中国平安人寿股份有限公司来华人员综合保险保障计划简

1、中国平安人寿股份有限公司来华人员综合保险保障计划简介 Brief Introduction to Ping An Life Insurance Corporate Of China, Ltd. Comprehensive Insurance If the disabilities fall into differe nt disability degrees, the disability in sured amoun tfor the more serious disability shall 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

2、 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 accide ntal injury and the previous disability take n together, the In sured could draw the in sura nee for the more serious disability, the in sura nee shall be paid in accorda nce with the

3、 sta ndard for the more serious disability, but the disability in sura nce which has previously bee n paid (the disabilities took place before buying in sura nce or the disabilities listed in the Proporti on Table betwee n the Degree of Disability and the Payme nt which were resulted from excepti on

4、s shall be treated as being compe nsated already)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 nce compe nsati on for accide ntal disability in accorda nce with the policy, no matter the Insured suffers from accidental inj

5、ury for once or several times, however the accumulative payme nt 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 exceed the in sured sum set for the

6、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 within 180 days since the occurre nce of accide ntal injury which results in any disability, Party B shall be

7、 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 caused by the same reas on., and the in sura nc

8、e liability shall be termi nated. 3、意外伤害医疗保险责任: 3.Accide ntal Injury Medical Treatme nt In sura nee 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 额达到其保险金额时，对该被保险人的该项保险责任终止。 I

9、f the In sured receives any medical treatme nt with in 180 days since the occurre nee of the accide ntal injury, the in surer shall be liable for the full amount of the actual and reas on able expe nses for medical treatme nt; however the accumulative payme nt shall n ot exceed the stipulated in sur

10、ed sum. No matter the In sured suffered from accide ntal injury once or many times, the In surer shall respectively pay for the Accidental Injury Medical Treatment in accordanee with the foresaid provisi ons, but the accumulative amount of payme nt shall not exceed the In sured amount, where the acc

11、umulative amount of payme nt amounts to the in sured n sured sum, the said in sura nee liability for the said In sured shall be term in ated. 4、住院医疗保险责任： 4. Hospitalizatio n Medical Treatme nt In sura nee 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院医疗)，乙方就其实际支出的护工费(限额

12、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” If the hospitalization is diagnosed to be necessary of the insured due toany accidental injury, or for any disease (in cludi ng SARS) after the day of in sura nee policy become effective (Ambulato

13、ry Surgery and observation room treatme nt due to no bed available shall be treated as hospitalizatio n 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 accumulative 30 days), ambula

14、nee 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 and treatme nt, operati on, medici ne, treatme nt, laboratory test, radiati on and etc., and shall pay 100% of the costs of hospitalizati on medica

15、l treatme nt. 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 hospitalizati on treatme nt which is within the scope of in sura nee liability is n ecessary to the in sured , the outpatie nt and emergency treatme nt fee before and after hospitalizati on arise from the same disease shall

16、 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 with in the regulated limits, however in sura nee liability s

17、hall be termi nated once the accumulative payme nts reached the sum in sured.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 In sured suffered from critical ill ness or chronic disease before buying this in sura nee, the In surer shallbe released from its liability to make payme nts. 注：1 )以上所有医疗机构仅限于中

18、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 withi n the board of the Peoplec of ChsiRepubli 2) The scope of medical treatment expenses shall be limited to the items and expens

19、es 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 medici ne shall be paid by in sured. 责任免除 Liability Exempti on 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： This

20、 corporate shall be exempted from the in sura nee liabilities for the death and disability of the In sured for any of the followi ng circumsta nces: 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

21、生上述情形，被保险人身故的，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 tio nal act of the applica nt for in sura nce or the ben eficiary; 2. crim inal act, addict ion to n arcotic, fight ing, drunkenn ess, self-injury or suicide of the in sured; 3. driving while intoxicated or driving without license;

22、4. preg nancy, miscarriage or childbirth of the in sured; 5. AIDS or other VD of the in sured; 6. War, military action, civil rebellion or armed revolt; 7. Nuclear explosi on, radiati on or pollutio n; 8. High-risk sports and athletic activities by the professi on als; If any of the forego ing circu

23、msta nces happe ns result ing in the death of the In sured, the in surer shall end the in sura nce liabilities and return the unearned premium after the deduct ion 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 hospit

24、alizati on medical treatme nt) 因下列情形之一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 nce liabilities for any of the followi ng circumsta nces: 、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

25、； 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； 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 act or arrest resista nee , suicide or inten t

26、i onal self-injury of the in sured; 3. fighti ng, drunkenn 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 o

27、peration or other physician or surgery operati ons of the in sured; 6. the expe nses for orthopaedic, cosmetic operati on or rehabilitati ng treatme nt of the in sured; 7. the expe nses food and teleph one of the in sured; 8. taking, coating or injecting drugs not in conformity with doctor s advice;

28、 9. war, military act, rebellion or armed revolt; 10. nu clear explosi on, radiati on or polluti on; 11. pregnancy, miscarriage or childbirth of the insured; 12. out-patie nt treatme nt expe nses of com mon disease. 保险费 In sura nee Premium 保障责任 保险金额 （元） RMB 6 45岁 46 69岁 保险费 （元从半 年） 保险费 （元/ 人年） 保险费 （元从半 年