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扫一扫安装PP助手iOS版& & & & 太平环球团体医疗保险（2007）太平环球团体医疗保险（2007）主险?产品险种：医疗保险　?意外保障团体医疗保险责任说明条款相关咨询包含本产品的计划一、紧急医疗运送和转移
本项责任适用于精选型、舒适型和菁英型。
在保险期间内，如果被保险人在居住国境内或其在境外旅行时发生保险事故，根据我们授权的环球保险服务机构的医生的建议需要进行紧急医疗运送或转移的：
1、我们会安排将被保险人转送到离事发地最近的最合适的医疗机构，该医疗机构可能处于事发地以外的国家，并支付所有被保险人必需的医疗运送费用。如果被保险人已经住院的，我们会安排将被保险人转送到治疗设施更好或更合乎专业水准的医院。
2、如果救援机构的医生从最有利于被保险人的角度考虑决定要安排其进行紧急医疗运送或转运到保险单承保地区以外的国家，则我们将承担在保险期间内在该国家发生的经救援机构的医生同意的所有的必需的治疗费用。
3、紧急医疗运送或转运应当是能够在当地可以有效使用的恰当的方式，如果是空运，我们将采用通常的飞机航班或租赁飞机，或根据救援机构医生的意见认为在医疗上是必需的，也可租赁专门的救护飞机进行运送。如果被保险人旅行时是乘坐飞机的，则其航空医疗运送乘坐飞机的标准与被保险人旅行最初的机票标准一致（除非是医疗必需）；如果被保险人旅行采用的是飞机以外的其他方式，则航空医疗运送的标准与飞机的经济舱标准一致（除非是医疗必需）。
4、在救援机构的医生认为在治疗上是必要的并同意的前提下，我们会安排一位医疗陪护人员陪同运送并支付相关的费用。
5、我们将会安排在保险事故发生时与被保险人在一起的一名亲属或朋友陪同医疗运送，并支付其在医疗运送中发生的合理的旅行费用。此外，我们将支付该陪同人员在被保险人住院期间的就近住宿费用，但每晚费用不超过人民币800元，累计最长不超过10天。
6、 在对被保险人的紧急救援及转运，以及其他治疗措施结束后，救援机构的医生认为被保险人的病情或伤势已稳定可以旅行时起的3天内，救援机构将安排被保险人乘坐与其原始旅行机票同等级的飞机航班返回离其居住地最近的地方（或离居住地最近的适合的医院），如果被保险人最初旅行采用的是飞机以外的其他方式，则其返回时可安排乘坐火车的头等舱或飞机的经济舱或二等舱。若救援机构的授权医生认为有必要，将为被保险人安排医疗护送。在适当的情况下，我们将安排在被保险人紧急医疗运送途中的陪同亲友返回离其居住地最近的地方，并支付合理的返回费用。
二、医疗及住院费用
本项责任适用于精选型、舒适型和菁英型。
我们将以最有效最合适的方式安排运送被保险人到最近最适合的医院，包括使用公路救护车、非公路救护车、火车、直升飞机或固定机翼的飞行器，若救援机构的医生认为有必要，将为被保险人安排医疗护送。
我们将根据救援机构医生的建议安排被保险人进行住院治疗或日间护理，并承担救援机构医生认可的以下必要的医疗费用和服务：
1、单人病房住宿费、膳食费、住院所使用的医疗器具、医生要求住院病人或日间护理所发生的治疗费和服务费用包括外科手术费和麻醉费、医生出诊费、会诊费、诊断、物理治疗费用及处方药。
2、医疗需要的加护病房的膳宿费。
3、未满16周岁的被保险人住院治疗时，我们可安排与其同行的一位家长陪同住院，若该医院无陪住设施，可安排该家长入住附近酒店，并承担其必要的住宿及早餐费用。
4、住院病人需要进行的手术的日间护理费用。
5、在保险期间??，精神疾病、精神和心理紊乱的治疗仅限于住院治疗，且最高累计以30天为限。对于救援机构医生认为非必要的住院天数或非合理的住院费用，我们有权仅支付到救援机构医生认为通常的、合理的、符合惯例的费用为止。
6、在被保险人出院后3个月内，我们将承担其为后续治疗发生的门诊费用，以使被保险人的病情仍在治疗医生或专家的控制或监控之下，或该治疗是医生要求的且该治疗应是保险事故直接导致的疾病引起的治疗。
以上责任不包括因生育、牙科疾病或严重慢性病住院而发生的医疗费用。
C – 家庭护理
当获得了上项责任下的有效理赔后，在被保险人出院后，经我们同意可支付由医生指定的一名注册护士在被保险人家中提供的必要的与保险事故直接相关的家庭医疗服务费用，支付金额每次事故最高限人民币12,000元。
以上责任不包括因精神疾病、精神或心理紊乱而进行的家庭护理。
D – 门诊医疗
本项责任不适用于精选型。
经我们同意的门诊费用，包括医生诊疗费、化验费、X光费、扫描费、摄片费、处方药费。对于医生指定的物理治疗费、脊椎指压治疗费、整骨治疗费、同种疗法费及针灸治疗费用，每一保险期间内每一被保险人总共累计最高限20次(含出院后的后续治疗)，每次限人民币800元。如医疗必需并经医生同意，我们将支付被保险人购买或租用拐杖、轮椅、基本整形假体和器具，每一被保险人每次事故最高限人民币4000元。
------------------------------
（以下简称本公司）
太平环球团体医疗保险条款（）
Worldwide Group Health
（年 月经中国保险监督管理委员会备案）
目&&&&&&&& 录
第一条&&&& 重要提示
1.&& Important Note…………….…...…&& 2
第二条&&&& 环球医疗保险计划的运作
2.&& How the healthcare plan
operates...&& 2
第三条&&&& 释义
3.&& Meaning Of Words……………..…&& 3
第四条&&&& 保险责任
4.&& Insurance Benefit……………....…&& 8
一、紧急医疗运送和转移
gency Medical
Transfer/Evacuation….…&&&&&&& 8
二、 医疗及住院费用0
Hospital Benefits…….…………...… 10
三、 附加运送服务
Transportation Benefits……….…….. 12
四、 紧急牙科治疗
Dental Treatment ………….……..…13
五、 常规健康护理
Care…………………………..…13
六、 生育保险
.…………………………..…..…15
七、 遗体遣送
Following Death………..…….…...
八、 选择性特定医疗项目转送..&&& 16
Transfer..……………...…....&
第五条&&&& 通用条款
5.&& General conditions……..………… 17
第六条&&&& 责任免除
6.&& General Exclusions……….……….19
第七条&&&& 理赔申请及流程
7.&& Claims ..…..………….……...…… 22
第八条&&&& 如实告知
8.&& Honest Representation……..…..… 24
第九条&&& 年龄的确定及错误处理
9.&& of Age and error handling...25
第十条&&& 被保险人变动
10.&& Change of the Insured…….…..… 25
第十一条&&资料提供26
11.&& Supply of Information….…….…. 26
第十二条&&合同的解除26
12.& &Surrender of the
Contract….……...26
第十三条&&法律适用26
13.&& Governing Law….…….……...…..26
第十四条&&争议处理26
14.&& Handling
of Disputes….……….&& 26
在保险期间内，我们将根据您所选择并缴纳了保费的保障利
益，在本保险单约定的承保地区内，根据本保单及保险凭证规 定的保险责任、除外责任及其他条款，为您提供保险服务和保 险利益。
provide the
services and benefits described
during the period of insurance
within the geographical limits, &subject
&to &the &limits &of
&cover &and &all &other &terms,
and &exclusions &contained &in
&this &Policy, &and following payment of the appropriate premium
for the level of
as stated on the Certificate of Insurance.
