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中國意外急救醫(yī)療保險(xiǎn)單

CHINA ACCIDENTAL EMERGENCY MEDICAL INSURANCE POLICY

(只適用于中國廣東省境內(nèi))

(ONLY APPLICABLE TO GUANGDONG PROVINCE, P.R.C.)



茲根據(jù)被保險(xiǎn)人填具之要保聲明書,并鑒于被保險(xiǎn)人已給付保費(fèi),特出立本保險(xiǎn)單。被保險(xiǎn)人同意以該要保書暨聲明書作為訂立本保險(xiǎn)契約的基礎(chǔ)并視作本保險(xiǎn)的組成部分。

Whereas the Insured by a proposal and declaration which shall be the basis of this Contract and is deemed to be incorporated herein and has applied to China Communications Insurance Co., Ltd. (hereinafter called “China Communications Insurance”) for the insurance hereinafter contained and has paid the Premium as consideration for such insurance.

在本保險(xiǎn)單有效期間內(nèi),如被保險(xiǎn)人在中國廣東省境內(nèi)發(fā)生確屬本保險(xiǎn)單應(yīng)負(fù)責(zé)的外來明顯意外事故,中國交通保險(xiǎn)保險(xiǎn)有限公司(以下簡稱“中國交通保險(xiǎn)”)當(dāng)按照后開保險(xiǎn)條款或批文提供保障。

Now this Policy Witnesses that if during the Period of Insurance the Insured shall suffer bodily injury within the territory of Guangdong Province, P.R.C. resulting solely and directly from accident caused by violent external and visible means which shall be directly and independently of any other cause, then China Communications Insurance shall subject to the Terms, Conditions and Exceptions contained herein or endorsed hereon provide the Benefits to the extent specified in the Schedule.


保障項(xiàng)目

COVERAGE


第一節(jié)  緊急救治醫(yī)療費(fèi)用

SECTION 1  EMERGENCY MEDICAL EXPENSES



最高保障限額:每宗事故港幣260,000圓

Limit of Benefits: HKD260,000 per event


在保險(xiǎn)有效期內(nèi),若被保險(xiǎn)人在中國廣東省境內(nèi)發(fā)生確屬明顯外來意外事故所直接引致之明顯身體損傷,而需要緊急救治醫(yī)療,在本保險(xiǎn)單之最高保障限額之內(nèi),中國交通保險(xiǎn)將為被保險(xiǎn)人支付由法律上合格的醫(yī)師、醫(yī)生、謢士及醫(yī)院因施救所繳收的必要及合理救治費(fèi)用。

If during the Period of Insurance the Insured shall suffer bodily injury within the territory of Guangdong Province, P.R.C. resulting solely and directly from accident caused by violent external and visible means which shall be directly and independently of any other cause result in emergency medical expenses, then China Communications Insurance will indemnify the Insured against the necessary and reasonable costs of such emergency medical expenses charged by a legally qualified medical practitioner, physician, nurse and/or hospital up to the maximum Limit of Benefits specified in this Policy.


中國交通保險(xiǎn)之“廣東省意外急救醫(yī)療保險(xiǎn)卡”(以下簡稱 “醫(yī)療卡”)是由中國衛(wèi)生部及中國解放軍總后勤部衛(wèi)生部特許認(rèn)可作為繳付緊急救治醫(yī)療費(fèi)用之方式,通用于中國衛(wèi)生部、解放軍總后勤部衛(wèi)生部認(rèn)定之緊急救援網(wǎng)絡(luò)醫(yī)院,而被保險(xiǎn)人無須預(yù)付按金。

“Accidental Emergency Medical Card” issued by China Communications Insurance (hereinafter called “our medical card”) is recognized and approved by The Ministry of Health P.R. China and The Bureau of Medical Administration Health Department of the General Logistics Department People’s Liberation Army of China. Our medical card will be accepted by MOH International Assistance Net-work Hospitals and the hospital network of The Bureau of Medical Administration Health Department of the General Logistics Department People’s Liberation Army of China as a means of payment for providing necessary emergency medical treatments to the Insured without requiring any deposit payment.但被保險(xiǎn)人仍需自行負(fù)責(zé)支付超出本保險(xiǎn)單之最高保障限額之醫(yī)療費(fèi)用給予施救者。

Nevertheless the Insured shall be responsible for paying medical expenses exceeding the maximum Limit of Benefits to the medical providers directly.


