投保條件
來華留學生、港澳臺學生及華僑學生（華僑身份須由相關單位出具證明），凡身體健康、能正常參加學習的、年齡在8歲-69歲可參加本保險。
保險責任
在保險期間（從本次保險生效日期到截止日期的期限）內，本公司承擔下列保險責任：
1、身故保險責任：
被保險人因意外事故或疾病身故，本公司按約定保險金額給付保險金，保險責任終止。
2、意外傷殘保險責任：
被保險人因遭受意外事故，并自事故發生之日起180日內因該事故造成《人身保險傷殘評定標準及代碼》（JR/T0083—2013）（原中國保險監督管理委員會發布，保監發〔2014〕6號）所列傷殘項目的，本公司依照該標準規定的評定原則對傷殘項目進行評定，除另有約定外，本公司按評定結果所對應該標準規定的給付比例乘以相對應責任下的保險金額給付意外傷殘保險金。如治療仍未結束的，按事故發生之日起第180日的身體情況進行傷殘鑒定，并據此給付意外傷殘保險金。
被保險人該次意外事故導致的傷殘合并前次傷殘按照《人身保險傷殘評定標準》可評定為較嚴重項目的，本公司按較嚴重項目標準給付，但前次已給付的意外傷殘保險金（投保前已有或因責任免除事項導致《人身保險傷殘評定標準及代碼》（JR/T0083—2013）（原中國保險監督管理委員會發布，保監發〔2014〕6號）所列傷殘的，視為已給付意外傷殘保險金）應予以扣除。
每一被保險人的意外傷殘、意外身故、疾病身故保險金的累計給付金額以其對應的保險金額為限，累計給付金額達到其保險金額時，對該被保險人的保險責任終止。
注：《人身保險傷殘評定標準及代碼》（JR/T0083—2013）（原中國保險監督管理委員會發布，保監發〔2014〕6號）可登陸中國保險行業協會網站查看。
3、意外醫療保險責任：
被保險人因遭受意外事故，并自事故發生之日起180日內進行治療，保險人就其實際支出的合理且必要的醫療費用按100%給付意外醫療保險金，累計給付金額以20,000元為限。被保險人不論一次或多次發生意外事故，保險人均按上述規定分別給付“意外醫療保險金”，但累計給付金額以不超過該被保險人的意外醫療保險金額為限，累計給付金額達到其意外醫療保險金額時，對該被保險人的該項保險責任終止。
即：如因磕傷、燒燙傷、崴腳、切菜不小心切著手、貓狗抓咬傷等等造成意外事故的；
報銷公式：合理費用合計*100%=可報銷金額（合理費用合計不含當地社會基本醫療保險規定的自費及部分自費費用）。
4、門急診醫療保險責任：
被保險人因疾病在門診、急診進行治療所發生的合理且必要的醫療費用，在一個保險期間內，就診日費用限額為600元（即：若當日醫療費用超日限額的只能按600元計算，當日醫療費用未超600元限額的按實際發生金額計算）在日限額的基礎上累計超過650元免賠額以上的部分按照85%比例賠付，累計給付保險金額以20000元為限。當累計給付金額達到其保險金額時，對被保險人的該項保險責任終止。
門急診醫療費用包括：普通門診、急診、門診手術、急診留觀、急診搶救所產生的相關費用；由公立醫院或衛生防疫部門提供證明的傳染病因隔離期間所產生的相關費用；因與住院同一病因而產生的院前、院后的門診費用等均歸屬于門急診醫療責任范圍內。
即：如因發燒、突然腹痛、暈倒、身體某處炎癥等等在門診或急診進行治療的；
報銷公式：每天在日限額600元以內的費用相加650元）*可報銷費用（合理費用合計不含當地社會基本醫療保險規定的自費及部分自費費用）。
釋義:
日限額：為每日就診的最高費用限額。
免賠額：本險種設置650元為免賠額（一個保險期間內累計扣一次650元）），免賠額以下部分不予賠付。
5、住院醫療保險責任：
被保險人因遭受意外事故或疾病，經醫院診斷必須住院治療的,本公司就其實際支出的合理且必要的護工費（限額200元/天，最多累計60天）、建病歷費、取暖費、空調費、床位費、檢查檢驗費、特殊檢查治療費、手術費、藥費、治療費、化驗費、放射費等合理醫療費用，按100%的比例向被保險人給付“住院醫療保險金”。
在一個保期內，被保險人不論一次或多次住院治療，本公司均根據理賠規則向其給付保險金，每次給付的住院醫療保險金累計相加達到400,000元時，該項保險責任終止。
即：因受傷或生病后，經醫院診斷必須住院治療，可申請網絡醫院住院墊付或自付后申請報銷；
報銷公式：合理住院費用
*可報銷費用（合理費用合計不含當地社會基本醫療保險規定的自費及部分自費費用）。
注：
1）以上所有醫療保險責任所涉及的醫療機構僅限于在中華人民共和國大陸境內的公立醫院。但是，若被保險人是在公立醫院的外賓病區、VIP病區、包房、A等病房、單間、特診特需病區、特診特需病房和高干病房等同類病區或病房接受的治療，則其所有的醫療費用本公司均不予報銷。