第一条&&&&&&&&&&& 重要提示
ovision 1.&& &Important Note
一、 既往症 不承担因被保险人在投保前已知的疾病或心理症状，或已经接
受的治疗（包括处方药），或已经出现的症状直接或间接引起 的理赔，但在投保时已告知我们并经我们书面同意承保的除 外。
Pre-existing Medical
Conditions
claim arising
directly or indirectly from any known illness
or psychological condition from which the
insured person has suffered or for
which the insured person
has received medical treatment (including
prescription drugs) or of which symptoms have manifested
themselves prior to the insured person being first included for insurance under this Policy
二、 返回国籍所在国
被保险人返回国籍所在国：
1、 如果在保险期间内，被保险人为外籍人士，且临时返回国 籍所在国，同时该国家位于保险单列明的承保地区范围内，且 已支付了相应的保费，我们将继续承担被保险人在国籍所在国
停留累计不超过 90 日的本保险单的保险责任。
Return To Home Country
will continue
for temporary return to the home country
and visits to the home country up to a maximum of 90 days during
the period of insurance for expatriates, provided the appropriate& premium&
to &include &that&
geographical& area &has
been paid.
2、 如果在保险期间内：
1） 被保险人永久返回国籍所在国，请及时联系我们以确定
是否继续该保险。此条适用于被保险人为外籍人士(包括在中
国大陆工作生活的香港、澳门或台湾人士)；
2） 被保险人永久居住在中国大陆以外地区的，请及时联系
我们以确定是否继续该保险。此条适用于中国大陆人士(不包 括在中国大陆工作生活的香港、澳门或台湾人士)。
the period of insurance,
If &the &insured person &is&
expatriate &(includes& person &from Hong Kong, Macao or
Taiwan) and he/she is returning
permanently to their home country, please contact us to
discuss continuation
If the insured
person is Chinese citizen (excludes person from Hong Kong, Macao or Taiwan) and he/she is permanently leaving mainland China, please contact us to
discuss continuation
三、 到本保险单约定范围以外的地区旅行 若被保险人在保险期间内到其保险凭证约定承保范围以外的 地区旅行累计未超过 30 天的，我们可承担其急诊医疗费用，
但不承担此种情况下任何非紧急救援医疗的费用。
Travel Outside The Specified Geographical Area
the insured person is traveling
outside the countries of the geographical area specified on the Certificate issued to the insured person
we will pay for emergency treatment only.
This emergency cover will only operate when the insured
person does not travel for more than 30 days in total in any one period
of insurance.
ergency treatment is
not covered at
all outside the
geographical area specified on the Certificate.
第二条&&&&&&&&&&& 环球医疗保险计划的运作
ovision 2.&& &How the healthcare plan operates
本保险单所说的保险利益是指我们为被保险人所签发的附于 本保险单，并且是本保险单的重要组成部分的有效保险凭证中 所载明的保险利益，我们不承担任何未载明于保险凭证的保险 利益。
Policy describes the benefits which are available, but the cover which will be provided to
each insured person is that
specified in the Certificate issued to the insured
person which attaches to and forms part of this Policy. Any benefit
not specified in the
Certificate does not apply.
本保险在投保人及被保险人认可本保险单中所载明的术语、条
款和除外责任，并经保险人同意接受投保申请后生效。
当被保险人发生残疾或死亡，由被保险人的法定代理人处理保
insurance is effective only
after the Policyholder
accepted for cover by the Insurer and becomes, and remains, insured in accordance with the terms,
provisions, conditions and exclusions laid down in this Policy.
the event of the insured person’s incapacity or decease, his /
legal personal representative
shall have the right to
for him / her or his / her estate.
我们将通过我们授权的环球保险服务机构代表被保险人向本
保险单认可的医疗、怀孕护理及牙科治疗和服务的提供者或者
被保险人本人支付保险利益。
are payable on behalf of
the insured person to the
licensed &providers &of &the &medical, &maternity
&care &and& / &or dental treatment and service insured under this Policy, or alternatively are
reimbursable to the insured person.
保险金的给付将由我们通过我们授权的环球保险服务机构的
专门处理医疗索赔的理赔专员负责（请见第七条理赔申请及流
犹豫期：当您阅读了保险单后认为并没有满足您的需求，请在 保险单生效日后的 10 日内退还本保险单和保险凭证，如果在
这期间您没有发生任何索赔或不存在任何在这 10 天内发生的
可能导致索赔的情况，我们将退还您已缴纳的保险费，同时我 们与您签署的保险合同无效。
payments shall be processed by claims administrators, specialised &in&
the &handling &of &medical
&claims, &who &are
appointed by the Insurer
(see Claims Procedure).
off period: If, when reading your policy, you decide
that it does not meet your requirements, please return the policy and certificate to us
within 10 days of the
commencement date. On condition
that you have not made a claim or
know of any circumstances
that may lead to a claim, we will refund& any& premium you have &paid. The contract between you and us
will be annulled, which means it
will be treated as if it had never existed.
第三条&&&&&&&&&&& 释义&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& ovision 3.&&& Meaning Of Words
本保险单及保险凭证中出现的下列词汇将适用以下释义：&&&&&&&&&&&&&& the following
words and phrases
shown below in CAPITALS appear in
this Policy (and in the Certificate attaching to and forming part of the Policy) they will always
the meanings defined below.
我们/保险人：
指太平人寿保险有限公司。
or Insurer
means TaiPing Life Insurance
我们授权的环球保险服务机构:&
指由我们授权负责向被保险人提供医疗服务安排和救援，
并接受被保险人???赔，向被保险人支付保险金的服务机构。
(Worldwide &Insurance
&Service &Provider)&&&& means
&the service provider
authorized by us to provide medical assistance
and services to the Insured
Persons. Also, WISP will process the
claim arise from the Insured Person and
handle claim payment.
意外伤害:&
是指因外来的或暴力而引起的突??的、并不可预见的身体 伤害。
Y means a sudden and unforeseen bodily
injury caused by violent or external means.
附属于本保险单的证明，载明了保险单持有人、被保险人、 承保地区、保险期间，及特别约定和责任免除。
TIFICATE means the document attaching to this Policy, stating amongst others the Policyholder, the insured person,
the geographical area of
cover, the period
of insurance and any special terms and conditions or exclusions which apply to this Policy.
严重慢性病：
指拥有以下两个以上特点（含两个）的疾病或伤害：
&病情严重，病因复杂，没有已知的公认的治疗方法；
&永久的持续，复发或可能复发；
CHRONIC DISEASE means an illness or injury which
has two or more of the following characteristics:
It has serious
condition with, complex cause and has no known
recognized cure；
It continues indefinitely, and likely to relapse
or recurrence
&需要缓解治疗，以及长期的监护、会诊、检查或检测；
&需要康复治疗或特别训练。
指被保险人在每次治疗中根据保险凭证约定必须承担的
Requires &palliative &treatment, &as &well
&as &long- &term
monitoring, consultations, inspections, examinations or tests
You need to be rehabilitated or specially
trained to cope
ANCE means the
proportion of costs for which the insured person
remains responsible, when specified
in the Certificate. The insured person must pay the coinsurance in respect of each diagnosed
medical condition covered under this Policy.
指在保险凭证中载明的保险单第一次生效的日期。&&&&&&&&&&&&&&&&& DATE &means &the &date
&on &which &this
y is first
effected as specified in the Certificate.
指在投保申请单和保险凭证中载明的被保险人最主要的 或次要的居住的国家。
Y OF RESIDENCE means the country
or countries where the
insured person has his / her
primary and / or secondary home(s), as stated
the Application Form and specified in the
Certificate.
参保日期：
指被保险人的保险责任开始的日期。&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& TE OF ENTRY means the date that cover first starts for an
insured person.
日间护理：
指医院提供的允许被保险人接受的治疗，但无需延续到过 夜的治疗。
Y-CARE shall mean treatment provided
hospital where
an &insured& person &is
&admitted&
but& is &not &required, &out &of
medical necessity, to stay overnight.
指保险单载明的每次理赔时被保险人需要支付的固定金额。
means &the &fixed&
amount &each& claim necessitated by
each insured event which the insured person must
&pay, &when& specified in& the& appropriate &Section
&of the Policy.