索償程序 只適用于第一節(jié)

CLAIM PROCEDURES APPLY TO SECTION 1 ONLY


使用中國交通保險(xiǎn)之醫(yī)療卡

Using Medical Card Issued by China Communications Insurance


遇有事故,被保險(xiǎn)人只須依從下列事項(xiàng)索償即可:

In case of an accident, the Insured shall:

1.1 向中國衛(wèi)生部、解放軍總后勤部衛(wèi)生部認(rèn)定之緊急救援網(wǎng)絡(luò)醫(yī)院出示醫(yī)療卡, 即可獲得救治;及此后

1.1 present our medical card to MOH International Assistance Net-work Hospitals and the hospital network of The Bureau of Medical Administration Health Department of the General Logistics Department People’s Liberation Army of China for immediate treatment, and thereafter

1.2 填妥索償表;及

1.2 complete the claim form and;

1.3 提供是次意外之證明或說明。

1.3 provide evidence or report of the alleged accident.

中國交通保險(xiǎn)審核由施救醫(yī)院/醫(yī)療單位直接交予之索償?shù)任募?以轉(zhuǎn)帳方式向有關(guān)醫(yī)療單位支付該醫(yī)療費(fèi)用。

China Communications Insurance will verify the claim documentation submitted from the hospital/clinic concerned and reimburse the medical expenses to them directly.


不使用中國交通保險(xiǎn)之醫(yī)療卡<}94{>Not Using Our Medical card


若被保險(xiǎn)人不使用中國交通保險(xiǎn)之醫(yī)療卡作為繳付緊急救治醫(yī)療費(fèi)用之方式,可直接將以下文件遞交中國交通保險(xiǎn)索賠:

In the event of the Insured paying the emergency medical expenses without using our medical card, the Insured can submit the following claims documentation to China Communications Insurance directly:



2.1 被保險(xiǎn)人填妥之索償表。

2.1 The claim form completed by the Insured.

2.2 主診醫(yī)生之診斷書正本詳細(xì)列明損傷之程度及原因、診斷結(jié)果及所提供之醫(yī)療方法。

2.2 Original Medical Certificate issued by the attending doctor stating the nature and extent of injuries, diagnosis and what kind of treatments were provided.

2.3 所有由醫(yī)院/醫(yī)療單位發(fā)出之醫(yī)療單據(jù)正本(包括所有費(fèi)用的明細(xì))。

2.3 All original bills/receipts issued by the hospital/clinic concerned with detail breakdown of costs /expenses.

2.4 負(fù)責(zé)是次意外之政府有關(guān)部門報(bào)告正本或說明。

2.4 Original report issued by the official authorities concerned or evidence of the alleged accident.


損失通知

Notification of Loss

被保險(xiǎn)人必須遵守以下?lián)p失通知事項(xiàng),否則中國交通保險(xiǎn)有權(quán)不接受索償:

The Insured must comply with the following requirements, otherwise the claim may be denied for settlement:

若需要留院治療,被保險(xiǎn)人必需盡快或在入院后二十四小時(shí)內(nèi)致電中國交通保險(xiǎn)之二十四小時(shí)緊急支持服務(wù)熱線;

In case of hospitalization, the Insured is required to notify China Communications Insurance within 24 hours after admission to hospital or as soon as practicable by calling the designated 24 hours Emergency Assistance Hotline;

若是接受門診治療,被保險(xiǎn)人必須在接受門診治療后三十天內(nèi),以書面通知中國交通保險(xiǎn)有關(guān)意外事故。

For Clinical Visit, a written notice of Claim must be given by the Insured to China Communications Insurance as soon as practicable after the occurrence of an accident giving rise to a claim and in any case within 30 days after clinical visit.


第二節(jié) 緊急支持服務(wù)

SECTION 2 EMERGENCY ASSISTANCE SERVICES


在保險(xiǎn)有效期內(nèi),若被保險(xiǎn)人在中國廣東省境內(nèi)發(fā)生確屬意外事故所直接引致之明顯身體損傷, 而需要緊急支持服務(wù),被保險(xiǎn)人可致電二十四小時(shí)緊急服務(wù)熱線,中國交通保險(xiǎn)特約之服務(wù)機(jī)構(gòu)國際救援(亞洲)公司(以下簡稱“I.P.A.”)將提供下列之服務(wù)。

If during the Period of Insurance the Insured shall suffer bodily injury within the territory of Guangdong Province, P.R.C. resulting solely and directly from accident caused by violent external and visible means, the following emergency assistance services shall be arranged and provided directly by China Communications Insurance’s appointed agent, Inter Partner Assistance Hong Kong Limited (hereinafter called “I.P.A.”) upon notification by the Insured to the designated 24 hours emergency assistance services hotline.


