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American International Assurance (AIA,AIG) Beijing branch. www.aia.com.cn
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| Address |
The Exchange Beijing, No.118 Jian Guo Lu Yi, Chaoyang District, Beijing. 100022 |
| Agent |
Xu Feng (Ricky) |
Agent code: 110043766 |
| Tel |
86-13911460247 |
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The translation of this contract into English is for your information only. The official and binding contract is the Chinese version.
GENERAL PROVISIONS
1. THE CONTRACT
This Policy, application attached and endorsements constitute the entire contract.
The name of this Policy is known as Travel Accident(Basic Policy), or abbreviated as TA.
2. ENTRY AGE
Age limit of this Policy is from 60 days to 70 years old. The Policyowner must disclose the true age of the Insured upon application. In the event the Policyowner misstates the Insured's age, the Company will adjust the Policy according to the following guidelines:
If the Insured's true age is classified by the Company as unacceptable, the Company shall not be liable for the insurance indemnities and will refund the paid premium.
3. CHANGE OF BENEFICIARY
The Policyowner may assign the Beneficiary with the consent of the Insured upon application.
The Policyowner may change the Beneficiary by submitting a written notice to the Company. No change of Beneficiary under this Policy shall bind the Company unless such change is with the consent of the Insured and formally endorsed hereon by the Company. The Company shall not be responsible for any legal problem regarding such change.
The death indemnity will be paid to the Beneficiary. If the beneficiaries die before the Insured, the indemnity payable under this Policy will come to the Insured's estate unless there is other special arrangement,
4. CHANGE OF ADDRESS
Written notice of change in address of the Policyowner must be given by the Policyowner to the Company immediately after such change has occurred.
If the Policyowner fails to notify the Company as such, any document sent to the last address of the Policyowner stated on this Policy will be treated as delivered.
5.LIMITATION ON TIME FOR CLAIM
The right to claim is reserved until 2 years from the date the accident being informed.
6.CONFORMITY WITH LAW
Any provision of the Policy which on its Effective Date or hereafter is in conflict with the law of China shall be deemed to conform to the minimum requirements of such laws.
INSURANCE TERM
7. EFFECTIVE DATE
No liability of the Company under this Policy should bind the Company unless the enrollment payment is paid and with the consent of the Company. The Company will issue the Policy contract as evidence.
The effective date is stated on the application.
8. INSURANCE PERIOD
This policy is effective from the effect date and time to the expired date and time stated on the application. Twenty-four(24)hours will be counted as one day. The time is based on Beijing Standard Time.
9.POLICY EXTENSION
This provision shall not be effective unless it's stated effective in the application or by endorsement of the Policy.
When the policy is in force, the insured is a fair paying passenger in an aircraft on a regular scheduled trip over its established route, and is encounted in a hijack, the insurance term will be automatically extended until the insured is set free.
SUM ASSURED
10. SUM ASSURED
The sum assured of this Policy is the benefit amount stated on the application form. If the benefit amount is changed by the Policy provision afterwards, the changed benefit amount will be the sum assured of this Policy.
BENEFIT PROVISIONS
11. BENEFIT AREA
The Company agrees to pay the sum assured or part of the sum assured subject to and in accordance with the provisions of this Policy if, while this Policy is in force, the Insured shall sustain death, dismemberment or bodily injury caused by an accident and independently of any other cause. The accident shall mean any external, sudden event other than sickness.
12. BENEFIT PROVISION
Accidental Death & Dismemberment Benefit, abbreviated as ADD.
(1) Death Benefit:
The Company will pay the sum assured of this Policy as stated in the application to the Beneficiary if, while this Policy is in force, the Insured shall sustain death caused solely by an accident defined in article 11 and within 180 days from the date of such accident. But any indemnities already paid before under this Policy shall be deducted from the Death Benefit.
(2) Dismemberment Benefit:
The Company will pay a percentage of the sum assured subject to the Indemnities' Schedule to the Insured as stated in the application if, while this Policy is in force, the Insured shall sustain any injury included in the Indemnities' Schedule caused solely by an accident defined in article 11 and within 180 days from the date of such accident.
The Company shall pay for one or more than one injury resulting from one accident according to The Indemnities' Schedule, but the total amount shall not be more than 100% of the sum assured of the Policy as stated in the application. Should more than one injury resulting from one accident happen to one limb, the Company will pay one of the Indemnities listed in the Indemnities' Schedule, whichever is the greatest.
Should more than one injury resulting from different accidents happen to one limb, the Company will pay one of the indemnities listed in the Indemnities' Schedule , whichever is the greatest. But any indemnities already paid for this limb before shall be deducted from the payment.
EXCLUSION PROVISION
13. EXCLUSIONS AND LIMITATIONS
The Policy shall not cover any injury or death or dismemberment caused by or during the period of any one of the following occurrences:
(1) self-inflicted injury or injury intentionally caused by the Policyowner or Beneficiary;.
