招商信诺,智享睿健条款

IMGB1401智享睿健招商信诺智享睿健高端个人医疗保险条款阅读指引TheReadingGuidetoCigna&CMBMassGoldenMedicalInsuranceProvision本阅读指引帮助您理解条款，保险合同的内容以条款为准。Thisguideintendstohelpyoubetterunderstandthefollowingpolicyprovision,thepolicyprovisionshouldalwaysbevalidandbinding.ü您所拥有的重要权益HighlightofYourRights1.如果您方自签收本合同之日起10天内要求解除本合同，我方将向投保人无息退还已交付的保险费，本合同解除。对合同解除前发生的保险事故，我方不承担保险责任；签收本合同之日起10天后,您仍然有解除合同的权利，但可能会存在退保损失。Whenyouwanttocancelthispolicywithin10dayssinceyoureceiveandsignoffthispolicy,wewillrefundthepaidpremium,thispolicywillbeinvalidfromallthebeginning.Wewon’tberesponsibleforallclaimsrelatedtothispolicy.After10days,youcouldterminatethispolicy,therefundwillbelessthanthepaidpremium.2.被保险人可以享受本合同提供的保障。Beneficiariesarecoveredbythebenefitsonthepolicy.ü您应特别注意的事项Mattersforattention1.请您留意保险责任条款中的各保障利益内容，并根据您方的需求购买。Pleasemakesureyouknowallbenefits,anddecideyourinsurancecoverageaccordingly.2.请您留意保险金的给付条件和范围，以及预先授权、赔付比例、赔付限额等。Pleasepayattentiontotheprovisionsaboutthecoverageandconditionsofcover,priorapprovals,coinsuranceandlimits.3.请您留意各项责任的责任免除，尤其是已加下划线的免除或限制我方责任的条款。Pleasepayattentiontotheprovisionsaboutexclusions,especiallythosehavingbeenunderlinedortheprovisionsoflimitingourliabilities.4.请您留意合同中关于保险期间、等待期、应追讨款项及合同效力终止的条款。Pleasepayattentiontotheprovisionsaboutperiodofcover,waitingperiod,clawbackclaimsandpolicytermination.5.请您留意续保的条件，如果您方不愿意续保，请在保单周年日前通知我方。Pleasepayattentiontotherenewalconditions.Ifyoudecidenottorenew,pleaseinformuspriortoyourpolicyanniversary.6.请您留意保险条款中术语的释义条款。PleasepayattentiontotheclauseofDefinitions.ü条款目录Tableofcontents第一章关于本保险合同的说明Section1.GeneralTermsofThisPolicy1.保险双方协议Insuranceagreement2.保险合同构成Policyconstitution3.保险责任生效Whendoesthecoverbegin第二章投保的重要事项Section2.ApplicationNotes4.投保年龄与年龄误告的处理EligibleAgesandMis-disclosureofAge5.常驻地HabitualResidence6.被保险人WhoisCovered7.增减被保险人AddorRemoveBeneficiaries第三章保障的重要事项Section3.CoverageNotes8.保障计划及方案PlansandPackages9.保障区域AreaofCover10.等待期WaitingPeriod11.医疗服务网络ClinicalNetworkIMGB1401智享睿健212.医疗费用项目CoveredMedicalCosts13.受保障医疗费用的审核VerificationofCoveredCosts14.赔付比例Coinsurance15.赔付限额Limits第四章保险责任Section4.Benefits16.基本保险责任CoreBenefit17.可选保险责任一OptionalBenefitA18.可选保险责任二optionalbenefitB19.可选保险责任三optionalbenefitC20.可选保险责任四optionalbenefitD第五章本合同的责任免除Section5.ExclusionsofThisPolicy21.对疾病的责任免除exclusionstodiseasesandconditions22.对费用的责任免除exclusionsforcosts23.对保险事故原因的责任免除exclusionsforreasons第六章保险费及续保Section6.PremiumandRenewal24.保险费的交纳PaymentofPremium25.未交纳保险费的处理Non-paymentofPremium26.续保条件HowisThisPolicyRenewed27.