附属被保险人：
指被保险人合法的配偶，及被保险人的未婚子女、继子女、 养子女，并且被保险人在首次加入本保险或续保时其子女的年
龄小于 19 周岁（如果出示证明提示该子女全日制读书，投保
年龄可延迟到 25 周岁），并且在经济上完全依赖被保险人。
means the insured
person's legal spouse, and his
her unmarried child, step-child,
foster child or legally adopted child - provided that such child is less than 19 years old on the date the insured person is first included under this Policy or at any subsequent renewal of
the Policy (or less than 25
old if &it &can
&be &demonstrated &that &the &child &is&
continuing& in full-time education) and is financially dependent
on the insured person for support.
直接付费医院& ：
直接付费指被保险人在任何网络内医院就诊时只需出示 保险卡而无需支付现金，但同时应负担自付额部分和不属保险
范围内的费用。对于保险人承担的部分，医院会直接与保险人 结算。
billing hospital for any direct billing hospital in our
network, the insured receives treatment without any cash
payment as long as the insured presents his/her insurance card,
however and the insured shall bear the co-payment or
any expenses not covered by insurance. The insurer
will settle its responsible payments directly
with the hospital.
选择的国家：
指在保险凭证中载明，在投保申请单上已预先选择的符合
保险单规定的承保地区内的被保险人因所保的医疗治疗而接 受特定医疗项目的国家，或后续因该类特定医疗项目的理赔而
选择的国家。所选择的国家必须经我们证实是适合条款中载明
的各种类型的治疗。
means the country within the geographical area specified in the Certificate, pre-selected on
the Application Form as the country where the insured person opts to receive any major
intervention for covered medical
treatment, or subsequently selected by the insured person for such major intervention in the event of a claim. The elected
country must be approved by us as suitable for
the provision of the required treatment.
紧急牙科治疗：
指因意外事故造成的口腔伤害，并在事故发生 48 小时内
为了立刻减轻意外事故导致牙齿脱落或牙齿受伤而引起的痛 苦而需要接受的口腔治疗。
AL TREATMENT means treatment
necessary& as& a result&
of an accident/injury by&
an& extra-oral impact, received within 48 hours from the date and
time of the accident/injury
for the immediate relief of pain
caused by natural teeth being lost or damaged in an accident.
紧急医疗运送或转运：
经我们授权的环球保险服务机构的 24
小时救援中心核实
并同意，被保险人因遭受意外事故需要紧急运送到能提供合理
的设备和护理的最近的医院，我们将承担此期间的运送费用和
运送期间的护理费，并且该医院可以不在被保险人的居住国。
OR EVACUATION
means the medically necessary expense of
emergency transportation& when &approved
&by &our &24-hour
&Assistance Centre of WISP, and medical care during
such transportation, to move an
insured person who suffers a critical medical
condition& to &the &nearest &suitable &hospital &where &appropriate care and facilities are available, which may not necessarily be in the insured person's country of residence.
外籍人士：
指在护照签发地以外的国家生活或工作的人，包括在中国 大陆工作生活的香港、澳门或台湾人士。
means a person living or working outside the country which he/she holds a passport.
For the purpose of
this Policy, persons from Hong Kong, Macao or Taiwan are considered as Expatriates.
承保地区：
指在保险凭证上载明的，已缴纳了相应的保险费，且保险
责任所适用的特定地区。
HICAL AREA means the Area specified
in your Certificate for which the appropriate
premium has been paid
and to which cover applies:
地区一：包括除以下地区外的全球所有其他地区：美国、安圭
拉、安提瓜和巴布达、阿鲁巴岛、巴哈马群岛、巴巴多斯、百
慕达、开曼群岛、古巴、Cura&ao、多米尼加、多米尼加共和 国、荷属安的列斯群岛（包括圣马丁）、格林纳达、瓜德罗普 岛、海地、牙买加、马提尼克岛、波多黎各、圣基茨和尼维斯、 圣鲁加、St. Vincent、特立尼达和多巴哥、维京群岛
all countries worldwide with the exception of
the following: United States of America, Anguilla, Antigua
Aruba, Bahamas, Barbados, Bermuda, Cayman
Islands, Cuba, Cura&ao,
Dominica, Dominican
Republic, Dutch Antilles (including St. Maarten), Grenada, Guadeloupe, Haiti,
Jamaica, Martinique, Puerto Rico, St. Kitts-Nevis, St. Lucia,
Vincent, Trinidad
& Tobago, Virgin Islands.
地区二：包括全球所有国家。&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& comprises
all countries worldwide.
指保险凭证或投保申请单中列明的被保险人在居住国首 要的或次首要的居住地。
means the insured person's primary and / or secondary
home(s) within the country or countries
of residence as stated
on the Application Form and specified in the Certificate.
国籍所在国：
指被保险人持有护照上或在投保申请单及保险凭证上列 明的作为国籍的国家。家庭参加本保险计划时，则国籍所在国 为投保申请单和保险凭证上载明的国籍所在国。
means the country of which the insured
person holds a passport or the country which is
stated as the
insured person's home country
on the Application Form, as specified in the Certificate.
When a family is covered
under this Policy the home country will be deemed to
be the single country stated on the Application Form and specified in the Certificate.
指在当地合法注册，并且有住院医生不间断监控的医疗机构。
any institution under the constant supervision of a resident
physician which is legally licensed as a medical or surgical hospital in the country where it is located.
指经过医生适时诊断确诊的任何疾病、病症、失调或健康
状况的改变。
S means any sickness, disease, disorder
or alteration in the insured
person's medical
condition as duly diagnosed by a physician.
指被保险人因医疗必须且入院占据床位至少超过一个晚
上。但每次保险事故住院的总天数累计不超过 12 个月。
means treatment provided in a hospital where an insured
person is admitted
and, out of medical necessity,
occupies a bed for one or more nights but not exceeding 12 months in total for any one insured event.
保险事故：
在保险期间及承保地区内，因意外事故或疾病导致被保 险人必须接受治疗。特别提示：在保险期间内且已支付了合 理的保费的情况下，因意外事故或疾病导致被保险人必须接受
治疗，但不在承保地区以内，我们只承担紧急情况下的保险责 任，并且在承保地区以外我们只承担累计 30 天的费用。
EVENT means an accident or illness which arising during the period of insurance within the geographical area which entitles the insured person to receive treatment. Note:
Accident or illness arising
during the period of insurance but in a country outside the geographical
area for which the
appropriate premium has been
paid will be deemed to be an
insured event for the purposes
of emergency treatment only,
and on condition that no more than 30 days in total in any one
period of insurance has been or will have been
spent by the insured person outside the geographical
area for which the appropriate premium
has been paid.
被保险人：
指保险单持有人指定的参加本保险计划的个人，及其附 属被保险人。所有被保险人都要在投保申请单上明示，并且 通过我们的审核及缴纳了相应的保费。
PERSON means the individual who is included in the Program subscribed to by the Policyholder, together
with any dependant, all of whom are described
a completed Application Form for this insurance
and have been accepted
for cover by us,
and for whom the appropriate premium
has been paid.
当地救护车服务： 指转出或转入医院时专用的有医疗设备的交通工具。
AMBULANCE SERVICES shall mean the necessary medical
transportation to or from a
local hospital.
特定医疗项目：
指事先计划安排的治疗：
1、 包括在一般麻醉方法或脊椎麻醉方法下的手术治疗
（不包括生育），并且该治疗根据医生的建议至少需要住 院治疗 3 天。或者
2、 因意外伤害或疾病根据医生的建议至少需要住院治疗
7 天。或者
3、 需要化学疗法或放射性疗法的疾病。或者
4、 必须事先向我们提交并经我们同意的以下一种或多种 治疗方案：
特别复杂的外科手术；
高风险的生育；
通过成熟的技术和高度专业的医疗团队进行的医疗 检查；
加强的并且是长期的医学治疗。
VENTION means scheduled treatment:
&under &general &or &spinal/vertebral anaesthesia (excluding childbirth) which,
according to our physicians,
requires a minimum of 3 nights spent in hospital. OR
For accident or illness which, according to our physicians, requires a minimum of 7 nights spent in hospital.