2.1 轉(zhuǎn)院服務(wù)

Medical Evacuation


每宗事故最高保障限額:不設(shè)上限

Limit of Benefits per event: Unlimited


當(dāng)被保險(xiǎn)人因遭意外損傷住院醫(yī)療時(shí), 基于醫(yī)療上之需要, I.P.A. 將為被保險(xiǎn)人作下列之安排及直接負(fù)責(zé)有關(guān)費(fèi)用:

If the Insured shall suffer bodily injury such that I.P.A.’s medical team and the attending physician recommend hospitalization, I.P.A. will arrange and pay for: the transfer of the Insured into one of the nearest hospital and, - if necessary, on medical grounds


(1) 在醫(yī)護(hù)人員監(jiān)護(hù)下使用各種必需之醫(yī)療運(yùn)送設(shè)備,例如空中救難專機(jī)、定期班機(jī)及救護(hù)車等轉(zhuǎn)送被保險(xiǎn)人至適合治療其意外傷害之醫(yī)院;或

(1) the transfer of the Insured with necessary medical supervision by any means (including but not limited to air ambulance, schedule commercial flight, and road ambulance) to a hospital more appropriately equipped for the particular bodily injury, or

(2) 在醫(yī)護(hù)人員監(jiān)護(hù)下經(jīng)由救護(hù)車及定期班機(jī)直接轉(zhuǎn)送至適當(dāng)醫(yī)院/醫(yī)療機(jī)構(gòu)。

(2) the direct repatriation, including road ambulance transfers to and from the airports, of the Insured with necessary medical supervision by scheduled airline to an appropriate hospital or other health care facility, if his medical condition permits such repatriation.唯此項(xiàng)運(yùn)送安排必須經(jīng)由 I.P.A. 的醫(yī)療小組及主診醫(yī)生共同決定。

I.P.A.’s medical team and the attending physician will determine the necessary arrangements according to the circumstances.


出院后返香港

Repatriation To Hong Kong After Treatment


每宗事故最高保障限額:不設(shè)上限<}100{>Limit of Benefits per event: Unlimited

被保險(xiǎn)人在接受第2.1條承保項(xiàng)目就醫(yī)后,如身體狀況穩(wěn)定且經(jīng)主診醫(yī)生及 I.P.A. 醫(yī)療小組認(rèn)定可以返回香港時(shí),I.P.A. 將安排被保險(xiǎn)人乘搭定期班機(jī)返回香港。若被保險(xiǎn)人持有回程機(jī)票,但因意外事故后不能使用時(shí),被保險(xiǎn)人應(yīng)將原有機(jī)票交給 I.P.A. 人員處理,并由 I.P.A.安排機(jī)票或其它適當(dāng)之交通工具返港,I.P.A. 將負(fù)擔(dān)其費(fèi)用,但此項(xiàng)返港機(jī)票以經(jīng)濟(jì)客位為限。被保險(xiǎn)人若因醫(yī)療上的理由需要使用輔助設(shè)備(例如輪椅),I.P.A.將為被保險(xiǎn)人安排及負(fù)責(zé)其費(fèi)用。

Upon the discharge of the Insured from the local hospital where such Insured has been admitted or transferred as provided in Section 2.1 above, I.P.A. will arrange and pay for the repatriation of the Insured to Hong Kong by schedule airline flight (on economy class) or any other appropriate means of transportation, including any supplementary cost of transportation to and from the airport, if his original ticket is not valid for the purpose, provided that the Insured shall surrender any unused portion of his ticket to I.P.A. If, on medical ground, the Insured needs any supplemental equipment (e.g. wheelchair), I.P.A. will arrange and pay for the supplemental equipment.唯此項(xiàng)出院后返香港之服務(wù)必須經(jīng)由I.P.A.的醫(yī)療小組及主診醫(yī)生共同決定。<}74{>Any decision on the repatriation of the Insured shall be made jointly and exclusively by both attending physician & I.P.A.’s medical team.