2）以上所有醫療保險責任所涉及的醫療費用只限于當地社會基本醫療保險可報銷項目內的費用，自費和部分自費項目本公司均不予報銷。
3）首次投保或非連續投保的被保險人，自保險生效之日起30日內為等待期（觀察期），如等待期內發生住院或疾病門診的醫療費用，本公司不承擔理賠責任。連續投保或被保險人遭受意外事故進行治療的無等待期。
4）以上所有醫療費用，若其它第三方支付了部分或全部費用，我司僅就剩余的、且在當地社會基本醫療保險可報銷項目范圍內的合理費用予以賠付；但保險責任中所涉及的床位費、護工費、門急診日限額等限額部分同樣受限，如第三方有賠付比例的受限部分按照受限金額為基礎扣除已賠付金額,我司只賠付剩余金額,如無賠付比例,受限部分按照當地社會醫療保險的標準,以受限金額為基礎扣除此項目的標準金額,賠付剩余金額,并以保險金額為限。
5）被保險人在本次投保前發生重大疾病或慢性病的，保險人不承擔給付保險金的責任。
責任免除
一、身故及傷殘保險責任免除
因下列情形之一導致被保險人身故、傷殘的，本公司不承擔給付保險金的責任：
（一）投保人、受益人故意殺害或故意傷害被保險人；
（二）被保險人故意自傷、自殺、故意犯罪或者抗拒依法采取的刑事強制措施；
（三）被保險人毆斗、醉酒或受酒精影響，主動服用、吸食或注射毒品；
（四）被保險人酒后駕駛機動車、無合法有效駕駛證駕駛機動車，或駕駛無有效行駛證的機動車；
（五）戰爭、軍事沖突、暴亂或武裝叛亂；
（六）核爆炸、核輻射或核污染；
（七）被保險人妊娠、流產、墮胎、分娩（含剖腹產）、避孕、節育絕育手術、治療不孕不育癥、人工受孕及由以上情形導致的并發癥；
（八）被保險人因整容手術或其他內、外科手術導致醫療事故；
（九）被保險人未遵醫囑，私自使用藥物，但按使用說明的規定使用非處方藥不在此限；
（十）被保險人患艾滋病（AIDS）或感染艾滋病病毒（HIV呈陽性）期間；
（十一）被保險人從事潛水、跳傘、攀巖、蹦極、駕駛滑翔機或滑翔傘、探險、摔跤、武術比賽、特技表演、賽馬、賽車等高風險運動；
（十二）被保險人在中國大陸地區以外身故或造成傷殘的；
（十三）提供虛假投保信息的，外籍專家及外教以學生身份投保的；
（十四）被保險人在勤工助學期間發生的事故。
發生上述情形之一，被保險人身故的，本公司對該被保險人保險責任終止。
二、醫療保險責任（意外醫療、門急診醫療、住院醫療）免除
因下列情形之一造成被保險人醫療費用支出的，本公司不承擔給付保險金的責任：
（一）投保人、受益人故意殺害或故意傷害被保險人；
（二）被保險人故意自傷、故意犯罪或者抗拒依法采取的刑事強制措施；
（三）被保險人毆斗、醉酒或受酒精影響，服用、吸食或注射毒品；
（四）被保險人酒后駕駛機動車、無合法有效駕駛證駕駛機動車，或駕駛無有效行駛證的機動車；
（五）戰爭、軍事沖突、暴亂或武裝叛亂；
（六）核爆炸、核輻射或核污染；
（七）被保險人患先天性疾病、遺傳性疾病、既往癥（投保前已患疾病或已存在的癥狀,保險期間非連續的）；
（八）被保險人患艾滋病或感染艾滋病病毒、性病；
（九）被保險人懷孕、流產、分娩、不孕不育癥治療、人工受精、產前產后檢查；節育、墮胎，及以上原因引起的并發癥；
（十）被保險人因整容手術或其它內、外科手術導致醫療事故；
（十一）被保險人因牙護理，如洗牙、牙移植、義齒、鑲牙、烤瓷牙等發生的醫療費用，以及口腔修復、口腔正畸、口腔保健及美容所發生的費用；（被保險人因齲齒、牙髓病、牙隱裂所引起的補牙、治牙神經、拔牙、阻生齒治療以及牙周組織疾病，如牙周炎、牙齦炎、根周炎（潔牙治療除外），所發生的合理醫療費用，屬于保險人保險責任范圍）；
（十二）被保險人因矯形、矯正、整容或康復性治療等所支出的費用；
（十三）被保險人如體檢、疾病普查等項目；各種預防、保健性、療養、靜養或特別護理的診療項目：如各種疫苗預防接種、足部反射推拿療法、健身按摩等項目；
（十四）被保險人未遵醫囑，私自服用、涂用、注射藥物；
（十五）在中國大陸地區以外發生及中國大陸境內私立醫院發生的醫療費用及藥店、醫療器材公司所支出的費用；
（十六）被保險人在中國大陸地區以外發生的意外事故及后續治療；
（十七）被保險人支出的電話費、交通費等
（十八）專業人員參與的高風險運動及高危競技類活動，如被保險人從事潛水、跳傘、滑翔傘、滾軸輪滑、滑雪滑冰、蹦極、攀巖、摔跤、柔道、跆拳道、武術、空手道、擊劍等高風險運動；
（十九）提供虛假投保信息的，外籍專家及外教以學生身份投保的
（二十）被保險人在醫院進行試驗性治療且以醫學實驗為目的所產生的相關費用；
（二十一）嚴格按照就診醫院的入院標準就醫未達到入院指標但被保險人按自己意愿住院的費用不予報銷；
（二十二）未提前撥打400電話詢診或未審核通過的相關就診費用
（二十三）被保險人在勤工助學期間產生的相關費用。
保險費
