在保险期间（从本次保险生效日期到截止日期的期限）内，本公司承担下列保险责任：
1、身故保险责任：
被保险人因意外事故或疾病身故，本公司按约定保险金额给付保险金，保险责任终止。
2、意外伤残保险责任：
被保险人因遭受意外事故，并自事故发生之日起180日内因该事故造成《人身保险伤残评定标准及代码》（JR/T0083—2013）（原中国保险监督管理委员会发布，保监发〔2014〕6号）所列伤残项目的，本公司依照该标准规定的评定原则对伤残项目进行评定，除另有约定外，本公司按评定结果所对应该标准规定的给付比例乘以相对应责任下的保险金额给付意外伤残保险金。如治疗仍未结束的，按事故发生之日起第180日的身体情况进行伤残鉴定，并据此给付意外伤残保险金。
被保险人该次意外事故导致的伤残合并前次伤残按照《人身保险伤残评定标准》可评定为较严重项目的，本公司按较严重项目标准给付，但前次已给付的意外伤残保险金（投保前已有或因责任免除事项导致《人身保险伤残评定标准及代码》（JR/T0083—2013）（原中国保险监督管理委员会发布，保监发〔2014〕6号）所列伤残的，视为已给付意外伤残保险金）应予以扣除。
每一被保险人的意外伤残、意外身故、疾病身故保险金的累计给付金额以其对应的保险金额为限，累计给付金额达到其保险金额时，对该被保险人的保险责任终止。
注：《人身保险伤残评定标准及代码》（JR/T0083—2013）（原中国保险监督管理委员会发布，保监发〔2014〕6号）可登陆中国保险行业协会网站查看。
3、意外医疗保险责任：
被保险人因遭受意外事故，并自事故发生之日起180日内进行治疗，保险人就其实际支出的合理且必要的医疗费用按100%给付意外医疗保险金，累计给付金额以20,000元为限。被保险人不论一次或多次发生意外事故，保险人均按上述规定分别给付“意外医疗保险金”，但累计给付金额以不超过该被保险人的意外医疗保险金额为限，累计给付金额达到其意外医疗保险金额时，对该被保险人的该项保险责任终止。
即：如因磕伤、烧烫伤、崴脚、切菜不小心切着手、猫狗抓咬伤等等造成意外事故的；
报销公式：合理费用合计*100%=可报销金额（合理费用合计不含当地社会基本医疗保险规定的自费及部分自费费用）。
4、门急诊医疗保险责任：
被保险人因疾病在门诊、急诊进行治疗所发生的合理且必要的医疗费用，在一个保险期间内，就诊日费用限额为600元（即：若当日医疗费用超日限额的只能按600元计算，当日医疗费用未超600元限额的按实际发生金额计算）在日限额的基础上累计超过650元免赔额以上的部分按照85%比例赔付，累计给付保险金额以20000元为限。当累计给付金额达到其保险金额时，对被保险人的该项保险责任终止。
即：如因发烧、突然腹痛、晕倒、身体某处炎症等等在门诊或急诊进行治疗的；
报销公式：每天在日限额600元以内的费用相加650元）*可报销费用（合理费用合计不含当地社会基本医疗保险规定的自费及部分自费费用）。
释义:
日限额：为每日就诊的最高费用限额。
免赔额：本险种设置650元为免赔额（一个保险期间内累计扣一次650元）），免赔额以下部分不予赔付。
5、住院医疗保险责任：
被保险人因遭受意外事故或疾病，经医院诊断必须住院治疗的,本公司就其实际支出的合理且必要的护工费（限额200元/天，最多累计60天）、建病历费、取暖费、空调费、床位费、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%的比例向被保险人给付“住院医疗保险金”。
在一个保期内，被保险人不论一次或多次住院治疗，本公司均根据理赔规则向其给付保险金，每次给付的住院医疗保险金累计相加达到400,000元时，该项保险责任终止。
即：因受伤或生病后，经医院诊断必须住院治疗，可申请网络医院住院垫付或自付后申请报销；
报销公式：合理住院费用
*可报销费用（合理费用合计不含当地社会基本医疗保险规定的自费及部分自费费用）。
注：
1）以上所有医疗保险责任所涉及的医疗机构仅限于在中华人民共和国大陆境内的公立医院。但是，若被保险人是在公立医院的外宾病区、VIP病区、包房、A等病房、单间、特诊特需病区、特诊特需病房和高干病房等同类病区或病房接受的治疗，则其所有的医疗费用本公司均不予报销。
