來華留學(xué)生綜合醫(yī)療保險(xiǎn)ComprehensiveMedicalInsurancePlanof

1、 來華留學(xué)生綜合醫(yī)療保險(xiǎn)ComprehensiveMedicalInsurancePlanofForeignStudentsinChina留學(xué)生綜合保障計(jì)劃簡(jiǎn)介BriefIntroductiontotheComprehensiveInsurancePlanofForeignStudents保險(xiǎn)責(zé)任InsuranceLiabilities在保險(xiǎn)責(zé)任有效期內(nèi)，本公司承擔(dān)下列保險(xiǎn)責(zé)任：Thiscompanyshallundertakethefollowinginsuranceliabilitiesduringtheperiodofinsurance:1、身故保險(xiǎn)責(zé)任：被保險(xiǎn)人因意外傷害事故或疾病（含

2、SARS）死亡，本公司按約定保險(xiǎn)金額給付保險(xiǎn)金，保險(xiǎn)責(zé)任終止。LossofLifeInsuranceThiscompanyshallpaythestipulatedamountofinsurancecompensationiftheInsureddiesofanyaccidentalinjuryordisease（includingSARS）.2、殘疾保險(xiǎn)責(zé)任：被保險(xiǎn)人因遭受意外傷害事故，并自遭受意外傷害之日起一百八十日內(nèi)導(dǎo)致殘疾，本公司按照平安意外殘疾附加責(zé)任條款所附“殘疾程度與給付比例表”的規(guī)定比例乘以約定保險(xiǎn)金額給付保險(xiǎn)金。DisabilityInsuranceIftheInsureds

3、uffersfromanyaccidentalinjurywhichresultsinanydisabilitywithin180dayssincetheoccurrenceoftheaccidentalinjury,thiscompanyshallbeliablefortheagreedamountofinsurancemultiplyingtheproportionstipulatedintheProportionTablebetweentheDegreeofDisabilityandthePaymentattachedtoPingAnsAdditionalLiabilityClausef

4、orAccidentalDisability.被保險(xiǎn)人不論一次或多次發(fā)生意外傷害保險(xiǎn)事故，本公司均按規(guī)定分別給付意外殘疾保險(xiǎn)金，但累計(jì)給付金額以不超過約定保險(xiǎn)金額為限。ThiscompanyshallrespectivelypaytheinsurancecompensationforaccidentaldisabilityinaccordancewiththestipulationsnomattertheInsuredsuffersfromaccidentalinjuryforonceorseveraltimes,howevertheaccumulativepaymentheretoshall

5、notexceedthestipulatedamountofinsurance.被保險(xiǎn)人自意外傷害事故發(fā)生并導(dǎo)致殘疾之日起一百八十日內(nèi)由于同一原因死亡，本公司只給付約定保險(xiǎn)金額與意外殘疾保險(xiǎn)金的差額；超過一百八十日死亡，不論是否同一原因所致，本公司按約定保險(xiǎn)金額給付保險(xiǎn)金，保險(xiǎn)責(zé)任終止。IftheInsureddiesofthesamereasonwithin180dayssincetheoccurrenceofaccidentalinjurywhichresultsinanydisability,thiscompanyshallbeliableonlyforthedifferencebetw

6、eenthestipulatedamountofinsuranceandtheinsurancecompensationforaccidentaldisability;iftheInsureddiesafter180days,thiscompanyshallpaythestipulatedamountofinsurancenomatterthedeathiscausedbythesamereason.3、意外傷害醫(yī)療保險(xiǎn)責(zé)任：AccidentalInjuryMedicalTreatmentInsurance被保險(xiǎn)人因遭受意外傷害事故，并自事故發(fā)生之日起一百八十日內(nèi)進(jìn)行治療，本公司就其實(shí)際支出的

7、合理醫(yī)療費(fèi)用按100%給付意外傷害醫(yī)療保險(xiǎn)金，累計(jì)給付金額以約定的保險(xiǎn)金額為限。IftheInsuredreceivesanymedicaltreatmentwithin180dayssincetheoccurrenceoftheaccidentalinjury,thiscompanyshallbeliablefortheactualandreasonableexpensesformedicaltreatment,howevertheaccumulativepaymentshallnotexceedthestipulatedamountofinsurance.4、住院醫(yī)療保險(xiǎn)責(zé)任：Hospit

