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平安境外旅行紧急救援医疗保险条款(节选)
Policy Clauses of Ping An Overseas Traveling Emerg
作者:佚名
译者:佚名
中国平安人寿保险股份有限公司
平安境外旅行紧急救援医疗保险条款(节选)
保险责任
在本合同保险责任有效期内,被保险人在中华人民共和国境外(含香港、澳门、台湾地区)旅行期间遭受意外伤害事故或突发急性病时,本公司根据投保时约定承担下列保险责任中的一项或多项:
(一)、紧急救援医疗保险金
被保险人遭受意外伤害事故或突发急性病,需要紧急救援的,应及时拨打本公司提供的24小时援助热线电话通知本公司授权的救援机构(以下简称救援机构),救援机构的授权医生(以下简称授权医生)将根据其专业知识向被保险人提供医疗咨询,并在确认被保险人需要医疗援助时,本公司按投保时约定承担下列保险责任:
1. 安排就医和紧急医疗转送
被保险人遭受意外伤害事故或突发急性病,经授权医生确认需要医疗援助的,本公司将通过救援机构安排被保险人至最近的医院就医或安排离事发地最近的医生至事发地为被保险人治疗并承担相应的运送费用。
如授权医生认为事发地医院的医疗条件无法满足被保险人治疗的需要时,本公司将通过救援机构安排被保险人转送到更适合其治疗的医院并承担相应的运送费用。如授权医生认为病情需要或事发地法律要求,本公司将通过救援机构派遣医护人员护送并承担由此产生的费用。
如授权医生认为被保险人所在地及其合理路程范围内的医院的医疗条件无法满足被保险人治疗的需要时,本公司将通过救援机构安排被保险人返回中华人民共和国境内常驻地的医院或离其常驻地最近的医院治疗并承担相应的运送费用。如授权医生认为病情需要,本公司将通过救援机构派遣医护人员护送并承担由此产生的费用。
2. 住院医疗保险金
被保险人遭受意外伤害事故或突发急性病,经授权医生确认并由救援机构安排住院治疗的,本公司通过救援机构承担被保险人住院治疗期间合理且必要的医疗费用(含床位费、检查费、化验费、治疗费、手术费、药费和救护车费等)。
未满12周岁的被保险人住院治疗的,本公司可通过救援机构安排一位家长陪同住院;若该医院无陪住设施,本公司将通过救援机构安排该位家长入住附近酒店。在该被保险人住院期间,本公司通过救援机构承担该位家长陪同住院或酒店住宿的费用。
3. 转送回国
对被保险人的治疗措施结束后或授权医生认为被保险人的病情或伤势已经稳定可以旅行时,本公司将通过救援机构安排被保险人以经济交通方式返回中华人民共和国并尽可能使用被保险人的原始回程票(含机票、火车票、汽车票或轮船票等,以下同)。如被保险人的原始回程票因救援过程而失效,本公司通过救援机构承担被保险人的回程票费用。如被保险人未购买原始回程票,回程票费用由被保险人自行承担。
如授权医生认为被保险人病情需要,本公司将通过救援机构派遣医护人员护送并承担由此产生的费用。
被保险人返回中国人民共和国后,本公司对该被保险人的该次保险责任结束。
4. 安排子女回国
被保险人遭受意外伤害事故或突发急性病,其随行的未成年子女无人照料时,本公司可通过救援机构安排经济交通方式送其子女回国,且尽可能使用其子女的原始回程票。但回程票费用由被保险人自行承担。
本公司累计承担安排就医和紧急医疗转送、住院医疗保险金、转送回国及安排子女回国等保险责任各项费用的总额以其保险金额为限,超过保险金额的费用须由被保险人自负,本公司和救援机构均不再承担保险责任。
(二)遗体处理保险金
被保险人遭受意外伤害事故或突发急性病身故,本公司将通过救援机构按照被保险人的遗愿或其家属的愿望,将被保险人的遗体或骨灰按下列三种方式之一处理并承担相关费用,但累计承担费用总额以不超过各处理方式相应的保险金额为限。
1. 遗体转送回国
本公司通过救援机构安排用正常航班运送被保险人的遗体至其中华人民共和国境内的常驻地并承担灵柩费和运送灵柩的费用。
2. 骨灰运送回国
本公司通过救援机构安排被保险人的遗体在被保险人身故地火葬,并用正常航班将骨灰盒运送至被保险人在中华人民共和国境内的常驻地。本公司通过救援机构承担火葬费用和骨灰盒运送回国费用。
3. 就地安葬
本公司通过救援机构将被保险人的遗体在被保险人身故地就地安葬并承担相关费用。
Policy Clauses of Ping An Overseas Traveling Emergency Assistance Medical Insurance (Extract)
Insurance Liabilities
Within the period of validity of the insurance liabilities of the Contract, in the event that the insured suffers any accidental injury or acute disease when he/she is traveling outside P.R. China (including Hong Kong, Macao and Taiwan), the Company will cover one or several of the following insurance liabilities as per the agreements in the policy:
(I) Amount insured for Emergency Medical Assistance
In the event of any accidental injury or acute disease and the need of any emergency assistance, the insured shall call the Ping An 24-hour hotline to inform the Assistance Company authorized by the Company (the "Assistance Company") of the situation in order to get medical advice from the authorized doctor of the Assistance Company(the "Authorized Doctor"). Once it is confirmed that the insured needs any medical assistance, the Company will execute the below insurance liabilities according to the agreements in the policy:
1. Arrange for medical care and emergency medical transfer
Once the Authorized Doctor confirms that the insured who is suffering from any accidental injury or acute disease needs any medical assistance, the Company will arrange via its Assistance Company the nearest hospital to provide medical care to the insured, or arrange a nearby doctor to arrive on the spot to attend the insured, the transportation expenses being covered by the Company.