2）以上所有医疗保险责任所涉及的医疗费用只限于当地社会基本医疗保险可报销项目内的费用，自费和部分自费项目本公司均不予报销。
3）首次投保或非连续投保的被保险人，自保险生效之日起30日内为等待期（观察期），如等待期内发生住院或疾病门诊的医疗费用，本公司不承担理赔责任。连续投保或被保险人遭受意外事故进行治疗的无等待期。
4）以上所有医疗费用，若其它第三方支付了部分或全部费用，我司仅就剩余的、且在当地社会基本医疗保险可报销项目范围内的合理费用予以赔付；但保险责任中所涉及的床位费、护工费、门急诊日限额等限额部分同样受限，如第三方有赔付比例的受限部分按照受限金额为基础扣除已赔付金额,我司只赔付剩余金额,如无赔付比例,受限部分按照当地社会医疗保险的标准,以受限金额为基础扣除此项目的标准金额,赔付剩余金额,并以保险金额为限。
5）被保险人在本次投保前发生重大疾病或慢性病的，保险人不承担给付保险金的责任。
责任免除
一、身故及伤残保险责任免除
因下列情形之一导致被保险人身故、伤残的，本公司不承担给付保险金的责任：
（一）投保人、受益人故意杀害或故意伤害被保险人；
（二）被保险人故意自伤、自杀、故意犯罪或者抗拒依法采取的刑事强制措施；
（三）被保险人殴斗、醉酒或受酒精影响，主动服用、吸食或注射毒品；
（四）被保险人酒后驾驶机动车、无合法有效驾驶证驾驶机动车，或驾驶无有效行驶证的机动车；
（五）战争、军事冲突、暴乱或武装叛乱；
（六）核爆炸、核辐射或核污染；
（七）被保险人妊娠、流产、堕胎、分娩（含剖腹产）、避孕、节育绝育手术、治疗不孕不育症、人工受孕及由以上情形导致的并发症；
（八）被保险人因整容手术或其他内、外科手术导致医疗事故；
（九）被保险人未遵医嘱，私自使用药物，但按使用说明的规定使用非处方药不在此限；
（十）被保险人患艾滋病（AIDS）或感染艾滋病病毒（HIV呈阳性）期间；
（十一）被保险人从事潜水、跳伞、攀岩、蹦极、驾驶滑翔机或滑翔伞、探险、摔跤、武术比赛、特技表演、赛马、赛车等高风险运动；
（十二）被保险人在中国大陆地区以外身故或造成伤残的；
（十三）提供虚假投保信息的，外籍专家及外教以学生身份投保的；
（十四）被保险人在勤工助学期间发生的事故。
发生上述情形之一，被保险人身故的，本公司对该被保险人保险责任终止。
二、医疗保险责任（意外医疗、门急诊医疗、住院医疗）免除
因下列情形之一造成被保险人医疗费用支出的，本公司不承担给付保险金的责任：
（二）被保险人故意自伤、故意犯罪或者抗拒依法采取的刑事强制措施；
（三）被保险人殴斗、醉酒或受酒精影响，服用、吸食或注射毒品；
（七）被保险人患先天性疾病、遗传性疾病、既往症（投保前已患疾病或已存在的症状,保险期间非连续的）；
（八）被保险人患艾滋病或感染艾滋病病毒、性病；
（九）被保险人怀孕、流产、分娩、不孕不育症治疗、人工受精、产前产后检查；节育、堕胎，及以上原因引起的并发症；
（十）被保险人因整容手术或其它内、外科手术导致医疗事故；
（十一）被保险人因牙护理，如洗牙、牙移植、义齿、镶牙、烤瓷牙等发生的医疗费用，以及口腔修复、口腔正畸、口腔保健及美容所发生的费用；（被保险人因龋齿、牙髓病、牙隐裂所引起的补牙、治牙神经、拔牙、阻生齿治疗以及牙周组织疾病，如牙周炎、牙龈炎、根周炎（洁牙治疗除外），所发生的合理医疗费用，属于保险人保险责任范围）；
（十二）被保险人因矫形、矫正、整容或康复性治疗等所支出的费用；
（十三）被保险人如体检、疾病普查等项目；各种预防、保健性、疗养、静养或特别护理的诊疗项目：如各种疫苗预防接种、足部反射推拿疗法、健身按摩等项目；
（十四）被保险人未遵医嘱，私自服用、涂用、注射药物；
（十五）在中国大陆地区以外发生及中国大陆境内私立医院发生的医疗费用及药店、医疗器材公司所支出的费用；
（十六）被保险人在中国大陆地区以外发生的意外事故及后续治疗；
（十八）专业人员参与的高风险运动及高危竞技类活动，如被保险人从事潜水、跳伞、滑翔伞、滚轴轮滑、滑雪滑冰、蹦极、攀岩、摔跤、柔道、跆拳道、武术、空手道、击剑等高风险运动；
（十九）提供虚假投保信息的，外籍专家及外教以学生身份投保的
（二十一）严格按照就诊医院的入院标准就医未达到入院指标但被保险人按自己意愿住院的费用不予报销；
保险费
保障责任
保险金额
（元）
8岁—69岁
（元/人·半年）
（元/人·年）
身故+意外伤残
