平安养老保险股份有限公司来华人员综合保险保障计划简介

1、平安养老保险股份有限公司来华人员综合保险保障计划简介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保险责任In sura nee coverage在保险责任有效期内，本公司承担下列保险责任：Ping An shall un dertake the follow ing in sura nee liabilities duri ng the pe

2、riod of in sura nee:1、身故保险责任：被保险人因意外伤害事故或疾病（含SARS）死亡，本公司按约定保险金额给付保险金，保险责任终止。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、残疾保险责任：被保险人因

3、遭受意外伤害保险事故，并自遭受意外伤害之日起一百八十日内导致残疾，乙方按照平安养老保险股份有限公司残疾程度与给付比例表”的规定比例乘以约定保险金额给付保险金。如第一百八十日治疗仍未结束，则按第一百八十日的 身体情况进行残疾鉴定，并据残疾程度与给付比例表”给付意外残疾保险金”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 .被保险人因同一意外伤害事故造

6、成残疾程度与给付比例表”所列残疾程度两项以上者，保险人给付各对应项残疾保险金之和。但不同残疾项目属于同一手或同一足时，仅给付一 项残疾保险金；若残疾项目所属残疾等级不同时，给付较严重项目的残疾保险金。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.该次意外伤害事故导致的残疾合并前次残疾可领较严重项目残疾保险金者，按较严重 项目标准给付，但前次已给付的残疾保险金（投保前已患或因责任免除事项所致残疾程度与给付比例表”所列的残疾视为已给付残疾保险金）应予以扣除。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.被保险人不论一次或多次发生意外伤害保险事故，乙方均按规定分别给付意外残疾保 险金，但累计给付金额以不超过约定保险金额为限。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.每一被保险人的意外残疾、意外身故保险金的累计给付金额以其对应的意外伤害保险 金额为限。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.被保险人自意外伤害保险事故发生并导致残疾之日起一百八十日内由于同一原因死亡， 乙方只给付约定意外身故保险金额与意外残疾保险金的差额；超过一百八十日死亡，不论 是否同一原因所致，乙方按约定意外身故保险金额给付保险金，保险责任终止。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、意外伤害医疗保险责任：3. Accide ntal Injury Medical Treatme nt In sura nce Liability被保险人因遭受意外伤害事故，并自事故发生之日起一百八十日内进行治疗，本公司 就其实际支出的合理医疗费用按100%给付意外伤害医疗保险金，累计给付金额以约定的保险金额为限。被保险人不论一次或多次发生意外伤害保险事故，保险人均按上述规定分别 给付意外伤害医疗保险金”但累计给付金额以不超过该被保险人的保险金额为限，累计 给付金

15、额达到其保险金额时，对该被保险人的该项保险责任终止。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、住院医疗保险责任:4. Hospitalizati on Medical Treatme nt In sura nce Liability被保险人因意外伤害事故或于保单生效日后因疾病(含SARS)，经医院诊断必须住院治疗(门诊手术及医院无床位原因的观察室治疗视同住

18、院医疗)，乙方就其实际支出的护工费(限额100元/天，累计30天)、救护车费、建病历费、取暖费、空调费、床位费(限额 300 元/天)、检查检验费、特殊检查治疗费、手术费、药费、治疗费、化验费、放射费等合理 医疗费用，按100%给付住院医疗保险金”。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.被保险人发生保险责任范围内的住院治疗，其因同一病因发生的院前、院后门急诊医 疗费用可以按住院医疗费用赔付标准予以赔付。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.被保险人不论一次或多次住院治疗，本公司均在规定限额内给付保险金，分项累计给 付金额达到其保险金额时，该项保险责任终止。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.被保险人在本次投保前发生重大疾病或慢性病的，保险人不承担给付保险金的责任。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)以上所有医疗机构

24、仅限于中华人民共和国大陆境内的公立医院。2)医疗费用范围只限于符合当地社会基本医疗保险规定报销范围的项目和费用， 但承担乙类药品的自负费用。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.责任免除Liability Exemption身故及残疾责任免除Liability Exemption for Death and Disability因下列情形之一，造成被保险人身故、残疾的，本公司不负给付保险金责任：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为；二、被保险人犯罪、吸毒、殴斗、酒醉、自残或自杀；三、被保险人酒后驾驶或无照驾驶；四、被保险人怀孕、流产或分娩；五、被保险人患有爱滋病或其它性病。六、战争、军事行动、内乱或武装叛乱；七、核爆炸、核辐射或核污染；八、专业人员参与的高风险运动及高危竞技类活动。发生上述情形，被保险人身

27、故的，本公司对该被保险人保险责任终止，并在扣除手续 费后退还该被保险人的未满期保险费。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.医疗责任(意外伤害医疗、住院医疗)免除Liability Exemption for Medical Treatment (accidental injury medical treatment and hospitalization medical treatment)因下列情形之一

30、造成被保险人支出的医疗费用，本公司不负给付保险金责任：The in surer shall be exempted from the in sura nee liabilities for any of the followi ng eireumsta nces:一、投保人、受益人对被保险人故意杀害、伤害；二、被保险人故意犯罪或拒捕、自杀或故意自伤；三、被保险人殴斗、醉酒，服用、吸食或注射毒品；四、被保险人酒后驾驶、无照驾驶及驾驶无有效行驶证的机动交通工具；五、被保险人因整容手术或其他内、外科手术导致医疗事故；六、被保险人因矫形、整容或康复性治疗等所支出的费用；七、被保险人支出膳食费、电话费等

31、；八、被保险人未遵医嘱，私自服用、涂用、注射药物；九、战争、军事行动、暴乱或武装叛乱；十、核爆炸、核辐射或核污染。十一、在中国大陆地区以外发生的医疗费用。十二、被保险人怀孕、流产或分娩；十三、普通疾病门诊医疗费用。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.保险费In sura nee Premium保障责任保险金 额（元）RMB6 69 岁（留学生）6 45 岁（外籍专家及外教）46 69 岁（外籍专家