保障責任 | 保險金額 （元） | 8歲—69歲 | |
保險費 （元/人·半年） | 保險費 （元/人·年） | ||
身故+意外傷殘 | 100000 | 400 | 800 |
意外醫療 | 20000 | ||
門、急診疾病醫療 （日費用限額600元，免賠額650元以上的部分按照85%比例賠付） | 20000 | ||
住院醫療 | 400000 | ||
注：未盡事宜以《平安附加殘疾保障團體意外傷害保險（2013版）（D款）》、《平安一年期團體定期壽險》、《平安附加意外傷害團體醫療保險》、《平安住院門診急診綜合團體醫療保險》、《平安住院團體醫療保險》、《平安住院安心團體醫療保險（A款）》等條款執行。
尊敬的客戶：
您如果想了解平安養老保險股份有限公司來華人員綜合保險理賠服務事項，請您仔細閱讀如下內容。
（一）理賠程序：
保險事故發生后，理賠的規范程序:
咨詢、報案電話：4008105119
因疾病或意外事故需就診，需直接致電4008105119，由救援醫生進行健康詢診、就醫指導及理賠注意事項說明。如經過詢診且門診治療后醫生確診需進一步住院治療的可向救援公司申請住院墊付，救援公司與醫院溝通確認后決定是否啟動住院墊付程序。凡未經救援公司醫生詢診備案且未經門診診治而直接入院治療的（包括病情未達到住院程度卻要求門診醫生同意住院治療的），救援公司不負責住院費用墊付。對于未按照上述程序申請的，個人自行墊支醫療費用的將無法獲得賠付。
（二）理賠應備文件：
1）．身故或意外傷殘
A被保險人護照復印件及簽證頁復印件
B被保險人傷殘時需提供傷殘鑒定證明（由指定鑒定機構出具鑒定報告）
C被保險人死亡證明
D被保險人與所有受益人關系證明及受益人身份證明復印件。
E如意外事故須提供意外事故證明及相關部門的定性材料（如：交通事故須出具交通部門的交通事故責任認定書，高墜、溺水等須公安機關或相關部門出具事故屬意外或自殺的定性材料，飲酒導致事故須出具酒精含量定量報告）
2）．意外醫療
A被保險人護照復印件及簽證頁復印件
B意外事故經過及證明（如是交通事故須出具交通部門的交通事故責任認定書等）
C收費收據原件
D相對應每次就診病歷（病歷日期須與發票日期一一對應）、費用明細、檢查、化驗報告單復印件
3）．門急診醫療
A被保險人護照復印件及簽證頁復印件
B收費收據原件
C相對應每次就診病歷（病歷日期須與發票日期一一對應）、費用明細、檢查、化驗報告單復印件如果已滿650元免賠額，須提交650元以下的發票原件、病歷、費用明細、檢查化驗報告單的復印件。
4）．住院醫療
A被保險人護照復印件及簽證頁復印件
B如意外事故須提供意外事故證明（如是交通事故出具交通部門的交通事故責任認定書等）
C住院收據原件、費用明細原件
D出院小結或住院病歷復印件
以上2）-4）項特別說明：
（1）每次申請理賠，申請材料中必須附上被保險人中國大陸境內的銀行賬號及該賬號的準確賬戶信息，包括賬戶名、賬號和開戶行信息，可通過存折復印件或銀行客戶信息表載明以上信息。（詳情請撥打4008105119進行咨詢）
（2）若一次保險事故分別在兩家（包含兩家）以上醫院就診，須出具每次就診的診斷證明書、病歷復印件等相關文件。
（3）就診醫院必須是中華人民共和國大陸境內的公立醫院，申請理賠費用應屬于當地社會基本醫療保險規定可報銷的范圍之內的費用。
5）．護工費申請
住院期間醫院或護工服務公司出具的護工費發票原件。
Comprehensive Medical Insurance & Protection Scheme for
Foreigners Staying in China of Ping An Annuity Insurance Co., Ltd.
To participate in conditions:
International students in China, students from Hongkong, Macao and Taiwan, as well as overseas Chinese students（identities are needed to be proved by relative authority）in healthy condition, able to participate in study normally and from 8 to 69, are eligible to this policy.
Insurance Liabilities:
Ping An shall undertake the following insurance liabilities during the valid period of insurance（Insurance period （from the valid date of the policy to the expiry date of the insurance period））
