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中国人民健康保险股份有限公司关爱专家短期重疾(推荐版)团体疾病保险(0)

中国人民健康保险股份有限公司关爱专家短期重疾(推荐版)团体疾病保险(0)
中国人民健康保险股份有限公司关爱专家短期重疾(推荐版)团体疾病保险(0)

PICC Health Insurance Co. Ltd.

Care Expert - Group Short-term Critical Illness Insurance

(Recommended Version)

(These conditions and the general conditions of Short-term Illness Insurance constitute the insurance conditions of the insurance contract.) Code:260301

1 Liabilities and Exclusions

1.1 Sum Insured The Sum Insured is concluded as per agreement reached by

the Policyholder and the Insurer and is stated in the policy.

Once concluded, the Sum Insured shall not be changed

during the Insurance Period of the Policy.

1.2 Insurance Liability The Insurance Period of the Policy is one year. During the

Insurance Period, the Insurer shall bear following liabilities:

Critical Illness Benefit In the event that an accidental injury occurs to the Insured after the Insurer starts to bear insurance liability or a non-accidental incident occurs to the Insured 90 days thereafter (if the policy is renewed after the Insurer starts to bear renewed insurance liability), and causes critical illness (es) stated in the Policy to the Insured for the first time, the Insurer shall pay the Sum Insured as Critical Illness Benefit and the coverage of the Policy for the particular Insured Person shall terminate.

In the event that a non-accidental incident occurs to the Insured within 90 days after the Insurer starts to bear insurance liability (renewed policy excluded), and causes critical illness (es) stated in the Policy to the Insured for the first time, the Insurer shall pay a sum as Critical Illness Benefit on the basis of the sum of premium paid for the particular Insured Person and the coverage of the Policy for him/her shall terminate.

Death Benefit In the event that a non-accidental incident occurs to the

Insured 90 days after the Insurer starts to bear insurance

liability (if the policy is renewed, after the Insurer starts to

bear renewed insurance liability), and results in the death of

the Insured, the Insurer shall pay the Sum Insured as Death

Benefit and the coverage of the Policy for the particular

Insured Person shall terminate.

In the event that a non-accidental incident occurs to the

Insured within 90 days after the Insurer starts to bear

insurance liability (renewed policy excluded), and results in

the death of the Insured, the Insurer shall pay a sum as

Death Benefit on the basis of the sum of premium paid for

the particular Insured Person and the coverage of the Policy

for him/her shall terminate.

1.3 Exclusions The Insurer shall bear no benefit liability in the event that

the illness, the status of illness or the operated surgery is

caused to the Insured as the result of any following reasons:

1)The Insured Person is killed or injured intentionally by

the Policyholder or the Beneficiary;

2)Intentional self-inflicted injury, committing criminal

crimes intentionally, resistance to arrest;

3)Substance abuse by ingesting, taking or injecting drugs;

4)Driving under the influence of alcohol, driving without a

Valid Driving License, or driving an automotive vehicle

that is not validly licensed;

5)Infected by HIV virus or suffering from AIDS;

6)Wars, military conflicts, riots or armed insurrection;

7)Nuclear explosion, nuclear radiation or nuclear

pollution;

8)Hereditary diseases, congenital malformation,

deformation, and chromosomal abnormality.

If any reason mentioned above caused the death or critical

illnesses covered by the Policy to the Insured, the Policy

validity for this particular Insured Person shall terminate

and the Insurer shall refund the unearned premium after

processing fee is deducted.

2 Other Issues

2.1 Change of the

Insured If the Policyholder requests to add new Insured Persons, the Policyholder shall notify the Insurer in writing. The liabilities shall start at the time as agreed in the endorsement after consent of the underwriter and collection of premium. If the Policyholder needs to apply for canceling the

coverage of an Insured Person, a written notice shall be sent to the Insurer and the qualification of the Insured Person shall terminate on the day when the notice is received. If the termination date requested by the Policyholder is later than the arrival date of the notice, the Insured Person’s coverage shall terminate from 00:01a.m. of the termination date. The Insurer shall refund the unearned premium for the specific Insured Person after deducting processing fee.

If a covered loss has already occurred to the Insured Person, the Policyholder shall not apply for the cancellation of the Policy.

If the number of the Insured is fewer than 8 or lower than 75% of the number of the people eligible for the Policy, the Insurer has the right to cancel the Policy and refund the unearned premium after deducting processing fee.

2.2 Benefit Application

Documentation The Claimant shall provide following materials upon claim application and the Insurer has the right to keep the original or duplicated copies of the materials:

Documents for Critical Illness Benefit 1)Proof of the identification of the Beneficiary;

2)Certificate of diagnosis, prescriptions, medical record,

and microscopy, blood test, imaging and other scientific examination reports essential for disease diagnosis

issued by the hospital;

3)Other proofs and materials relevant to the nature, cause,

etc. of the Insured Incident.

