平安养老保险股份有限公司来华人员综合保险保障计划简介
投保条件
留学生：来华留学生、港澳台学生及华侨学生（华侨身份须由相关单位出具证明），凡身体健康、年龄在6-69周岁可参加本保险。
保险责任
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、意外残疾保险责任：
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》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》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保险金累计给付金额以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，对该被保险人的保险责任终止。
注：《人身保险伤残评定标准》可登陆中国保险行业协会网站查看。
每一被保险人的意外残疾、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。
3、意外伤害医疗保险责任：
被保险人因遭受意外事故，并自事故发生之日起一百八十日内进行治疗，保险人就其实际支出的合理且必要的医疗费用按100%给付意外伤害医疗保险金，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。
4、门急诊医疗保险责任：
被保险人因疾病在门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达到650元（起付线）以上的部分保险人按照85%的比例予以赔付，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。
门急诊医疗保险责任包括：普通门诊、急诊、门诊手术、急诊留观、急诊抢救所产生的相关费用；由公立医院或卫生防疫部门提供证明的传染病因隔离期间所产生的相关费用；因与住院同一病因而产生的院前、院后的门诊费用等均归属于门急诊医疗责任范围内。
释：
日限额：为每日就诊的最高费用限额。
起付线：本险种设置650元为起付线（一个保险期间内累计一次），起付线以下部分不予赔付。
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150元/天，最多累计30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。
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分院、外宾病区、VIP病区、包房、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，自投保之日起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、身故及残疾责任免除
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，主动服用、吸食或注射毒品；
（四）被保险人酒后驾驶、无合法有效驾驶证驾驶，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）被保险人患爱滋病（AIDS）或感染爱滋病毒（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残疾的；
（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）留学生在勤工俭学期间发生的事故。
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、医疗责任（意外伤害医疗、门急诊医疗、住院医疗）责任免除
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：
（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、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，服用吸食或注射毒品 ；
（四）被保险人酒后驾驶、无合法有效驾驶证驾驶，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、外科导手术致医疗事故 ；
（十一）被保险人因矫形、矫正、整容或康复性治疗等所支出的费用；
（十二）被保险人健康检查（体检）、疗养、静养或特别护理；
（十三）被保险人未遵医嘱，私自服用、涂用、注射药物 ；
（十四）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所支出的费用 ；
（十五）被保险人支出电话费、交通费等；
（十六）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；
（十七）提供虚假投保信息的，外籍专家及外教以学生身份投保的；
（十八）被保险人在医院进行试验性治疗,且以医学实验为目的所产生的相关费用；
（十九）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；
（二十）未提前拨打400电话询诊或未审核通过的相关就诊费用；相关费用；
（二十一）留学生在勤工俭学期间产生的相关费用。
保险费
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》等条款执行。
以上内容若有争议，请以中文的解释为准。
Comprehensive Insurance & Protection Scheme for Foreigners Staying in
China
of Ping An Annuity Insurance Company, Ltd.
To participate in conditions:
International students: international students in
China
, students from Hongkong and Macao and overseas Chinese students ( identityies are needed to be proved by relative authority) in healthy condition from 6 to 69 are eligible to this policy.
Insurance coverage
Ping An shall undertake the following insurance liabilities during the valid period of insurance (Insurance period (from the valid date of 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 any accident or disease. Insurance liabilities thus terminate.
2、Accidental disability insurance:
If the Insured suffers from any accident which results in any disability listed in the Injury and Disability Assessment Criteria for Personal Insurances within 180 days since the occurrence of the accident, according to the policy Ping An shall pay the insurance money, whose amount shall be calculated based on the multiplication of the sum insured, which is corresponding to insurer’s responsibilities, and the proportion that is specified in the “Proportion Table of Disability Degree and Payment” of Ping An Annuity Insurance Company, Ltd. If medical treatment is still not over on the 180th 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 “Proportion Table of Disability Degree and Payment”.