8、alizationMedicalInsurance被保險(xiǎn)人因意外傷害事故或因疾?。ê琒ARS），經(jīng)醫(yī)院診斷必須住院治療，本公司就其實(shí)際支出的護(hù)理費(fèi)邙限額100元/天）、床位費(fèi)（限額100元/天）、手術(shù)費(fèi)、藥費(fèi)、治療費(fèi)、化驗(yàn)費(fèi)、放射費(fèi)、檢查費(fèi)等合理醫(yī)療費(fèi)用，按100%給付“住院醫(yī)療保險(xiǎn)金”，累計(jì)給付金額以約定的保險(xiǎn)金額為限。IftheInsuredmustbehospitalizedthroughdiagnosisforanyaccidentalinjuryordisease(includingSARS),thiscompanyshallbeliablefortheactualandreason

9、ableexpensesformedicaltreatmentincludingnursingfee(limitedtoRMB100Yuanperday),bedfee(limitedtoRMB100Yuanperday),expensesforoperation,medicine,treatment,laboratorytest,radiationandexamination,howevertheaccumulativepaymentshallnotexceedthestipulated5、團(tuán)體高額醫(yī)療費(fèi)用保險(xiǎn)責(zé)任：GroupMajorMedicalExpensesInsurance被保險(xiǎn)人

10、因疾病(含SARS)或意外傷害住院治療而導(dǎo)致的在保險(xiǎn)期間發(fā)生的合理且必要的醫(yī)療費(fèi)用以及在保險(xiǎn)期間內(nèi)發(fā)生并延續(xù)至保險(xiǎn)合同到期日后一個(gè)月內(nèi)的合理且必要的住院醫(yī)療費(fèi)用(包括床位費(fèi)(限額100元/天)、藥費(fèi)治療費(fèi)、護(hù)理費(fèi)、護(hù)工費(fèi)(限額100元/天)、檢查檢驗(yàn)費(fèi)、特殊檢查治療費(fèi)、救護(hù)車費(fèi)和手術(shù)費(fèi))，在累計(jì)超過起付線(人民幣6萬元)時(shí)，本公司對(duì)起付線以上至封頂線(人民幣40萬元)的部分按100%給付住院醫(yī)療保險(xiǎn)金。Asforthereasonableandnecessaryexpensesforthemedicaltreatmentheretooccurredduringtheperiodofinsura

11、nceaswellastheexpensesforhospitalizationmedicalexpenses(includingthebedfee(limitedtoRMB100Yuanperday),expensesformedicine,nursingfee(limitedtoRMB100Yuanperday),treatment,laboratorytestandexamination,specialexaminationandtreatment,ambulanceandoperation)whichisoccurredduringtheperiodofinsuranceandexte

12、ndedintoonemonthaftertheexpirationoftheinsuranceagreement,iftheInsuredishospitalizedforanydisease(includingSARS)oraccidentalinjury,thiscompanyshallbeliablefortheamountofinsurancecompensationexceedingRMB60,000YuanbutlimitedtoRMB400,000Yuan.注：以上所有醫(yī)療機(jī)構(gòu)僅限于中華人民共和國大陸境內(nèi)的公立醫(yī)院。醫(yī)療費(fèi)用范圍只限于符合當(dāng)?shù)厣鐣?huì)基本醫(yī)療保險(xiǎn)規(guī)定報(bào)銷范圍的項(xiàng)目和

13、費(fèi)用，但承擔(dān)乙類藥品的自負(fù)費(fèi)用。Note:AlltheforegoingmedicalorganizationsshallbelimitedtothepublichospitalsestablishedwithintheboardofthePeoplesRepublicofChina;Thescopeofmedicaltreatmentexpensesshallbelimitedtotheitemsandexpenseswhichcanbereimbursedinaccordancewiththelocalregulationsonsocialbasicmedicalinsurance.How

14、evertheexpensesfortheB-classmedicineshallbepaidbythemselves.責(zé)任免除LiabilityExemption身故及殘疾責(zé)任免除LiabilityExemptionforLossofLifeandDisability因下列情形之一，造成被保險(xiǎn)人身故、殘疾的，本公司不負(fù)給付保險(xiǎn)金責(zé)任：ThiscompanyshallbeexemptedfromtheinsuranceliabilitiesforthelossoflifeanddisabilityoftheInsuredforanyofthefollowingcircumstances:一、投

15、保人或受益人的故意行為；二、被保險(xiǎn)人犯罪、吸毒、毆斗、酒醉、自殘或自殺；三、被保險(xiǎn)人酒后駕駛或無照駕駛；四、被保險(xiǎn)人懷孕、流產(chǎn)或分娩；五、被保險(xiǎn)人患有愛滋病或其它性病。六、戰(zhàn)爭(zhēng)、軍事行動(dòng)、內(nèi)亂或武裝叛亂；七、核爆炸、核輻射或核污染；八、專業(yè)人員參與的高風(fēng)險(xiǎn)運(yùn)動(dòng)及高危競(jìng)技類活動(dòng)。發(fā)生上述情形，被保險(xiǎn)人身故的，本公司對(duì)該被保險(xiǎn)人保險(xiǎn)責(zé)任終止，并在扣除手續(xù)費(fèi)后退還該被保險(xiǎn)人的未滿期保險(xiǎn)費(fèi)。anyintentionalactoftheapplicantforinsuranceorthebeneficiary;criminalact,addictiontonarcotic,fighting,drunke

16、nness,self-injuryorsuicideoftheinsured;drivingwhileintoxicatedordrivingwithoutlicenseoftheinsured;pregnancy,miscarriageorchildbirthoftheinsured;AIDSorotherVDoftheinsured;War,militaryaction,civilrebellionorarmedrevolt;Nuclearexplosion,radiationorpollution;High-risksportsandathleticactivitiesbytheprof

17、essionals;IfanyoftheforegoingcircumstanceshappensresultinginthedeathoftheInsured,thiscompanyshallendtheinsuranceliabilitiesandreturntheimmatureinsurancepremiumafterthedeductionofthecommission.醫(yī)療責(zé)任（意外傷害醫(yī)療、住院醫(yī)療、高額醫(yī)療費(fèi)用）免除LiabilityExemptionforMedicalTreatment（accidentalinjurymedicaltreatment,hospitaliza

18、tionmedicaltreatmentandmajormedicalexpenses）因下列情形之一造成被保險(xiǎn)人支出的醫(yī)療費(fèi)用，本公司不負(fù)給付保險(xiǎn)金責(zé)任：Thiscompanyshallbeexemptedfromtheinsuranceliabilitiesforanyofthefollowingcircumstances:一、投保人、受益人對(duì)被保險(xiǎn)人故意殺害、傷害；二、被保險(xiǎn)人故意犯罪或拒捕、自殺或故意自傷；三、被保險(xiǎn)人毆斗、醉酒，服用、吸食或注射毒品；四、被保險(xiǎn)人酒后駕駛、無照駕駛及駕駛無有效行駛證的機(jī)動(dòng)交通工具；五、被保險(xiǎn)人因整容手術(shù)或其他內(nèi)、外科手術(shù)導(dǎo)致醫(yī)療事故；六、被保險(xiǎn)人因矯形

19、、整容或康復(fù)性治療等所支出的費(fèi)用；七、被保險(xiǎn)人支出的掛號(hào)費(fèi)、膳食費(fèi)、陪住費(fèi)、取暖費(fèi)、交通費(fèi)等；八、當(dāng)?shù)厣鐣?huì)基本醫(yī)療保險(xiǎn)或公費(fèi)醫(yī)療管理部門規(guī)定的自費(fèi)項(xiàng)目和藥品；九、被保險(xiǎn)人未遵醫(yī)囑，私自服用、涂用、注射藥物；十、戰(zhàn)爭(zhēng)、軍事行動(dòng)、暴亂或武裝叛亂；十一、核爆炸、核輻射或核污染。十二、首次投保前的既往癥、精神疾病、艾滋病、性病、先天性或遺傳性疾病及其并發(fā)癥；十三、在中國大陸地區(qū)以外發(fā)生的醫(yī)療費(fèi)用。intentionalkillingorinjuretheinsuredbytheapplicantorthebeneficiary;criminalactorarrestresistance,suicide

20、orintentionalself-injuryoftheinsured;fighting,drunkenness,drugtaking,addictionorinjectionoftheinsured;drivingwhileintoxicatedorwithoutlicenseordrivingmotor-drivenvehiclewithoutvaliddrivingcertificateoftheinsured;medicalaccidentoccurredduringthecosmeticoperationorotherphysicianorsurgeryoperationsofth

21、einsured;theexpensesfororthopaedic,cosmeticoperationorrehabilitatingtreatmentoftheinsured;registrationfee,expensesforboard,accompanyingaccommodation,heatingandtrafficoftheinsured;itemsanddrugsatprivateexpensestipulatedbythelocaldepartmentsinchargeofthesocialbasicmedicalinsuranceormedicaltreatmentonp

22、ublicexpense;taking,coatingorinjectingdrugsnotinconformitywithdoctorsadvice;war,militaryact,rebellionorarmedrevolt;nuclearexplosion,radiationorpollution;previousdisease,mentaldisease,AIDS,VD,congenitalorhereditarydiseaseandthecomplicationsbeforethefirstapplicationforinsurance;medicaltreatmentexpense

