Brief Introduction of Ping An Life Insurance's Overall Insurance & Benefit Plan for People Coming to China.
Insurance Liabilities
1. This company shall undertake the following insurance liabilities during the period of insurance:
1) Loss of Life Insurance
This company shall pay the stipulated amount of insurance compensation if the insured dies of any accidental injury or disease (including SARS) and the insurance liabilities shall be terminated hereto.
2) Disability Insurance
If the insured suffers from any accidental injury which results in any disability within 180 days since the occurrence of the accidental injury, this company shall be liable for the agreed amount of insurance multiplying the proportion stipulated in the Proportion Table between the Degree of Disability and the Payment attached to Ping An's Additional Liability Clause for Accidental Disability.
This company shall respectively pay the insurance compensation for accidental disability in accordance with the stipulations no matter whether the insured suffers from accidental injury for once or several times; however, the accumulative payment hereto shall not exceed the stipulated amount of insurance.
If the insured dies of the same reason within 180 days since the occurrence of accidental injury which results in any disability, this company shall be liable only for the difference between the stipulated amount of insurance and the insurance compensation for accidental disability; if the insured dies after 180 days, this company shall pay the stipulated amount of insurance no matter whether the death is caused by the same reason and the insurance liabilities shall be terminated hereto.
3) Accidental Injury Medical Treatment Insurance
If the insured receives any medical treatment within 180 days since the occurrence of the accidental injury, this company shall be liable for the actual and reasonable expenses for medical treatment; however, the accumulative payment shall not exceed the stipulated amount of insurance.
4) Hospitalization Medical Insurance
If the insured must be hospitalized through diagnosis for any accidental injury or disease (including SARS), this company shall be liable for the actual and reasonable expenses for medical treatment including nursing fee (limited to RMB100 Yuan per day), bed fee (limited to RMB100 Yuan per day), expenses for operation, medicine, treatment, laboratory tests, radiation and examination; however, the accumulative payment shall not exceed the stipulated amount of insurance.
5) Group Major Medical Expenses Insurance
As for the reasonable and necessary expenses for the medical treatment hereto incurred during the period of insurance as well as the expenses for hospitalization (including the bed fee (limited to RMB100 Yuan per day), expenses for medicine, treatment, nursing, personal support workers (limited to RBM100 Yuan per day), laboratory tests and examination, special examination and treatment, ambulance and operation) which are incurred during the period of insurance and extended into one month after the expiration of the insurance agreement, if the insured is hospitalized for any disease (including SARS) or accidental injury and the accumulative expenses exceed RMB60,000 Yuan, this company shall be liable for the amount of insurance compensation exceeding RMB60,000 Yuan but limited to RMB400,000 Yuan.
Notes:
1) All the foregoing medical organizations shall be limited to the public hospitals established within the territory of the People's Republic of China;
2) The scope of medical treatment expenses shall be limited to the items and expenses which can be reimbursed in accordance with the local regulations on social basic medical insurance. However, the expenses for the B-class medicine shall be paid by themselves.
Liability Exemption
Liability Exemption from Loss of Life and Disability
This company shall be exempted from the insurance liabilities for the loss of life and disability of the insured under any of the following circumstances: Any intentional act of the policy-holder or the beneficiary; Criminal act, addiction to narcotics, fighting, drunkenness, self-injury or suicide of the insured; The insured's driving while intoxicated or driving without license; Pregnancy, miscarriage or childbirth of the insured; AIDS or other VD of the insured; War, military action, civil rebellion or armed revolt; Nuclear explosion, nuclear radiation or nuclear pollution; High-risk sports and athletic activities by the professionals.
If any of the foregoing circumstances occurs, resulting in the death of the insured, this company shall terminate the insurance liabilities and return the immature insurance premium after the deduction of the commission.
Liability Exemption from Medical Treatment (accidental injury medical treatment, hospitalization medical treatment and major medical expenses)
This company shall be exempted from the insurance liabilities under any of the following circumstances: Intentional killing or injuring of the insured by the policy-holder or the beneficiary; Intentional criminal act or arrest resistance, suicide or intentional self-injury of the insured; Fighting, drunkenness, drug taking, addiction or injection of the insured; The insured's driving while intoxicated or without license or driving motor-driven vehicle without valid driving certificate; The insured's medical accidents resulting from cosmetic operation or other internal medicine or surgical operations; The expenses for orthopedic, cosmetic operation or rehabilitating treatment of the insured; The expenses for registration, board, accompanying accommodation, heating and traffic of the insured; Items and drugs at private expense stipulated by the local departments in charge of the social basic medical insurance or medical treatment on public expense; The insured's taking, coating or injecting drugs not in conformity with doctor's advice; War, military act, rebellion or armed revolt; Nuclear explosion, nuclear radiation or nuclear pollution; Previous disease, mental disease, AIDS, VD, congenital or hereditary disease and the complications before the first application for insurance; Medical expenses incurred outside the territory of the People's Republic of China; Pregnancy, miscarriage or childbirth of the insured; Out-patient treatment expenses of common disease.
