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招商信诺寰球至尊高端个人医疗保险(A 款)主险?

产品险种:医疗保险 ?

意外保障
住院
门诊
重大疾病

保额与缴费举例:

保障金额不是固定的,根据投保人年龄、缴费高低的不同,对应获得的保障金额也不同,此处对一些常见情况进行列举供您参考。

投保年龄年缴费缴费期保障项目和金额保障期
25岁26378.00元1年

孕产生育18.0万

门诊50.0万

住院2000.0万

1年

注:具体缴费与保额,可依个人实际情况灵活定制,以上举例仅为参考

  • 保险责任说明条款
  • 相关咨询
  • 包含本产品的计划

8.1 本保险合同承担经专科医生建议并由我方医疗团队所确认,因损伤
或疾病而导致的、属于医疗必要的护理及治疗费用给付责任,以及
特定服务费用给付责任。
This policy covers certain costs of services or supplies which are
recommended by a medical practitioner, and which are medically necessary
for the care and treatment of an injury or sickness, as determined by our
medical team.
8.2 保险条款中所列的费用。这些费用的支付须符合本保险合同的规定
及保险凭证所载的限额及责任免除。
The costs which are covered are set out in the provision. These costs are
subject to the limits and exclusions which are set out in the provision and
your certificate of insurance.
8.3 我方可能给予个别被保险人特别责任免除。特别责任免除详细内容
在保险凭证上明示。
Special exclusions, imposed on an individual basis, may apply. Details of
these special exclusions will be shown on your certificate of insurance.
8.4 任何理赔均须符合既定的免赔额,以及保险条款与保险凭证所载的
给付限额。
Any claim is subject to the applicable deductible and limits of cover set out
in the provision and your certificate of insurance.
8.5 本保险合同将不承担任何发生在保险合同开始前与终止后相关治疗
的费用,即使该治疗在保险合同终止前已经获得了我方的批准。
This policy will not cover any costs relating to treatment received before the
cover starts, or after the cover ends (even if that treatment was approved by
us before the cover ends).
9. 保障选项
Coverage options
9.1 国际医疗保障为被保险人的必选保障,具体责任(参考适用的条
款、规定、限额及责任免除)详见本保险合同中"保障利益表"所
载。
The International Medical Insurance plan is provided to every beneficiary.
The benefits which are available (subject to the applicable terms, conditions,
limits and exclusions) are set out in 'list of benefits' in the provision.
9.2 您方可以为任一被保险人选择下述一个或以上的可选保障,以附加
于国际医疗保障,并交纳相应的附加保险费:
You may (for additional premium) add to the cover provided under the
IGAB1212 寰球至尊A
7
International Medical Insurance plan by choosing one or more from the
following extra coverage options for any beneficiary or beneficiaries:
9.2.1 国际医疗补充保障;
International Medical Insurance Plus;
9.2.2 国际健康与体检保障;
International Health and Wellbeing; and
9.2.3 国际眼科与牙科保障。
International Vision and Dental.
9.3 可选保障的保险责任具体详见本保险合同"保障利益表"所载。
Details of the extra coverage options are set out in 'list of benefits' in the
provision.
9.4 保险期间内不能变更已选定的可选保障。如果您方希望增加或减少
可选保障选项,请于年度续保日前及时通知我方。
Coverage options cannot be changed at your request during the period of
cover. If you want to add or remove coverage options, you should let us
know before the annual renewal date.
9.5 若您方增加新的可选保障选项,请向我方提交一份详细的健康问
卷,我方可能对您方新增的保障选项责任适用新的特殊规定或除外
责任。
If you want to add new coverage options, we may ask for a completed
medical history questionnaire, and we may apply new special restrictions or
exclusions on the new coverage options.
9.6 您方可以根据被保险人的需要来选择以下任一保障区域:
You may choose between two options, which determine where in the world
beneficiaries will be covered.
9.6.1 全球不含美国
Worldwide, excluding USA.
9.6.2 全球含美国
Worldwide, including USA.
------------------------------