1. Death insurance:
Ping An shall pay the stipulated amount of insurance compensation if the Insured dies of an accident o r disease. Insurance liabilities thus terminate.
2. Accidental disability insurance:
If the Insured suffers from an accident which results in any disability listed in the Standards and Codes for Personal Insurance Disability Assessment （JR/T0083-2013）（issued by former China Insurance Regulatory Commission, BJF [2014] No. 6）within 180 days since the occurrence of the accident, Ping An shall assess the injury and disability according to the assessment principles stipulated by this Criteria, unless otherwise stipulated, Ping An shall pay the accidental disability insurance money, whose amount shall be calculated based on the multiplication of the proportion stipulated in this Criteria, which is corresponding to the assessment result, by the sum insured, which is corresponding to insurer’s responsibilities. If medical treatment is still not over on the 180 th day, disability evaluation shall be made on the basis of the Insured’s physical condition on that day and the Insurance of Accidental Disability shall be paid in accordance with the evaluation results.
If with the disability resulted from this accident and the previous disability combined as a more serious disability according to the Injury and Disability Assessment Criteria for Personal Insurances, the insuran ce shall be paid in accordance with the standard for the more serious disability, but the insurance of accidental disability which has been paid previously （disabilities listed in the Standards and Codes for Personal Insurance Disability Assessment （JR/T0083-2013） （issued by former China Insurance Regulatory Commission, BJF [2014] No. 6）have taken place before purchase of insurance or caused by events under Liability Exemption, shall be deemed as having been compensated already）shall be deducted therefrom .
