSt