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The Comprehensive Insurance Scheme for Foreign Students Insurance Liabilities

 
发布时间: 2016-11-02    浏览次数: 10
   
 

(For XiamenUniversity Scholarship Students and Self-supporting Students)

The company shall undertake the following insurance liabilities during the period of insurance:

1Life Insurance

The company shall pay the stipulated amount of death benefit if the Insured dies of any accidental injury or disease (including SARS). The Company's liability for this Insured is terminated.

2Disability Insurance

If the Insured suffers from any accidental injury which results in any disability within 180 days since the occurrence of the accidental injury, the company shall be liable for the stipulated face amount multiplying the Indemnity Scale according to the Table attached to Ping An’s Accidental Disability Rider of Group AD&D.

This company shall respectively pay the Accidental Disability Benefit in accordance with the stipulations no matter the Insured suffers from accidental injury once or for several times, however the accumulative payment hereto shall not exceed the stipulated benefit amount in the Insurance Policy.

If the Insured dies of the same reason within 180 days since the occurrence of accidental injury which results in any disability, the company shall be liable only for the difference between the stipulated amount of insurance and the Accidental Disability Benefit paid before; if the Insured dies after 180 days, the company shall pay the benefit up to the stipulated face amount no matter the death is caused by the same reason.

3Accidental Injury Medical Treatment Insurance

If the Insured receives any medical treatment within 180 days since the occurrence of the accidental injury, the company shall be liable for the actual and reasonable expenses for medical treatment, however the accumulative payment shall not exceed the stipulated amount in the Insurance Policy.

4Hospitalization Medical Insurance

If the Insured must be hospitalized through diagnosis for any accidental injury or disease (including SARS), the company shall be liable for the actual, necessary and reasonable medical expenses including nursing fee (limited to RMB100 Yuan per day), fee for bed (limited to RMB300 Yuan per day), expenses for operation, medicine, treatment, test, radiation and examination, however the accumulative payment shall not exceed the stipulated amount in the Insurance Policy.

5Group Major Medical Expenses Insurance

If the Insured is hospitalized for any disease (including SARS) or accidental injury, when the sum of the reasonable, necessary medical expenses as well as the hospitalization medical expenses (including the fee for bed (limited to RMB300 Yuan per day), medicine, nursing fee, fee for tendance (limited to RMB100 Yuan per day,30days in total), treatment, test and examination, special examination and treatment, ambulance and operation) occurred during the insurance period or occurred during the insurance period and extended into one month after the expiration of the Insurance Policy is between RMB60,0000 yuan and RMB400,000 yuan, the company shall pay the insurance benefit.

Note: 1All the foregoing medical organizations shall be limited to the public hospitals established within the boundaries of the Mainland China;

2The scope of medical 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.

Exclusions

Exclusions for Life and Disability Insurance

The company shall be exempted from the insurance liabilities for the life and disability benefit of the Insured for any of the following circumstances:

1. The deliberate action by the Applicant or a Beneficiary that leads to the death or injury of the Insured;

2. The Insured commits crime intentionally, addiction or abuse of drug, fights, alcohol abuses, self-inflicted or commits suicide;

3. The Insured drives after drinking, drives without proper license or drives the a vehicle without valid license;

4. The Insured is pregnant, childbearing (including dystocia), barren, sterile, miscarriage or childbirth;

5. The Insured has AIDS or is infected by HIV virus (HIV positive) or other VD;

6. War, declared or undeclared, military action, riot, civil commotion or any war like-armed operations;

7. Nuclear explosion, nuclear radiation or nuclear contamination;

8. High-risk sports and athletic activities by the professionals;

If any of the foregoing circumstances results in the death of the Insured, the company's liability for this Insured is terminated and the company will return the immature premium after the deduction of the commission.