The accumulative payment amount of accidental disability insurance, and death due to any accidental injury or disease shall not exceed the corresponding insured sum of the Insured. If the accumulative amount of payment exceeds the insured sum of the Ins ured, then the insurance liabilities to the insured thus terminate.
Note:Standards and Codes for Personal Insurance Disability Assessment （JR/T0083-2013） （issued by former China Insurance Regulatory Commission, BJF [2014] No. 6 is accessible from the web site of Insurance Association of China.
3. Accidental Medical Insurance:
If the Insured, who suffers from the accidental incident, receives medical treatment Within 180 days since the occurrence of the accident, the Insurer shall be liable for the full amount of the reasonable and necessary expenses actually paid by the Insured for the medical treatment, but the accumulative amount of payment shall not exceed RMB 20,000. Whether an accident happens to the Insured for once or several times, the Insurer shall pa y the "accidental medical insurance" respectively in accordance with the aforesaid provisions, but the accumulative amount of payment shall not exceed the insured sum of the accidental medical insurance of the Insured. When the accumulative amount of payme nt reaches the insured sum of the accidental medical insurance of the Insured, the said insurance liability for the said Insured shall be terminated.
For example, the accidents such as bruises of bumps, burns, sprained ankle, accidental cut- wound when cutting vegetables, scratches and bites by cats and dogs.
Reimbursement equation: total amount of reasonable expenditure * 100%=reimbursable amount（the total amount of reasonable expenditures shall exclude the self-paid or partly self-paid items and expenses stipulated by the local regulations of the social basic medical insurance）
4. Outpatient and Emergency Medical Insurance:
The reasonable and necessary expenses incurred by the Insured for receiving outpatient or
emergency medical treatment because of illnes s, within each insurance period, the daily limit f for outpatient is RMB600,（that said, for the medical expense of the day exceeding RMB 600 shall be calculated as RMB600, for the medical expense of the day not exceeding RMB600 shall be calculated by the ac tual amount）. For the medical expenses exceeding the starting line of RMB650, The remaining amount of the medical expenses exceeding the deductible RMB650 yuan on the basis of the daily limit will be reimbursed at a percentage of 85%, and the accumulative payment shall not exceed the limit of RMB20000. The insurance liability shall be terminated once the accumulative amount of payment reaches the sum insured.
Medical expenses of outpatient and emergency treatment: The related expenses incurred from general outpatient treatment, emergency treatment, outpatient surgery, hospitalization for observation, emergency rescue, isolation due to infectious diseases that is certified by the public hospital or department of public health and epidemic prevention, and expense or cost of outpatient and emergency treatment before and after hospitalization that arise from the same cause of disease are also deemed as outpatient and emergency treatment.
For example, being treated in the outpatient or emergency for fever, sudden abdominal pain, faint, and inflammation etc.
Reimbursement equation:（the expense of each day within the daily limit RMB600 yuan add up-650 yuan）*85%=reimbursable amount（the total amount of reasonable expenditures shall exclude the self-paid or partly self-paid items and expenses stipulated by the local regulations of the social basic medical insurance）
Definitions:
Daily limit: The top claim limit of available medical cost
Deductible: RMB 650 yuan（A total of RMB650 yuan is deducted accumulatively for one time during an insurance period）. Below the starting line, there is no compensation.
5. Hospitalization and Medical Insurance:
If diagnosis confirms that the Insured must be hospitalized for treatment because of suffering from the accident or the illness, Ping An shall pay 100% of the “hospitalization and medical insurance” to the insured with regard to the actual and reasonable expenses for medical treatment, including reasonable and necessary fees for nursing（limited to RMB200 Yuan per day and accumulate up to 60 days）, medical record, heating, air conditioning, bed, examination, special examination and treatment, operation, medicine, treatment, laboratory test, radiation, etc.
During one valid insurance period, whether the Insured is hospitalized for once or several times, the Insurer shall pay the insurance payment as per compensation rule, but the insurance liability shall be terminated once the accumulative amount of payment reaches the limitation of RMB 400,000.