Documents for Death Benefit 1)Proof of the identification of the Beneficiary;

2)Proof of the annulment of the household register of the

Insured Person;

3)Death certificate of the Insured Person issued by the

police or hospital;

4)Other proofs and materials relevant to the nature, cause,

etc. of the Insured Incident.

2.3 Special Notice The accessory policy of this Policy is Accessory Care Expert

-Group Accidental Injury Insurance (Recommended

Version) of PICC Health Insurance Co., Ltd.

The validity of this Policy is bound by that of the accessory policy and shall terminate upon the termination of the latter.

Definitions

1 Processing Fee Refers to the average sum of the operation expense and

commission on each policy. The processing fee is 25% of the

premium.

2 Unearned

Premium: Formula: Annual Premium * (1-25%) * (Number of days from current date to expiration date/365)

3 Force Majeure Refers to objective circumstances that are unforeseeable,

unavoidable and insurmountable.

4 Attained Age Refers to the age calculated based on the date of birth recorded in

legal identification documents.

5 Accidental

Injury Refers to the injury caused by accidental incident(s) that is external, eruptive, unintentional, and non-disease related.

6 Driving

Without A

Valid Driving

License Refers to one of following situations:

1)Driving without a legally issued driving license;

2)Driving at the time while the driving license is legally

detained;

3)The vehicle driven does not match the vehicle type registered

in the license;

4)Driving with an un-inspected driving license or expired

driving license;

5)Other situation that the public traffic administration

departments deems as driving without a valid driving license.

7 Infected by HIV

Virus or

Suffering from

AIDS HIV Virus refers to human immunodeficiency virus, abbreviated as HIV in English. AIDS refers to acquired immune deficiency syndrome caused by HIV virus, abbreviated as AIDS in English. If the Insured Person’s blood sample or other samples test positive for HIV or HIV antibody, and no clinical features and other symptoms appear, this indicates that the Insured Person is infected by HIV virus; if distinct clinical features or other symptoms appear at the same time, this indicates that the Insured Person is suffering from AIDS.

8 Hereditary

Diseases Hereditary Diseases refers to the diseases caused by the mutation or aberration of germ plasm (chromosomes and genes) in germ cells or fertilized ovum, usually featuring a vertical pass from

parents to offspring.

9 Congenital

Malformation,

Deformation,

and

Chromosomal

Abnormality Refers to the born malformation, deformation, and chromosomal abnormality of the Insured Person. The relevant stipulations in the International Statistical Classification of Diseases and Health Related Problems (ICD-10) released by the World Health Organization shall be referred to as the standard for Congenital Malformation, Deformation, and Chromosomal Abnormality.

10 Hospital Refers to medical institutions which are legally established and

fall into Grade A of Level 2 or higher grade of the Medical

Institutions Ranking System of the Ministry of Health of P.R.

China, but do not include sanatorium, nursing center,

rehabilitation center, abstinence center or drug treatment center,

mental and psychiatric treatment center and union hospital or

union ward without relevant medical personnel or medical

facilities founded by hospitals falling into Level 2 or Level 3 of

the Medical Institutions Ranking System.

11 Critical Illness

Malignancy That the Insured Person suffers from illnesses meeting following critical illness definitions shall be supported by the diagnosis of specialists.

Malignancy refers to the disease in which the malignant cells grow and proliferate uncontrolled progressively, soak and destroy the normal tissues around and can metastasize to other parts of the body through veins, lymphatic and coelom. Through pathological examination and clinical diagnosis, these cells meet the standards for malignancy stated in the International Statistical Classification of Diseases and Related Health Problems (ICD-10) released by the World Health Organization.

Following illnesses are not in the coverage scope of the Policy:

1)Carcinoma in situ;

2)Chronic lymphocytic leukaemia equivalent to Stage A in

Binet Cancer Staging

3)Hodgkin’s Disease equivalent to Stage I in Ann Arbor Cancer

Staging;

4)Skin cancer (melanoma and skin cancer that has

Acute Miocardial Infarction

Stroke Sequela

metastasized);

5)Prostate equivalent to Stage T1N0M0 or younger stages in

TNM Cancer Staging;

6)Malignancy acquired when being infected by HIV virus or

suffering from AIDS.

Acute Miocardial Infarction means that the obstruction of coronary artery causes blood deficiency in relevant part of the heart which, in turn, results in the partial necrosis of cardiac muscle. The illness shall meet at least 3 of the following conditions:

1)Typical clinical features, acute chest pain for instance;

2)Latest cardiogram change indicating Acute Miocardial

Infarction;

3)The level of cardiac enzyme or troponin increase

diagnostically, or change dynamically, which indicates Acute Miocardial Infarction;

4)After the Insured begins to suffer from Acute Miocardial

Infarction, checkups confirm that the performance of the left ventricle falls, the left ventricular ejectfraction decreases by 50%, for instance.