For illness involving chemotherapy or radiotherapy. OR
&one &or &more &of &the &following,
&subject &to
submission to us and with our
prior approval:
exceptionally complicated surgical oper
high risk child
examinations involving sophisticated technology and a
highly-specialized
medical therapies of a lengthy duration.
医疗费用：
因意外伤害或疾病导致保险事故发生，被保险人接受治疗 所发生的按照当地标准合理的费用。
ENSES shall mean the usual reasonable and customary expenses incurred in the country where treatment
is provided for treatment of an accident or illness as
a result of an insured event.
器官移植：
指移植肾、心脏、肺、肝脏移植、骨髓或骨髓的干细胞移
植的医疗行为。但不包括人造心脏的培植。
TRANSPLANT means medical treatment incurred
in respect of kidney, heart, lung， , bone marrow or stem
&does &NOT &include &the &implantation &of
&an artificial heart.
门诊服务：
指提供给被保险人的或根据医生的建议无需住院治疗或
无需接受医院的日间护理的，或无需接受其他医疗设备的治 疗。
SERVICES shall mean the medical treatment
provided to the insured
person or ordered by a physician when
it is not medically necessary for an insured person to be admitted
as an in-patient or day-care patient in a hospital or
other facility
for medical care.
缓解措施：
指以缓解病情，减轻症状为目的而不是以治愈为目的治 疗措施。
TIVE means treatment, the primary purpose of which
is only to offer temporary relief of symptoms rather
than to cure the illness or injury causing the symptoms.
保险期间：
指保险凭证上载明的在保费已支付的条件下，自保险单生 效日起连续的 12 个月作为保险期间。
OF& &INSURANCE& &means& &the& &period&
&of&& 12 consecutive months
from the commencement date specified in the Certificate for which the appropriate premium has been
指在当地合法注册的开业医生，并且经过所在国的法律的
确认，该医生在他的执照许可范围内所接受的训练能提供本保
险单列明的专业治疗。包括我们授权的环球保险服务机构雇佣
的、间接或直接合同签约的开业医生。
means& a& legally& licensed& medical
&practitioner
who is a doctor recognized by the law of the country where
treatment covered under this Policy is provided and who, in rendering such treatment is practicing within the scope of his / her
license and training.
WISP's physicians are medical practitioners employed, contracted or sub-contracted
物理治疗：
在中国大陆地区之外发生的物理治疗是指发生保险事故 后，有执照的物理治疗医生出于医疗目的推荐的物理治疗方 法。
在中国大陆地区发生的物理治疗是指应用人工物理因子
（如光、电、磁、声、温热、寒冷等）来治疗疾病。相应的疗 法有电疗、光疗、磁疗、热疗、冷疗、水疗，以及超声波疗法
等。在中国具体的项目必须符合全国医疗服务项目规范规定的
项目，但不包括泥疗，蜡敷治疗，气泡浴与药物浸浴治疗。
OTHERAPY outside Mainland China means treatment recommended by a physician for medical
reasons following an insured incident and provided by a licensed
Physiotherapist
Mainland China means application of
physical factors (such as light, electricity, magnetism, sound, warm, cold, etc.) to
treat disease. The corresponding therapy shall
include electrotherapy, phototherapy, magnetism
therapy, thermotherapy,&&
cold& &therapy,& &hydrotherapy&
&as& &well& &as ultrasound and other therapies. Specific physiotherapy services in &China& must &comply &with &the &National& Medical
Items, &but &does &not &include& mud &therapy,& wax &treatment, gas-bubble bath and drug bathing treatment.
保险单持有??：
指投保本保险计划并代表被保险人支付或承担保费的公 司、企业、组织或雇主。
ER&&& means&&&& the&&&& Company,&&&& Corporation, Organization or Employer which subscribes to this Program and pays or undertakes to pay the
appropriate premium on behalf of the insured person(s).
指被保险人在首次加入本保险单前已知的疾病或心??症状，或
已经接受的治疗（包括处方药），或已经出现的症状。
MEDICAL CONDITION means a known illness &or &psychological
&condition &from& which &the &insured person &has &suffered&
or &for& which& the &insured& person &has
received medical treatment (including prescription drugs) or of which
symptoms have manifested themselves prior to
the insured person being first
included for insurance under
this Policy.
指被保险人购买和使用药品时必须出示医生的处方。购买
时无需出示医生处方的药品不包括在处方药内，并且不属于本 保险承担的保险责任。
CRIPTION DRUGS shall mean medications whose sale and use are legally restricted
to the order of a physician. Items
that may be purchased
without a physician’s prescription are not included
in this Definition and are not covered
the insurance.
保险单生效日对应的周年日。
AL DATE shall mean the annual anniversary of the
commencement date.
指被保险人经受意外事故或疾病以后需要接受的合理及 必须的手术过程或治疗过程，及严重慢性病的长期护理过程。
shall &mean& any &medically &necessary &surgical
procedure or medical intervention which
is required to treat
an accident/injury& or &illness
&or &to& provide &relief& of &a &serious
chronic condition.
指中华人民共和国刑法规定的鸦片、海洛因、甲基苯丙胺
（冰毒）、吗啡、大麻、可卡因以及国家规定管制的其他能够 使人形成瘾癖的麻醉药品和精神药品，但不包括由医生开具并
遵医嘱使用的用于治疗疾病但含有毒品成分的处方药品。
DRUGS shall
mean opium, heroin, methyl benzedrine (methamphetamine hydrochloride), morphine, hemp and cocaine stipulated by China Criminal
Law as well as any controlled addictive anesthetic
and psychoactive
drugs, but not including prescription drugs with narcotic ingredient to
treat illness or bodily injury.
现金价值：
指保险单所具有的价值，通常体现为解除合同时，根据精 算原理计算的，由本公司退还的那部分金额,即指扣除手续费 后的保险费×未经过期间÷保险期间，未经过期间和保险期间
以天数计算。
VALUE shall mean the remaining
value of the insurance, that is, the portion of premium refund to insured person upon cancellation of Contract calculated based on
actuarial principles.
第四条&&&&&&&&&&& 保险责任&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& ovision 4.&& &Insurance Benefit
我们对于每一被保险人在每一保险期间内发生的，在承保责任
范围内的合理的必要的医疗费用，累计最高支付限额为人民币
16,000,000 元。如果本保险单终止或被保险人退出本保单，我 们所承担的保险责任也将随之终止。
will pay costs up to RMB16,000,000 for
each insured person, each period of insurance, for treatment of
an insured event which occurs and for which reasonable and
necessary expenses are incurred during the period of insurance.
Our liability in respect of all claims will cease immediately upon termination of the Policy and/or deletion of an insured person from the Policy.
一、紧急医疗运送和转移&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& gency Medical Transfer/Evacuation
本项责任适用于精选型、舒适型和菁英型。
在保险期间内，如果被保险人在居住国境内或其在境外旅行时
发生保险事故，根据我们授权的环球保险服务机构的医生的建
议需要进行紧急医疗运送或转移的：
1、 我们会安排将被保险人转送到离事发地最近的最合适的 医疗机构，该医疗机构可能处于事发地以外的国家，并支付所 有被保险人必需的医疗运送费用。如果被保险人已经住院的，
我们会安排将被保险人转送到治疗设施更好或更合乎专业水 准的医院。
e under Select, Premier & Elite)
the period of insurance an insured
event occurs either inside, or when the insured
person is traveling outside,
the country of residence
and which, in the opinion
of WISP's physicians, requires
the insured person's emergency medical transfer or evacuation:
We will arrange
and pay all necessary costs for the insured
person's medical transportation to the nearest
suitable and appropriate hospital, which may be in a country other than the one where
the insured person is located at the
the insured incident occurs.
If the insured person has been hospitalised as the result of the insured
incident, we may arrange for the insured person's medical transfer to a hospital which is more suitably equipped or more suitably specialised to treat his / her
condition.