In another word: if diagnosis confirms that the insured must be hospitalized for treatment because of suffering from the injury or illness, the insured may apply online for advanced payment by the hospital or at his own expense of medical expense for hospitalization and reimburse later.
Reimbursement equation: reasonable hospitalization expenditure * 100%=reimbursable amount（the total amount of reasonable expenditures shall exclude the self-paid or partly self-paid items and expenses stipulated by the local regulations of the social basic medical insurance）
Note:
1）Medical organizations which are involved in all the foregoing medical insurance liabilities are limited to the public hospitals established within the border of Mainland Chin a; However, for the insured who are treated in the ward area for foreigners, ward area for VIPs, private room, Class A ward, separate ward room, ward area for special treatment and needs, ward for special treatment and needs, ward for high ranking official s, or similar ward area of the public hospitals,, shall be excluded from the insurance, then all medical expenses incurred by such shall not be covered by the insurer.
2）Medical treatment expenses generated by all the foregoing medical insurance liabilities are limited to the items and expenses that can be reimbursed in accordance with the local regulations of social basic medical insurance, the self paid or partly self paid items and expenses cannot be reimbursed by the insurer.
3）For the insured who apply for the insurance for the first time or the insured who is not continuously insured, the first 30 days from the effective date of the insurance is the waiting period （observation period）. Where the insured is hospitalized or treated in outpatient during the waiting period and related medical cost occurs, the insurer bears no liability of compensation. The treatment for the insured of continuously insured or the Insured suffered from an accident is not subject to any waiting period.
4）If any third party has partially or fully paid any above-mentioned medical treatment fees, Ping An shall be liable for the remaining amount of reasonable fees that are within the reimbursable payment scope of the local social basic medical insurance. But the limited portion of the fees for the bed, nursing, outpatient and emergency treatment within the daily limitation is also limited; if the third party has a specified proportion for payment of the limited sum, Ping An shall be liable only for the remaining amount after deducting the already paid amount from the limited sum. If the third party has no specified proportion for payment, then Ping An shall be liable for the remaining amount, but not exceeding the insured sum, after deducting the standard amount of this item from the limited sum which takes the regulations of the local social medical insurance as the standard.
5）If the Insured suffers from a major disease or a chronic disease before the purchase of this insurance, the Insurer shall not bear the liability of payme nt.
Liability Exemption
I. Liability Exemption for Death and Accidental Disability Insurance
Ping An shall be exempted from the insurance liabilities for death and disability caused by any of the following circumstances on the part of the Insured:
1. Deliberate killing or injury conducted by the policy-holder or beneficiary to the Insured;
2. Deliberate self-harm, suicide, intentional crime, resistance to criminal compulsory measures taken according to the law on the part of the Insured;
3. Fightin g, drunkenness or affected by alcohol, and active taking, sucking or injection of drugs on the part of the Insured;
4. Driving a motor vehicle under the influence, driving a motor vehicle without a legal and valid driving license or driving a motor vehicle without a valid driving license on the part of the Insured;
5. War, military conflict, riot or armed rebellion;
6. Nuclear explosion, nuclear radiation or nuclear pollution;
7. Pregnancy, abortion, miscarriage, delivery （including caesarean birth）, birth control, treatment of infertility, contraceptive sterilization, artificial impregnation and related complication on the part of the Insured;
8. Medical accident occurring to the Insured because of cosmetic surgery or other surgical operations;
9. Taking of medicine （excluding OTC medicine taken according to instructions）without permission of doctor on the part of the Insured;
10. During the period when the Insured suffers from AIDS or is infected with the AIDS virus （HIV-positive）;
11. The Insured engages in high-risk activities such as diving, parachuting, mountain climbing, bungee jumping, paragliding, expedition, wrestling, martial art, stunt performance, horse racing, car racing, etc.
12. The Insured passes away or becomes disability because of an accident outside mainland China.
13. Providing false insurance information, or international experts and teachers taking out an insurance policy as a student
14. Those accidents that occur during the time when the Insured do their part time work;
If the Insured is caused dead in any of the foregoing circumstances, Ping An shall terminate the insurance liability of the Insured.