遺體或骨灰送返香港

Repatriation Of Mortal Remains/Ashes To Hong Kong

每宗事故最高保障限額:不設(shè)上限

Limit of Benefits per event: Unlimited



倘若被保險(xiǎn)人在意外事故中身亡,I.P.A. 將安排一切所需(包括任何迎合當(dāng)?shù)厥掷m(xù)上的安排),并予支付 (i) 遺體或骨灰送返香港安葬,或 (ii) 應(yīng)被保險(xiǎn)人之繼承人或其合法代表人要求,進(jìn)行當(dāng)?shù)匕苍?;但?dāng)?shù)匕苍嶂M(fèi)用只限相等于與遺體或骨灰送返香港之費(fèi)用。

Upon the death of the Insured after an accident, I.P.A. will and make all the necessary arrangements (including any steps or arrangements necessary to meet local formalities) and pay for (i) the repatriation of the Insured’s mortal remains or ashes to Hong Kong, or (ii) at the request of the Insured’s heirs or legal representative, the local burial of the Insured, provided that the I.P.A.’s financial responsibility for such local burial shall be limited to the equivalent of the cost of repatriation of mortal remains as provided in this benefit.



安排親友探望

Compassionate Visit


當(dāng)被保險(xiǎn)人因意外受傷而需要連續(xù)住院七天以上時(shí),I.P.A. 將安排一位被保險(xiǎn)人在香港的家屬或其它所指定之友人,搭乘定期班機(jī)前往醫(yī)院探視,并由I.P.A. 負(fù)擔(dān)其兩張來回機(jī)票及住宿費(fèi)用; 但機(jī)票費(fèi)用以經(jīng)濟(jì)艙票價(jià)為限;住宿費(fèi)用每天港幣1,200圓;最多連續(xù)支付七天,且并不包括飲料、膳食及其它房間服務(wù)。

In the event of the Insured suffering from serious Bodily Injury resulting in hospital confinement for more than 7 (seven) consecutive days, I.P.A. will arrange and pay for the cost of two Return Scheduled Airline (on economy fare basis) for a relative or designated person of the Insured to travel from Hong Kong to the Insured’s bedside, including the cost of an ordinary room accommodation in any reasonable hotel up to HKD1,200.00 per day for a maximum period of 7 (seven) consecutive days, but excluding the cost of drinks, meals and other room services.


安排幼童返香港(年齡為十六歲以下)

Return of Unattended Dependent Child(ren) to Hong Kong(Age below 16)


被保險(xiǎn)人因意外傷害需要入院治療,而致其隨行未滿十六歲之幼童乏人照顧者,I.P.A. 將安排其未滿十六歲之幼童搭乘定期班機(jī)(包括往返機(jī)場之交通工具)返香港,I.P.A. 并負(fù)擔(dān)所須費(fèi)用;但機(jī)票費(fèi)用以經(jīng)濟(jì)艙票為限。

If any of the Insured’s travelling dependent child(ren) under 16 years of age is left unattended by reason of the Insured’s Bodily Injury resulting in hospital confinement, I.P.A. will organize and pay for the cost of a schedule airline ticket (on economy fare basis),若被保險(xiǎn)人未滿十六歲之幼童持有回程機(jī)票,因意外事故后不能使用時(shí),被保險(xiǎn)人必須將原有機(jī)票交給I.P.A. 人員處理。

for such child(ren) to return to Hong Kong, including any supplementary cost of transportation to and from the airport, if the original ticket is not valid for the return, provided that the Insured shall surrender any unused portion of the return ticket to I.P.A.必要時(shí),I_.P.A.將聘雇適當(dāng)人員隨行照顧被保險(xiǎn)人之未滿十六歲之幼童返香港,并負(fù)擔(dān)該項(xiàng)聘雇費(fèi)用。

If necessary, I.P.A. will also hire and pay for a qualified attendant to accompany any such dependent child(ren) for return journey to Hong Kong.


入院醫(yī)療費(fèi)用擔(dān)保

Hospital Admission Deposit Guarantee

最高擔(dān)保額:港幣65,000圓

Maximum Deposit Guarantee: HKD65,000.00



如被保險(xiǎn)人因意外受傷,并經(jīng)主診醫(yī)生及 I.P.A.醫(yī)療小組共同認(rèn)許需要入院治療,而被保險(xiǎn)人當(dāng)時(shí)未能支付入院按金及有關(guān)之醫(yī)療費(fèi)用,I.P.A.可代被保險(xiǎn)人擔(dān)保及墊支住院醫(yī)療費(fèi)用,最高擔(dān)保額為港幣65,000圓。

