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

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BriefIntroductiontoPingAnLifeInsuranceCorporateOfChina,Ltd.ComprehensiveInsurance&ProtectionSchemeforForeignersstayinginChina保险责任Insurancecoverage一、在保险责任有效期内，本公司承担下列保险责任：I.PingAnshallundertakethefollowinginsuranceliabilitiesduringtheperiodofinsurance:1、身故保险责任：被保险人因意外伤害事故或疾病(含SARS)死亡，本公司按约定保险金额给付保险金，保险责任终止。1．DeathInsurancePingAnshallpaythestipulatedamountofinsurancecompensationiftheInsureddiesofanyaccidentalinjuryordisease(includingSARS).Insuranceliabilitiesthusterminate.2、残疾保险责任：被保险人因遭受意外伤害保险事故，并自遭受意外伤害之日起一百八十日内导致残疾，乙方按照中国平安人寿保险股份有限公司“残疾程度与给付比例表（见附件一）”的规定比例乘以约定保险金额给付保险金。如第一百八十日治疗仍未结束，则按第一百八十日的身体情况进行残疾鉴定，并据“残疾程度与给付比例表”给付“意外残疾保险金”。2．DisabilityInsurance:IftheInsuredsuffersfromanyaccidentalinjurywhichresultsinanydisabilitywithin180dayssincetheoccurrenceoftheaccidentalinjury,ThesuminsuredshallbepaidbyPartyBintheamountofagreedinsuredsumspecifiedintheinsurancepolicymultiplybycertainproportionstatedintheDisabilityDegreeandPaymentProportionTableofPingAnLifeInsuranceCorporateOfChina,Ltd.(SeeAnnex1).Ifthetreatmentisnotfinishedonthe180thdays,disabilityidentificationshallbeconductedonthebasisoftheInsured’sphysicalconditiononthe180thday,andtheInsuranceforAccidentalDisabilityshallbepaidinaccordancewiththeDisabilityDegreeandthePaymentProportionTable.被保险人因同一意外伤害事故造成“残疾程度与给付比例表”所列残疾程度两项以上者，保险人给付各对应项残疾保险金之和。但不同残疾项目属于同一手或同一足时，仅给付一项残疾保险金；若残疾项目所属残疾等级不同时，给付较严重项目的残疾保险金。IfthesameaccidentalinjuryresultsintwoormoredisabilitieslistedintheDisabilityDegreeandPaymentProportionTabletotheInsured,theInsurershallpaythesuminsuredtothesumoftheamounttoeachcorrespondingdisability.However,howeverifdifferentdisabilitiestakeplacetothesamearmorleg,onlyonedisabilityinsuredamountshallbepaid;Ifthedisabilitiesfallintodifferentdisabilitydegrees,thedisabilityinsuredamountforthemoreseriousdisabilityshallbepaid.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。Ifwiththedisabilityresultedfromthisaccidentalinjuryandthepreviousdisabilitytakentogether,theInsuredcoulddrawtheinsuranceforthemoreseriousdisability,theinsuranceshallbepaidinaccordancewiththestandardforthemoreseriousdisability,butthedisabilityinsurancewhichhaspreviouslybeenpaid(thedisabilitiestookplacebeforebuyinginsuranceorthedisabilitieslistedintheProportionTablebetweentheDegreeofDisabilityandthePaymentwhichwereresultedfromexceptionsshallbetreatedasbeingcompensatedalready)shallbededucted.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。PartyBshallrespectivelypaytheinsurancecompensationforaccidentaldisabilityinaccordancewiththepolicy,nomattertheInsuredsuffersfromaccidentalinjuryforonceorseveraltimes,howevertheaccumulativepaymentheretoshallnotexceedthestipulatedsuminsured.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。Theaccumulativeamountofinsuranceforaccidentaldisabilityordeathofeachinsuredshallnotexceedtheinsuredsumsetforthecorrespondingaccidentalinjury.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。IftheInsureddiesofthesamereasonwithin180dayssincetheoccurrenceofaccidentalinjurywhichresultsinanydisability,PartyBshallbeliableonlyforthedifferencebetweenthestipulatedinsuredamountforaccidentaldeathandforaccidentaldisability;iftheInsureddiesafter180days,PartyBshallpaythestipulatedinsuredamountforaccidentaldeathnomatterifthedeathiscausedbythesamereason.,andtheinsuranceliabilityshallbeterminated.3、意外伤害医疗保险责任：3．AccidentalInjuryMedicalTreatmentInsuranceLiability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。IftheInsuredreceivesanymedicaltreatmentwithin180dayssincetheoccurrenceoftheaccidentalinjury,theinsurershallbeliableforthefullamountoftheactualandreasonableexpensesformedicaltreatment;howevertheaccumulativepaymentshallnotexceedthestipulatedinsuredsum.NomattertheInsuredsufferedfromaccidentalinjuryonceormanytimes,theInsurershallrespectivelypayfortheAccidentalInjuryMedicalTreatmentinaccordancewiththeforesaidprovisions,buttheaccumulativeamountofpaymentshallnotexceedtheInsuredamount,wheretheaccumulativeamountofpaymentamountstotheinsured’sInsuredsum,thesaidinsuranceliabilityforthesaidInsuredshallbeterminated.4、住院医疗保险责任：4．HospitalizationMedicalTreatmentInsuranceLiability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”。Ifthehospitalizationisdiagnosedtobenecessaryoftheinsuredduetoanyaccidentalinjury,orforanydisease(includingSARS)afterthedayofinsurancepolicybecomeeffective(AmbulatorySurgeryandobservationroomtreatmentduetonobedavailableshallbetreatedashospitalizationmedicaltreatment),PartyBshallbeliablefortheactualandreasonableexpensesformedicaltreatmentincludingnursingfee(limitedtoRMB100Yuanperdayforaccumulative30days),ambulancefee,medicalrecordfee,heatingfee,airconditionerfee,bedfee(limitedtoRM