国寿生命绿荫疾病保险2.doc

国寿生命绿荫疾病保险条款 第一条 保险合同构成国寿生命绿荫疾病保险合同（以下简称本合同）由保险单及所附条款、声明、批注、批单、病种目录，以及与本合同有关的投保单、健康声明书、体检报告书和其他书面文件共同构成。第二条 投保范围凡年满三周岁以上六十周岁以下、身体健康的人，均可作为被保险人，由本人或对其具有保险利益的人向中国人寿保险公司（以下简称本公司）投保本保险。第三条 保险责任开始本合同自本公司同意承保、收取首期保险费并签发保险单的次日开始生效。除另有约定外，本合同生效的日期为本公司开始承担保险责任的日期。第四条 保险责任在本合同有效期间内，本公司负以下保险责任：一、自本合同生效（或复效）之日起，被保险人在免责期后发生病种目录表所列疾病或手术，本公司按照病种目录表列明的该种疾病或手术所对应的给付限额在有效保额内给付疾病保险金。当有效保额低于病种目录表列明的疾病或手术所对应的给付限额时，本公司按有效保额给付疾病保险金。二、自本合同生效（或复效）之日起，被保险人因遭受意外伤害身故，本公司按保险金额（扣除已给付的疾病保险金）给付身故保险金，本合同终止。三、自本合同生效（或复效）之日起180日后，被保险人因疾病身故，本公司按保险金额（扣除已给付的疾病保险金）给付身故保险金，本合同终止。自本合同生效（或复效）之日起180日内，被保险人因疾病身故，本公司无息退还有效保额部分的已交保险费，本合同终止。四、 被保险人不论一次或多次发生病种目录表所列疾病或手术，本公司均按本条第一款规定给付疾病保险金，当累计给付的保险金达到保险金额时，本合同终止。如投保人为被保险人多次投保本保险，当被保险人发生保险责任范围内的事故时，本公司按保险单签发时间的先后顺序给付保险金。被保险人发生病种目录表中列明的疾病或手术后180日内再罹患相同疾病、手术，本合同按一次保险事故处理。第五条 责任免除一、因下列情形导致被保险人发生病种目录表所列疾病、手术或身故时，本公司不负给付保险金的责任：1.投保人、受益人对被保险人的故意行为。2.被保险人在本合同生效（或复效）之日起二年内自杀。3.被保险人犯罪或拒捕。4.被保险人殴斗、醉酒、故意自伤身体及服用、吸食、注射毒品。5.被保险人酒后驾驶、无有效驾驶执照驾驶及驾驶无有效行驶证的机动交通工具。6.被保险人从事潜水、跳伞、攀岩、探险、武术、摔跤、特技、赛马、赛车等高风险运动期间。7.被保险人患先天性疾病、职业病、特定传染病、地方病以及投保本保险前已患有的疾病、生理缺陷或残疾国寿生命绿荫疾病保险病种及手术录序号疾病编码疾病及手术名称免责期赔付限额ICD_序号101.0903颅内硬脑膜下冲洗术(外伤性硬膜下积液行钻孔引流术)0200010005201.24031颅骨骨折去骨片减压术0300012810301.24032颅骨切除减压术(脑囊虫病去骨瓣减压术)1801000012816401.2404硬脑膜外脓肿清除术180800010015501.3101硬脑膜下血肿清除术0800010021601.3903脑脓肿清除术1801000010024701.3905脑脓肿清除术(外伤性脑脓肿)90800010026801.4102丘脑囊虫摘除术1801500010030901.5101脑膜瘤手术(良性)18015000100331001.5911脑囊肿切除术(脑结核瘤切除术)18015000100461101.59111脑囊肿切除术(脑型包虫病)18015000128131201.59112脑囊肿切除术(脑型血吸虫病)18015000128141301.59113脑囊肿切除术(脑型肺吸虫病)18015000128151401.6 01颅骨病损切除术(颅骨骨髓炎)1805000128111501.6 011颅骨肿瘤切除术（颅骨骨瘤）18010000128171601.6 012颅骨纤维肉瘤手术18020000128181701.6 013颅骨骨肉瘤手术180200001281918013.001+320.402*结核性脑膜炎18050001280219018.001急性血行播散型肺结核18030002352002.0201颅骨骨折复位术(凹陷性)02000100592102.0202颅骨骨折清创术(开放性颅脑损伤)05000100602202.0601颅骨骨成形术(外伤性颅骨缺损)04000100652302.1201脑脊液漏修补术18010000100712402.3401脑室腹腔分流术1808000100912503.09031脊椎骨折与脱位行椎板切除脊髓探查术010000130022603.09032椎管内硬脊膜下积脓行椎板切除及脓肿引流术18010000130042703.0904硬脑膜外血肿清除术03000101022803.101沙门氏菌性败血症1803000128032903.4001脊髓肿瘤切除术(良性)18010000101183003.5201脊髓脊膜膨出修补术18080001012931037 