招商信诺寰球至尊高端个人医疗保险(A 款)条款阅读指引
The Reading Guide to CIGNA&CMC Individual PrivateMedical Insurance (A) Provision
本阅读指引帮助您理解条款,若与条款冲突,以条款为准。
This guide intends to help you better understand the following policy provision. In the case of any conflicts with the policy provision, the policy provision should always be valid and binding.
........ 您所拥有的重要权益
Highlight of Your Rights
1. 本保险合同的保障人员为国籍国在大中华地区的被保险人,或者国籍国曾经在大中华地区 并且投保时在大中华地区有固定住所的被保险人。
This policy only covers beneficiaries whose country of nationality is in Great China, or beneficiaries who have ever had country of nationality in Great China and have permanent adobe in Great China while application.
若本保险合同不符合您的需求或期望,您可以在收到保险合同并书面签收之日起10 天内联 系我方解除本保险合同。如果尚未发生理赔、付款担保或付款预授权,我方将无息全额退还您方已交纳的全部保险费。粗体词汇的理解请见释义。
If the policy does not meet your needs, or has not been issued in accordance with your intention, you may ask us to cancel it within ten (10) days upon your receipt of your certificate of insurance. If no claims have been made, and no guarantees of payment or prior approvals have been put in place, we will refund any premium which has been paid and without accrued interest. Words and phrases in boldhave the meanings given to them in 'Definitions'.
2. 被保险人可以享受本保险合同提供的保障。
Beneficiaries are covered by the benefits on the policy.
........ 您应特别注意的事项
Matters for attention
1. 请您注意理解各项保险责任的保障内容,相应选择您的保障计划。
Pleasemake sure you know all benefits, and decide your insurance coverage accordingly.
2. 请您留意关于保险金给付限额和条件的条款。
Please pay attention to the provisions about the limits and conditions of cover.
3. 请您留意责任免除条款,尤其是已加下划线的免除或限制我方责任的条款。
Please pay attention to the provisions about exclusions, especially those having been
underlined.
4. 请您留意保险合同中关于保险期间及合同效力终止的条款。
Please pay attention to the provisions about period of cover and policy termination.
5. 请您留意续保的条件,如果您方不愿意续保,请在保单周年日前通知我方。
Please pay attention to the renewal conditions. If you decide not to renew, please informus prior to your policy anniversary.
6. 请您留意一些重要术语的定义,如"常住国"、"日间病房治疗"、"专科医生"、"执业医 生"等。
Please pay attention to the definitions of some key terms, such as "country of habitual
residence", "day case treatment", "specialist", "medical practitioner" and etc.
IGAB1212 寰球至尊A
........ 条款目录
Table of contents
第一章一般条款及规定
Section 1 - General Terms and Conditions
1. 保险双方协议
Insurance agreement
2. 保险合同构成
Policy constitution
3. 保险责任生效
When does the cover begin
4. 保险责��终止
When does the cover end
5. 保险合同续保
How is the policy renewed
6. 被保障人员
Who is covered?
7. 增减被保险人
Add or remove beneficiaries
8. 保障范围
What is covered?
9. 保障选项
Coverage options
10. 保险费及其他费用的交纳
Premium and other charges
11. 免赔额
Deductible
12. 保险合同的终止
Termination of cover
13. 明确说明和如实告知
Truthful and Full Disclosure
14. 未如实告知的处理
False or withheld information
15. 外籍常住者与本国国民
Expatriates and nationals
16. 变更地址与国籍
Changes of address and nationality
17. 联系您方
Contacting you
18. 联系我方
Contacting us
19. 保险合同变更
Changes to this policy
20. 保险合同执行人
Who can enforce this policy?
21. 其他保险
Other insurance