、 如果救援机构的医生从最有利于被保险人的角度考虑决 定要安排其进行紧急医疗运送或转运到保险单承保地区以外 的国家，则我们将承担在保险期间内在该国家发生的经救援机
构的医生同意的所有的必需的治疗费用。
3、 紧急医疗运送或转运应当是能够在当地可以有效使用的 恰当的方式，如果是空运，我们将采用通常的飞机航班或租赁
飞机，或根据救援机构医生的意见认为在医疗上是必需的，也 可租赁专门的救护飞机进行运送。如果被保险人旅行时是乘坐
飞机的，则其航空医疗运送乘坐飞机的标准与被保险人旅行最
初的机票标准一致（除非是医疗必需）；如果被保险人旅行采 用的是飞机以外的其他方式，则航空医疗运送的标准与飞机的
经济舱标准一致（除非是医疗必需）。
If &our &physicians &decide &that& the &insured &person's &best interests will be
served by arranging for emergency medical
transfer or evacuation
to a country outside the geographical
area for which the insured person has paid the premium, then
all subsequent medical costs of
necessary treatment agreed by our physicians
in such country will be met by
us, during the period of insurance.
The insured person's emergency medical transfer
or evacuation will be effected
the most appropriate means
available locally. If by air we will employ a regular scheduled or charter airline, or, if medically
necessary in the opinion of
our physicians, a specially chartered air ambulance. If the
insured person had been traveling by plane,
air transportation by regular scheduled
airline shall be in the same class
as the insured person's original
airline ticket (unless medical needs
prescribe otherwise). If the
insured person had been
traveling other than by plane, the air transportation shall be by the
airline's& &economy& &/& &tourist&
&class&& (unless&& medical&& needs
prescribe otherwise).
在救援机构的医生认为在治疗上是必要的并同意的前提 下，我们会安排一位医疗陪护人员陪同运送并支付相关的费 用。
We will arrange and pay for a medical escort to accompany
the insured person during the transportation, when agreed
by our physicians as medically necessary.
我们将会安排在保险事故发生时与被保险人在一起的一 名亲属或朋友陪同医疗运送，并支付其在医疗运送中发生的合
理的旅行费用。此外，我们将支付该陪同人员在被保险人住院
期间的就近住宿费用，但每晚费用不超过人民币 800 元，累计 最长不超过 10 天。
arrange and pay the reasonable travel costs of
one other person (being a relative or friend)
traveling with the insured person
at the time the
insured incident occurred,
to accompany& the insured &person&
during &the& transportation. &In
addition, we will pay for his / her overnight accommodation to stay near
the insured person while the insured person is hospitalized, up to RMB800 each night for a maximum of 10 nights.
6、 在对被保险人的紧急救援及转运，以及其他治疗措施结束 后，救援机构的医生认为被保险人的病情或伤势已稳定可以旅
行时起的 天内，救援机构将安排被保险人乘坐与其原始旅行
机票同等级的飞机航班返回离其居住地最近的地方（或离居住 地最近的适合的医院），如果被保险人最初旅行采用的是飞机 以外的其他方式，则其返回时可安排乘坐火车的头等舱或飞机
的经济舱或二等舱。若救援机构的授权医生认为有必要，将为 被保险人安排医疗护送。在适当的情况下，我们将安排在被保
险人紧急医疗运送途中的陪同亲友返回离其居住地最近的地 方，并支付合理的返回费用。
On completion of the insured person's hospital treatment
which &has &given &rise&
to& the &need& for& emergency
transfer or evacuation, and
within three days of our physicians
pronouncing the insured
person fit to travel, we will arrange and pay all necessary costs for the
insured person to return
to the insured person's nearest place of residence
to a suitable hospital near to this place of
residence) in the country of residence, by the same class of
air travel if the insured person
had been flying, or by first class rail
or economy / tourist class
air if the insured person
had been originally traveling
other than by air. We will
arrange and pay for a medical escort to accompany the insured person, if
deemed medically necessary
our physicians. When applicable, we will arrange and pay the reasonable return travel costs of the traveling companion
who accompanied the insured person during the emergency medical transfer or evacuation
to return to the traveling companion's nearest place of
residence in the country of residence.
对于上述保险责任一，必须满足：
救援机构医生的诊断是明确的，但我们有权拒绝任何 与被保险人的医疗状况和安全相违背的要求。
救援机构的医生将组建医疗小组并配备救援中需要 的医疗用品，以保证被保险人在医疗运送过程中的安
如果被保险人拒绝我们所建议的救援安排，我们将不 承担本项保险责任下的任何责任和义务。
Conditions Applying To Section 1
The decision
of our physicians is final and we are entitled to refuse
any request which is incompatible
with the insured person's medical condition
and safety.
physicians will set up the medical team
and resources to be used as
and when appropriate, to
ensure the insured person's safety during the emergency&
medical transfer or evacuation.
the insured
person rejects the assistance procedures we propose &then &we &shall
&be &released &from &our&
obligations under this Section.
对于上述保险责任，我们将不承担在我们将被保险人转运到居 住地之后因同一保险事故所发生的后续的转运费用。
subsequent transfer costs arising out of the same
event once we have
insured person
to the place of residence.
在本项保险责任项下，我们还将为被保险人提供下列额外的医
疗辅助服务：
如果被保险人遭受或罹患较小的疾病（即非紧急状态 或是因慢性疾病需要紧急医疗运送或转运的）：
电话提供基本的医疗建议。
当需要咨询或辅助治疗时，可提供有关的当地医
生、医院、诊所和牙科医生的姓名和地址，并进 行电话联系安排。
Assistance Services: Medical Referral
If the insured person suffers from or is concerned about a minor ailment
(not an emergency situation
or a chronic illness&&&&&&&&&&&&& requiring& emergency&&&&&&&&&&&&&& medical&&&&&& transfer&&&&&&&&&& or evacuation):
of basic medical advice by telephone.
&to& &names& &and&&
addresses& &of&
&local& &doctors, hospitals, clinics and dentists when
consultation or minor treatment is required,
and arranging for a doctor to call.
2、&帮助获取在被保险人旅行地已经丢失的或无法获??
的基本处方药、或在旅行地已经丢失或打破的处方眼
镜或隐形眼镜，或提供在旅行地无法获得的血液（以 有效法律规定和承运人规定为限）。我们将不承担获 取这些辅助服务及物品过程中所发生的任何费用或 进口税。
replacing essential prescription drugs which have been lost or are unobtainable
in the insured person's
travel location, and lost or
broken prescription glasses or contact&& lenses,& &or& &in&& supplying&&
blood,&& which& &are
unobtainable in the insured
person's travel location (subject to legislation in force and to freight regulations). We will
not pay for any fees, charges or customs
duties resulting from the provision or
supply of any item.
二、医疗及住院费用 本项责任适用于精选型、舒适型和菁英型。
&Medical & Hospital Benefits
e under Select, Premier & Elite)
– 当地救护车服务&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& - Local Ambulance Services
我们将以最有效最合适的方式安排运送被保险人到最近最适
合的医院，包括使用公路救护车、非公路救护车、火车、直升 飞机或固定机翼的飞行器，若救援机构的医生认为有必要，将 为被保险人安排医疗护送。
will arrange for the insured person's
transport to the nearest suitable hospital by the most appropriate means available,
comprising &road &/ &off-road& ambulance, &train,
&helicopter &or
fixed-wing aircraft, with a medical escort if necessary in the opinion of our physicians.