Insurance Premium
|
Types of Insurance |
Sum Insured (Yuan) RMB |
Age: 6--45 |
Age: 46--69 |
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|
Insurance Premium (Yuan per half-year for each) |
Insurance Premium (Yuan per year for each) |
Insurance Premium (Yuan per half-year for each) |
Insurance Premium (Yuan per year for each) |
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|
Ping An's regular 1-year group insurance |
100,000 |
400 |
600 |
600 |
1,000 |
|
Ping An's group insurance against additional accidental injury medical treatment |
10,000 |
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Pin An's group insurance against hospitalization treatment |
60,000 |
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Pin An's group insurance against major medical expenses |
60,000-400,000 |
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Note: Other matters that are not stipulated in this plan shall be governed by Ping An's Regular 1-Year Group Insurance Clause, Ping An's Additional Liability Clause for Disability Benefit and Group Accidental Injury, Ping An's Insurance Clause for Group Additional Accidental Injury Medical Treatment, Ping An's Insurance Clause for Group Hospitalization Medial Treatment and Ping An's Insurance. A Guide for People Coming to China to Insurance Claim against Ping An Life Insurance
Respectful clients of Ping An Insurance Company,
If you would like to know services for settlement of claims on comprehensive insurance for people coming to China, please read this guide carefully.
1. Procedure for settling claims
Formal procedure
Submit your claim to Group Insurance Division with affiliated companies under China Ping An Life Insurance Co., Ltd. as stipulated in the agreement.
Claim & consulting hotlines:
Please call the local branches under China Ping An Life Insurance Co., Ltd. or directly dial the service and claim consulting number: 010-66213388-69013 of Beijing Branch to inquire the numbers and specific address of the local branches as agreed in the contract.
2. Documents to be presented for settlement of claims
One-year group insurance:
Photocopy of the passport of the insured;
Disability assay certificate in case the insured is disabled (provided by the judicial or labor department);
Death certificate of the insured in case the insured is dead;
Proof of accident provided by the communications department of the police in case a traffic accident occurs;
Photocopy of the beneficiary's identity proof in case the insured is dead;
Insurance distribution scheme signed and ratified by the beneficiary in case of death compensation;
Photocopy of the insurance card of the insured.
Additional medical treatment for group accidental injury:
Photocopy of the passport of the insured;
Account of the accident and its proof (a proof of accident provided by the communications department of the police has to be presented in case a traffic accident occurs);
Diagnoses certificate, medical records, medical examination receipts, prescription charge, and assistant examination records of ultrasonic, CT, X-ray, nuclear magnetic resonance etc.
Photocopy of the insurance card of the insured.
Group medical treatment in hospital:
Photocopy of the passport of the insured;
Account of the accident and its proof;
Original copy of diagnoses certificate and receipts and detailed documents of hospitalization;
Photocopy of the insurance card of the insured.
Account number of the insured or the school in designated bank and the signature of the insured or the school's seal is to be annexed to each of the claim settling documents.
Notes:
1. Where in one insured incident, the insured has to be treated in two or more hospitals, diagnoses certificates from those aforesaid hospitals and the medical records and other documents in respect thereof shall be presented.
2. The insured shall get treatment in hospitals which are public medical institutions and at least in second rank.
3. After the insurance company settles a claim, dividable medical charge bills sealed by the insurance company and the indemnity will be sent to the applicant so as to compensate the remaining medical charge.
4. Application for expenses for personal support workers:
Materials the insured is required to submit: receipts of expenses for personal support workers presented by the hospital;
Materials required from the applicant's working unit: receipts of expenses for personal support workers presented by the hospital or letter of identification with the signature of the personal support worker and the official seal of the unit of the applicant.
5. Materials sent to: the appointed local branches subordinated to China Ping An Life Insurance.