If the same accident causes the Insured to suffer two or more disabilities, as are specified in the “Proportion Table of Disability Degree and Payment”, the Insurer (PingAn) shall pay the total insured amount of the relevant disabilities. However, if different disabilities befall the same upper limb or lower limb, only the insured amount of one disability shall be paid; if disabilities are of different degrees, the insured amount of the disability that is more serious shall be paid.
If, with the disability resulted from this accident and the previous disability combined, the Insured can claim the insurance for the more serious disability, the insurance shall be paid in accordance with the standard for the more serious disability, but the disability insurance which has been paid previously (disabilities that have taken place before purchase of insurance, or disabilities that are caused by and as a result of liability exemption and are listed in the “Proportion Table of Disability Degree and Payment” shall be deemed as having been compensated already) shall be deducted therefrom.
Note: “Proportion Table of Disability Degree and Payment” is accessible from the website of INSURANCE ASSOCIATON OF CHINA.
The accumulative amount of payment of insurance for death or accident of each insured shall not exceed the insured sum of the insured’s total insurance for the death or accident.
3、Medical Insurance for Accidental Injury:
If the Insured receives medical treatment within 180 days since the occurrence of the accident, the Insurer shall be liable for the payment of 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 the agreed sum insured, which is up to RMB 20,000 limitation. Whether an accidental injury happens to the Insured for once or several times, the Insurer shall pay the respective “medical insurance for accidental injury” in accordance with the foresaid provisions, but the accumulative amount of payment shall not exceed the Insured’s sum insured. When the accumulative amount of payment reaches the Insured’s sum insured, the said insurance liability for the said Insured shall be terminated.
4、Outpatient and Emergency Medical Insurance:
If the Insured receive outpatient or emergency medical treatment because of illness and actually incur reasonable and necessary expenses for medical treatment, Within the insurance time , the daily limit for outpatients is RMB600. On the precondition of not exceeding the daily limit, should the daily medical cost is less than RMB600, the actual cost shall be used for calculation. if the daily medical expenses and cost is more than RMB600, the Insurer only cover RMB600 per day.For medical expenses exceeding the starting line of RMB650, their remaining amount after deducting RMB650 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.
Insurance Responsibilities of emergency medical treatment and general outpatient treatment include: The fees of 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.
Note:
Daily limit: The top claim limit of available medical cost
Starting-line to pay the limitation: RMB 650 (accumulative for one time during one valid insurance period). Below the starting-line, there is no claim.
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 be liable for the full payment of the “hospitalization and medical insurance” with regard to the actual and reasonable expenses for medical treatment, including reasonable and necessary fees for nursing (limited to RMB150 Yuan per day for limitation of accumulative 30 days), medical record, heating, air-conditioning, bed, examination, special examination and treatment, operation, medicine, treatment, laboratory test, radiation, etc to the insured as 100% proportion.
During one valid insurance period, whether the Insured is hospitalized for once or several times, the Insurer shall pay the costs of hospitalization as per compensation rule, but the insurance liability shall be terminated once the accumulative amount of payment reaches the limitation of RMB 400,000.
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 payment.
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 the Chinese mainland; However, for the insured, all medical expenses incurred in sub-branch of public hospitals, ward area for foreigners, ward area for special treatment and needs, ward for special treatment and needs, ward for high-ranking officials, or similar ward area or VIP ward room or separate ward room, shall be excluded from the insurance, and such expenses for treatment 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) The first 30 days period of the first application for insurance or non-continuous coverage is waiting period (observation period). Where the insured is hospitalized or outpatient during the waiting period and related medical cost is occurred, the insurer bears no liability of compensation. The treatment for continuous 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 amount of reasonable fees that are in accordance with the payment scope. But the fees for nursing, bed, outpatient and emergence treatment daily limitation fee and other fees within the insurance coverage are also limited. If the third party has a specified proportion for payment, then Ping An shall be liable only for the payment within its proportion deducting the already paid amount. If the third party has no specified proportion for payment, then Ping An shall be liable for the rest, not exceeding the insured sum, of the limited amount in accordance with the regulations of the local social medical insurance and with a deduction of the standard amount of this item.