–& 住院医疗&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& - Hospitalization Costs
我们将根据救援机构医生的建议安排被保险人进行住院治疗
或日间护理，并承担救援机构医生认可的以下必要的医疗费用
will arrange for
the insured person's in-patient or day-care
admission to the hospital recommended by our physicians. We
will pay necessary costs, when approved by our physicians, for the following
medical expenses and services:
、&&单人病房住宿费、膳食费、住院所使用的医疗器具、医生
要求住院病人或日间护理所发生的治疗费和服务费用包括外 科手术费和麻醉费、医生出诊费、会诊费、诊断、物理治疗费 用及处方药。
Hospital accommodation
in a single-bedded room, meals, all&& hospital&& medical&& facilities,&&
medical&& treatment&& and services ordered by a physician for in-patient or day-care
admission, including Surgeon's and Anaesthetist's charges, physician's charges, consultations, diagnostic procedures, physiotherapy, and prescription
、&医疗需要的加护病房的膳宿费。&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& Intensive&
&care& &unit& &accommodation& &when&
&medically
、 未满 16 周岁的被保险人住院治疗时，我们可安排与其同
行的一位家长陪同住院，若该医院无陪住设施，可安排该家长
入住附近酒店，并承担其必要的住宿及早餐费用。
If the insured person is a child aged under 16 who requires
hospitalization, we will pay for necessary
overnight accommodation& for &one
&parent &in& the &same &hospital, &or
when no such accommodation is available, for necessary bed and breakfast accommodation in a nearby hotel.
、&住院病人需要进行的手术的日间护理费用。&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& Day-care &surgery &of
&a &type &normally &carried &out
、 在保险期间内，精神疾病、精神和心理紊乱的治疗仅限于
住院治疗，且最高累计以
天为限。对于救援机构医生认为 非必要的住院天数或非合理的住院费用，我们有权仅支付到救 援机构医生认为通常的、合理的、符合惯例的费用为止。
reatment of mental illness, psychiatric
and psychological disorders will be covered on an in-patient basis only, and for
a maximum period
of 30 days only, and in all during any one period of insurance. In the case of what
our physicians deem to be an unreasonable length of stay or unreasonable hospital charges, we reserve the right to
limit payment to what our
physicians deem to
be usual, reasonable and customary costs.
、 在被保险人出院后 个月内，我们将承担其为后续治疗发 生的门诊费用，以使被保险人的病情仍在治疗医生或专家的控
制或监控之下，或该治疗是医生要求的且该治疗应是保险事故
直接导致的疾病引起的治疗。
the three month period immediately following
the insured person's discharge from an in-patient admission in a hospital, we
will also pay for post-hospitalization
treatment received on
an outpatient basis provided
the insured person remains
under the control and supervision
of the treating physician or specialist consultant or such treatment has been ordered
by the physician and
for which treatments are directly resultant from
the accident or illness
for which the insured person
was hospitalised.
以上责任不包括因生育、牙科疾病或严重慢性病住院而发生的 医疗费用。
家庭护理 当获得了上项责任下的有效理赔后，在被保险人出院后，经我
们同意可支付由医生指定的一名注册护士在被保险人家中提 供的必要的与保险事故直接相关的家庭医疗服务费用，支付金
额每次事故最高限人民币 元。
以上责任不包括因精神疾病、精神或心理紊乱而进行的家庭护
benefit&&& scheme&&&& does&& &not&&& cover&& &any hospitalization expense incurred
due to maternity,
dental disease or serious
chronic disease.
- Nursing at Home
a valid claim for hospitalization
under this Section, when &the &insured
&person &has &been
&discharged &from &an
in-patient admission in a hospital, as agreed by us we will pay
for &necessary &medical
&services &of &a &licensed&
nurse &in &the insured person's
home when prescribed by a physician and directly related to the insured
event. The maximum we will pay
arising out of any one insured
event is RMB12,000.
is not covered:
psychiatric or psychological disorders.
门诊医疗 本项责任不适用于精选型。
经我们同意的门诊费用，包括医生诊疗费、化验费、光费、
扫描费、摄片费、处方药费。对于医生指定的物理治疗费、脊 椎指压治疗费、整骨治疗费、同种疗法费及针灸治疗费用，每 一保险期间内每一被保险人总共累计最高限 次含出院后的 后续治疗，每次限人民币 元。如医疗必需并经医生同意，
我们将支付被保险人购买或租用拐杖、轮椅、基本整形假体和
器具，每一被保险人每次事故最高限人民币 元。
以上责任不包括因生育、牙科疾病或严重慢性病而发生的门诊
医疗费用。
- Out-Patient Costs
covered under Select)
necessary costs agreed by us for out-patient services, &including &physician's
&fees, &laboratory
&and &X-Ray,
scanning, imagery services, prescription drugs. For the
cost of physiotherapy,chiropractic, osteopaths, homeopaths
acupuncturist which referred by a physician, we will pay
to RMB800 per visit for a maximum of combined 20 visit
（the treatment immediately following the insured
s discharge from an in-patient admission）period
insurance.
In the case of medical necessity, as
agreed by our
we will pay up to RMB4,000
each insured person in respect of any one insured event for the purchase or hire of
es,& walkers, &wheelchairs& and& basic& orthopaedic prostheses and equipment.
above benefit scheme does not cover any outpatient expense&& incurred &due
&to &maternity,
&dental &disease &or
serious chronic disease.
–& 严重慢性病治疗 本项责任不适用于精选型。
若意外伤害或疾病引起的疾病被认定为严重慢性病（详见释 义）的，则本保险单的保障责任包括所有必需的合理的严重慢
性病治疗费用，每一保险期间内每一严重慢性疾病以最高给付
金额人民币 元为限。
– Treatment to Serious Chronic&&
covered under Select)
an accident/injury or illness is deemed to be ‘serious
chronic’ (See serious chronic disease definition), all and any
cover under this Policy shall be limited to a maximum
benefit of RMB80,000 each serious
chronic condition, each period of
insurance in respect of
necessary and reasonable treatment costs.
以上责任不包括在被保险人在参加本保险之前已经存在的严 重慢性病。
not covered:
t for a serious chronic condition
which existed prior to the date of entry of an insured person under this
三、附加运送服务 本项责任适用于精选型、舒适型和菁英型。
&Additional Transportation Benefits
e under Select, Premier & Elite)
若因发生保险事故而如本条第一项责任中所述进行紧急医疗
运送，或被保险人已经如本条第二项责任中所述发生住院，我 们将提供下列保险利益：
following& an &insured&
event &we &have&
carried &out& an emergency medical transfer or
evacuation under Section 1, or the insured person has been hospitalized within
the terms of Section 2, we will provide the
following benefits.
– 看护无人照料的子女&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& –Care of Unaccompanied Children
、 若被保险人的一名或多名子女在家中无人照料，我们可安 排该子女乘坐列车头等舱或飞机经济舱到保险单约定地区范 围内的被保险人指定的目的地，或者安排被保险人指定人员乘
坐列车头等舱或飞机经济舱前往被保险人家中照看该子女，并 支付所发生的载有该指定人员姓名的一次往返车票或飞机票。
、 若被保险人的一名或多名子女随同旅行，我们将安排与其 最初旅行同等级别的同???交通方式送其回家或继续旅行至本 保险单规定地区范围内的被保险人指定的目的地，并支付其相
关的必要的旅行费用。
、 在任何情况下，我们将承担该成年看护人员的旅行费用。
若被保险人无法指定看护人员，则我们将安排合适的看护人 员，并承担相关的费用。
以上所涉及的民航飞机票，按照实际购买的经济舱票价支付旅
行费用，如果购买的飞机票是其它类型的机票，我们按照可获 得的最低价格的经济舱价格进行赔付。
If any one or more of the insured person's children
is left at home unsupervised,
we will arrange and
for the child or
children to travel to a destination specified by the insured person within the geographical area, by first
class rail or economy& / tourist class air travel.& Alternatively, we will
arrange and pay for one return
ticket by first class rail or economy / tourist air travel for a person nominated by the insured person to travel to the insured person's
home and care for the child /
any one or more of the insured person's children was traveling
with the insured person on
a journey we will arrange and pay necessary additional
travel costs, by the same means and class as their original ticket, for the child
or children to return home or
continue to a destination specified &by &the &insured&
person &within& the& geographical
In either case we will also pay the travel costs of one adult
to &accompany &the &child &or&
children.& When &the &insured person cannot nominate this adult, we will arrange and
pay for a suitable escort.
would pay the
actual economy class
air ticket in the above regarding clause, however, if air ticket is other than economy class, &the
&maximum &payment &is
&up &to& the &lowest
&price &of economy class air ticket
which is obtainable.