Sequela of Stroke means that the paroxysmal cerebrovascular pathological changes cause cerebrovascular haemorrhage, embolism or infarction and results in the permanent dysfunction of the nervous system, which means that the Insured Person still suffers from at least one of following dysfunction features 180 days after the disease of stroke is diagnosed:

1)The total loss of the function of one or more extremities;

2)The total loss of the power of speech or mastication and

swallowing function;

3)The total loss of the capability of living on one’s own, not

able to independently conduct 3 or more of the 6 Basic Daily Living Activities.

Transplant Operation of Major Organs or Hematopoietic Stem Cell Transplant

Coronary Artery Bypass Grafting (Coronary

End-stage Renal Disease (Uraemia Stage of Chronic Renal Failure

Severance of Multiple Transplant Operation of Major Organs refers to the allogeneic transplant operation of kidney, liver, heart or lungs due to the failure of relevant organs.

Hematopoietic Stem Cell Transplant refers to the allogeneic transplantation of hematopoietic stem cells (including bone marrow stem cells, peripheral blood stem cells and umbilical cord blood stem cells) due to impairment or malignancy of the hematopoietic system.

Coronary Artery Bypass Grafting refers to the coronary artery bypass grafting performed after thoracotomy for the treatment of serious coronary heart disease.

Coronary stent implantation, cardiac balloon catheter expansion , laser and RF technology and other non –open-chest interventional surgeries, endoscopic surgery are not in the coverage scope of the Policy.

End-stage Renal Disease means that both kidneys suffer from irreversible chronic renal failure and enter into the stage of uraemia, and the Insured Person has received at least 90 days of regular dialysis treatment or has received kidney implantation.

Severance of Multiple Extremities refers to the complete severance of 2 or more extremities from the proximal end (the end connecting the trunk) to wrists or ankles as the result of diseases or accidents.

Extremities

Acute or

Sub-acute Severe Hepatitis

Benign Brain Tumor

Decompensation Stage of Chronic Liver Failure The hepatitis virus causes diffuse necrosis of the liver tissue and acute liver failure, which shall be confirmed by serological or viral examinations , and the illness shall meet all following conditions:

1)Severe jaundice or the jaundice rapidly turns severe;

2)Hepatic encephalopathy;

3)B-type ultrasonic or other imaging checkups show an

fulminant liver atrophy;

4)Progressive deterioration of hepatic function indicators.

Benign Brain Tumor has caused the rise of intracranial pressure and such clinical features as papilledema, mental symptoms, epilepsy, kinaesthesia dysfunction and so on, and may endanger the life of the Insured Person. The benign brain tumor shall be confirmed by CT, MRI or PET and other imaging examinations and shall meet at least one of following conditions:

1)The brain tumor has been completely or partially resected,

which is performed after craniotomy;

2)Radiation therapy has been performed to the brain tumor. Pituitary adenoma, cerebral cyst, cerebral vascular diseases are not in the coverage scope of the Policy.

Decompensation Stage of Chronic Liver Failure refers to the liver failure caused by chronic liver diseases and shall meet all following conditions:

1)Continuous jaundice;

2)Ascites;

3)Hepatic encephalopathy

4)Congestive splenomegaly with hypersplenism or esophageal

and gastric fundus varices.

The liver failure caused by bibulosity or drug abuse is not in the coverage scope of the Policy.

Encephalitis Sequela or Meningitis Sequela

Deep Coma

Deafness of Both Ears Encephalitis Sequela or Meningitis Sequela refers to the permanent dysfunction of the nervous system caused by encephalitis or meningitis. The permanent dysfunction of the nervous system means that the Insured Person still suffers from one or more of following dysfunction features 180 days after the disease of encephalitis or meningitis is diagnosed:

1)The total loss of the function of one or more extremities;

2)The total loss of the power of speech or mastication and

swallowing function;

3)The total loss of the capability of living on one’s own, not

able to independently conduct 3 or more of the 6 Basic Daily Living Activities.

Deep coma means that the Insured Person loses his/her consciousness due to diseases or accidental injuries and is not responsive to both external stimulation and internal need; the coma degree scores 5 or below 5 according to Glasgow coma scale; and the Insured Person has used the ventilator and other life support systems for more than 96 hours.

Deep coma caused by bibulosity or drug abuse is not in the coverage scope of the Policy.

Deafness of Both Ears means that the hearing of both ears is permanently and irreversibly lost due to diseases or accidental injuries, and the pure-tone average is larger than 90 db under the voice frequency of 500 Hz, 1000 Hz and 2000 Hz, which shall be confirmed by pure tone audiometry, acoustic immittance or auditory evoked potential and so on.

The Insured Person shall at least attain the age of 3 when applying for the benefits and the certificate of diagnosis for hearing loss and proof of checkups shall be provided.