(2) assault or murder where there was a provocation on the part of the Insured;
(3) service in armed forces or making an arrest as an officer of the law;
(4) violation of the law or resistance to arrest, or imprisonment;
(5) accident occurring while the Insured is under the influence of alcohol and drug or medications or treatments not prescribed by a physician;.
(6) accident or due to mental/ nerve disorders;
(7) sickness, pregnancy, miscarriage, childbirth, allergy to medicine, food poisoning;
(8) bacterial infection (except infection which shall occur with and through an accidental cut or wound);
(9) war, declared or undeclared, riot, civil commotion or any warlike-armed operations;
(10) atomic or nuclear explosion, barns or radioactive emission;
(11) AIDS or infection by HIV. The definition of AIDS shall be used by the World Health Organization. Infection shall be deemed to have occurred if blood tests indicate either the presence of any HIV or antibodies to HIV;
(12) riding in or on, ascending or descending from or with any aircraft or aerial conveyance except
while the Insured is a passenger riding in or on, ascending or descending from or with an aircraft on a regular scheduled trip over its established route;
(13) diving, water skiing, skiing, skating, gliding, parachuting; cliff-climbing or exploration;
(14) wrestling, judo, karate, taekwondo, horse performance, boxing or stunt;
(15) racing on any wheels or horse.
(16) engaged in the professional activities, as mining, felling .construction.
Transportation, and/or high act. Physician shall mean a qualified practitioner of medicine in the hospital;
Note:
Hospital: shall mean an institution which meets all the following requirements:
(1) holds a license as a hospital;
(2) operates primarily for the reception, care and treatment of sick, ailing or injured persons as in-patients;
(3) provides 24-hour a day medical and nursing services by legally registered Physicians and nurses;
(4) is not primarily a hospital for rehabilitation, clinic, nursing, rest or convalescent home, a
place for alcoholics or drug addicts or similar establishment.
3. Physician: shall mean a qualified practitioner of medicine in the hospital, and also means legally authorized and registered to render medical and surgical services, make diagnosis, and write prescriptions in the district of his or her practice.
PREMIUM
14. PREMIUM PAYMENT MODE
The premium under this Policy is calculated on daily basis, in single payment.
15. RENEWAL
This Policy may not be renewed.
CANCELLATION & TERMINATION
16. DUTY OF REPRESENTATION
The Policyowner or Insured must, as requested by the Company, disclose his / her risk when the Company decides whether or not to accept the application for insurance, or modify the rate of premium for it. If the Policyowner or Insured fails to disclose as the above mentioned, the Company shall rescind the Policy and not be liable for the insurance indemnities. In case the Policyowner or Insured fails by mistake, the premium may be refunded; In case the Policyowner or Insured fails by intention, the premium may not be refunded.
17. CANCELLATION
In the event that the Policy is canceled by the Policyowner, the Company will return the corresponding portion of the full year premium paid according to the following table:
Period between the date of cancellation % of the premium returned and the Policy Expiration Date
150days or above 50%
120days or above 40%
90days or above 25%
less than 90 days 0 100% of the paid premium will be refunded with the consent of the Company in case the trip is canceled, and the Company gets the information before the effective date.
18. TERMINATION
This Policy shall automatically be terminated on the earliest of the following:
(1) upon the insured's death;
(2) 100% sum assured of the Policy as stated in the application is paid;
(3) the Policy expires
19. NOTICE OF CLAIM
Written notice of a claim must be submitted to the Company within 30 days of the accident, or as quickly as possible after any insured loss, with affirmative proof of loss at the claimant's own expenses. In case of any delay on the part of the claimant which causes the failure in proving the insured loss, the Company shall not be liable for any indemnities.
20. LIMITATION ON TIME FOR BRINGING SUIT
No action in law or equity shall be brought to recover on this Policy prior to the expiration of sixty(60)days
after proof of loss has been filed in accordance with the requirements of this Policy.
21.DISAPPEARANCE
If while this Policy is in force ,the Insured shall encounter an accident defined in article ll and disappear from the date of the accident, the Company will pay the death benefit upon the declaration of death by the court. Should the Insured be found alive afterwards. The payee of the death benefit shall give the payment back to the Company within one month.
22.MEDICAL EXAMINATION
The Company reserves the rights to examine or cause medical examination of the Insured and to require a report there of whenever it deems necessary during the pendency of a claim. In case of death, the Company shall have the right to conduct an autopsy where it is not forbidden by law.