In case of hospital admission due to an accident for emergency medical treatment duly approved by both the attending physician and I.P.A.’s alarm centre doctor and the Insured is without means of payment of the required hospital admission deposit, I.P.A. on behalf of the Insured guarantee or provide such payment up to HKD65,000.00.但被保險(xiǎn)人或其代表人必須依照 I.P.A.之要求及同意負(fù)責(zé)承擔(dān)在I.P.A. 墊支后三十天內(nèi)退還有關(guān)醫(yī)療費(fèi)用給中國交通保險(xiǎn)。

The costs of this benefit and the advanced sum should be undertaken by the Insured or his legal representative subject to I.P.A.’s requirements and reimbursed by the Insured to China Communications Insurance within 30 days from the date I.P.A. provides the service.


條款 只適用于第二節(jié)

CONDITIONS APPLY TO SECTION 2 ONLY


所有緊急支持服務(wù)必須直接經(jīng)由中國交通保險(xiǎn)特約之服務(wù)機(jī)構(gòu) I.P.A. 安排及提供有關(guān)服務(wù)。

All emergency assistance services must be arranged and provided by China Communications Insurance’s appointed agent I.P.A.

否則中國交通保險(xiǎn)將不負(fù)擔(dān)或發(fā)還任何未經(jīng)中國交通保險(xiǎn)/I.P.A._預(yù)先批準(zhǔn)的費(fèi)用予任何人仕或機(jī)構(gòu)。

China Communications Insurance will not pay or reimburse any costs of emergency assistance provided or incurred by any other parties without the prior approval from China Communications Insurance


第三節(jié) 人身意外保障

SECTION 3 PERSONAL ACCIDENT


保障限額:列明于承保表內(nèi)

Limit of Benefits: As stated in Policy Schedule

在本保險(xiǎn)單有效期間內(nèi),若被保險(xiǎn)人中國廣東省境內(nèi)發(fā)生確屬意外事故所致之明顯身體損傷或身故,中國交通保險(xiǎn)當(dāng)按照后開保險(xiǎn)條或批文及賠償責(zé)任的規(guī)定,依照本保險(xiǎn)單內(nèi)所載賠償金額表所規(guī)定的金額賠償給被保險(xiǎn)人或其指定的受益人。

If during the Period of Insurance the Insured shall suffer bodily injury within the territory of Guangdong Province, P.R.C. resulting solely and directly from accident caused by violent external and visible means which shall be directly and independently of any other cause, then China Communications Insurance will subject to the Terms and Conditions contained herein or endorsed hereon pay to the Insured, or in the event of the death of the Insured to his appointed Beneficiary, the benefits specified in the Schedule of Benefits.



賠償金額表

The Schedule of Benefits


身故(失蹤不能作為意外身故,但因乘坐飛機(jī)或船只失事而致完全滅失的不在此限)

Death (Accidental death shall not be in any way be presumed by reason of disappearance of the Insured except in the event of the total loss by wreck of the ship or aeroplane on which the Insured was travelling.


列明于承保表內(nèi)

As stated in Policy Schedule


全身癱瘓(必須終身臥床或永久性喪失工作能力)

Total Paralysis (resulting in being permanently bedridden or permanent disablement from engaging in or giving attention to profession or occupation)


規(guī)約:本表內(nèi)賠款按下列規(guī)約辦理:

PROVISOES:


在保險(xiǎn)有效期內(nèi),不論發(fā)生一次或多次賠償,中國交通保險(xiǎn)最高賠償責(zé)任,以不超過保險(xiǎn)金額為限。

The total liability of the Company in respect of any claim or claims accumulated shall not exceed the total amount insured.


表列第一項(xiàng),身故必須在意外事故發(fā)生之日起12個(gè)月內(nèi)造成者。

Under Item 1, Death must occur within 12 calendar months from the date of accident.


保戶不得因遭受一次意外,而獲得表列一項(xiàng)以上的賠款金額。

The Insured shall not be entitled to have compensation under more than one of the Items in the Schedule of Basic Benefits in respect of any one accident.


索償手續(xù)

Claims Procedures


被保險(xiǎn)人在保險(xiǎn)有效期間,內(nèi)發(fā)生意外傷害,須在十五天內(nèi)或盡快以書面通知本公司,被保險(xiǎn)人如意外身故,其受益人須盡快以書通知本公司。

Upon the happening of any accident during the Period of Insurance likely to give rise to a claim under this policy, the Insured shall give written notice to the Company within 15 days or as soon as practicable after the happening of such accident. In the event of the death of the Insured prompt notice shall be given to the Company by his beneficiary.被保險(xiǎn)人或其受益人必須履行此一規(guī)定,才有索賠權(quán)利。

No claim shall be payable unless the provisions of this Article are fulfilled by the Insured or his beneficiary.