Exclusions for Medical Insurance (medical expenses of accidental injury and hospitalization expenses, major medical expenses)

The company shall be exempted from the insurance liabilities for any of the following circumstances:

1. The deliberate action by the Applicant or a Beneficiary that leads to the death or injury of the Insured;

2. The Insured commits crime intentionally, resists arrest, self-inflicted or commits suicide;

3. Fights, alcohol abuses, suicide, addiction or abuse of drug;

4. The Insured drives after drinking, drives without proper license or drives the a vehicle without valid license;

5. Medical accident caused by plastic surgery or any derive surgery;

6. The expenses of orthopaedic operation, cosmetic operation or rehabilitating treatment of the insured;

7. Registration fee, expenses for board, accompanying accommodation, heating and traffic fee of the insured;

8. Items and drugs paid by individual stipulated by the social basic medical insurance or the managing department of the public medical expense;

9. The Insured takes, applies or injects medicines without doctor’s permission;

10. War, declared or undeclared, military action, riot, civil commotion or any war like-armed operations;

11. Nuclear explosion, nuclear radiation or nuclear contamination;

12. Medical expenses for disease occurs before the first application for the insurance, mental disease, AIDS, VD, congenital or hereditary disease and the complications before the first application for the insurance;

13. Medical expenses occurred out of the boundaries of the Mainland China;

14.Pregnancy, miscarriage or childbirth of the Insured.

15.Out-patient treatment expenses of common diseases.

Premium


Types of Insurance product

Sum Insured (Yuan) RMB

Age: 6--45

Age: 46--69

Premium (Yuan per   half-of-year for each)

Premium (Yuan per year for   each)

Premium (Yuan per   half-of-Year for each)

Premium (Yuan per Year for   Each)

Group one-year term life insurance

100,000

RMB300

RMB600

RMB600

RMB1,000

Group accidental medical insurance rider

20,000

Group hospitalization insurance

60,000

Group major medical expenses insurance

60,000--

400,000

Note: Matters that are not stipulated in this plan shall refer to the following Clauses: Ping An’s Group One-Year Term Life Insurance, Ping An’s Accidental Disability Rider of Group AD&D, Ping An’s Group Accidental Medical Insurance Rider, Ping An’s Group Hospitalization Medical Insurance Rider and Group Major Medical Expenses Insurance (B).



Guide to Foreign People Applying for Insurance and Claim Payment

Respectful Clients of Ping An Insurance Company:

If you want to know service for Benefit Application for the comprehensive insurance as a foreigner, please read this guide carefully.

Procedure of the Benefit Application:

On occurrence of the insured incident, the standard procedure of Benefit Application is as the following:

1. Report to the claim settlement department of Fujian branch of Ping An Insurance Company directly by calling Miss. Haiyan, Zhao on 0-1367-5023-463; Send all relevant medical documents to OSAO (Room 508, Jiageng 3, Siming Campus), which will be forwarded to the Insurance company.

2. Documents to be presented for Benefit Application:

①Group one-year term life insurance:

A. Copy of passport of the insured;

B. Disability appraisal (provided by judicial or labor department) in case the insured is disabled;

C. Death Testimonial of the Insured issued by the medical establishment accepted by the Public Security Department or our Company;

D. Proof of accident provided by the ministry of communications in case a traffic accident occurs;

E. Copy of the beneficiary’s I.D. card in case the insured is dead;

F. Benefit distribution scheme signed and ratified by all the beneficiaries in death benefit;

G. Copy of the Insurance Card or Insurance Policy of the insured.

②Group accidental medical insurance rider

A. Copy of passport of the insured;

B. Process of the accident and its testimonial (A proof of accident provided by the ministry of communications has to be presented in case a traffic accident occurs);

C. Diagnoses record, case history record and out-patient receipt, medicine prescription, record of ultrasonic, CT, X-ray, nuclear and magnetic etc.

D. Copy of the insurance card or Insurance Policy of the insured.

③Group hospitalization insurance

A. Copy of passport of the insured;

B. Process of the accident and its proof;

C. Original copy of diagnoses record, medical expense receipt and documents in details during the hospitalization;

D. Copy of the insurance card or Insurance Policy of the insured

④ Bank account number of the insured with the insured’s signature or the account number in the bank designated by the school with school’s seal shall be attached to each claim document.

Notes:

1. For each insured incident, if the insured was treated in two or more hospitals, diagnose records, case history records and other relative documents from aforesaid hospitals shall be provided.

2. The insured shall get treatment in hospitals which are second-rank or higher rank public medical institutions.

3. After the insurance company settles a Benefit Application, partition sheet of the medical bill sealed by the Insurance Company and the insurance benefit will be sent to the applicant for further compensation of the remaining medical expenses.



 
 
 
 
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