100000
400
800
意外医疗
20000
门、急诊疾病医疗
（日费用限额600元，免赔额650元以上的部分按照85%比例赔付）
住院医疗
400000
注：未尽事宜以《平安附加残疾保障团体意外伤害保险（2013版）（D款）》、《平安一年期团体定期寿险》、《平安附加意外伤害团体医疗保险》、《平安住院门诊急诊综合团体医疗保险》、《平安住院团体医疗保险》、《平安住院安心团体医疗保险（A款）》等条款执行。
尊敬的客户：
您如果想了解平安养老保险股份有限公司来华人员综合保险理赔服务事项，请您仔细阅读如下内容。
（一）理赔程序：
保险事故发生后，理赔的规范程序:
因疾病或意外事故需就诊，需直接致电4008105119，由救援医生进行健康询诊、就医指导及理赔注意事项说明。如经过询诊且门诊治疗后医生确诊需进一步住院治疗的可向救援公司申请住院垫付，救援公司与医院沟通确认后决定是否启动住院垫付程序。凡未经救援公司医生询诊备案且未经门诊诊治而直接入院治疗的（包括病情未达到住院程度却要求门诊医生同意住院治疗的），救援公司不负责住院费用垫付。对于未按照上述程序申请的，个人自行垫支医疗费用的将无法获得赔付。
（二）理赔应备文件：
1）．身故或意外伤残
A被保险人护照复印件及签证页复印件
B被保险人伤残时需提供伤残鉴定证明（由指定鉴定机构出具鉴定报告）
C被保险人死亡证明
D被保险人与所有受益人关系证明及受益人身份证明复印件。
2）．意外医疗
B意外事故经过及证明（如是交通事故须出具交通部门的交通事故责任认定书等）
C收费收据原件
D相对应每次就诊病历（病历日期须与发票日期一一对应）、费用明细、检查、化验报告单复印件
3）．门急诊医疗
B收费收据原件
C相对应每次就诊病历（病历日期须与发票日期一一对应）、费用明细、检查、化验报告单复印件如果已满650元免赔额，须提交650元以下的发票原件、病历、费用明细、检查化验报告单的复印件。
4）．住院医疗
B如意外事故须提供意外事故证明（如是交通事故出具交通部门的交通事故责任认定书等）
C住院收据原件、费用明细原件
D出院小结或住院病历复印件
以上2）-4）项特别说明：
（1）每次申请理赔，申请材料中必须附上被保险人中国大陆境内的银行账号及该账号的准确账户信息，包括账户名、账号和开户行信息，可通过存折复印件或银行客户信息表载明以上信息。（详情请拨打4008105119进行咨询）
（3）就诊医院必须是中华人民共和国大陆境内的公立医院，申请理赔费用应属于当地社会基本医疗保险规定可报销的范围之内的费用。
5）．护工费申请
住院期间医院或护工服务公司出具的护工费发票原件。
ComprehensiveMedicalInsurance&ProtectionSchemefor
ForeignersStayinginChinaofPingAnAnnuityInsuranceCo.,Ltd.
Toparticipateinconditions:
InternationalstudentsinChina,studentsfromHongkong,MacaoandTaiwan,aswellasoverseasChinesestudents（identitiesareneededtobeprovedbyrelativeauthority）inhealthycondition,abletoparticipateinstudynormallyandfrom8to69,areeligibletothispolicy.
InsuranceLiabilities:
PingAnshallundertakethefollowinginsuranceliabilitiesduringthevalidperiodofinsurance（Insuranceperiod（fromthevaliddateofthepolicytotheexpirydateoftheinsuranceperiod））
1.Deathinsurance:
PingAnshallpaythestipulatedamountofinsurancecompensationiftheInsureddiesofanaccidentordisease.Insuranceliabilitiesthusterminate.