22. 资料保护
Data protection
23. 语言
Language
24. 申诉及争议处理
Complaints & Dispute Settlement
25. 适用的法律法规
Applicable law and jurisdiction
第二章保险责任
Section 2 - Benefits
26. 国际医疗保障
International Medical Benefit
27. 国际医疗补充保障(可选保障)
International Health Insurance Plus
Option
28. 国际健康与体检保障(可选保障)
International Health and Wellbeing Cover
Option
29. 国际眼科与牙科保障(可选保障)
International Vision and Dental Cover
Option
第三章责任免除
Section 3 - Exclusions
30. 通用责任免除
General Exclusions
第四章预先批准
Section 4 - Prior approvals
31. 预先批准清单
List of prior approvals
32. 在美国以外地区治疗的预先批准
Prior approval for treatment outside the
USA
33. 在美国地区治疗的预先批准
Prior approval for treatment in the USA
34. 严格遵从理赔流程
Strict compliance with claim procedure
第五章保险金申请
Section 5 - Claims application
35. 提供信息
Providing information
36. 诉讼时效
Claiming period
37. 美国地区治疗的理赔
Claims for treatment in the United States
38. 中国大陆地区治疗的理赔
Claims for treatment in Mainland China
39. 其他地区治疗的理赔申请
Claims for treatment in other areas
40. 保险金的给付
How we pay claims
41. 其它核定结果
Other decisions
第六章释义
Section 6 - Definitions
42. 术语定义
Defined terms
附件:保险利益表
Appendix: List of benefits
IGAB1212 寰球至尊A
1
招商信诺寰球至尊高端个人医疗保险(A 款)条款
CIGNA&CMC Individual PrivateMedical Insurance (A) Provision
第一章一般条款及规定
Section 1 - General Terms and Conditions
1. 保险双方协议
Insurance
agreement
根据本保险合同载明的各条款、赔付条件、赔付限额、责任免除等条款,
我方将支付在本保险合同保险期间内、所选择保险区域内被保险人发生损
伤、疾病、怀孕及分娩而产生的医疗费用及相关费用,在扣除相应免赔额
后,以相应赔付限额为限。
Subject to the terms, conditions, limits and exclusions set out in this policy, Cigna
shall reimburse medical and related expenses relating to treatment provided within
the selected area of coverage for injury, sickness, and medical conditions relating
to pregnancy and childbirth. The treatment must occur during the period of cover,
in excess of the deductible and up to the limits of cover.
2. 保单合同构成
Policy
constitution
2.1 本保险合同由投保申请、保险凭证、保险条款等其他文件组成,请
注意详细阅读。
This policy consists of your application, your certificate of insurance and
this provision. They constitute the entire contract between us and you. You
should read them carefully.
2.2 如果在你发出申请到保单生效时间前,您方的健康与医疗情况发生
了变化,不同于投保时的健康告知,您方应告知我方。我方将重新
审核您方的投保申请,并可能增加(额外的)特别责任免除,或重
新评估是否承保。
You must let us know of any change in yourmedical condition which occurs
between the date of your application and the start time of your policy.We
will then review your application and may need to apply (additional) special
exclusions or review coverage acceptance.
3. 保险责任生效
When does the cover begin?
3.1 保险责任将于保险凭证首页所载生效时间起生效,该保险凭证将发
送给您方。如果续保的,年度续保日也为每年对应的此日期,如当
月无对应的日期,则以该月的最后一日计算。
The cover will begin on the start time shown on the first certificate of
insurance which we send to you. If the policy is renewed, the annual
renewal date will fall on this date each year.
3.2 如您方选择为其他被保险人购买本保险责任,该被保险人保障的生
效时间为其所在保险凭证首页载明的时间,该保险凭证将发送给您
方。
If you choose to buy cover for any additional beneficiaries, their cover will
begin on the start time shown on the first certificate of insurance on which
they are listed, which we send to you.