01破伤风9080002653204.0402外伤性胫神经损伤的手术治疗05000101513304.0404外伤性臂丛神经损伤的手术治疗05000101533404.0405外伤性尺神经损伤的手术治疗02000101543504.0407外伤性正中神经损伤的手术治疗02000101563604.0409外伤性桡神经损伤的手术治疗03000101583704.041外伤性坐骨神经损伤的手术治疗08000130053804.0412外伤性腓总神经损伤的手术治疗05000101613904.0702视网膜视神经切除手术18010000101634006.301阿米巴性肝脓肿1808000129194106.3101甲状腺腺瘤切除术1805000102404206.3901甲状腺部分切除术（良性肿瘤）1805000102434306.3902甲状腺次全切除术1805000102444406.4 02甲状腺癌根治术18030000128234506.8101甲状旁腺切除术1805000128224607.2101肾上腺切除术(肾上腺髓质功能亢进)1808000102554707.21011肾上腺切除术(肾上腺腺瘤)1808000129664807.8001胸腺切除术(重症肌无力)18020000102764907.80011胸腺瘤切除术180100001296550070.903+573.120病毒性肝炎急性重型(暴发性肝炎）180100001280051071 01狂犬病1801000038652078.601+81.809流行性出血热（伴重度肾功能损害）905000128015311.6001板层角膜移植术18010000103525413.7101人工晶体植入术伴白内障摘除术(外伤)1803000130265513.7201人工晶体植入术白内障摘除术后(老年人)18030001302756136.903+323.603*急性播散性脑脊髓炎18010000127995714.5101视网膜脱离手术治疗18050001302558140.901唇恶性肿瘤1803000056859141.901舌恶性肿瘤1803000057160143.901牙龈恶性肿瘤1803000057761144.901口底恶性肿瘤1803000057862145.001颊粘膜恶性肿瘤1803000058063145.501硬腭恶性肿瘤1803000058464146.001扁桃体恶性肿瘤1803000058565147.901鼻咽恶性肿瘤(儿童性)1803000059066147.9011鼻鄂恶性肉芽肿180300001303067148.902喉咽恶性肿瘤180300001304168150.901食管恶性肿瘤(肉瘤)1803000059869150.9011食管恶性肿瘤(淋巴)180300001286770150.9012食管恶性黑色素瘤180300001286871151.9011胃平滑肌肉瘤180300001287972151.9014胃肠平滑肌肉瘤(小儿)180300001305173152.9011小肠腺癌180300001289874152.9012小肠脂肪肉瘤180300001289775152.9013小肠恶性神经鞘瘤180300001289676152.9014小肠神经纤维肉瘤180300001289577152.9015小肠血管肉瘤180300001289478152.9016小肠网状细胞肉瘤180300001289379152.9017小肠纤维肉瘤180300001289280152.9018小肠平滑肌肉瘤180300001289181153.901结肠恶性肿瘤1803000062282153.902大肠平滑肌肉瘤180300001291383154.101直肠恶性肿瘤1803000062484154.301肛管恶性肿瘤1803000062685155.001肝原发性恶性肿瘤1805000062886155.201肝恶性肿瘤(肝肉瘤)1805000063087157.901胰腺恶性肿瘤(囊性腺癌)1805000064388158.001腹膜后恶性肿瘤1803000064489158.801肠系膜肉瘤1803000064590159.101脾恶性肿瘤180300006479116.4901眼球摘除术(眼外伤性)0150001046292160.001鼻腔平滑肌肉瘤1803000064993160.0012鼻腔软骨肉瘤180300001303394160.0013鼻腔恶性黑色素瘤180300001303495160.0014鼻腔淋巴上皮癌180300001303596160.00151鼻腔淋巴肉瘤180300001303697160.00152鼻腔腺癌180300001303798160.0016