被保險(xiǎn)人或其受益人索賠時(shí),須向本公司提供足以證明意外傷殘或身故之證據(jù),該項(xiàng)提供證據(jù)之費(fèi)用由被保險(xiǎn)人(或其受益人)自己負(fù)擔(dān)。

In the event of claim being made or arising from this Policy the Insured or his beneficiary shall furnish the Company with all certificates, information and evidence required by the Company at the expense of the Claimant.


一般不保事項(xiàng) 適用于各節(jié)

GENERAL EXCEPTIONS APPLY TO ALL SECTIONS


凡直接或間接由于下列任何原因所引致受傷或死亡,皆不在本保單之承保范圍以內(nèi),本保險(xiǎn)單概不負(fù)責(zé):

This policy does not cover any bodily injury or death directly or indirectly resulting from or consequent upon:


戰(zhàn)爭、侵略、外國敵意行為(不論宣戰(zhàn)與否)、內(nèi)戰(zhàn)、叛變、暴動、軍事力量或政變、罷工,或由于核子武器,核子游離幅射,核子燃料或其燃燒后產(chǎn)生的廢料所致幅射能的沾染。

War, invasion act of foreign enemy, hostilities (whether war is declared or not), civil war, rebellion, insurrection, military force or coup, strikes, riots or caused by or arising from ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel.上述核子燃燒包括自發(fā)的核子分裂在內(nèi)。

For the purpose of this exception combustion shall include any self-sustaining process of nuclear fission.


被保險(xiǎn)人自愿招惹不必要之危險(xiǎn)(欲拯救他人之生命者除外)、自殺、自加傷害,或因觸犯刑章的不法行為。

The Insured Person willfully exposing himself to needless peril (except in an attempt to save human life) or the Insured Person committing or attempting to commit suicide or self-injury or any criminal or felonious act.


參與專業(yè)運(yùn)動,打獵、攀山(指需要利用繩索或誘導(dǎo)繩為輔助工作者)、滑雪、滑水、冬季運(yùn)動、潛水、參加各種競賽、毆斗、神經(jīng)錯(cuò)亂,或因酗酒,吸毒或?yàn)E用藥物。

The Insured Person engaging in professional sports, hunting, mountaineering necessitating ropes or guides, skiing, water skiing, winter sports, diving, racing of any kind or fighting or insanity or being under influence of drugs, alcohol , intoxication and solvent abuse.


被保險(xiǎn)人因本身存在的缺陷或病癥,而此缺陷或病癥在保單有效前已存在。

The Insured Person suffering from any pre-existing physical defect or infirmity which existed prior to inception of this policy.


被保險(xiǎn)人從事高空中飛行工作(以旅客身份乘搭由航空公司或注冊商業(yè)公司擁有和控制的注冊航班機(jī)除外)。

The Insured Person engaging in air travel, except as a passenger in a properly licensed multi-engined aircraft being operated by a licensed commercial air carrier or owned and operated by a commercial concern.


中國廣東省范圍以外之醫(yī)療費(fèi)用及緊急支持服務(wù)。

All medical expenses and emergency assistance services incurred outside the territory of Guangdong Province, P.R.C.


疾病、傳染病或非因意外事故而引致的受傷或死亡。

Illness, infectious disease or any bodily injury or death which is not caused solely and directly by violent accidental external and visible means.


懷孕、分娩、難產(chǎn)或墮胎或在進(jìn)行任何內(nèi)、科治療手術(shù)而致的受傷或死亡。

Pregnancy, childbirth, dystocia, abortion or by any medical or surgical treatment causing bodily injury or death.


從事軍警工作而當(dāng)執(zhí)行職務(wù)時(shí)所致的傷殘或身故。

In case of the Insured engaging service in the forces or police.


遭遇謀害。

The Insured Person suffering injury by encountering murder.(只限于第三節(jié)之人身意外保障)<}76{>(Applicable to Personal Accident under Section 3 only)


因語言上之障礙而對提供緊急救援引致延誤。

Any delay in providing emergency assistance caused by language barrier.

.

恐怖襲擊活動所致的傷殘或身故。

TERRORISM EXCLUSION CLAUSE


Notwithstanding any provision to the contrary within this insurance or any endorsement thereto, it is agreed that this insurance excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any act of terrorism regardless of any other cause or event contributing concurrently or in any other sequence to the loss.