Blindness of Both Eyes

Paralysis

Heart Valve Surgery

Severe Alzheimer’s Disease Blindness of Both Eyes means that the eyesight of both eyes is permanently and irreversibly lost due to diseases or accidental injuries and the better one of both eyes shall meet at least one of following conditions:

1)The eyeball is lost or extirpated;

2)The rectified eyesight is lower than 0.02 (according to

international standard visual acuity chart, the scores shall be converted if other visual acuity charts are used)

3)The viewing radius is smaller than 5 degree.

The Insured Person shall at least attain the age of 3 when applying for the benefits and the certificate of diagnosis for eyesight loss and proof of checkups shall be provided.

Paralysis refers to the permanent total loss of the function of two or more extremities caused by diseases or accidents. The permanent total loss of the function of extremities refers to the ankylosis of two of the three major joints of the extremities, or the inability to control joint movements 180 days after the disease are diagnosed or 180 days after the accidental injuries occurs

Heart Valve Surgery means that the Insured Person has received the heart valve replacement or restoration performed after thoracotomy for the treatment of heart valve diseases.

Severe Alzheimer’s Disease means that the progressive and irreversible transformation causes severe decline or loss of one’s intelligence. Clinical features may include obvious cognitive dysfunction, behavioral abnormality and decline of social acceptability and that the Insured Person’s daily life shall be under progressive and close guard. CT, MRI or PET and other imaging examinations shall confirm the severe Alzheimer’s disease, the Insured Person shall completely lose his/her capability of living on his/her own and be not able to

Severe Cerebral Injury

Severe Parkinson's Disease

Severe Degree ⅢBurns independently conduct 3 or more of the 6 Basic Daily Living Activities.

Neurosis and mental diseases are not in the coverage scope of the Policy.

Severe Cerebral Injury means that an external mechanical force blows the head, causes injuries to major parts of the brain and results in permanent dysfunction of the nervous system. CT, MRI or PET and other imaging examinations shall confirm the severe cerebral injury. The permanent dysfunction of the nervous system means that the Insured Person still suffers from at least one of following dysfunction features 180 days after the severe cerebral injury occurs:

1)The total loss of the function of one or more extremities;

2)The total loss of the power of speech or mastication and

swallowing function;

3)The total loss of the capability of living on one’s own, not

able to independently conduct 3 or more of the 6 Basic Daily Living Activities.

Parkinson's Disease is a kind of neurodegenerative disease of the central nervous system; its clinical features include parkinsonism, ataxia and so on. Severe Parkinson's disease shall meet all following conditions:

1)The state of illness is beyond the control of medication;

2)The total loss of the capability of living on one’s own, not

able to independently conduct 3 or more of the 6 Basic Daily Living Activities.

Secondary Parkinson's syndrome is not in the coverage scope of the Policy.

Severe Degree ⅢBurns means that the degree of the burns is

Ⅲand the area with degree Ⅲburns accounts for 20% or more of the total body surface area, which shall be calculated according

Severe Primary Pulmonary Hypertension

Severe Motor Neuron Disease

Loss of Speech

Severe Aplastic Anaemia to Chinese Rule of Nines.

The continuous pressure increase, which is caused by unidentified reasons, of the pulmonary artery, develops progressively into chronic disease, which has caused permanent and irreversible limitations on the capacity of conducting physical activities; the Insured Person enters into the Degree IV of the Status of Heart Function of US New York Heart Association and the average pressure of the pulmonary artery is over 30 mmHg when he/she is under resting state.

Severe Motor Neuron Disease is a kind of progressive and degenerative disease of the motor neuron of the central nervous system, including progressive spinal muscular atrophy, progressive bulbar paralysis, primary lateral scleosis, amyotrophic lateral sclerosis. The Insured Person shall completely lose his/her capability of living on his/her own and be not able to independently conduct 3 or more of the 6 Basic Daily Living Activities.

Loss of Speech means that the Insured Person completely loses his/her power of speech due to diseases or accidental injuries and cannot rehabilitate through current existing medical therapeutics. The loss of speech caused by mental factors is not in the coverage scope of the Policy.

The Insured Person shall at least attain the age of 3 when applying for the benefits and the certificate of diagnosis for loss of speech and proof of checkups shall be provided.

Severe Aplastic Anaemia refers to the anaemia, neutropenia and platelet decrease caused by chronic and progressive bone marrow failure, and shall meet all following conditions:

1)The diagnosis of severe aplastic anaemia is supported by

Surgery To Aorta

End-stage Chronic Respiratory Failure

Systemic-Lupus -Erythematosus

examinations through bone marrow puncture or bone marrow biopsy;

2)The peripheral blood shall meet all following three

conditions:

a.The absolute value of neutrophilic granulocyte≤0.5×

109/L

b.Reticulocyte<1%;

c.The absolute value of platelet≤20×109/L.