2.Accidentaldisabilityinsurance:
IftheInsuredsuffersfromanaccidentwhichresultsinanydisabilitylistedintheStandardsandCodesforPersonalInsuranceDisabilityAssessment（JR/T0083-2013）（issuedbyformerChinaInsuranceRegulatoryCommission,BJF[2014]No.6）within180dayssincetheoccurrenceoftheaccident,PingAnshallassesstheinjuryanddisabilityaccordingtotheassessmentprinciplesstipulatedbythisCriteria,unlessotherwisestipulated,PingAnshallpaytheaccidentaldisabilityinsurancemoney,whoseamountshallbecalculatedbasedonthemultiplicationoftheproportionstipulatedinthisCriteria,whichiscorrespondingtotheassessmentresult,bythesuminsured,whichiscorrespondingtoinsurer’sresponsibilities.Ifmedicaltreatmentisstillnotoveronthe180thday,disabilityevaluationshallbemadeonthebasisoftheInsured’sphysicalconditiononthatdayandtheInsuranceofAccidentalDisabilityshallbepaidinaccordancewiththeevaluationresults.
IfwiththedisabilityresultedfromthisaccidentandthepreviousdisabilitycombinedasamoreseriousdisabilityaccordingtotheInjuryandDisabilityAssessmentCriteriaforPersonalInsurances,theinsuranceshallbepaidinaccordancewiththestandardforthemoreseriousdisability,buttheinsuranceofaccidentaldisabilitywhichhasbeenpaidpreviously（disabilitieslistedintheStandardsandCodesforPersonalInsuranceDisabilityAssessment（JR/T0083-2013）（issuedbyformerChinaInsuranceRegulatoryCommission,BJF[2014]No.6）havetakenplacebeforepurchaseofinsuranceorcausedbyeventsunderLiabilityExemption,shallbedeemedashavingbeencompensatedalready）shallbedeductedtherefrom.
Theaccumulativepaymentamountofaccidentaldisabilityinsurance,anddeathduetoanyaccidentalinjuryordiseaseshallnotexceedthecorrespondinginsuredsumoftheInsured.IftheaccumulativeamountofpaymentexceedstheinsuredsumoftheInsured,thentheinsuranceliabilitiestotheinsuredthusterminate.
Note:StandardsandCodesforPersonalInsuranceDisabilityAssessment（JR/T0083-2013）（issuedbyformerChinaInsuranceRegulatoryCommission,BJF[2014]No.6isaccessiblefromthewebsiteofInsuranceAssociationofChina.
3.AccidentalMedicalInsurance:
IftheInsured,whosuffersfromtheaccidentalincident,receivesmedicaltreatmentWithin180dayssincetheoccurrenceoftheaccident,theInsurershallbeliableforthefullamountofthereasonableandnecessaryexpensesactuallypaidbytheInsuredforthemedicaltreatment,buttheaccumulativeamountofpaymentshallnotexceedRMB20,000.WhetheranaccidenthappenstotheInsuredforonceorseveraltimes,theInsurershallpaythe"accidentalmedicalinsurance"respectivelyinaccordancewiththeaforesaidprovisions,buttheaccumulativeamountofpaymentshallnotexceedtheinsuredsumoftheaccidentalmedicalinsuranceoftheInsured.WhentheaccumulativeamountofpaymentreachestheinsuredsumoftheaccidentalmedicalinsuranceoftheInsured,thesaidinsuranceliabilityforthesaidInsuredshallbeterminated.
Forexample,theaccidentssuchasbruisesofbumps,burns,sprainedankle,accidentalcut-woundwhencuttingvegetables,scratchesandbitesbycatsanddogs.
Reimbursementequation:totalamountofreasonableexpenditure*100%=reimbursableamount（thetotalamountofreasonableexpendituresshallexcludetheself-paidorpartlyself-paiditemsandexpensesstipulatedbythelocalregulationsofthesocialbasicmedicalinsurance）
4.OutpatientandEmergencyMedicalInsurance:
ThereasonableandnecessaryexpensesincurredbytheInsuredforreceivingoutpatientor
emergencymedicaltreatmentbecauseofillness,withineachinsuranceperiod,thedailylimitfforoutpatientisRMB600,（thatsaid,forthemedicalexpenseofthedayexceedingRMB600shallbecalculatedasRMB600,forthemedicalexpenseofthedaynotexceedingRMB600shallbecalculatedbytheactualamount）.ForthemedicalexpensesexceedingthestartinglineofRMB650,TheremainingamountofthemedicalexpensesexceedingthedeductibleRMB650yuanonthebasisofthedailylimitwillbereimbursedatapercentageof85%,andtheaccumulativepaymentshallnotexceedthelimitofRMB20000.Theinsuranceliabilityshallbeterminatedoncetheaccumulativeamountofpaymentreachesthesuminsured.