3.3 请您务必及时向我方告知在申请日与接受承保条件日之间您方所发
生的任何医疗情况变化,我方将重新审核您方的申请,并可能增加
特别责任免除、或重新评估是否承保。
It is important that you notify us immediately of any change in your medical
condition which occurs between your application and your acceptance of
the policy. We will then review your application and may need to apply
(additional) special exclusions or review coverage acceptance.
4. 保险责任终止
When does the
4.1 本保险合同为一年期保险合同。即:除非本保险合同提前终止或本
保险合同续保,保险责任将在保单终止日终止。
This policy is an annual contract. This means that, unless it is terminated
IGAB1212 寰球至尊A
2
cover end? earlier or renewed, the cover will end on the end day.
4.2 在下列情况下,保险责任自动终止:
Cover will automatically end for any beneficiary if:
4.2.1 被保险人死亡(虽然有些责任在其死亡后仍可获赔偿,如医
疗运送回国及遗体运送回国),对该被保险人的保险责任终
止;或
the beneficiary dies (although any benefits which may be payable
after death, such as repatriation of mortal remains, will still be
paid) ,the insurance liabilities for the corresponding insured will
terminate; or
4.2.2 本保险合同被终止。您方及我方可终止本保险合同的情形请
见第12 条。
the policy is terminated. The circumstances in which you or we can
terminate the policy are explained in provision 12.
4.3 如果投保人死亡,所有被保险人的保障将在投保人已缴保险费所对
应的期间届满时终止。在这样的情况下,我方将尝试联系本保单下
的所有被保险人,允许他们选择其中的一位作为新的投保人、如此
则所有被保险人的保障将延续到保单终止日。如果被保险人确实希
望延续保障,他们必须在30 天内书面确认他们同意延续。如果被保
险人不希望,所有被保险人保障将在投保人已缴保险费所对应的期
间届满时即行终止;我方将不支付保障终止日及以后发生的医疗费
用及服务。
If you die, cover will end for all beneficiaries when the insured period
corresponding the premiums having been paid by you ends. If this happens,
we will try to contact any other beneficiaries who are covered under this
policy, and offer them the opportunity to continue the cover until the end
date, with one of them taking over as policyholder. If the beneficiary does
wish to continue the cover, they must respond, in writing, within 30 days, to
confirm their acceptance. If they do not do so, all cover will end when the
insured period corresponding the premiums having been paid by you ends,
and we will not make any payments in relation to treatment or services
which are received on or after the date on which the cover ends.
4.4 如果在保险终止日前本保险合同提前终止,只要被保险人在终止日
前没有进行理赔、付款担保或预先批准,我方将向您方退还未满期
净保费。
If this policy ends before the normal end date, unearned net premiumwill
be refunded on a pro rata basis, so long as no claims have been made and no
guarantees of payment or prior approvals have been put in place during the
period of cover.
5. 保险合同续保
How is the policy
renewed?
5.1 我方将在本保单终止日前至少一个月前书面询问您是否希望续保当
前保单。我方将同时告知您续保后保费的变化及续保的承保条件。
We will write to you at least one month before the end date and ask you
whether you want to renew the cover you currently have. We will also
inform you of any changes to the premiums or terms and conditions which
would apply on renewal.
5.2 如果您方同意续保,您方无需给予任何反应,您的保障将延续12 个
月。续保所依据的是在续保时我方生效的术语定义、保险条款、保
障利益等。如果我方不同意继续承保,我方将根据后面12.6 条款通
知您方。如果您方不同意续保,您方须在保单终止日前至少7 天通
知我方。
If you choose to renew, you do not need to do anything, and your cover will
IGAB1212 寰球至尊A
3
be renewed automatically for another 12 months. Renewal is subject to the