–& 亲属或朋友探访&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& –Visit of Relative or Friend
若在紧急医疗运送或转运中被保险人无人陪同，且被保险人住
院的医院离被保险人最近的居住地超过 公里（英里）
以上，我们将：
the event that no
traveling companion is available to
accompany the insured
person during the emergency medical transfer or evacuation, and the insured person is hospitalized more &than &400& km &(250
&miles) &from &the &insured
&person's nearest place of residence:
、 安排一名被保险人指定的亲属或朋友乘坐列车头等舱或 飞机的经济舱前往被保险人所在地方探望被保险人，并承担一
次往返车票或机票。
We will arrange
and pay for one return trip, by first class rail
or by economy/tourist
class air travel, for a relative
or friend nominated by the insured
person to travel to
the location where the
insured person is situated.
2、&我们承担该被保险人指定的亲属或朋友在被保险人住院
期间陪同的必要住宿费用，每晚费用不超过人民币 800 元，累
计入住以 10 日为限。
We will pay for necessary overnight accommodation for the insured person's nominated
relative or friend
while the insured person
remains hospitalised, up to
RMB800 each night for a
maximum of 10 nights.
四、紧急牙科治疗&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& Emergency Dental Treatment
本项责任适用于精选型、舒适型和菁英型。
在保险期间内，我们将承担被保险人因意外伤害事故直接造成
的口腔或牙齿损伤进行的紧急牙科治疗费用，并仅限于在发生 意外事故后 48
小时内接受紧急治疗以减轻被保险人的疼痛的
费用，在每一保险期间内每一被保险人最高给付限额为人民币
8,000 元。
e under Select, Premier & Elite)
will arrange and pay for
emergency dental treatment necessary as a result of an extra-oral impact
and received within 48 hours from the date and time of the accident/injury
for the immediate
relief of pain the insured person suffers as the direct result
of an accident occurring during the period of
insurance. We will pay up to a maximum of RMB8,000
in total each insured
person in any one period of insurance.
以上责任不包括：
因以下事故或伤害而接受的治疗：
&在进食或饮用过程中造成的伤害，包括吞噬异物对 口腔造成的损伤。
&口腔或牙齿正常的磨损和老化
&刷牙或其他口部清洁过程引起的伤害
&因非外部撞击造成的口腔伤害。
除减轻疼痛进行的有效的牙科手术以外，任何牙齿修补、 使用任何贵金属材料、任何牙齿矫正治疗或在医院进行的
牙科手术。
is not covered:
necessary by the accident/injury
if: the injury was caused by eating or drinking anything, even if it contains a foreign body; the damage was caused by normal wear and
the damage was caused
by toothbrushing or any other oral hygiene
the injury was
caused by any means other than extra-oral impact.
ency& dental& treatment& shall& not& include
restorative or remedial work, the use of any precious metals, and orthodontic treatment
of any kind or dental surgery performed in a hospital,
unless dental surgery is the
only treatment available to alleviate the pain.
五、常规健康护理 本项责任仅适用于菁英型。
&Routine Health Care
e under Elite only)
在保险期间内，我们将承担以下保险责任，并对每一被保险人
发生的以下必 要的医疗服务 和费用最高累 计支付到人民 币
will pay up to an overall maximum
of RMB16,000 each insured &person& in &total
&in &any &one &period &of
&insurance &in respect of the following
services and benefits which become necessary.
– 常规口腔护理
我们将承担以下合理的，符合惯例的费用：
、& 牙检及牙齿保健，包括洗牙。
在保险期间内，下列牙科治疗，每一被保险人累计支
付限人民币 元：
–Routine Dental Care
will pay the usual reasonable and customary cost of:
check-up and hygienist
visit to a dentist in each
period of insurance, including
de-scaling and polishing treatment.
Dental treatment as specified below, subject to an overall maximum of RMB8,000 each insured person in total in any
线检查、印模膏、石膏模、临时义齿；
合金或合成物的填充物；
龋病治疗包括牙体充填，嵌体冠修复；
拔牙费用，包括阻生牙拔除；
新型烤瓷冠、烤瓷桥；
根管治疗；
抗感染治疗费用，包括口服抗生素、髓腔治疗等。
、 在保险期间内，每一被保险人因牙周疾病的治疗（包 括牙龈炎、牙周炎或其他牙龈疾病）累计支付限人民 币 元。
以上责任不包括：
．在需要进行牙科治疗前 个月未进行常规牙科检查， 或在被保险人参加本保险单前
&个月内未进行常规 牙科检查而发生的牙科治疗引起的任何费用；
．在投保前被保险人未按牙科医生的建议进行必要的治 疗而引起的常规牙科治疗费用；
．具有美容性质的牙科治疗如陶瓷镶盖牙齿，美白牙齿
以及种植，正畸治疗
除保险单特别约定外，任何牙科治疗过程中所使用的 贵金属材料、假牙。
period of insurance:
X-rays, &Impression
&plaster, &plaster &molds, &temporary
artificial denture
using amalgam or composite materi
caries &treatment &including
&tooth &filling &and
repairmen for inlays/crowns
extractions, including surgery to remove impacted teeth
new porcelain
crowns or bridges;
root canal treatment
for& &the& &relief&
&of& &an& &infection,& &including
prescribed antibiotics and pulp treatment .
We &will &pay &up& to& an &overall
&maximum &of &RMB &2,000 claims due to periodontitis
(including gingivitis,
parodontitis or other gum disease)&
for each insured person during one policy year.
is not covered:
for routine dental treatment
if the insured person& has& not& undergone &a&
routine& dental& check-up within the 12 months prior to
their date of entry to this Policy or prior to requiring the treatment.
for routine dental treatment if the insured
person has not undergone all necessary treatment recommended by a dental practitioner prior to their date
of entry to this Policy.
Cosmetic dental treatment,
e.g. ceramic tooth veneers, tooth whitening and implant, orthodontic treatment.
dental procedures other than those specified, the cost of
metals in any dental procedure, , dentures.
–& 常规眼部护理&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& – Routine
Optical Care
我们将承担以下合理的，符合惯例的费用：&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& will pay the usual reasonable and customary cost of:
、& 每年一次视力检查；&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& One
annual vision test in each period of insurance.
眼科医生处方的眼镜或隐形眼镜
以上两项费用在保险期间内累计最高支付以人民币&
Glasses or contact lenses prescribed by an ophthalmologist,
The total cost for above two items is subject to an overall
maximum of RMB2,400 each insured person in total in
any one period of insurance.
以上责任不包括：
．因美容需要而配置的隐形眼镜；
．任何形式的太阳眼镜（包括处方的太阳眼镜???。
is not covered:
lenses supplied for purely cosmetic purposes
Sunglasses& &of&
&any& &kind,&
&including& &prescription
常规听力护理
我们将承担以下合理的，符合惯例的费用：
、& 每年一次听力检查；
医生处方的助听器
以上两项费用在保险期间内累计最高支付以人民币&
–Hearing Care
will pay the usual reasonable and customary cost of: i. One annual hearing test in each
period of insurance. ii.A hearing aid prescribed
by a physician
for above two items is subject to an overall maximum of RMB2,400 each insured person in total in any one period of
insurance.
六、生育保险
本项责任仅适用于舒适型和菁英型。
Maternity Care
e under Premier & Elite only)
若被保险人的预产期在参加了本保险单后还有至少&个月的，
我们将安排生育护理。但续保后的保险期间内怀孕的被保险人
不受此限。
arrange for maternity care when the insured person's
expected delivery date is at least 10 months
after the date of entry
&to &this &Policy.& This &condition &will
&not& apply &if
&the insured person becomes pregnant in
second or subsequent period of insurance following renewal
of this Policy.