Medicalexpensesofoutpatientandemergencytreatment:Therelatedexpensesincurredfromgeneraloutpatienttreatment,emergencytreatment,outpatientsurgery,hospitalizationforobservation,emergencyrescue,isolationduetoinfectiousdiseasesthatiscertifiedbythepublichospitalordepartmentofpublichealthandepidemicprevention,andexpenseorcostofoutpatientandemergencytreatmentbeforeandafterhospitalizationthatarisefromthesamecauseofdiseasearealsodeemedasoutpatientandemergencytreatment.
Forexample,beingtreatedintheoutpatientoremergencyforfever,suddenabdominalpain,faint,andinflammationetc.
Reimbursementequation:（theexpenseofeachdaywithinthedailylimitRMB600yuanaddup-650yuan）*85%=reimbursableamount（thetotalamountofreasonableexpendituresshallexcludetheself-paidorpartlyself-paiditemsandexpensesstipulatedbythelocalregulationsofthesocialbasicmedicalinsurance）
Definitions:
Dailylimit:Thetopclaimlimitofavailablemedicalcost
Deductible:RMB650yuan（AtotalofRMB650yuanisdeductedaccumulativelyforonetimeduringaninsuranceperiod）.Belowthestartingline,thereisnocompensation.
5.HospitalizationandMedicalInsurance:
IfdiagnosisconfirmsthattheInsuredmustbehospitalizedfortreatmentbecauseofsufferingfromtheaccidentortheillness,PingAnshallpay100%ofthe“hospitalizationandmedicalinsurance”totheinsuredwithregardtotheactualandreasonableexpensesformedicaltreatment,includingreasonableandnecessaryfeesfornursing（limitedtoRMB200Yuanperdayandaccumulateupto60days）,medicalrecord,heating,airconditioning,bed,examination,specialexaminationandtreatment,operation,medicine,treatment,laboratorytest,radiation,etc.
Duringonevalidinsuranceperiod,whethertheInsuredishospitalizedforonceorseveraltimes,theInsurershallpaytheinsurancepaymentaspercompensationrule,buttheinsuranceliabilityshallbeterminatedoncetheaccumulativeamountofpaymentreachesthelimitationofRMB400,000.
Inanotherword:ifdiagnosisconfirmsthattheinsuredmustbehospitalizedfortreatmentbecauseofsufferingfromtheinjuryorillness,theinsuredmayapplyonlineforadvancedpaymentbythehospitalorathisownexpenseofmedicalexpenseforhospitalizationandreimburselater.
Reimbursementequation:reasonablehospitalizationexpenditure*100%=reimbursableamount（thetotalamountofreasonableexpendituresshallexcludetheself-paidorpartlyself-paiditemsandexpensesstipulatedbythelocalregulationsofthesocialbasicmedicalinsurance）
Note:
1）MedicalorganizationswhichareinvolvedinalltheforegoingmedicalinsuranceliabilitiesarelimitedtothepublichospitalsestablishedwithintheborderofMainlandChina;However,fortheinsuredwhoaretreatedinthewardareaforforeigners,wardareaforVIPs,privateroom,ClassAward,separatewardroom,wardareaforspecialtreatmentandneeds,wardforspecialtreatmentandneeds,wardforhighrankingofficials,orsimilarwardareaofthepublichospitals,,shallbeexcludedfromtheinsurance,thenallmedicalexpensesincurredbysuchshallnotbecoveredbytheinsurer.
2）Medicaltreatmentexpensesgeneratedbyalltheforegoingmedicalinsuranceliabilitiesarelimitedtotheitemsandexpensesthatcanbereimbursedinaccordancewiththelocalregulationsofsocialbasicmedicalinsurance,theselfpaidorpartlyselfpaiditemsandexpensescannotbereimbursedbytheinsurer.