For the purpose of this exclusion an act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization(s) or government(s), committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear.

This exclusion also excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to any act of terrorism.

If the Company alleges that by reason of this exclusion, any loss, damage, cost or expense is not covered by this insurance the burden of proving the contrary shall be upon the Insured.

In the event any portion of this exclusion is found to be invalid or unenforceable, the remainder shall remain in full force and effect.


基本條款 適用于各節(jié)

GENERAL CONDITIONS APPLY TO ALL SECTIONS


本保險(xiǎn)單及承保表內(nèi)之記載應(yīng)視為同一契約,不論單內(nèi)或表內(nèi)的任何部份之字句或措辭,其顯示有特定之含義者,則均應(yīng)以該項(xiàng)特定含義為準(zhǔn)。

This Policy and the Schedule shall be read together as one contract and any word or expression to which a specific meaning has been attached in any part of this Policy or of the Schedule shall bear such specific meaning wherever it may appear.


被保險(xiǎn)人所簽署的要保書,是中國交通保險(xiǎn)簽保險(xiǎn)單的根據(jù),也是本保險(xiǎn)單的組成部份。

The written application which the Insured has made and declared being the basis of issuing this policy must be true and correct.因此,被保險(xiǎn)人須確實(shí)填報(bào),如有虛報(bào)或提供偽證等情況,本保險(xiǎn)單即行失效。

If any claim made shall be fraudulent or exaggerated or if any false declaration or statement shall be made in support thereof, then this Policy shall be void.


訟裁

Arbitration

所有由于本保險(xiǎn)單所引起的爭議,應(yīng)提交一位仲裁人裁決,該仲裁人由爭議雙方以書面委任。

All differences arising out of this Policy shall be referred to the decision of an Arbitrator to be appointed in writing by the parties in difference如雙方對該一被選之仲裁人不能同意時(shí),則每方可于對方書面請求一個(gè)月內(nèi)各委任一人為仲裁人決定之。

or if they cannot agree upon a single Arbitrator to the decision of two Arbitrators one to be appointed in writing by each of the parties within one calendar month after having been required in writing so to do by either of the parties如果該兩位仲裁人不能取得一致意見,則應(yīng)于仲裁未開始前由該兩位仲裁人以書面委任一位公斷人參與公斷程序,并擔(dān)任公斷時(shí)之主席,作出公斷。

or in case the Arbitrators do not agree of an Umpire appointed in writing by the Arbitrators before entering upon the reference. The Umpire shall sit with the Arbitrators and preside at their meetings .在公斷人未作出公斷書之前,被保險(xiǎn)人不得對中國交通保險(xiǎn)進(jìn)行起訴。

and the making of an Award shall be a condition precedent to any right of action against China Communications Insurance 如中國交通保險(xiǎn)拒絕被保險(xiǎn)人的任何賠償要求,而被保險(xiǎn)人在被拒絕后的十二個(gè)月內(nèi)不根據(jù)本條款規(guī)定提交仲裁,則作為放棄索賠要求論。此后將不再獲得賠償。

If China Communications Insurance shall disclaim liability to the Insured for any claim hereunder and such claim shall not within twelve calendar months from the date of such disclaim have been referred to arbitration under the provisions herein contained, then the claim shall for all purposes be deemed to have been abandoned and shall not thereafter be recoverable hereunder.




危險(xiǎn)減輕義務(wù)

Mitigation

被保險(xiǎn)人應(yīng)盡其最大努力減輕急難狀況之影響。

Insured shall be obliged to use reasonable efforts to mitigate the effects of an emergency.



時(shí)限

Time Limitation

任何向中國交通保險(xiǎn)索償訴訟之行動,應(yīng)于意外事故發(fā)生后一年內(nèi)提出。否則將喪失所有索償及訴訟之權(quán)利。

Every action or proceeding against China Communications Insurance for the recovery of any claim under or by the virtue of this contract is absolutely barred unless commenced within one year after the accident occurs.