若被保险人参加的是舒适型，我们将承担被保险人在保险期间
内每次怀孕所发生的，经过我们的医生认定为合理的和符合惯
例的正常分娩费用，累计最高支付限人民币 32,000 元。
agreed by our physicians as
being usual reasonable and customary, we
will pay up to a maximum of RMB32,000
in total each pregnancy in any one period of insurance for the following:
All costs of normal childbirth.
若被保险人参加的是菁英型，我们将承担被保险人在保险期间
内每次怀孕所发生的，经过我们的医生认定为合理的和符合惯
例的以下各项费用，累计最高支付限人民币 64,000 元：
产前检查费用
正常分娩费用
产后检查费用
婴儿出生后 天内的护理（包括包皮环切）及疫 苗费用，疫苗包括乙肝疫苗，卡介苗，脊髓灰质炎疫 苗，百白破，流脑疫苗，乙脑疫苗。
Elite Cover:
by our physicians
as being usual reasonable and
customary, we will pay up to a maximum of RMB64,000 in total
each pregnancy in any one period of insurance for the following:
examinations by a phy
All costs of normal childbirth.
Post-natal examinations
a physician.
Vaccines and
Baby care （ion）&7 days
birth Vaccines, including hepatitis B vaccine, BCG, polio vaccine, DPT, meningitis vaccine, Japanese encephalitis vaccine.
由于怀孕或分娩引发的并发症属于本保险的第二项保险责任
范围，因此该并发症引发的相关医疗费用赔付时的最高限额以 本保险的第二项保险责任项下的责任限额为限。
如果怀孕延续至下一保险年度，所有与该次怀孕有关的医疗费
用的赔付限额为怀孕开始时所在保险年度的限额。
any medical complications
arise in connection with
pregnancy &or &childbirth, &the&
cover &under &Section &2 &of &this Policy will apply instead, and
the insured person will be
covered up to the limit of Section 2 in respect of any necessary
medical expenses arising from such medical complications.
the pregnancy is carried
to next policy year, all medical expenses related to this pregnancy should be subject to
the maternity benefit limit of the policy year where the pregnancy
以上责任不包括：
&除流产、异位妊娠、死胎以外的终止妊娠；
&医生认为非医疗必要的选择性剖腹产，以及因此产 生的治疗；
&产前辅导课程，与生产无关的助产士费用；
&计划在家中分娩导致或引起的并发症。
is not covered:
Terminations &of &pregnancy, &other
&than &miscarriage, ectopic pregnancy and still birth.
Elective caesarean section deliveries not agreed by our physicians &as
&being &medically
&necessary &and &treatment
Ante-natal classes,
mid-wifery costs
when not directly
associated with the delivery.
Complications which may arise during or as a result of
七、遗体遣送 本项责任适用于精选型、舒适型和菁英型。
7.&& &Repatriation Following Death
e under Select, Premier & Elite)
若被保险人在保险期间内因保险事故死亡，我们将按照被保险 人临死前的意愿或最亲近的亲属的意愿给付下列保险利益之 一：
the insured
person dies during the period of
insurance as the result of an insured event, we will provide the following benefits
according to the wishes of the insured
person expressed prior to decease or of the next-of-kin.
– 遗体遣送回国&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& –Repatriation of Remains
、 安排将被保险人的遗体通过空运从事发地运至其被保险
人国籍所在国或居住国的葬礼所在地，所有必要的运送安排都 将按照国际规则及惯例的要求进行，其中灵柩费最高不超过人 民币 元；
We will arrange and pay for preparation and repatriation by air transportation of the mortal remains of the insured person from the country where death
occurs to the place of the funeral in the home country or in the country of residence.
will make all necessary arrangements as required under
international regulations
and will pay up to RMB8,000 towards the cost
of the coffin.
&承担一名陪同运送被保险人遗体并参加葬礼人员的列车
头等舱或飞机经济舱的往返旅行费用。
We will also arrange and pay the additional travel costs of one other person who was
accompanying the deceased
insured person, to return by first class train or economy / tourist class air travel to attend the funeral.
–& 火葬&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& – Cremation
或者我们将选择安排并承担以下费用：
被保险人死亡地的火葬费用，最高限人民币 元；
、& 将灵柩运送其国籍所在国或居住国。
tively we will arrange and pay:
&RMB2,400 &towards &the
&cost &of &cremation &in
&the country where death
for transportation of the funeral urn to the home country or
country of residence.
就地安葬&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& l
或者若被保险人在国籍所在国或居住国以外的国家死亡， 我们可以将被保险人的遗体就地安葬，并承担最高不超过人民 币 8000 元的就地安葬费用。
will arrange and pay up to RMB8,000 for burial in the
country where death
occurs if the insured person dies
outside the home country or the country of residence.
八、选择性特定医疗项目转送 本项责???仅适用于舒适型和菁英型。
Elective Medical
e under Premier and Elite)
经我们同意并根据被保险人的病情状况，需要进行治疗计划安
排的特定医疗项目，只要被保险人病情许可，并在下述条件下， 我们在满足下列条件的情况下可安排通过正常飞机航班（限经 济舱）或包机（根据需要指派医护人员）运送被保险人到其在 保险凭证规定范围内选择的国家治疗：
we& agree &that& it& is &necessary &for&
the& insured &person&
to undergo a scheduled major
intervention, we will arrange and
pay&&&&&& for&&&&&&&&&& the&&&&&&&&& insured&&&&&& person's&& transfer,&&& by&&&&&&&&&&&&& regular
scheduled(economy class only)
or charter airline (and
with medical escort if necessary),
to the insured person's
country as specified in the Certificate, as soon as the insured
person's medical condition permits, and on condition that:
、& 在选择的国家有合适的医院，并同意接受被保险人。&&&&&&& There is a suitable hospital available in the elected country, which
accepts the insured person
for admission.
救援机构医生认为转运不会造成被保险人额外增加 的风险或病情的恶化。
救援机构医生认为通过正常航班或租用飞机进行运 送是安全的。
Our physicians
are of the opinion that the transfer is not
likely to induce any additional
risk or deterioration in
the insured person's medical condition.
Our physicians agree that such transfer can safely be made by regular scheduled or charter airline.
、& 航空公司接受被保险人作为乘客搭乘飞机。&&&&&&&&&&&&&&&&&&&&&&& The &airline &company
&accepts &the
&insured &person &as
&a passenger.
、 适合的飞行应是在考虑了被保险人医疗状况许可的 情况下，在合适的时间内的合适的航班。
A suitable &flight
&is& available&
within& a &satisfactory
&time period, bearing
in mind the insured person's medical
condition.
在紧急情况下，只有在不会延误紧急医疗运送或转运时，我们
才能同意转运至被保险人选择的国家。
an emergency situation, we will only agree to the insured person's transfer
to the elected country if such election does
not significantly delay the emergency medical transfer or
evacuation.
当被保险人的治疗结束时，在救援机构医生认为被保险人的病
情已可以适合旅行起的 天内，我们将安排被保险人乘坐列车
头等舱或飞机经济舱返回居住地，并承担相关的旅行费用。若 救援机构的医生认为有必要，将为被保险人安排医疗护送。
以上责任不包括：
．被保险人所选择转运治疗的国家可能会严重延误医疗 运送或转运；
．被保险人选择的但我们的医生不建议转运至的国家；
．除非因紧急医疗转运或运送，因选择性特定医疗项目 被转送其他国家或地区，而产生的看护无人照料子女 的费用。
completion
of the insured person's treatment and within
three days of our physicians pronouncing the insured person fit to travel, we will arrange and pay for the insured person's
return to home in the country of
residence, by first class rail travel or economy / tourist
class air travel. We will arrange and pay for a medical escort to
accompany the insured person,
if deemed medically necessary by our physicians.
is not covered:
The insured person's
election of transfer
country which would significantly delay the
insured person's emergency transfer or evacuation.
to any elected country which is not approved
our physicians for any reason.
Any payment in respect of
care of an unaccompanied child under Section 2 in the event of a scheduled major
tervention
which does not involve the insured person's
emergency medical transfer or evacuation
第五条&&&&&&&&&&& 通用条款&}