3）Fortheinsuredwhoapplyfortheinsuranceforthefirsttimeortheinsuredwhoisnotcontinuouslyinsured,thefirst30daysfromtheeffectivedateoftheinsuranceisthewaitingperiod（observationperiod）.Wheretheinsuredishospitalizedortreatedinoutpatientduringthewaitingperiodandrelatedmedicalcostoccurs,theinsurerbearsnoliabilityofcompensation.ThetreatmentfortheinsuredofcontinuouslyinsuredortheInsuredsufferedfromanaccidentisnotsubjecttoanywaitingperiod.
4）Ifanythirdpartyhaspartiallyorfullypaidanyabove-mentionedmedicaltreatmentfees,PingAnshallbeliablefortheremainingamountofreasonablefeesthatarewithinthereimbursablepaymentscopeofthelocalsocialbasicmedicalinsurance.Butthelimitedportionofthefeesforthebed,nursing,outpatientandemergencytreatmentwithinthedailylimitationisalsolimited;ifthethirdpartyhasaspecifiedproportionforpaymentofthelimitedsum,PingAnshallbeliableonlyfortheremainingamountafterdeductingthealreadypaidamountfromthelimitedsum.Ifthethirdpartyhasnospecifiedproportionforpayment,thenPingAnshallbeliablefortheremainingamount,butnotexceedingtheinsuredsum,afterdeductingthestandardamountofthisitemfromthelimitedsumwhichtakestheregulationsofthelocalsocialmedicalinsuranceasthestandard.
5）IftheInsuredsuffersfromamajordiseaseorachronicdiseasebeforethepurchaseofthisinsurance,theInsurershallnotbeartheliabilityofpayment.
LiabilityExemption
I.LiabilityExemptionforDeathandAccidentalDisabilityInsurance
PingAnshallbeexemptedfromtheinsuranceliabilitiesfordeathanddisabilitycausedbyanyofthefollowingcircumstancesonthepartoftheInsured:
1.Deliberatekillingorinjuryconductedbythepolicy-holderorbeneficiarytotheInsured;
2.Deliberateself-harm,suicide,intentionalcrime,resistancetocriminalcompulsorymeasurestakenaccordingtothelawonthepartoftheInsured;
3.Fighting,drunkennessoraffectedbyalcohol,andactivetaking,suckingorinjectionofdrugsonthepartoftheInsured;
4.Drivingamotorvehicleundertheinfluence,drivingamotorvehiclewithoutalegalandvaliddrivinglicenseordrivingamotorvehiclewithoutavaliddrivinglicenseonthepartoftheInsured;
5.War,militaryconflict,riotorarmedrebellion;
6.Nuclearexplosion,nuclearradiationornuclearpollution;
7.Pregnancy,abortion,miscarriage,delivery（includingcaesareanbirth）,birthcontrol,treatmentofinfertility,contraceptivesterilization,artificialimpregnationandrelatedcomplicationonthepartoftheInsured;
8.MedicalaccidentoccurringtotheInsuredbecauseofcosmeticsurgeryorothersurgicaloperations;
9.Takingofmedicine（excludingOTCmedicinetakenaccordingtoinstructions）withoutpermissionofdoctoronthepartoftheInsured;
10.DuringtheperiodwhentheInsuredsuffersfromAIDSorisinfectedwiththeAIDSvirus（HIV-positive）;
11.TheInsuredengagesinhigh-riskactivitiessuchasdiving,parachuting,mountainclimbing,bungeejumping,paragliding,expedition,wrestling,martialart,stuntperformance,horseracing,carracing,etc.
12.TheInsuredpassesawayorbecomesdisabilitybecauseofanaccidentoutsidemainlandChina.
13.Providingfalseinsuranceinformation,orinternationalexpertsandteacherstakingoutaninsurancepolicyasastudent
14.ThoseaccidentsthatoccurduringthetimewhentheInsureddotheirparttimework;
IftheInsurediscauseddeadinanyoftheforegoingcircumstances,PingAnshallterminatetheinsuranceliabilityoftheInsured.