權(quán)利轉(zhuǎn)讓

Subrogation

中國交通保險(xiǎn)有權(quán)以被保險(xiǎn)人之名義向其它個(gè)人或團(tuán)體追討中國交通保險(xiǎn)所支付之任何賠償,而被保險(xiǎn)人應(yīng)協(xié)助及提交有關(guān)之文件給與中國交通保險(xiǎn)以便索償。

In the event that any payment is made under this Policy in respect of any claim, China Communications Insurance shall be subrogated to all the Insured Person's rights of recovery and therefore against any person or organization and the Insured Person shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights.被保險(xiǎn)人同意不會影響或妨礙中國交通保險(xiǎn)追討權(quán)利。

The Insured shall agree not to prejudice such rights.



被保險(xiǎn)人有權(quán)以書面形式通知本保險(xiǎn)公司取消此保險(xiǎn)單,并需退還醫(yī)療卡正本,其未到期保險(xiǎn)費(fèi)將按下列方式計(jì)算退回被保險(xiǎn)人:

The Insured may cancel this insurance by sending written notification to the Company together with Original Medical Card, the balance of premium for the unexpired period of Insurance will be made subject to the following conditions :

(i) 如保險(xiǎn)期為一年,保單一經(jīng)簽發(fā)則沒有保費(fèi)退還予被保險(xiǎn)人。

(i) For one-year contract, no refund of premium will be made once the insurance policy is issued.

(ii) 如保險(xiǎn)期為兩年,被保險(xiǎn)人于起保日起計(jì)算十二個(gè)月內(nèi)要求取消此保險(xiǎn)單,保險(xiǎn)單將作為一年期保險(xiǎn)單收費(fèi)計(jì)算,其余未到期的保險(xiǎn)費(fèi)將退還予被保險(xiǎn)人;如被保險(xiǎn)人于起保日計(jì)算十二個(gè)月后要求取消此保險(xiǎn)單,則沒有保險(xiǎn)費(fèi)退還予被保險(xiǎn)人。

(ii) For two-year contract, if the Insured cancels the insurance within 12 months from the commencement date of this Policy, the Company will treat this insurance as one-year contract, and charge the full premium, the balance of premium for the unexpired period of the insurance will be refund. If the insured cancels this Policy after 12 months from the commencement date of this insurance, no refund of premium will be made.

如保險(xiǎn)期為三年,被保險(xiǎn)人于起保日起計(jì)算十二個(gè)月內(nèi)要求取消此保險(xiǎn)單,或于起保日計(jì)算第十三個(gè)月至二十四個(gè)月內(nèi)要求取消此保險(xiǎn)單,本保險(xiǎn)公司將分別以一年期保險(xiǎn)費(fèi)或兩年期保險(xiǎn)單收費(fèi)計(jì)算,其余未到期的保險(xiǎn)費(fèi)將退還予被保險(xiǎn)人;如被保險(xiǎn)人于起保日計(jì)算第二十四個(gè)月后要求取消,則沒有保險(xiǎn)費(fèi)退還予被保險(xiǎn)人。

(iii) For three-year contract, if the Insured cancels this insurance within 12 months or after 12 months but within 24 months from the commencement date of this Policy, the company will treat this Policy as one-year contract or two-year contract respectively and charge the corresponding full one-year or two-year premium, the balance of premium for the unexpired period of the insurance will be refunded. If the Insured cancels this insurance after 24 months from the commencement of this Policy, no refund of premium will be made.





如被保險(xiǎn)人于發(fā)卡后宣稱遺失醫(yī)療卡或要求更改有關(guān)內(nèi)容,被保險(xiǎn)人應(yīng)立即以書面通知本保險(xiǎn)公司有關(guān)事項(xiàng),并需繳付港幣200元手續(xù)費(fèi),以便本保險(xiǎn)公司印發(fā)新醫(yī)療卡予被保險(xiǎn)人。

If the Insured declares that the Medical Card has been lost or requests to alter any information after issuance of this card, a replacement Medical Card will be issued upon receiving the written notification to the company together with a replacement fee of HK$200 from the Insured.


本保單遵從香港之司法管轄權(quán)。

This insurance is subject to Hong Kong Jurisdiction.


注意 :

Remarks : 中文譯本只供參考。

The Chinese version is for reference only.若保險(xiǎn)單的中文及英文譯本有差異而引致爭議,當(dāng)以英文譯本為準(zhǔn)。

Should the Chinese and English version of this Policy has different interpretation giving rise to a dispute, the English version shall prevail.


授權(quán)簽署

Authorized Signature


人身意外保障(意外身故或全身癱殘)

Personal Accident (Accidental Death or Total Paralysis


中國交通保險(xiǎn)有限公司

CHINA COMMUNICATIONS INSURANCE CO., LTD.


 
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