鼻腔鳞癌180300001303899160.0017鼻腔未分化癌1803000013032100160.2011上颌窦恶性肿瘤(肉瘤)1803000013042101160.2012上颌窦恶性混合瘤1803000013043102160.2013上颌窦恶性黑色素瘤1803000013044103160.2014上颌窦粘液上皮癌1803000013045104160.2015上颌窦鳞癌1803000013046105160.3011筛窦恶性肿瘤(肉瘤)1803000013047106160.3012筛窦腺样囊性癌1803000013048107160.3013筛窦鳞癌1803000013049108160.501蝶窦癌18030000655109161.901喉恶性肿瘤(肉瘤)18030000662110162.901支气管恶性肿瘤（肺癌）18050000668111163.901胸膜恶性肿瘤(胸膜恶性间皮瘤)18030000672112164.102心脏恶性肿瘤18030000675113164.901纵膈恶性肿瘤18030000678114171.0012耳部（颞骨）癌1803000013029115171.002耳廓癌18030000700116171.0021外耳道及中耳癌1805000013028117171.40211胸壁结缔组织恶性肿瘤(胸壁Ewing瘤)1803000012830118171.40212胸壁淋巴管肉瘤1803000012839119171.4022胸壁纤维肉瘤1803000012831120171.4023胸壁血管外皮肉瘤1803000012832121171.4024胸壁软骨肉瘤1803000012833122171.4025胸壁神经纤维肉瘤1803000012834123171.4026胸壁骨肉瘤1803000012835124171.4027胸壁恶性纤维组织细胞瘤1803000012836125171.4028胸壁恶性黑色素瘤1803000012837126171.4029胸壁脂肪肉瘤1803000012838127173.101眼睑恶性肿瘤(肉瘤)18030000729128174.901乳腺恶性肿瘤(乳房肉瘤)18030000746129174.9011乳腺恶性淋巴瘤1803000012827130174.9012炎性乳癌1803000012828131174.9013男性乳腺癌1803000012829132179 01子宫恶性肿瘤(肉瘤)18030000748133180.901子宫颈癌18030000749134181.01 M91000/3绒毛膜癌1805000013023135183.0019卵巢恶性肿瘤(小儿)1803000013050136184.001阴道恶性肿瘤18030000757137185 01前列腺癌（肉瘤）18030000763138186.901睾丸恶性肿瘤18030000765139186.9011睾丸绒癌1803000012963140188.901膀胱癌（肉瘤）18030000770141189.0011恶性肾脂肪瘤1803000012947142189.0012肾癌（肉瘤）1803000012948143189.101肾盂恶性肿瘤18030000772144189.201输尿管癌18030000773145191.901脑恶性肿瘤(脑胶质细胞瘤)1803000012820146191.9021脑继发恶性肿瘤1803000012821147192.101脑膜恶性肿瘤18030000801148192.201脊髓恶性肿瘤(肉瘤)18050000802149193 01甲状腺恶性肿瘤(甲状腺滤泡状腺癌)18030000804150197.201胸膜继发恶性肿瘤18030000840151197.501大肠恶性肿瘤(小儿)18030000844152198.501骨继发性肉瘤18030000861153198.702肾上腺转移癌1803000012967154198.815甲状腺继发恶性肿瘤（甲状腺转移癌）1803000088015520.4201乳突根治术180300010532156201.901 M96500/3何杰金氏病18050000915157202.101皮肤蕈样肉芽肿1803000013012158202.401毛细胞性白血病18050000920159202.802 M95900/0非何杰金氏淋巴瘤（Hodgkin）1805000012798160202.803小肠恶性淋巴肉瘤18030000924161202.805胃恶性淋巴瘤18030000926162202.811大肠恶性淋巴瘤18030000932163202.821鼻咽恶性淋巴瘤1803000013031164203.101浆细胞性白血病18050000935165204.001 