II. Liability Exemption for Medical Insurance Liability （Accidental Medical Treatment,
Outpatient, Emergency and Hospitalization）
Ping An shall be exempted from the insurance liabilities for medical expenses caused by any of the following circumstances on the part of the Insured:
1. Deliberate killing or injury conducted by the policy-holder or beneficiary to the Insured;
2. Deliberate self-harm, intentional crime or resistance to criminal compulsory measures taken according to the law on the part of the Insured;
3. Fighting, drunkenness or affected by alcohol, and active taking, sucking or injection of drugs on the part of the Insured;
4. Driving a motor vehicle under the influence, driving a motor vehicle without a legal and valid driving license or driving a motor vehicle without a valid driving license on the part of the Insured;
5. War, military conflict, riot or armed rebellion;
6. Nuclear explosion, nuclear radiation or nuclear pollution;
7. The insured suffers from congenital diseases, hereditary diseases, existing diseas （disease or symptoms that already exist prior to the date of insurance and non-continuous within the insurance period）;
8. The insured suffers from AIDS or HIV infection, sexually transmitted diseases;
9. Pregnancy, miscarriage or delivery on the part of the Insured, infertility treatment, artificial insemination, prenatal and postnatal check, birth control, abortion and complications caused by above-mentioned causes;
10. Medical accident occurring to the Insured because of cosmetic surgery or other surgical operations;
11. The medical expenses incurred by the Insured for dental care, such as washing teeth, dentures, dental implants, false filling, porcelain teeth, etc., as well as expenses incurred in oral restoration, orthodontics, oral health care and beauty; the reasonable medical expenses of the Insurer's dental fillings, tooth nerve treatment, tooth pulling, tooth impaction treatment and periodontal diseases （such as, periodontitis, gingivitis, periapical inflammation, except for teeth cleaning）due to dental caries, dental pulp disease and cracked teeth are within the insurance liability of the Insurer;
12. Expenses of orthopedics, correct procedure, plastic surgery or rehabilitation therapy received by the Insurer;
13. Items such as physical examination and disease screening for the Insured; various medical treatment items for prevention, health care, recuperation, rest and special care: such as various vaccines vaccinat ion, foot reflexology massage therapy, fitness massage and other items;
14. Taking, application or injection of medicine without the permission of doctor on the part of the Insured;
15. Medical expenses incurred outside Mainland China or in private hospitals within Mainland China, and expenses incurred in drug stores and companies of medical apparatus and instruments;
16. Accidents that occur outside Mainland China and the follow up treatments as a consequent on the part of the Insured
17. Charge of telephone, transportat ion, etc. on the part of the Insured;
18. Sports and athletic activities of high risk only professionals participate. （The Insured engages in high-risk activities such as diving, parachuting, paragliding, roller skating, skiing, skating, bungee jumping, rock climbing, wrestling, judo, taekwondo, martial art, karate, fencing, etc.
19. Providing false insurance information, or international experts and teachers taking out an insurance policy as a student.
20. Experimental treatment and costs incurred for medical experime nt purpose.
21. The insurant should turn to medical treatment in strict accordance with the hospital admissions standards. If not, the insurer does not reimburse the cost of hospitalization.
22. Medical treatment fees incurred without consulting in advance by dial ling 400 telephone numbers or not approved.
23. Relevant expenses incurred by the Insured during the time when they do their part time work.
Insurance premium
Insurance Amount （Yuan）RMB | Age 8—69 | ||
Insurance Premium （Yuan per half a ye ar per person） | Insurance Premium （Yuan per year per person） | ||
Liability for Death + Accidental Disability | 100000 | 400 | 800 |
Accidental Medical Treatment | 20000 | ||
Medical Treatment for Outpatient and Emergency （With a daily limit of 600 yuan; the medical expenses exceeding 650 yuan can apply for a claim, that excess portion will be reimbursed at a proportion of 85%） | 20000 | ||
Hospitalization Medical Treatment | 400000 |
Note:Matters not mentioned herein shall be executed according to “Ping An Additional Disabili tyGuarantee Group Accident Insurance（2013） （Clause D）”, “Ping An One year Group Term LifeInsurance”, “Ping An Additional Accidental Injury Group Medical Insurance”, “Ping An Inpatient,Outpatient and Emergency Comprehensive Group Medical Insurance”, “Pi ng An Inpatient GroupMedical Insurance” and “Ping An Inpatient Reassuring Group Medical Insurance（Clause A）”.
