Insurance & Medicalcare

Brief Introduction to the Comprehensive Insurance Guarantee Scheme for Ping An 's Old - age Insurance Co., Ltd

Insurance duty:

In the period of validity of the insurance liability, the Company assumes the following insurance liability:

1.Death Insurance liability:

If the insured person died due to an accident or illness (including SARS), the Company shall pay the insurance premium according to the agreed insurance amount and the insurance liability shall be terminated.

 2.The accident disability insurance liability: 

If the insured person is suffering from an accident and has caused the disability within one hundred and eighty days from the date of the accident, the Company multiplies the agreed insurance amount according to the stipulated proportion of the "disability degree and payment ratio table" of Ping An Annuity Insurance Co., Ltd. gold. If the treatment is not completed on the 180th day, the disability is assessed on the basis of the physical condition of the 180th day and the "Disability Insurance" is paid according to the "Disability Degree and Payment Scale". The insured person due to the same accident caused by "disability and payment ratio table" listed in the degree of disability more than two,this case the insurer to pay the corresponding disability insurance sum. However, when a disability item belongs to the same upper limb or the same lower limb, only a disability benefit is paid; if the disability item is of a different degree of disability, an additional disability benefit is paid for a more severe disability item. The disability caused by the accident ,the merger of the previous disability can lead to more serious accident insurance items, according to the more serious project standard payment, but the previous payment of the accidental disability insurance (before the insured or due to liability exemption And the disability listed in the Disability and Payment Proportion Table shall be deemed to have been paid for the disability insurance. The sum of the insured person's insured amount and the total amount of the disability insurance premium of the insured person shall be limited to the total amount of the insured person's death and the total amount of the unintentional disability liability, and when the accumulated payment amount reaches the insured amount, The person's insurance liability is terminated.

3.Accidental injury medical insurance liability:

If the insured person receives an accident and is treated within 180 days from the date of the accident, the insurer shall pay 100% of the reasonable medical expenses for the actual expenses of the accident, and the accumulated amount shall be paid in the agreed insurance Amount is limited. If the insured has incurred one or more accidental injury insurance accidents, the insurer shall pay the "accidental injury medical insurance fund" separately according to the above provisions, but the accumulated payment amount shall not exceed the insured amount of the insured person, and the accumulated payment amount shall reach The insured person's liability for insurance shall be terminated when the amount of insurance is increased.

4.The Emergency medical insurance liability:

The insured person due to the disease outpatient, emergency treatment occurred in the reasonable medical expenses incurred within each insurance period to pay more than 2,000 yuan part of the insurance companies in accordance with the proportion of 85% compensation, the daily limit of 600 yuan (daily limit refers to the same day in the same Hospitals, the same department to see the cost of the amount of treatment), the cumulative amount of insurance to 20,000 yuan limit. When the accumulated payment amount reaches its insured amount, the insured's insurance liability is terminated. General outpatient, emergency, outpatient surgery, emergency care, emergency medical expenses arising from emergency treatment, medical expenses provided by public hospitals or health and epidemic prevention departments, and the hospital due to the same cause of hospitalization. Before and after the hospital outpatient clinics and other medical expenses are attributed to the out-patient medical liability. In accordance with the relevant policy requirements:  acute disease 3 days, chronic disease 7 days, chronic diseases (such as high blood pressure, diabetes, etc.) long-term medication 30 days Attendance: one day up to three different departments of the cost, more than the cost of pays.

5.Hospital Medical Insurance liability:

If the insured person is hospitalized by the hospital due to an accident or after the effective date of the policy, the Company shall pay the medical expenses (the limit of 100 yuan / day, the accumulated 30 days). Heating fees, air conditioning fees, bed charges (limit 300 yuan / day), inspection and inspection fees, special inspection and treatment costs, surgery, medical expenses, treatment fees, laboratory fees, radio therapy and other reasonable medical expenses, according to 100% Medical insurance ".

The insured person shall pay the insurance premium within the prescribed limit, regardless of one or more hospitalizations, and the insurance liability shall be terminated when the accumulated amount of the sub-item reaches its insurance amount. If the insured has a major illness or chronic illness before the insured, the insurer shall not be liable for the payment of the insurance premium.

Note:

  1.  All medical liabilities mentioned above are limited to public hospitals in the territory of the People's Republic of China, but do not include public hospitals, foreign residents, special treatment ward, special care ward and high dry ward .And so on the same ward or ward medical expenses incurred.
  2.  The medical expenses incurred by all the above medical liabilities are limited to items and fees that meet the scope of reimbursement of local social basic medical insurance, and can not be reimbursed at their own expense and part of their own projects.
  3.  The insured person who has made the first insured or non-continuous insured is 30 years from the date of insured for the waiting period (observation period). If the hospitalization occurs during the waiting period, the Company shall not be liable for compensation. Continuous insured or insured person suffered an accident for treatment without waiting period.
  4.  All the above medical expenses, if other third parties to pay part or all of the cost, we only responsible for the rest of the compensation and the local social health insurance coverage in line with the reasonable costs, but the insurance liability involved in the bed fee, Fees and other restrictions on the same part of the limit, such as the third part of the proportion of the restricted part of the limited amount in accordance with the limited amount of deducted the amount of compensation has been paid, the Division I only pay the remaining amount, if no compensation ratio, the restricted part of the local community Medical insurance standards, based on the limited amount of the deduction of the standard amount of the project, pay the remaining amount, and the amount of insurance.