SPECIAL PROVISION
ACCIDENTAL MEDICAL REIMBURSEMENT (AMR)
ACCIDENTAL HOSPITAL INCOME SPECIAL PROVISION(AHI)
Schedule of Indemnities
Grade |
Item |
Details of Dismemberment |
Percentage of the Original Face Amount |
1 |
1
2
3
4
5
6
7
8 |
Permanent Total Loss of Sight of both eyes (Note 1)
Loss of both upper limbs at or above the wrist or of both lower limbs at or above the ankle
Loss of one upper limb at or above the wrist and of one lower limb at or above the ankle
Loss of sight of an eye and of one upper limb at or above the wrist Loss of sight of an eye and of one lower limb at or above the ankle Permanent total loss of function of joints of the limbs(Note 2) Permanent total loss of function of mastication and swallow (Note 3) Incapability to perform independently the daily activities and incapability to fit for any job/occupation due to loss of function of central nerve system or internal organ(Note 4) |
400% |
2 |
9
10 |
Permanent total loss of function of two or more great-joints of both upper limbs or of both lower limbs or of both an upper limb and lower limb(Note 5)
Total loss of fingers(Note 6) |
75% |
3 |
11
12
13
14
15 - |
Permanent total loss of one upper limb at or above the wrist or of function of three great-joints of an upper limb
Permanent total loss of one lower limb at or above the ankle or of function of three great-joints of a lower limb
Permanent total loss of function of joints of all fmgers(Note 7)
Total loss oftoes(Note 8)
Permanent total loss ofhearing(Note 9) |
50% |
4 |
16
17
18
19
20
21
22 |
Permanent total loss of sight of one eye
Permanent total loss of speech (Note 10)
Permanent total loss of function of two great-joints of an lower limb Permanent total loss of function of two great-joints of an upper limb Loss of five or more fingers includes thumb and forefinger of a hand Permanent shortening of leg by at least 5cm
Permanent total loss of function of all toes |
30% |
5 |
23
24
25
26
27
28
29 |
Permanent total loss of function of one great-joint of an upper limb Permanent total loss of function of one great-joint of an lower limb Loss of thumbs of two hands
Total loss of toes of a foot
Obvious defect of two eyelids(Note 11)
Permanent total loss of hearing in one ear
Defect of nasal part and severe dysosmia (Note 12) |
20% |
6 |
30
31
32 |
Loss of forefinger and thumb of a hand or of more than three fingers includes thumb or forefinger
Permanent total loss of function of more than three fingers includes thumb or forefinger
Permanent total loss of function of toes of a foot |
15% |
7 |
33
34 |
Loss of thumb or forefinger of a hand or more than either two fingers of middle-finger, ring-finger and small-finger
Permanent total loss of function of thumb and forefinger of a hand |
10% |
Notes:
1. Loss of sight ofeye(s) shall include eyeball(s) loss or removal, Anopia, or only light sensation, or visual acuity after correction lower than 0.02, or visual field narrower than 5 degrees. Medical evidence must be supplied by an opthalmologist appointed by the Company.
2. Loss of function ofjoint(s) shall mean permanent total stiffness or paralysis or moving of the joints.
3. Loss of function of mastication and swallow shall mean the organic or functional disturbance of the mastication and swallow which renders the insured incapable of eating solid diet. But exclude the dental causes.
4. Incapability to perform independently the daily activities and incapability to fit for any job or occupation shall mean complete and continuous inability of the Insured to perform daily life activities independently such as eating, releasing, dressing, walking, bathing, etc; and inability to perform or engage in any work, occupation or business.
5. Three great-joints pfupperlimb include shoulder joint, elbow joint and wrist joint; three great joints of lower limb include hip joint, knee joint, ankle joint.
6. Total loss of fingers shall mean complete severance through or above the proximal phalangeal joins (interphalangeal joints of thumb).
7. Total loss of function of joints of all fingers shall mean complete severance through the distal phalangeal joints, or stiffness of the proximal phalangeal joints on moving disturbance of the phalangeal joints.
8. Total loss of toes shall mean complete severance through or above the metatarsophalangeal joints.
9. Total loss of hearing shall mean permanent irrecoverable loss of hearing where
if a dB=Hearing loss at 500 Hertz
if b dB=Hearing loss at 1000 Hertz
if c dB=Hearing loss at 2000 Hertz
1/6 of (a+2b+2c) is above 90 dB
10. Total loss of speech shall mean the loss of ability in articulating any three of the four sounds which contribute to the speech such as the labial sounds, the alveololabia) sounds, the palatal sounds and the velar sounds or total loss of vocal cord or damage of speech center in brain resulting in aphasia, but all psychiatric related causes are excluded. Medical evidence must be supplied by an Ear, Nose and Throat specialist.
11. Obvious defect of two eyelids shall mean eyelids incapable of covering cornea completely when the insured closes his/her eyes.
12. Defect of nasal part and severe dysosmia shall mean the irrecoverable defect of total or one half nasal cartilages and nasal atresia, nasal dyspnea or anosmia of both sides.
13.Permanent total loss shall mean bodily injury lasting for at least 180 days from the date of injury and being beyond hope of improvement at the expiry of that period. But exclude the irrecoverable status such as removing the eyeball.
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