II.LiabilityExemptionforMedicalInsuranceLiability（AccidentalMedicalTreatment,
Outpatient,EmergencyandHospitalization）
PingAnshallbeexemptedfromtheinsuranceliabilitiesformedicalexpensescausedbyanyofthefollowingcircumstancesonthepartoftheInsured:
2.Deliberateself-harm,intentionalcrimeorresistancetocriminalcompulsorymeasurestakenaccordingtothelawonthepartoftheInsured;
7.Theinsuredsuffersfromcongenitaldiseases,hereditarydiseases,existingdiseas（diseaseorsymptomsthatalreadyexistpriortothedateofinsuranceandnon-continuouswithintheinsuranceperiod）;
8.TheinsuredsuffersfromAIDSorHIVinfection,sexuallytransmitteddiseases;
9.Pregnancy,miscarriageordeliveryonthepartoftheInsured,infertilitytreatment,artificialinsemination,prenatalandpostnatalcheck,birthcontrol,abortionandcomplicationscausedbyabove-mentionedcauses;
10.MedicalaccidentoccurringtotheInsuredbecauseofcosmeticsurgeryorothersurgicaloperations;
12.Expensesoforthopedics,correctprocedure,plasticsurgeryorrehabilitationtherapyreceivedbytheInsurer;
13.ItemssuchasphysicalexaminationanddiseasescreeningfortheInsured;variousmedicaltreatmentitemsforprevention,healthcare,recuperation,restandspecialcare:suchasvariousvaccinesvaccination,footreflexologymassagetherapy,fitnessmassageandotheritems;
14.Taking,applicationorinjectionofmedicinewithoutthepermissionofdoctoronthepartoftheInsured;
15.MedicalexpensesincurredoutsideMainlandChinaorinprivatehospitalswithinMainlandChina,andexpensesincurredindrugstoresandcompaniesofmedicalapparatusandinstruments;
16.AccidentsthatoccuroutsideMainlandChinaandthefollowuptreatmentsasaconsequentonthepartoftheInsured
17.Chargeoftelephone,transportation,etc.onthepartoftheInsured;
18.Sportsandathleticactivitiesofhighriskonlyprofessionalsparticipate.（TheInsuredengagesinhigh-riskactivitiessuchasdiving,parachuting,paragliding,rollerskating,skiing,skating,bungeejumping,rockclimbing,wrestling,judo,taekwondo,martialart,karate,fencing,etc.
19.Providingfalseinsuranceinformation,orinternationalexpertsandteacherstakingoutaninsurancepolicyasastudent.
20.Experimentaltreatmentandcostsincurredformedicalexperimentpurpose.
21.Theinsurantshouldturntomedicaltreatmentinstrictaccordancewiththehospitaladmissionsstandards.Ifnot,theinsurerdoesnotreimbursethecostofhospitalization.
22.Medicaltreatmentfeesincurredwithoutconsultinginadvancebydialling400telephonenumbersornotapproved.
23.RelevantexpensesincurredbytheInsuredduringthetimewhentheydotheirparttimework.
Insurancepremium
InsuranceLiabilities
InsuranceAmount（Yuan）RMB
Age8—69
InsurancePremium
（Yuanperhalfayear
perperson）
（Yuanperyearper
person）
LiabilityforDeath+AccidentalDisability
AccidentalMedicalTreatment
MedicalTreatmentforOutpatientandEmergency
（Withadailylimitof600yuan;themedicalexpensesexceeding650yuancanapplyforaclaim,thatexcessportionwillbereimbursedataproportionof85%）
HospitalizationMedicalTreatment
Note:Mattersnotmentionedhereinshallbeexecutedaccordingto“PingAnAdditionalDisabilityGuaranteeGroupAccidentInsurance（2013）（ClauseD）”,“PingAnOneyearGroupTermLifeInsurance”,“PingAnAdditionalAccidentalInjuryGroupMedicalInsurance”,“PingAnInpatient,OutpatientandEmergencyComprehensiveGroupMedicalInsurance”,“PingAnInpatientGroupMedicalInsurance”and“PingAnInpatientReassuringGroupMedicalInsurance（ClauseA）”.
Ifanydisputearisesconcerningthecontentsmentionedabove,theChineseinterpretationshallprevail.
Dearcustomers:
IfyouwanttolearnabouttheservicesofthesettlementofaclaimofcomprehensiveinsuranceforpeoplecomingtoChinaofPingAnEndowmentInsuranceCo.,Ltd.,pleasereadthisguidecarefully.