23、soccurredoutoftheboardofthePeoplesRepublicofChina;注：未盡事宜以學(xué)生平安一年定期保險(xiǎn)條款、平安意外殘疾附加責(zé)任條款、平安附加學(xué)生意外傷害醫(yī)療保險(xiǎn)條款、平安附加學(xué)生幼兒住院醫(yī)療條款團(tuán)體高額醫(yī)療費(fèi)用保險(xiǎn)（B）款的規(guī)定為準(zhǔn)。Note:othermattersthatarenotstipulatedinthisplanshallbegovernedbythePingAnsOne-YearFixedInsuranceClausefortheStudent,PingAnsAdditionalLiabilityClauseforAccidentalDisab

24、lity,PingAnsInsuranceCluaseforAdditionalStudentsAccidentalInjuryMedicalTreatment,PingAnsClausefortheAdditionalHopistalizationMedicalTreatmentoftheStudentandtheChildrenandtheClause(B)forGroupMajorMedicalExpensesInsurance.來華人員保險(xiǎn)投保與AGuideforPeopleComingtoChinatoInsureandClaim尊敬的平安保險(xiǎn)公司客戶：您如果想了解中國平安人壽保險(xiǎn)股

25、份有限公司來華人員綜合保險(xiǎn)理賠服務(wù)內(nèi)容,請(qǐng)您仔細(xì)閱讀下列內(nèi)容。RespectfulclientsofPingAnInsuranceCompany:IfyouwouldliketoknowservicesforsettlementofclaimsofcomprehensiveinsuranceforpeoplecomingtoChina,pleasereadthisguidecarefully.理賠程序保險(xiǎn)事故發(fā)生后，理賠的規(guī)范程序Procedureofsettlingclaims:Onoccurrenceoftheinsuredincident,thestandardprocedurefors

26、ettlingtheclaimsareasfollows:1、直接向平安保險(xiǎn)北京分公司理賠部報(bào)案。電話：(010)66210383、6621338883101慈霞女士或馮偉先生；1.1ReporttotheclaimsettlementdepartmentofBeijingbranchofPingAnInsuranceCompanydirectlybytelephoningtoMs.CiXiaorMr.FengWeion(010)66210383or6621338883101;2、理賠應(yīng)備文件：1.2Documentstobepresentedforsettlementofclaims:團(tuán)體一

27、年定期壽險(xiǎn)Grouptermlifeinsuranceofoneyear被保險(xiǎn)人護(hù)照復(fù)印件；Copyofpassportoftheinsured;被保險(xiǎn)人傷殘時(shí)需提供傷殘鑒定證明(由司法或勞動(dòng)部門出具)；Disabilityassaycertificateincasetheinsuredisdisabled(providedbyjudicialorlabordepartment);被保險(xiǎn)人死亡需提供死亡證明；Deathcertificateoftheinsured;如發(fā)生交通事故，需出具公安交通部門的事故證明；Proofofaccidentprovidedbythecommunications

28、departmentofthepoliceincaseantrafficaccidentoccurs;被保險(xiǎn)人死亡時(shí)提供受益人身份證明復(fù)印件；Copyofthebeneficiarysidentityproofincasetheinsuredisdead;死亡賠付需提供受益人親筆簽字認(rèn)可的保險(xiǎn)分配方案的文件；Insurancedistributionschemesignedandratifiedbythebeneficiaryindeathcompensation;被保險(xiǎn)人保險(xiǎn)卡復(fù)印件；Copyoftheinsurancecardoftheinsured.團(tuán)體意外傷害附加醫(yī)療Annexedme

29、dicaltreatmenttogroupaccidentalinjury被保險(xiǎn)人護(hù)照復(fù)印件；Copyofpassportoftheinsured;意外事故經(jīng)過及證明（若是交通事故則需出具公安交通部門事故證明）；Processoftheaccidentanditsproof（Aproofofaccidentprovidedbythecommunicationsdepartmentofthepolicehastobepresentedincaseatrafficaccidentoccurs）;醫(yī)院診斷證明、病歷本以及門診收據(jù)、藥費(fèi)處方、超聲波、CT、X光片、核磁等輔助檢查報(bào)告單；Diagnose

30、scertificateandthemedicalrecordsandmedicalexaminationreceipt,diagnoseswithmedicalcharge,assistexaminationrecordofultrasonic,CT,X-ray,nuclearandmagneticetc.被保險(xiǎn)人保險(xiǎn)卡復(fù)印件；Copyoftheinsurancecardoftheinsured.團(tuán)體住院醫(yī)療Groupmedicaltreatmentinhospital被保險(xiǎn)人護(hù)照復(fù)印件；Copyofpassportoftheinsured;意外事故經(jīng)過及證明；Processoftheaccidentanditsproof;醫(yī)院診斷證明以及住院收據(jù)住院明細(xì)文件原件；Originalcopyofdiagnosescertificateandreceiptanddetaileddocumentsforhospital