Surgery To Aorta refers to the resection, replacement, restoration of ill or impaired aorta performed after thoracotomy for the treatment of the illness of aorta. The aorta refers to the thoracic aorta and abdominal aorta, not including the branches of the thoracic aorta and abdominal aorta.

Percutaneous transluminal angioplasty is not in the coverage scope of the Policy.

The following 6 critical illnesses are not included in the scope of The Regulation on Illness Definitions for Critical Illness Insurance of the Insurance Association of China.

End-stage Chronic Respiratory Failure refers to the respiratory failure caused by chronic diseases of the respiratory system. The diagnosis of end-stage chronic respiratory failure shall be supported by all following conditions:

1)FEV (Forced Expiratory Volume) 1 is less than 1 liter;

2)Resistance rise of respiratory tract, rise to at least 0.5 kPa/l/s;

3)The residual volume accounts for 60% of TLC (Total Lung

Capacity);

4)Intrathoracis air volume rise above 170 (percentage of the

base value);

5)PaO2<60mmHg,PaCO2>50mmHg.

Systemic Lupus Erythematosus is a kind of autoimmune disease that affects multiple systems caused by multiple factors, featuring

Nephritis

Severe Multiple Sclerosis

Severe Muscular Dystrophy a great number of antibodies and immune complexes that can cause lesions to tissues.

Systemic-Lupus-Erythematosus Nephritis is a kind of complication when systemic lupus erythematosus affects the kidney. This Policy is only liable for Type III to Type V of Systemic-Lupus-Erythematosus Nephritis defined by WHO, other type of lupus erythematosuses, such as discoid lupus erythematosus and lupus erythematosus which only affects blood and joints, are not in the coverage scope of the Policy.

The Types of Systemic-Lupus-Erythematosus Nephritis Defined by World Health Organization:

Type I (minimal change type) Negative proved by microscopy, urine normal

Type II (mesangial change type) Medium albuminuria, occational change of urinary sediment

Type III (focal and segmental proliferative type) Albuminuria, change of urinary sediment

Type IV (diffuse proliferative type) Acute nephritis with change of urinary sediment and/or nephrotic syndrome

ype V (membranous type) Nephrotic syndrome or heavy albuminuria

Severe Multiple Sclerosis is a kind of disease featuring

multi-focal demyelinative change of the white matter (demyelination) of the central nervous system, which may sometimes affects the gray matter. This Policy is only liable for following condition: the multiple sclerosis causes lesions to the nervous system and makes the Insured Person completely lose his/her capability of living on his/her own and not able to independently conduct 3 or more of the 6 Basic Daily Living Activities.

Severe Muscular Dystrophy refers to the degenerative change of a group of muscle. Its clinical features include muscular weakness and muscular atrophy not related with the pathological change of

Acute Hemorrhagic Necrotizing Pancreatitis

Crohn's Disease the nervous system. This Policy is only liable for following condition: the muscular dystrophy makes the Insured Person completely lose his/her capability of living on his/her own and not able to independently conduct 3 or more of the 6 Basic Daily Living Activities

Acute Hemorrhagic Necrotizing Pancreatitis means that the Insured Person has received abdominal surgery due to acute hemorrhagic necrotizing pancreatitis in order to clear the necrotic tissues, excise focuses or resect the pancreas. Acute hemorrhagic necrotizing pancreatitis caused by drunk drinking or the treatment through celioscopy is not in the coverage scope of the Policy.

Crohn's Disease refers to a kind of chronic granulomatous enteritis. The ill state of Crohn's disease the Insured Person suffers from must have caused the formation of fistulas complicated by ileus or have caused intestinal perforation which can bring acute peritonitis. The diagnosis of the Crohn's disease shall be supported by colonoscopy and tissue pathological analysis.

12 Specialist The “Specialist” mentioned in the entry of Critical Illness shall

meet all following standards:

1)holding a valid Certificate of Licensed Physician of P.R.

China;

2)holding a valid Certificate of Practicing Physician of P.R.

China which is registered and renewed on time in relevant

administration departments;

3)holding a valid certificate of attending physician’s title or

higher title of P.R. China;

4)practicing in the relevant department of Level 2 or higher

grade hospitals for at least 3 years.

13 Total Loss of

Extremity

Function Total Loss of Extremity Function refers to the ankylosis of two of the three major joints of the extremities, or the inability to control joint movements. Extremities refer to the entire upper extremities

including the shoulder joint, and the entire lower extremities including the hip joint.

14 Total Loss of

Power of Speech

or Mastication

and Swallowing

Function Total Loss of Power of Speech refers to the inability to constitute any three of the four sounds that constitute speech (labial, dental, palatal and velar), or the vocal cords have been completely excised, or aphasia has developed as the result of the injury to the brain’s speech center.

