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原文標題:平安境外旅行緊急救援醫療保險條款(節選)


中國平安人壽保險股份有限公司
平安境外旅行緊急救援醫療保險條款(節選)
保險責任
在本合同保險責任有效期內,被保險人在中華人民共和國境外(含香港、澳門、臺灣地區)旅行期間遭受意外傷害事故或突發急性病時,本公司根據投保時約定承擔下列保險責任中的一項或多項:
(一)、緊急救援醫療保險金
被保險人遭受意外傷害事故或突發急性病,需要緊急救援的,應及時撥打本公司提供的24小時援助熱線電話通知本公司授權的救援機構(以下簡稱救援機構),救援機構的授權醫生(以下簡稱授權醫生)將根據其專業知識向被保險人提供醫療咨詢,并在確認被保險人需要醫療援助時,本公司按投保時約定承擔下列保險責任:
1. 安排就醫和緊急醫療轉送
被保險人遭受意外傷害事故或突發急性病,經授權醫生確認需要醫療援助的,本公司將通過救援機構安排被保險人至最近的醫院就醫或安排離事發地最近的醫生至事發地為被保險人治療并承擔相應的運送費用。
如授權醫生認為事發地醫院的醫療條件無法滿足被保險人治療的需要時,本公司將通過救援機構安排被保險人轉送到更適合其治療的醫院并承擔相應的運送費用。如授權醫生認為病情需要或事發地法律要求,本公司將通過救援機構派遣醫護人員護送并承擔由此產生的費用。
如授權醫生認為被保險人所在地及其合理路程范圍內的醫院的醫療條件無法滿足被保險人治療的需要時,本公司將通過救援機構安排被保險人返回中華人民共和國境內常駐地的醫院或離其常駐地最近的醫院治療并承擔相應的運送費用。如授權醫生認為病情需要,本公司將通過救援機構派遣醫護人員護送并承擔由此產生的費用。
2. 住院醫療保險金
被保險人遭受意外傷害事故或突發急性病,經授權醫生確認并由救援機構安排住院治療的,本公司通過救援機構承擔被保險人住院治療期間合理且必要的醫療費用(含床位費、檢查費、化驗費、治療費、手術費、藥費和救護車費等)。
未滿12周歲的被保險人住院治療的,本公司可通過救援機構安排一位家長陪同住院;若該醫院無陪住設施,本公司將通過救援機構安排該位家長入住附近酒店。在該被保險人住院期間,本公司通過救援機構承擔該位家長陪同住院或酒店住宿的費用。
3. 轉送回國
對被保險人的治療措施結束后或授權醫生認為被保險人的病情或傷勢已經穩定可以旅行時,本公司將通過救援機構安排被保險人以經濟交通方式返回中華人民共和國并盡可能使用被保險人的原始回程票(含機票、火車票、汽車票或輪船票等,以下同)。如被保險人的原始回程票因救援過程而失效,本公司通過救援機構承擔被保險人的回程票費用。如被保險人未購買原始回程票,回程票費用由被保險人自行承擔。
如授權醫生認為被保險人病情需要,本公司將通過救援機構派遣醫護人員護送并承擔由此產生的費用。
被保險人返回中國人民共和國后,本公司對該被保險人的該次保險責任結束。
4. 安排子女回國
被保險人遭受意外傷害事故或突發急性病,其隨行的未成年子女無人照料時,本公司可通過救援機構安排經濟交通方式送其子女回國,且盡可能使用其子女的原始回程票。但回程票費用由被保險人自行承擔。
本公司累計承擔安排就醫和緊急醫療轉送、住院醫療保險金、轉送回國及安排子女回國等保險責任各項費用的總額以其保險金額為限,超過保險金額的費用須由被保險人自負,本公司和救援機構均不再承擔保險責任。
(二)遺體處理保險金
被保險人遭受意外傷害事故或突發急性病身故,本公司將通過救援機構按照被保險人的遺愿或其家屬的愿望,將被保險人的遺體或骨灰按下列三種方式之一處理并承擔相關費用,但累計承擔費用總額以不超過各處理方式相應的保險金額為限。
1. 遺體轉送回國
本公司通過救援機構安排用正常航班運送被保險人的遺體至其中華人民共和國境內的常駐地并承擔靈柩費和運送靈柩的費用。
2. 骨灰運送回國
本公司通過救援機構安排被保險人的遺體在被保險人身故地火葬,并用正常航班將骨灰盒運送至被保險人在中華人民共和國境內的常駐地。本公司通過救援機構承擔火葬費用和骨灰盒運送回國費用。
3. 就地安葬
本公司通過救援機構將被保險人的遺體在被保險人身故地就地安葬并承擔相關費用。

 

譯文標題:Policy Clauses of Ping An Overseas Traveling Emerg


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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