definitions, benefits and terms of the provision in force at the time of
renewal. If we are unable to renew your cover, we will give you notice as
described in paragraph 12.6. If you do not want to renew your cover, you
must let us know at least seven days before your policy end date.
5.3 如果您方不同意续保,本保险合同将不延续。本保险合同符合条件
的各被保险人可以申请为自己投保。我方将个别审核,分别告知他
们我方是否同意承保及承保条件。
If you do not renew your cover, the policy will not be renewed. Any
beneficiaries who have been covered under the policy can apply for their
own cover. We will consider their applications individually, and inform them
whether, and on what terms, we are willing to offer them such cover.
6. 被保障人员
Who is covered?
6.1 本保险合同的保障人员为国籍国在大中华地区的被保险人,或者国
籍国曾经是在大中华地区并且投保时在大中华地区有固定住所的被
保险人。在本保险合同下被保险人与受益人为同一人。
This policy only cover beneficiaries whose country of nationality is in Great
China, or beneficiaries who have ever had country of nationality in Great
China and have permanent adobe in Great China while application. Under
this policy, beneficiary is the same person as the insured person.
6.2 您方可以酌情同时为其他人员投保;如果这样,您方需要把相应被
保险人添加在投保申请中。经我方审核同意后,该被保险人姓名将
载于保险凭证上,您方将可能承担额外的保险费,我方可能对新增
人员适用特别责任免除。
You may arrange cover for other people at our discretion. In order to do so,
you must include them in your application. If we agree to cover them, we
will include their names on your certificate of insurance. Additional
premium may be payable, and special exclusions may be applied in relation
to them.
6.3 您方可能为他人投保,却不为您本人投保。如果这样,您方将作为
投保人并承担交纳本保险合同保险费及其他所有本保险合同规定的
责任,但不享有保险保障。所有的申请须经医疗核保,我方将向您
方告知我方对保险凭证上列明的被保险人的承保条件。
It is possible for you to take out cover for other people, whilst not taking out
cover for yourself. In this situation, you will be the policyholder, and will be
responsible for payment of premiums and all other obligations under the
policy, but will not be covered. All applications will be subject to medical
underwriting and we will let the policyholder know the terms that will apply
to any beneficiary named on the certificate of insurance.
6.4 投保年龄与年龄误告的处理
Issue age and how to deal with incorrectness of age
6.4.1 被保险人在其最初生效时的年龄上限为70 周岁。并且,如
果在某被保险人最初生效时,已经包含或即将同时包含在同
一保险合同下的所有被保险人的年龄不超过18 周岁,该被
保险人在其最初生效时的年龄下限为出生后30 天。投保申
请上填写的各被保险人的出生日期以其有效身份证件为准。
One beneficiary's oldest age at his initial start time is 70 years old.
Besides, at one beneficiary's initial start time, if all beneficiary(ies)
which have been covered or will be simultaneously covered under
the same policies are less than 18 years old, this beneficiary's
youngest age at his initial start time is 30 days of birth. The birth
date of beneficiary(ies) on your application should be based upon
IGAB1212 寰球至尊A
4
effective identity card.
6.4.2 如您方申报的被保险人年龄不真实,并且其真实年龄不符合
本保险合同约定投保年龄限制的,我们有权解除保险合同,
并向您方退还未满期净保费。我方行使保险合同解除权,该
解除权自我方知道有解除事由之日起超过30 日不行使而消
灭。
If you provide us with an incorrect date of birth and the real age
does not comply with the eligibility requirements of this policy, we