M98210/3急性淋巴细胞性白血病18050000938166204.101 M98231/3慢性淋巴细胞性白血病1805000012796167204.902 M98250/3幼淋巴细胞性白血病18050000944168205.001 M98610/3急性粒细胞性白血病18050000945169205.101慢性粒细胞性白血病1805000012797170205.102 M98800/3嗜酸细胞性白血病18050000948171206.001 M98910/3急性单核细胞性白血病18050000951172207.802肥大细胞性白血病18050000959173211.302大肠黑色素瘤1803000099617422.4202额窦根治术180300010613175222.001睾丸卵黄囊瘤(小儿)180300001135176223.201子宫内膜癌180300001146177225.102听神经瘤180200001163178225.302脊髓良性肿瘤180150001192179227.301垂体腺瘤180200001201180231.001喉癌180300001246181233.301外阴癌180300001255182233.501阴茎癌180300001259183235.501壶腹部交界恶性肿瘤180500001273184238.702骨髓增生异常综合征18050001320185239.703恶性肾上腺瘤180300001348186250.102糖尿病性酮症酸中毒18050001399187250.202糖尿病高渗性昏迷18050001401188253.501尿崩症18050001443189255.401急性肾上腺皮质机能减退症（阿狄森病 Adisonian）1805000147819026.3101腮腺部分切除术(混合瘤)180300010685191284.901再生障碍性贫血（急性）180300001658192288.002急性粒细胞缺乏症180100001699193289.802骨髓纤维化又称髓纤1805000172919429.3 03鼻咽病损切除术(鼻咽部血管纤维瘤)18050001303919531.6101喉外伤缝合术050001078519631.6901喉成形术(疤痕性狭窄)180100001078719731.701气管裂伤缝合术050001304019832.4 01肺结核肺叶切除术180100001284219932.4 011支扩肺叶切除术180100001284520032.4 012肺脓肿肺叶切除术180100001284620132.4 013肺囊肿肺叶切除术180100001284720232.4 014肺包囊虫病肺叶切除术180100001284820332.4 015肺撕裂伤行肺叶切除术080001285020432.4 016支气管良性瘤肺叶切除术180100001285220532.4 017肺良性瘤肺叶切除术1801000012853206320.902细菌性脑膜炎（双球菌性脑膜炎）18050001876207323.902急性脊髓炎18010000189120833.34011胸廓成形术(肺结核胸膜内)180100001284020933.34012胸廓成形术（肺结核胸膜外）180100001284121033.7101气管及支气管损伤行手术01000012851211331.401脑积水1805000192421234.0201开胸(剖腹)探查术（外伤性骨折拌胸腹脏器破裂）0100001083421334.04011胸腔闭式引流术(气胸)18030001284321434.04012胸腔闭式引流术(脓胸)18030001284421534.0901胸腔切开引流术(脓胸)18050001084021634.1 01纵膈引流术（脓肿）18080001285421734.3 011纵隔良性肿瘤切除术180100001285521834.3 012纵隔神经源性肿瘤切除术180100001285621934.3 013纵隔胸腺肿瘤切除术180100001285722034.3 014纵隔淋巴源性肿瘤切除术180100001285822134.3 015纵隔囊肿切除术180100001285922234.5103胸膜外层纤维层板剥除术1801000010856223344.101截瘫(外伤性胸中下段脊髓胸3-12)0200001997224344.1011截瘫(外伤性腰膨大以下脊髓腰2以下)1801500013006225348.101肺性脑病18020002039226349.204硬脊膜外囊肿1808000206822735.0201二尖瓣狭窄闭式扩张术（开胸手术）180100001087222835.2201 35.2101主动脉瓣膜置换术180300001286222935.2401 