Total Loss of Mastication and Swallowing Function refers to organic impairment or dysfunction due to causes other than the teeth, causing the inability to chew or swallow, and inability to ingest or swallow anything but liquid food.

15 6 Basic Daily

Living

Activities The “6 Basic Daily Living Activities” mentioned in the entry of Critical Illness refers to:

1)dressing: to be dressed and take off one’s clothes on one’s

own;

2)moving: to go from one room to another on one’s own;

3)acting: to go to bed or get off bed on one’s own;

4)going to W.C.: to relieve one's bowels on one’s own;

5)eating: to take food that have been prepared from bowls or

plates and put it into the mouth on one’s own;

6)bathing: to have a shower or tub on one’s own.

16 Permanent and

Irreversible The “Permanent and Irreversible” in the entry of Critical Illness means that the patient cannot rehabilitate after 180 days of substantial medical treatment through current existing medical therapeutics from the day when the illness is diagnosed or the accidental injury occurs.

重大疾病终身保险条款模板(标准版)

重大疾病终身保险条款模板(标准版) Template of life insurance terms for major diseases (Standard Version) 合同编号:XX-2020-01 甲方:___________________________乙方:___________________________ 签订日期:____ 年 ____ 月 ____ 日

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中保人寿保险有限公司重大疾病终身保险条款(98版-利差返还型)

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阅 读 指 引 本阅读指引有助于........投保人...理解条款....,对本合同内容的解释以条款为准.............. 。 在本条款中,“本公司”指新华人寿保险股份有限公司。 投保人重要权益提示 被保险人、连带被保险人享受本保险合同提供的保障…………………第2.3条 投保人注意的事项提醒 投保人解除合同会有一定的损失,请慎重决策…………………………第1.5条 在某些情况下,本公司不承担保险责任…………………………………第2.4条 申请保险金给付时,应当提供的证明和资料……………………………第4.3条 投保人有如实告知的义务…………………………………………………第5.1条 本公司对一些重要术语进行了解释,请投保人注意……………………第 6 条 条款是保险合同的重要内容,为充分保障投保人的权益,请投保人仔细阅读本条款。 条款目录 4.保险金的申请与给付 4.1 保险金受益人 4.2 保险事故通知 4.3 保险金的申请 4.4 保险金的给付 5.基本条款 5.1 明确说明与如实 告知 5.2 本公司合同解除 权及解除被保险 人资格的限制 5.3 年龄确定与错误 处理 5.4 被保险人、连带 被保险人的变动 5.5 地址变更 5.6 争议处理 1.保险合同 1.1 合同构成 1.2 投保范围 1.3 合同成立与生效 1.4 合同内容变更 1.5 投保人解除合同 的手续及风险 1.6 合同终止 2.本公司提供的保障 2.1 保险金额 2.2 保险期间 2.3 保险责任 2.4 责任免除 3.投保人的权利与义务 3.1 保险费的交纳 3.2 续保 6.释义 6.1 保险凭证 6.2 本公司公章 6.3 周岁 6.4 现金价值 6.5 认可医院 6.6 专科医生 6.7 本合同所指的重 大疾病 6.8 毒品 6.9 酒后驾驶 6.10 无合法有效驾驶 证驾驶 6.11 无有效行驶证 6.12 机动车 6.13 遗传性疾病 6.14 先天性畸形、变 形或染色体异常 6.15 感染艾滋病病毒 或患艾滋病

方案一 泰康健康有约团体终身重大疾病保险条款

方案一——泰康健康有约终身重大疾病保险 一、什么是健康有约终身重大疾病保险终身重大疾病保险? 答:健康有约终身重大疾病保险终身重大疾病保险是一款费用低、保障高、保障全,并且涵盖60种重大疾病和26种轻症的终身重大疾病保险,保障终身,可有效弥补因重大疾病带来的家庭经济困难。 二、健康有约终身重大疾病保险的保险责任有哪些? 答:包括1、重大疾病; 2、身故责任; 3、轻症。

1、重大疾病保险金 被保险人于本合同生效之日起90日内经医院初次确诊非因意外伤害导致罹患本合同所定义的重大疾病(无论一种或者多种),保险公司支付被保险人已交纳的保费数额,保险公司对该被保险人的保险责任终止。 被保险人经医院初次确诊因意外伤害或者于本合同生效之日起90日后非因意外伤害导致罹患本合同所定义的重大疾病(无论一种或者多种),保险公司按保险金额给付保险金,保险公司对该被保险人的保险责任终止。 2、身故保险金 被保险人于本合同生效之日起90日内非因意外伤害身故,保险公司支付受益人已交纳的保险费数额,保险公司对该被保险人的保险责任终止。 被保险人因意外伤害或者于本合同生效之日起90日后非因意外伤害身故,保险公司按保额给付保险金,保险公司对该被保险人的保险责任终止。 3、轻症保险金 被保险人于本合同生效之日起90日内经医院初次确诊非因意外伤害导致罹患本合同所定义的轻症(无论一种或者多种),保险公司支付被保险人已交纳的保险费数额,保险公司对该被保险人的轻症保险责任终止,重疾保险继

