2013最新保险文件

Report
来华留学保险项目组
2013.8
来华留学生保险责任
自2013年8月1日以后购买并生效的保单,保险责任
如下并实行全程医疗管理服务。
保障项目
保险金额(人民币)
身故/残疾
Death/Disability
10万元
意外伤害医疗
Medical treatment for accidental
injury
2万元
门诊医疗保险责任
Outpatient medical insurance
liability
2万元
(起付线2000元,85%赔付
600元日限额)
住院医疗保险责任
Inpatient medical insurance liability
40万元
来华留学生保险服务卡_正面
每位参保学生会有一张服务卡,可以持卡
打电话得到保险服务
扫一扫,进入手机版
转1——24小时
热线咨询电话
留学保险网址
来华留学生保险服务卡_背面
这里有服务卡号
无卡号的,需要投
保时的护照号
 护照号和服务卡号是投
保后享受服务的两个辨
识条件。
来华留学生保险_信息查询
多种渠道提供给参保学生查询保险责任、保
险有效期及理赔信息,最便捷的是手机方式。
 留学保险网站(www.lxbx.net)
 联华国际网站(www.lhgj.net)
 手机版
来华留学生保险_信息查询
 手机查询信息
用护照号、服
务卡号登陆
当前保单信息,
理赔信息
来华留学生保险_保险提示
 被保险人在本次投保前发生的重大疾病或慢性病,
保险人不承担给付保险金的责任。
 首次投保或非连续投保的被保险人自投保之日起
30日为等待期(观察期),如等待期内出现住
院情况,不负担赔偿责任。如连续投保或被保险
人遭受意外事故进行治疗的无等待期。
来华留学生保险_保险提示
 记住你的保险服务电话:400-810-5119转1,有任何问题,可随
时咨询,取得正确的就医、理赔指导;
 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(北京环球医疗救援有限责任公司)收件人:来华项目理赔部 电
话:010-59104919 邮编:100022
 保险细则以《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》为准,或参阅www.lxbx.net中的投保指南及理赔指南
来华留学生保险_注意事项
 使用保险,须在公立医院的普通门诊就诊或普通科
室住院,外宾病区、特需、VIP病区、包床、包房、
私立及合资医院的费用不能报销;
 每次看病后要保存好病历、收据原件,达到起付线申
请理赔时要一并提供给保险公司;
 “日限额600元”:日限额指同一天在同一医院,
同一科室就诊费用的限制额度。
来华留学生保险_注意事项
 如果有多次就诊记录,必须提供每次医生写的就诊病历记录;
 看病时的名字与投保时一致,保证收费收据上的姓名准确,如
果不对,去医院收费处手工修改,在修改的地方要盖医院的章;
 理赔申请提供的护照,必须是有效期内的护照复印件,过期的
护照不能做为有效的身份证明;
 今年保险方案变更后,住院前、住院后、门诊手术的费用都归
为门诊责任;
 如果您的病情未到达住院条件,门诊治疗即可,而您自行住院,
发生的住院费用将无法获得理赔报销。
2013-14学年来华人员综合保险保障计划简表
(生效日期:2013年8月1日起)
保障项目
保险金额
身故/残疾
10万元
意外伤害医疗
2万元
保障范围
因意外伤害事故或疾病身故/意外残疾,我们将累计给付身故/意外残疾保险金;
因意外伤害事故需门诊治疗,发生的医疗费用,我们将就其事故发生之日起180日内实际支出的按照
当地社会医疗保险部门规定可报销的、必要的、合理的医疗费用给付医疗保险金;
被保险人因意外伤害事故或因疾病,经医院诊断必须住院治疗,就其实际支出的合理住院医疗费用,
住院医疗保险责任
40万元
按100%给付住院医疗保险金。
温馨提示:
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。
2万元
门诊医疗保险责任
(起付线2000元
,85%赔付600元日
限额)
被保险人因疾病咨询4008105119转1进行医疗咨询,需门诊治疗发生的医疗费用,我们按照当地社会
医疗保险部门规定可报销的、必要的、合理的医疗费用超过人民币2000元以上部分按85%的比例给付
门诊医疗保险金,且每次门诊费用日限额600元。
温馨提示:
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。
1.因疾病或意外事故需就诊,必须直接电话致4008105119转1键,进行健康询诊、就医指导及理赔注
全程医疗管理
紧急医疗救援
意事项说明。如确诊需住院可向救援公司申请住院垫付。未经救援公司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住院治疗的),救援公司不负责住院费用垫付。对于未经上述程
序申请的,个人自行垫支医疗费用的,将无法获得赔付。
2.理赔咨询、重大事故报案:4008105119转1键,未开通400电话地区可拨打010-67185217
Comprehensive Insurance & Protection Scheme for Foreigners
Staying in China of Ping An Annuity Insurance Company, Ltd
(Effective on August 1st, 2013)
Coverage
Insured amount
Death/Disability
RMB100,000
In case of death/accidental disability due to accidental injury or disease, we will provide accumulative insurance benefit for death/accidental
disability.
Medical treatment for
accidental injury
RMB20,000
If outpatient treatment is required due to accidental injury and medical expenses are incurred, we will provide medical insurance benefit for the
actual medical expenses considered as reimbursable, necessary and reasonable by the local social medical insurance department within 180
days after the accident.
Inpatient medical
insurance liability
RMB400,000
If the insured must be hospitalized after diagnosis of hospital due to accidental injury or disease, we will provide inpatient medical insurance
benefit equal to 100% of the actual and reasonable medical expenses.
Kindly reminder:
If the insured suffered from critical disease or chronic disease before buying this insurance, the insurer shall be released from its liability to make
payments.
Outpatient medical
insurance liability
RMB20,000
(Starting line is
RMB2,000. 85% of the
excessive part beyond
the starting line will be
paid. The daily limit is
RMB600. )
If the insured calls 4008105119 EXT 1 for medical consultation due to disease, and medical expenses are incurred by outpatient treatment, we
will provide outpatient medical insurance benefit equal to 85% of the excessive part of medical expenses beyond RMB2,000 considered as
reimbursable, necessary and reasonable by the local social medical insurance department. And the limit for each time of outpatient fee is
RMB600.
Kindly reminder:
If the insured suffered from critical disease or chronic disease before buying this insurance, the insurer shall be released from its liability to make
payments.
Whole-process medical management
Emergency medical rescue
Scope of insurance coverage
1. If he/she needs to see a doctor due to disease or accident, the insured has to directly call 4008105119 EXT 1 for consulting, diagnosis, medical
guidance and precautions for claim. If it is confirmed that hospitalization is required, the insured can apply for advanced payment of medical
expense for hospitalization to the rescue company. If the insured is directly hospitalized without recording of rescue company and outpatient
treatment (including those whose conditions do not meet the requirements of hospitalization but hospitalized), 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. Telephone number for claim consultation and reporting of major accident: 4008105119 EXT 1. You can call 010-67185217 in the areas without
telephone number beginning with 400.
结束语

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