35.2301二尖瓣置换术180300001286023035.2601 35.2501肺动脉瓣膜置换术180300001286323135.2801 35.2701三尖瓣膜置换术180300001286123235.9601二尖瓣狭窄球囊扩张术18050001092823336.1001冠状动脉搭桥术1803000010937234360.102交感性眼炎18050002157235362.110视网膜静脉周围炎180300013024236362.301视网膜中央动脉阻塞18050002196237362.303视网膜中央静脉阻塞1803000219823837.1102心房肿物切除术(心房粘液瘤)180100001286423937.1201心包切开引流术(化脓性)180150001095024037.3101心包切除术（缩窄性心包炎）180150001095624137.4002心脏外伤修补术0100001096524237.5 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021脾部分切除术(脾功能亢进)18080001293327341.5 022脾部分切除术(脾脏囊肿)18080001293427441.9501脾破裂修补术0500011191275410 01急性心肌梗塞18080002583276415.102肺栓塞(急性肺栓塞)1805000263027742.0901食管切开异物取出术080001119627842.3201食管平滑肌瘤摘除术180100001120327942.4101食管癌切除术（上、中、下段）180300001120628042.8201食道裂伤缝合术080001122628142.8501食管狭窄修补术(弥漫性食管痉挛)180300011229282420.901急性心包炎（化脓性、风湿性、）18050002636283421.004感染性心内膜炎（急性、亚急性）18020002640284425.404(限制型)心肌病18020002682285425.901(扩张型)心肌病1802000268628643.4101胃多发性息肉行胃大部切除术18080001124228743.7 03胃大部切除胃空肠吻合术(胃粘膜出血)18080001287528843.7 042胃大部切除术(胃溃疡出血)18080001287428943.7 043幽门梗阻行胃大部切除术18080001287329043.7 044胃大部切除术(十二指肠溃疡出血)18080001288029143.8901胃部分切除术(胃平滑肌瘤)18080001125529243.89012胃部分切除术(胃纤维瘤)18040001287629343.89013胃部分切除术(胃血管瘤)18040001287729443.89014胃部分切除术(胃脂肪瘤)180400012878295430 02蛛网膜下腔出血(原发性)180100002777296431 01脑出血180100002779297434.901脑梗塞（伴偏瘫）18010000280529844.0201高选择性胃迷走神经切断术18050001126629944.3901胃-空肠吻合术(幽门梗阻)18050001127230044.4101胃溃疡穿孔修补术18050001127330144.4201十二指肠溃疡穿孔修补术18050001127430244.6101胃破裂修补术050001127530344.6201 46.3903因外伤,而行胃或小肠造瘘术18080001287230444.9101门体静脉断流术180100001128130544.9102食管胃底静脉栓塞术18080001287130644.9201胃扭转复位术18050001128230745.0002肠切除术(肠结核)18050001128630845.00021肠切除术(伤寒肠穿孔)18050001290830945.00022肠切除术(阿米巴病肠穿孔)18050001290931045.00023肠切除术(急性坏死性肠炎)18050001291031145.00024肠平滑肌瘤切除术18050001291231245.33021小肠溃疡手术18050001288531345.33022小肠平滑肌瘤切除术18050001289031445.62011小肠部分切除术(小肠扭转坏死)9050001288731545.6301小肠损伤肠切除术050001288831645.72011部分结肠切除术(结核行右半结肠)18080001290031745.72012部分结肠切除术(套叠行右半结肠)18080001290131845.7901部分结肠切除术(炎性肉芽肿行右半结肠)18080001131331945.79011结肠部分切除术(结肠息肉)18050001290532