续有效。 被保险人经医院初次确诊因意外伤害或者于本合同生效之日起90日后非因意外伤害导致罹患本合同所定义的轻症(无论一种或者多种),保险公司按保险金额的20%给付保险金,保险公司对该被保险人的轻症保险责任终止,重疾保险继续有效。 3、责任免除 因下列第(1)至第(7)项情形之一导致被保险人身故的,本公司不承担给付身故保险金的责任;因下列第(2)至第(10)项情形之一导致被保险人发生本合同定义的重大疾病的,本公司不承担给付重大疾病保险金的责任:(1)被保险人在本合同成立(若曾复效,则自本合同最后复效)之日起2年内自杀,但被保险人自杀时为无民事行为能力人的除外; (2)投保人对被保险人的故意杀害、故意伤害; (3)被保险人故意犯罪或者抗拒依法采取的刑事强制措施; (4)被保险人主动吸食或者注射毒品;

附加09终身重大疾病保险

阅读指引 本阅读指引有助于您理解条款 .............,对本合同内容的解释以条款为准 ..............。 在本条款中,“您”指投保人,“我们”、“本公司”均指新华人寿保险股份有限公司。 您拥有的重要权益 ?被保险人享受本保险合同提供的保障……………………………………………第2.3条?您有选择减额交清的权利…………………………………………………………第3.5条?您有减保的权利……………………………………………………………………第3.6条 您应当特别注意的事项 ?在某些情况下,本公司不承担保险责任…………………………………………第2.4条?您应当按时交纳保险费……………………………………………………………第3.2条?申请保险金给付时,应当提供的证明和资料……………………………………第4.2条?您有如实告知的义务………………………………………………………………第5.1条?我们对一些重要术语进行了解释,并作了显著标识,请您注意………………第 6 条 条款是保险合同的重要内容,为充分保障您的权益,请您仔细阅读本条款。 条款目录 3.4 合同效力恢复 3.5 减额交清 3.6 减保 4.如何申请领取保险金 4.1 保险金受益人的 指定和变更 4.2 保险金的申请 4.3 保险金的给付 4.4 欠交保险费及未还款 项的扣除 5.基本条款 5.1 明确说明与如实告知 5.2 本公司合同解除权的 限制 5.3 年龄确定与错误处理 5.4 失踪处理 1.您与我们的合同 1.1 合同构成 1.2 投保范围 1.3 合同成立与生效 1.4 合同效力 1.5 合同内容变更 1.6 合同终止 2.我们提供的保障 2.1 保险金额 2.2 保险期间 2.3 保险责任 2.4 责任免除 3.您的权利和义务 3.1 保险费的交纳 3.2 续期保险费的 交纳、宽限期 3.3 合同效力中止 6.释义 6.1 认可医院 6.2 专科医生 6.3 本合同所指的重大 疾病 6.4 身体全残 6.5 意外伤害 6.6 遗传性疾病 6.7 先天性畸形、变形 或染色体异常 6.8 感染艾滋病病毒或 患艾滋病 6.9 现金价值 6.10本保险实际交纳的 保险费

购买重大疾病保险的100个理由(可直接打印版)

购买重疾险的100个理由

以上所有均不包括 给医院的红包、托人看病的礼金 患病期间家属所多支出的生活费 因患重疾之后所减少的收入损失成本 所需支付十几年几十年的基本生活费用 …… 2003年的急性重症肝炎治疗收费清单