保险费变更PremiumChanging第七章解除及终止保险合同Section7.CancellationandTerminationofThisPolicy28.投保人解除合同的手续及风险ProceduresandRisksofCancellation29.合同效力终止TerminationofThisPolicy第八章索赔Section8.Claims30.预先授权PriorApprovals31.诉讼时效ClaimingPeriod32.保险金申请ClaimApplication33.保险金给付HowWePayClaims34.其他核定结果OtherDecisions35.应追讨款项ClawBackClaims第九章其他规定Section9.OtherClauses36.明确说明和如实告知TruthfulExplanationandFullDisclosure37.我方合同解除权的限制HowWeCancelThisPolicy38.联系您方ContactingYou39.联系我方ContactingUs40.保险合同变更Changestothispolicy41.保险合同执行人Whocanenforcethispolicy42.其他保险Otherinsurance43.资料保护Dataprotection44.语言Language45.申诉Complaints46.适用的法律法规Applicablelawandjurisdiction47.争议处理DisputeSettlement48.释义Definitions附件：保险利益表Appendix:ListofbenefitsIMGB1401智享睿健1招商信诺智享睿健高端个人医疗保险条款Cigna&CMBMassGoldenMedicalInsuranceProvision第一章关于本保险合同的说明Section1.GeneralTermsofThisPolicy1.保险双方协议Insuranceagreement根据载明于本保险合同（下称“本合同”）的规定，我方（见释义）将支付被保险人因遭受伤害、疾病等合同所及事项而产生的治疗费用及相关费用支出。Subjecttotheconditionssetoutinthispolicy,Weshallreimbursemedicalandrelatedexpensesrelatingtotreatmentprovidedwithintheselectedareaofcoverageforinjury,sickness,andmedicalconditionscoveredunderthispolicy.2.保险合同构成Policyconstitution本合同包括以下部分：保险单（见释义）或其他保险凭证及所附条款、您方（见释义）的投保文件（见释义）、合法有效的声明、批注、附贴批单及其他协议。Thispolicyconsistsofyourcertificateofinsuranceandthisprovision,yourapplication,yourlawfulandvalidstatement,annotations,commentariesandotheragreements.您方须告知我方在您方发出申请至保单生效前，您方所发生的任何健康与医疗情况的变化。我方将重新审核您方的投保申请。Youshouldnotifyusimmediatelyofanychangeinyourmedicalconditionwhichoccursbetweenyourapplicationandyouracceptanceofthepolicy.Wewillthenreviewyourapplicationagain.3.保险责任生效Whendoesthecoverbegin保险责任将于保险单首页所载生效时间起生效，该保险单将发送给您方，合同生效日以后每年的对应日是保单周年日。如果当月无对应的同一日，则以该月最后一日作为对应日。Thecoverwillbeginonthestarttimeshownonthefirstcertificateofinsurancewhichwesendtoyou.Theanniversarydateswillfallonthistimeeachyear.IfthestartdateisFebruary29thandthereisnoFebruary29thinonefollowingyear,theanniversaryofthatyearwillbeFebruary28th.如您方选择为其他被保险人购买本保险责任，该被保险人保障的生效日期为其所在保险单首页载明的时间，该保险单将发送给您方。Ifyouchoosetobuycoverforanyadditionalbeneficiaries,theircoverwillbeginonthestarttimeshownonthefirstcertificateofinsuranceonwhichtheyarelisted,whichwesendtoyou.第二章投保的重要事项Section2.ApplicationNotes4.投保年龄与年龄误告的处理EligibleAgesandMis-disclosureofAge本合同接受的被保险人的投保年龄为出生满30天至65周岁（见释义），并可续保至75周岁。Onebeneficiary’seligibleageathisinitialstarttimeiselderthan30daysofbirthandnomorethan65yearsold,andrenewableto75yearsold.对被保险人的投保年龄，以有效身份证件登记的周岁年龄为准。您方在申请投保时，应按照与有效身份证件相符的被保险人的出生日期填写，IMGB1401智享睿健2如果发生错误按照下列方式办理：Thebirthdateofbeneficiary(ies)onyourapplicationshouldbeba