045.79012经腹结肠息肉摘切术18050001290632145.79013结肠切除术(慢性局限性肠炎行右半结肠切除术)18080001290732245.79014溃疡性结肠炎结肠部分切除术18050001290432345.7902结肠次全切除术(溃疡性结肠炎)180100001290332445.8012盲肠扭转右半结肠切除术080001290232546.3903空肠造口术18050001288932646.5201结肠损伤造瘘口闭合术020001133432746.62012小肠部分切除术(小肠纤维瘤)9020001288632846.7101十二指肠破裂伤修补术020001133632946.7301小肠裂伤修补术020001133733046.80021肠糸膜扭转复位术(系膜上动脉压迫.十二指肠外压迫.十二指肠结核或纤维粘连所致)18080001288133146.80022肠扭转复位术(结肠扭转)050001291133246.8003肠套叠松懈手术050001134233346.80031蛔虫肠梗阻手术18050001288433446.80032绞窄性肠梗阻手术080001288233547.0 01急性阑尾炎手术18020001289933648.4901直肠拖出式切除术18050001135533748.5 01经腹会阴直肠根治术18050001291633848.6501经腹直肠拖出肛门成形术18050001136033948.6903直肠脱垂切除术18030001291434048.7101直肠破裂缝合术0500012915341481 01大叶性肺炎1801000315434250.0 03肝脓肿切开引流术18080001292034350.2201肝部分切除术(肝腺瘤)180150001139834450.22012肝裂伤肝部分切除术0100001292234550.2202肝脓肿肝部分切除术18080001292134650.2901肝病损切除术(肝脏慢性病灶)180100001139934750.2902肝包囊虫腔清除填塞术180100001140034850.2904肝血管瘤切除术180150001140234950.3 01肝叶切除术(肝内胆管结石)180100001292535050.6101肝破裂缝合术080001292335151.0401胆囊切开取石术18050001141635251.2101胆囊部分切除术(胆囊息肉)18050001142135351.2201胆囊切除术(胆囊腺瘤)18050001142235451.22011胆囊切除术(急性胆囊炎)18050001292735551.3601胆总管空肠吻合术(胆总管下端狭窄)18080001143135651.36011胆总管空肠吻合术(胆总管扩张)18080001292935751.3702肝管空肠吻合术180100001143435851.4101胆总管切开取石术18050001143635951.4201胆总管切开取蛔虫引流术18050001292836051.4901肝内胆管切开取石术18080001144036151.5101胆总管探查术(胆总管损伤)080001144136251.7901肝管胆总管修复成形术180100001145436351.79021肝管扩张术(左肝管狭窄)180100001292436451.79022肝管扩张手术(左右肝管开口狭窄)180150001293036551.8301俄 奥狄氏括约肌切开术180800012926366510.901脓胸18030003212367513.001肺脓肿18030003227368518.401急性肺水肿18020003250369518.501成人呼吸窘迫综合征1802000325137052.0101胰腺囊肿引流手术180100001147037152.2 01急性坏死性胰腺炎手术治疗180100001293737252.4 02胰胃吻合术0150001293937352.4 03胰腺囊肿空肠吻合术180100001293837452.5201胰尾切除术(胰腺损伤)0100001148037552.5901胰部分切除术(胰岛细胞瘤)180150001148237652.9501胰腺修补术(裂伤)080001148837752.9601胰肠管吻合术180100001148937852.9602胰空肠吻合术(胰腺损伤)0150001149037952.9603胰尾空肠吻合术180100001149138053.7 01膈疝修补术，经腹0100001287038153.8001膈疝修补术，经胸0100001150438253.8002食管裂孔疝修补术01000012866383532.001急性胃、十二指肠溃疡伴大出血1803000349738454.1101剖腹探查术(肠