购买新康宁(2012版)的一百个理由 理由之1:只有善待自己,才能收获幸福和快乐。一辈子不长,学会爱自己;爱自己,才会爱他人。爱,从新康宁开始! 理由之2:如果客户没有足够的时间,我们就給他足够的钱;如果他有足够的时间,我们就把钱还给他。 理由之3:给孩子购买了各种保险,但孩子的父母却几乎没有保险。注意:家庭的经济支柱应该是保险的主要对象! 理由之4:中国人八成健康投资用于临死前一个月的治疗费。很多家庭一辈子都在为医院打工! 理由之5:进了医院别想跑,钞票越看越嫌少;毛病身上找一找,肚子里面扫一扫;一万完事运气好,五万出院事还小;啥药值钱开啥药,没个十万走不了! 理由之6:给家人务实的爱!我也想多买个LV包多一份奢华,但人生至少有两样东西无法控制:意外疾病,生老病死。今天我为自己补充新康宁,不为业绩不为奖励,只为万一发生重疾不拖累家人为我到处筹钱治病。 理由之7:全国失去独生子女家庭超百万!我国每年15~30岁独生子女因意外和疾病死亡人数至少7.6万人。 理由之8:科技进步,许多疾病及时医治完全可以挽救孩子的生命。而高额的费用令很多家庭被迫放弃。重疾险,成长路上不可或缺! 理由之9:癌症不再是绝症!很多早期癌症可以治愈,部分中晚期癌症可以控制,大多数癌症患者生活质量可以得到明显改善! 理由之10:专家建议意外险的保额应为家庭年收入的10至20倍;重疾险的保额应为年收入的5至10倍。算算看,你该加保多少? 理由之11:当代女性平均寿命比男性长5至8岁,而女性独特的生理功能决定了女性在罹患重疾方面的几率要大于男性。 理由之12:家长总认为买教育险比保障险合算。其实健康是教育的前提,给孩子买保险更多应考虑的是保险保障方面。 理由之13:环境污染和不良生活习惯是癌症主要病因。城市肺癌第一,归于吸烟和空气污染。农村肝癌第一,归于饮食和水污染。 理由之14:央视经济生活大调查什么商品会热销?2010年保险排名第九,2011年第七,2012年第三,老百姓有意识了! 理由之15:保险是买的时候用不着,用的时候买不着的特殊商品!投保须趁早,勿到临头悔莫及。 理由之16:劝君投保称无钱:有也说无!病到临头用万千:无也变有;若要与君谈保险:闲也说忙;上帝召唤命归天:忙也得去! 理由之17:环境恶化——中国1/3以上城市深陷垃圾困局,1/4已无填埋堆放场地。全国城市垃圾堆存累计侵占土地过5亿平米。 理由之18:医生可以拯救肉体生命,但不能挽救家庭经济生命!保险,就是力图在你最需要的时候为你提供经济独立! 理由之19:据统计,北京市民的退休人员的百分之七十的退休金都被用来看病!所以请把年轻时用命换来的钱,以一种“定时定量,只进不出,专款专用,时间够长”的方式来为老年的自己储备。 理由之20:金钱面前,生命不再伟大!我们购买保险不是因为有人要离去了,而是还有人要继续活着! 理由之21:电视剧《拿什么拯救你我的爱人》中,身家过亿的罗保春心脏病去世,全部资

平安常青树终身男性重大疾病保险(分红型)条款

平安常青树终身男性重大疾病保险(分红型)条款 (平保发[2001]223号,2001年12月经保监会核准备案) 第一条保险合同构成 本保险合同(以下简称“本合同”)由保险单或其他保险凭证及所附条款、投保单、与本合同有关的投保文件、合法有效的声明、批注、附贴批单、其他书面协议构成。 第二条投保范围 年龄为16至50周岁的男性均可作为被保险人参加本保险。 第三条保险责任 在本合同保险责任有效期内,本公司承担如下保险责任: 一、一类重大疾病保险金 被保险人因意外伤害事故或于保单生效日起90天后因疾病,经医院诊断初次发生本条款所定义的“一类重大疾病”,且从确诊之日起28天后仍然生存,本公司按照保险金额的80%给付“一类重大疾病保险金”,并从保险金额余额中扣除相应部分,“一类重大疾病保险金”的给付责任终止。 “一类重大疾病保险金”的给付以一次为限。 二、二类重大疾病保险金 被保险人因意外伤害事故或于保单生效日起90天后因疾病,经医院诊断初次发生本条款所定义的“二类重大疾病”,且从确诊之日起28天后仍然生存,本公司按照保险金额的20%给付“二类重大疾病保险金”,并从保险金额余额中扣除相应部分,“二类重大疾病保险金”的给付责任终止。 “二类重大疾病保险金”的给付以一次为限。 本公司给付“一类重大疾病保险金”和“二类重大疾病保险金”后,本保险责任终止。 三、保险费豁免 当本公司给付上述“一类重大疾病保险金”或“二类重大疾病保险金”后,本公司豁免本合同的以后各期保险费。 四、身故保险金 被保险人因意外伤害事故身故或于保单生效日起90天后因疾病身故,本公司按保险金额余额给付“身故保险金”,保险责任终止。 被保险人于保单生效日起90天内因疾病身故,或于保单生效日起90天内因疾病经医院确诊初次发生本条款所定义的“一类重大疾病”或“二类重大疾病”,本公司退还现金价值,本保险责任终止。 第四条保单红利 在本合同有效期间内,按照保险监管机关的有关规定,本公司每年将根据分红保险业务的实际经营状况确定红利的分配。若本公司确定本合同有红利分配,则该红利将于保单周年日分配给投保人。已获得保险费豁免的投保人不再享有红利分配权。 投保人在投保时可选择以下红利领取方式之一:

中保人寿保险有限公司重大疾病终身保险条款(98版 利差返还型)

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太保(备案)[2009]N107号-团体重大疾病保险条款

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