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 payment.
Liability Exemption
一、Liability Exemption for Death and Disability
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, intentional crime, resistance to criminal compulsory measures taken according to law, suicide or arrest resistance on the part of the Insured;
3. Fighting, drunkenness and active taking, sucking or injection of drugs on the part of the Insured;
4. Driving under the influence, driving 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 AIDS virus (HIV-positive);
11.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.
12.The Insured passes away or become disable outside the mainland
China
.
13.Providing false insurance information, or international experts and teachers taking out an insurance policy as a student
14.Accidents occurring after the expiration of the last insurance duration and before the start of the next insurance duration with failure to renew the insurance by rule of the Insured part.
If the Insured is caused dead in any of the foregoing circumstances, Ping An shall terminate the insurance liability of the Insured.
二、Liability Exemption for Medical Liability (Medical Treatment of Accidental Injury, 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 law on the part of the Insured;
3. Fighting, drunkenness and active taking, sucking or injection of drugs on the part of the Insured;
4. Driving under the influence, driving 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. Congenital diseases, hereditary diseases, existing disease (disease or symptoms that already exist prior to the date of insurance);
8. 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.Expenses of orthopedics, correct procedure, plastic surgery or rehabilitation therapy received by the Insurer;
12.Health check (physical examination), healing, convalesce or special care
13.Taking, application or injection of medicine without the permission of doctor on the part of the Insurer;
14.Medical expenses incurred outside the Chinese mainland or in private hospitals of the Chinese mainland, and expenses incurred in drug stores;
15.Charge of telephone, transportation, etc. on the part of the Insured;
16.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.
17.Providing false insurance information, or the international experts and teachers taking out an insurance policy as a student.
18.Experimental treatment and costs incurred for medical experiment purpose.
19.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.
20.Fees incurred without reporting the case in advance or through the guidance channels (400 telephone number) of medical treatment under non-emergent circumstances or fees are not approved.
21.Fees incurred without reporting the case in advance or through the guidance channels of medical treatment under non-emergent circumstances
Insurance premium
Note: Matters not mentioned herein shall be executed according to “Ping An Additional Disability Guarantee Group Accident Insurance (2013) (Clause D)”, “Ping An One-year Group Term Life Insurance”, “Ping An Additional Accidental Injury Group Medical Insurance”, “Ping An Inpatient, Outpatient and Emergency Comprehensive Group Medical Insurance” and “Ping An Inpatient Group Medical Insurance”.
If contradiction arises as regards the above contents, elaborations in Chinese shall prevail.
理赔说明
就医前务必拨打电话4008105119转1进行询诊
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。
理赔程序：
保险事故发生后，理赔的规范程序:
1.因疾病或意外事故需就诊，需直接致电4008105119转1键，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。
2.重大事故可通过以下联系方式报案
理赔咨询、报案电话：4008105119转1键 未开通400电话地区可拨打010-67185217：
凡是未经400电话报案或者未按照要求规范程序执行的，将无法获得赔付。
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。
E 如意外事故须提供意外事故证明及相关部门的定性材料（如：交通事故须出具交通部门的交通事故责任认定书，高坠、溺水等须公安机关或相关部门出具事故属意外或自杀的定性材料，饮酒导致事故须出具酒精含量定量报告）
F 有效投保凭证复印件
2)．意外伤害医疗
A 被保险人护照复印件及签证页复印件
B 意外事故经过及证明（如是交通事故出具交通部门的交通事故责任认定书等）
C 收费收据原件
D 相对应每次就诊病历（病例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
A 被保险人护照复印件及签证页复印件
B 收费收据原件
C 相对应每次就诊病历（病例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2000元的起付线，同样须提交2000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
A 被保险人护照复印件及签证页复印件
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转1进行咨询）
（2）若一次保险事故分别在两家（含）以上医院就诊，须出具每次就诊的诊断证明书、病历复印件等相关文件。
（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。
理赔材料寄送地址: 北京市朝阳区东三环中路55号双子座B座303室
收件人：来华项目理赔部
电话: 4008105119转1键
邮编: 100022
Do be sure to firstly call 4008105119 EXT 1 to make a diagnosis inquiry before you go to see a doctor.