（1）Proceduresforinsuranceclaims:
Standardproceduresofinsuranceclaimsaftertheoccurrenceofinsuranceaccident:
Telephoneforconsultationandreport:4008105119
Pleasecalldirectly4008105119formedicalconsultationduetodiseaseoraccident.Therescuingdoctorwillprovideconsultation,diagnose,andmedicalguidanceandinstructionsontheinsuranceclaim.Afterconsultingthedoctorandgettingoutpatienttreatment,ifthedoctorconfirmsthatfurtherhospitalizationisrequired,theinsuredcanapplyforadvancedpaymentofmedicalexpenseforhospitalizationtotherescuecompany.Aftercommunicationandconfirmationbetweentherescuecompanyandhospital,itwillbedecidedwhethertheadvancedpaymentproceduresshallbestarted.Iftheinsuredisdirectlyhospitalizedwithoutbeinginquired,recordedbythedoctoroftherescuecompanyaswellasnotbeingtreatedbytheoutpatient（includingthosewhoseconditionsdonotmeettherequirementsofhospitalizationbutrequiretheoutpatientdoctortoagreewithhospitalization）,therescuecompanywillnotberesponsibleforadvancedpaymentofmedicalexpenseforhospitalization.Ifadvancedpaymentformedicalexpensesismadewithouttheaboveprocedures,theinsuredwillnotbeabletogetcompensation.
（2）Documenttobepresentedforsettlementofclaims:
1）Deathoraccidentaldisability
A．CopyofpassportandvisapageoftheInsured
B．DisabilitycertificatewhentheInsuredisdisabled（anevaluationreportshallbeissuedbytheassignedevaluationbody）
C．DeathcertificateoftheInsured
D.CopiesofcertificatesoftherelationshipbetweentheInsuredandallthebeneficiaries,andcopiesofidentificationproofsofthebeneficiaries
E．Certificateofaccidentincaseofanaccident（incaseoftrafficaccident,thetrafficunitshouldissuealiabilityconfirmationoftrafficaccident;incaseoffallingfromtheheightanddrowning,thepublicsecurityorgansorrelevantdepartmentsshallissuethematerialsdeterminingwhetheritisaccidentalorsuicidal;incaseofalcohol-inducedaccident,aquantitativereportonthealcoholconcentrationshallbeissued.）
2）Accidentalmedicaltreatment
A．CopiesofpassportandvisapageoftheInsured
B．Processandcertificateofaccident（incaseofatrafficaccident,thetrafficunitshouldissuealiabilityconfirmationoftrafficaccident,whichisneeded.）
C．Originalofreceipt
D．Medicalrecord,detailedexpendituresheetandcopiesofexaminationreportandlaboratorytestreportofeachrespectivetreatment（Thedateofthemedicalrecordandthedateofinvoiceshallbecorrespondingwitheachother）.
3）Medicaltreatmentforoutpatientandemergency
B．Originalofreceipt
C．Medicalrecord,detailedexpendituresheetandcopiesofexaminationreportandlaboratorytestreportofeachrespectivetreatment（Thedateofthemedicalrecordandthedateofinvoiceshallbecorrespondingwitheachother）.
IfthefeesreachthedeductibleofRMB650Yuan,thentheoriginalinvoice,medicalrecord,detailedexpendituresheetandcopyofexaminationreportandlaboratorytestreportoftreatmentthatcostsbelow650Yuanarealsorequiredtobepresented.
4）Hospitalization
B.Certificateoftheaccidentincaseofanaccident（incaseofthetrafficaccident,thetrafficunitshouldissuealiabilityconfirmationoftrafficaccident）
C.Originalofreceiptanddetailedexpendituresheetforhospitalization
D.Copyofhospitaldischargesummaryormedicalrecordofhospitalization
Specialinstructionstoitem2）toitem4）above:
（1）TheInsured’sbankaccountopenedinmainlandChinaandaccurateinformationofthisaccount,includingaccountNo.,name,openingbankinformation,whichcanbeobtainedfromacopyofdepositbookandbankcustomertable,Imustbeattachedtotheclaimsettlingdocumentsforeachrequestforcompensation;（Fordetails,pleasecall4008105119）
（2）Wheretheinsuredtreatedintwoormorehospitals（includingtwohospitals）respectivelyforoneinsuredincident,relevantdocumentssuchasdiagnosiscertificateandmedicalrecordfromrelevanthospitalsofeachtreatmentshallbepresented.
（3）HospitalsfortreatmentshallbelimitedtothepublichospitalswithintheterritoryofMainlandChina,andrequesteditemsandexpensesthatcanbereimbursedshouldinaccordancewiththescopeoflocalregulationsofsocialbasicmedicalinsurance.
5）Applicationfornursingfee
OriginalInvoicesofnursingfeeissuedbythehospitalorbyanursingservicecompany