If any dispute arises concerning the contents mentioned above, the Chinese interpretation shall prevail.
Dear customers:
If you want to learn about the services of the settlement of a claim of comprehensive insurance for people coming to China of Ping An Endowment Insurance Co., Ltd., please read this guide carefully.
（1）Procedures for i nsurance claims :
Standard procedures of insurance claims after the occurrence of insurance accident:
Telephone for consultation and report: 4008105119
Please call directly 4008105119 for medical consultation due to disease or accident. The rescuing doctor will provide consultation, diagnose, and medical guidance and instructions on the insurance claim. After consulting the doctor and getting outpatient treatment, if the doctor confirms that further hospitalization is r equired, the insured can apply for advanced payment of medical expense for hospitalization to the rescue company. After communication and confirmation between the rescue company and hospital, it will be decided whether the advanced payment procedures shall be started. If the insured is directly hospitalized without being inquired, recorded by the doctor of the rescue company as well as not being treated by the outpatient （including those whose conditions do not meet the requirements of hospitalization but r equire the outpatient doctor to agree with hospitalization）, the rescue company will not be responsible for advanced payment of medical expense for hospitalization. If advanced payment for medical expenses is made without the above procedures, the insured will not be able to get compensation.
（2）Document to be presented for settlement of claims:
1）Death or accidental disability
A．Copy of passport and visa page of the Insured
B．Disability certificate when the Insured is disabled（an evaluation report shall be issued by the assigned evaluation body）
C．Death certificate of the Insured
D. Copies of certificates of the relationship between the Insured and all the beneficiaries, and copies of identification proofs of the beneficiaries
E．Certificate of accident in case of an accident（in case of traffic accident, the traffic unit should issue a liability confirmation of traffic accident; in case of falling from the height and drowning, the public security organs or relevant departments shall issue the materials determining whether it is accidental or suicidal; in case of alcohol-induced accident, a quantitative report on the alcohol concentration shall be issued.）
2）Accidental medical treatment
A．Copies of passport and visa page of the Insured
B．Process and certificate of accident（in case of a traffic accident, the traffic unit should issue a liability confirmation of traffic accident, which is needed.）
C．Original of receipt
D．Medical record, detailed expenditure sheet and copies of examination report and laboratory test report of each respective treatment（The date of the medical record and the date of invoice shall be corresponding with each other）.
3）Medical treatment for outpatient and emergency
A．Copies of passport and visa page of the Insured
B．Original of receipt
C．Medical record, detailed expenditure sheet and copies of examination report and laboratory test report of each respective treatment（The date of the medical record and the date of invoice shall be corresponding with each other）.
If the fees reach the deductible of RMB650 Yuan, then the original invoice, medical record, detailed expenditure sheet and copy of examination report and laboratory test report of treatment that costs below 650 Yuan are also required to be presented.
4）Hospitalization
A．Copies of passport and visa page of the Insured
B. Certificate of the accident in case of an accident（in case of the traffic accident, the traffic unit should issue a liability confirmation of traffic accident）
C. Original of receipt and detailed expenditure sheet for hospitalization
D. Copy of hospital discharge summary or medical record of hospitalization
Special instructions to item 2）to item 4）above:
（1）The Insured’s bank account opened in mainland China and accurate information of this account, including account No. , name, opening bank information, which can be obtained from a copy of deposit book and bank customer tab le, I must be attached to the claim settling documents for each request for compensation;（For details, please call 4008105119）
（2）Where the insured treated in two or more hospitals（including two hospitals）respectively for one insured incident, relevant do cuments such as diagnosis certificate and medical record from relevant hospitals of each treatment shall be presented.
（3）Hospitals for treatment shall be limited to the public hospitals within the territory of Mainland China, and requested items and expenses that can be reimbursed should in accordance with the scope of local regulations of social basic medical insurance.
5）Application for nursing fee
Original Invoices of nursing fee issued by the hospital or by a nursing service company
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