Dear customers:
If you want to learn about the services of settlement of claim of comprehensive insurance for people coming to China of Ping An Endowment Insurance Co., Ltd., please read this guide carefully.
（1）Procedures for insurance claims:
Standard procedures of insurance claims after occurrence of insurance accident:
1. Please call directly 4008105119 EXT 1 for medical consultation due to disease or accident. The rescue doctor will consult, diagnose, and provide medical guidance and precautions for insurance claim. After consulting diagnosis and outpatient treatment, if the doctor confirms that further hospitalization is required, the insured can apply for advanced payment of medical expense for hospitalization to the rescue company. After communication and confirmation of the rescue company and hospital, it will be decided whether the advanced payment procedures shall be started. If the insured is directly hospitalized without consulting, diagnosis and recording of doctor of the rescue company and outpatient treatment (including those whose conditions do not meet the requirements of hospitalization but require 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. Major accident can be reported with the following contact information
Telephone number for claim consultation and reporting: 4008105119 EXT 1. You can call 010-67185217 in the areas without telephone number beginning with 400.
You cannot get compensated without reporting through the 400 call or following the standard procedures.
（2）Document to be presented for settlement of claims:
1).One-year term life insurance
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 Certificate of relationship between the Insured and all the beneficiaries, and copy of identification proof 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)
2).Medical treatment for accidental injuries
A Copy of passport and visa page of the Insured
B Course and certificate of accident (in case of traffic accident, the traffic unit should issue a liability confirmation of traffic accident)
C Original of receipt
D Medical record, detailed expenditure sheet and copy of examination report and laboratory test report of each respective treatment (date of examination and date of invoice shall be corresponding).
3).Medical treatment for outpatient and emergency
A Copy of passport and visa page of the Insured
B Original of receipt
C Medical record, detailed expenditure sheet and copy of examination report and laboratory test report of each respective treatment (date of examination and date of invoice shall be corresponding).
If the fees have exceeded the minimum payment line of RMB2000 Yuan, then the medical record, detailed expenditure sheet and copy of examination report and laboratory test report of treatment that costs below 2000 Yuan are also required to be presented.
4).Hospitalization
A Copy of passport and visa page of the Insured
B Certificate of accident, in case of an accident (in case of 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) Besides, the Insured’s bank account opened in the mainland of China and accurate information (account No. name, opening bank information), which can be obtained from copy of deposit book and bank costumer table, in relation to the account must be attached to the claim settling documents for each request for compensation; (For details, please call 4008105119 EXT 1 )
(2). Where in one insured incident, the Insured has to be treated in two or more hospitals, relevant documents such as diagnosis certificate and medical record from relevant hospitals shall be presented.
(3). Hospitals for treatment shall be limited to the public hospitals within the territory of the Chinese mainland, 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 hospital or by nursing service company.