In the event the medical conditions in the local hospital are not sufficient for the insured in the opinion of the Authorized Doctor, the Company will arrange via its Assistance Company to transfer the insured to a hospital with more appropriate facilities, with the transfer cost thus incurred being borne by the Company. If deemed necessary by the Authorized Doctor or so required by the local laws, the Company will dispatch via its Assistance Company medical personnel to accompany the transfer, all costs thus incurred being borne by the Company.
In the event that the medical conditions in the hospitals on the spot and within a reasonable range are not sufficient for the insured in the opinion of the Authorized Doctor, the Company will arrange via its Assistance Company to send the insured to a hospital local to him/her within the territory of P.R. China, or a hospital that is nearest to the residence of the insured, the transfer cost thus incurred being borne by the Company. In the event deemed necessary by the Authorized Doctor, the Company will dispatch via its Assistance Company medical personnel to accompany the transfer, all costs thus incurred being borne by the Company.
2. Amount insured for hospitalization
In the event the insured is arranged for hospitalization after the Authorized Doctor has confirmed his/her case of accidental injury or acute disease, the Company will cover via its Assistance Company the reasonable and necessary medical expenses incurred during the hospitalization of the insured, including charges for the bed, the examinations, the assays, the treatments, the operations, the medicines, and the ambulance etc.
The Company will arrange via its Assistance Company a parent to accompany a hospitalized insured who is under 12 years of age. In the event that the hospital in question does not have the facility for the parent to accompany the hospitalization, the Company will arrange via its Assistance Company the accommodation of the parent in a nearby hotel. During the hospitalization of the said insured, the Company will cover via its Assistance Company the expenses incurred during his/her parent's stay in the hospital or a hotel.
3. Repatriation
Once the treatment for the insured is over, or the insured recovers from his/her illness or injury and is fit for travel in the opinion of the Authorized Doctor, the Company will arrange via its Assistance Company to repatriate the insured to P.R. China via an economical means of transportation, using if possible the original return tickets of the insured (including the air ticket, train ticket, bus ticket, and boat ticket; the same applies below). In the event that any original return ticket of the insured becomes invalid in the course of the medical assistance, the Company will cover via its Assistance Company the expense of the return ticket of the insured. In the event that the insured does not have a return ticket, the expense of the return ticket shall be borne by the insured him/herself.
In the event deemed necessary by the Authorized Doctor for the state of the insured, the Company will dispatch via its Assistance Company medical personnel to accompany the repatriation of the insured, all expenses thus incurred being borne by the Company.
The liabilities of the Company on the insured cease upon the insured's repatriation to P. R. China.
4. Repatriation of the offspring of the insured
In the event that any minor children who are traveling together are unattended due to the accidental injury or acute disease suffered by the insured, the Company will arrange via its Assistance Company to repatriate the minor children to China via an economical means of transportation, using if possible their original return tickets. The expenses of the return tickets shall be borne by the insured.
The total amount of expenses incurred for the execution of the insurance liabilities during medical care arrangements, emergency medical transfer, hospitalization, repatriation and the minor children's repatriation shall not exceed the insured amount. The insured shall be responsible for covering the part of expenses that exceeds the insured amount, for which the Company and its Assistance Company shall not have any insurance liabilities.
(II) Amount insured for Mortal Remains Handling
In the event of the decease of the insured from any accidental injury or acute disease, the Company will make arrangements via its Assistance Company to handle the remains or ashes of the insured in one of the following three ways according to the will of the insured or his/her family. The Company will cover the expenses to the extent that they do not exceed the insured amounts of the relevant handling methods.
1. Repatriation of mortal remains
The Company makes arrangements via its Assistance Company to repatriate by regular flight the mortal remains of the insured to his/her residence within the territory of the People's Republic of China, the coffin expense and coffin transportation expense being borne by the Company.
2. Repatriation of the ashes
The company makes arrangements via its Assistance Company to cremate the remains of the insured where he/she has deceased, and repatriates the ashes by regular flight to his/her residence within the territory of the People's Republic of China, the cremation expense and ashes repatriation expense being borne by the Company via its Assistance Company.
3. Local burial
The Company makes arrangements via its Assistance Company to bury the body of the insured where he/she has deceased, all relevant expenses being borne by the Company.
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