Materials for claims of settlement sent to: 北京市朝阳区东三环中路55号双子座B座303室（邮编100022）
Addressee: 来华项目理赔部
电话: 4008105119转1键
Please Dial: 4008105119 转 1
理赔说明
就医前务必拨打电话4008105119转1进行询诊
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。
理赔程序：
保险事故发生后，理赔的规范程序:
1.因疾病或意外事故需就诊，需直接致电4008105119转1键，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。
2.重大事故可通过以下联系方式报案
理赔咨询、报案电话：4008105119转1键
凡是未经400电话报案或者未按照要求规范程序执行的，将无法获得赔付。
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。
E 如意外事故须提供意外事故证明及相关部门的定性材料（如：交通事故须出具交通部门的交通事故责任认定书，高坠、溺水等须公安机关或相关部门出具事故属意外或自杀的定性材料，饮酒导致事故须出具酒精含量定量报告）
2)．意外伤害医疗
A 被保险人护照复印件及签证页复印件
B 意外事故经过及证明（如是交通事故出具交通部门的交通事故责任认定书等）
C 收费收据原件
D 相对应每次就诊病历（病例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
A 被保险人护照复印件及签证页复印件
B 收费收据原件
C 相对应每次就诊病历（病例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元起付线，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
A 被保险人护照复印件及签证页复印件
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转1进行咨询）
（2）若一次保险事故分别在两家（含）以上医院就诊，须出具每次就诊的诊断证明书、病历复印件等相关文件。
（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。
理赔材料寄送地址: 北京市朝阳区东三环中路55号双子座B座303室
收件人：来华项目理赔部
电话: 4008105119转1键
邮编: 100022
以上内容若有争议，请以中文的解释为准。
理赔说明
Do be sure to firstly call 4008105119 EXT 1 to make a diagnosis inquiry before you go to see a doctor.
Dear customers:
If you want to learn about the services of settlement of claim of comprehensive insurance for people coming to China of Ping An Endowment Insurance Co., Ltd., please read this guide carefully.
（1）Procedures for insurance claims:
Standard procedures of insurance claims after occurrence of insurance accident:
1. Please call directly 4008105119 EXT 1 for medical consultation due to disease or accident. The rescue doctor will consult, diagnose, and provide medical guidance and precautions for insurance claim. After consulting diagnosis and outpatient treatment, if the doctor confirms that further hospitalization is required, the insured can apply for advanced payment of medical expense for hospitalization to the rescue company. After communication and confirmation of the rescue company and hospital, it will be decided whether the advanced payment procedures shall be started. If the insured is directly hospitalized without consulting, diagnosis and recording of doctor of the rescue company and outpatient treatment (including those whose conditions do not meet the requirements of hospitalization but require 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. Major accident can be reported with the following contact information
Telephone number for claim consultation and reporting: 4008105119 EXT 1. You can call 010-67185217 in the areas without telephone number beginning with 400.
You cannot get compensated without reporting through the 400 call or following the standard procedures.
（2）Document to be presented for settlement of claims:
1).One-year term life insurance
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 Certificate of relationship between the Insured and all the beneficiaries, and copy of identification proof 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)
2).Medical treatment for accidental injuries
A Copy of passport and visa page of the Insured
B Course and certificate of accident (in case of traffic accident, the traffic unit should issue a liability confirmation of traffic accident)
C Original of receipt
D Medical record, detailed expenditure sheet and copy of examination report and laboratory test report of each respective treatment (date of examination and date of invoice shall be corresponding).
3).Medical treatment for outpatient and emergency
A Copy of passport and visa page of the Insured
B Original of receipt
C Medical record, detailed expenditure sheet and copy of examination report and laboratory test report of each respective treatment (date of examination and date of invoice shall be corresponding).
If the fees have exceeded the minimum payment line of RMB650 Yuan, then the 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 Copy of passport and visa page of the Insured
B Certificate of accident, in case of an accident (in case of 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) Besides, the Insured’s bank account opened in the mainland of China and accurate information (account No. name, opening bank information), which can be obtained from copy of deposit book and bank costumer table, in relation to the account must be attached to the claim settling documents for each request for compensation; (For details, please call 4008105119 EXT 1 )
(2). Where in one insured incident, the Insured has to be treated in two or more hospitals, relevant documents such as diagnosis certificate and medical record from relevant hospitals shall be presented.
(3). Hospitals for treatment shall be limited to the public hospitals within the territory of the Chinese mainland, 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 hospital or by nursing service company.
Materials for claims of settlement sent to: 北京市朝阳区东三环中路55号双子座B座303室（邮编100022）
Addressee: 来华项目理赔部
电话: 4008105119转1键
Please Dial: 4008105119 转 1
Chinese explanation prevails in case of contradiction arising out of the aforementioned contents.