have the right to cancel this policy. In this situation, we shall refund
the unearned net premium. The right to cancel the policy will be
rescinded after 30 days starting from the day we notice this error.
6.4.3 如您���申报的被保险人年龄不真实,致使实付保险费少于应
付保险费的,我们有权更正并要求您方补缴保险费。若已经
发生保险事故,我方有权在给付保险金时按实付保险费和应
付保险费的比例给付。
If you provide an incorrect date of birth, which directly leads to a
lower premium than it should, we have the right to make the
correction and charge the additional payment for premium
difference. In such cases, we will pay benefits on a proportional
basis (according to the difference between the true and incorrect
premium) for any insurance event prior to the date of correction.
6.4.4 如您方申报的被保险人年龄不真实,致使实付保险费多于应
付保险费的,我方会将多收的保险费无息退还给您。
If you provide an incorrect date of birth, which directly leads to
higher premium than it should be, we will refund the difference
without interest.
7. 增减被保险人
Add or remove
beneficiaries
7.1 除非发生重大人生事件,您方仅可在每一保险期间终止时增加或减
少被保险人。例如,您方的保险凭证所载生效时间为1 月1 日,您
方仅能在下一年度的1 月1 日增加或减少被保险人。
Unless there has been a relevant qualifying life event, you may add or
remove a beneficiary only when you are renewing the cover at the end of an
annual period of cover. For example, if the start time shown on your
certificate of insurance is appointed within 1 January, you may only add or
remove a new beneficiary with effect from 1 January the following year.
7.2 如果已发生重大人生事件,您方将可在保险期间中途增加或减少因
受重大人生事件影响的被保险人。如果您方需要增加被保险人,请
务必寄给我方一份载有所增加的被保险人完整信息的申请,我方将
及时通知您方是否接受此投保以及由于接受这一投保而可能需要增
加的额外责任免除、额外保险费等其他条件。新增被保险人的保险
责任将于我方确认同意接受该申请之日起生效,我方将会出具包含
该新增被保险人的保险凭证并发送给您方。
If there has been a relevant qualifying life event, you may add or remove
the other person involved in that qualifying life event as a beneficiary part
way through the period of cover. If you would like to add a new beneficiary
on this basis, you must send us a completed application for that person. We
will then tell you whether we will offer cover to that person and, if so, any
special conditions or exclusions and any additional premium which would
apply. Cover for the new beneficiary will begin from the date on which we
confirm acceptance of the application. We will send you an updated
certificate of insurance to confirm that the new beneficiary has been added.
7.3 若您或您的配偶分娩,您方可要求增加新生儿至已有的保险责任
IGAB1212 寰球至尊A
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中:
If you or your spouse gives birth, you may apply to add the newborn as a
beneficiary to your existing plan:
7.3.1 如在新生儿出生前的10 个月或更长期间内,其父母中至少
有一位已经持续有效地作为我方被保险人,并且我方在该新
生儿出生后7 天内收到该新生儿的投保申请的,该新生儿将
无须经医疗核保,我方不要求新生儿的健康或医疗信息。根
据您的选择,该新生儿的保险责任将于其出生之时或我方确
认收到该申请之日起生效。我方将把更新的保险凭证发送给
您方。
If at least one parent has been covered by the policy for a
continuous period of 10 months or more prior to the newborn's
birth and the application is received by us within 7 days of the
newborn's date of birth, the newborn will not be subject to medical
underwriting, we will not require information regarding the
newborn's health or a medical examination, and according to your
preference, the cover will begin at the newborn's birth or our
confirmation of receiving the application. We will send you an
updated certificate of insurance confirming that the new
beneficiary has been added.
7.3.2 如在新生儿出生前的10 个月或更长期间内,其父母中至少
有一位已经持续有效地作为我方被保险人,并且我方在该新
生儿出生后8-30 天内收到该新生儿的投保申请的,该新生儿
将无须经医疗核保,我方不要求新生儿的健康或医疗信息,
该新生儿的保险责任将于我方确认收到该申请之日起生效。
我方将把更新的保险凭证发送给您方。
If at least one parent has been covered by the policy for a
continuous period of 10 months or more prior to the newborn's
birth and the application is received by us from 8 to 30 days of the
newborn's date of birth, the newborn will not be subject to medical
underwriting, we will not require information regarding the
newborn's health or a medical examination, and cover will begin
when we confirm receipt of the application. We will send you an
updated certificate of insurance confirming that the new
beneficiary has been added.
7.3.3 如在新生儿出生前的10 个月或更长期间内,其父母中至少
有一位已经持续有效地作为我方被保险人,并且我方在该新
生儿在出生30 天后才收到该新生儿的投保申请的,则该新
生儿须经医疗核保。我方将及时通知您方是否同意增加,以
及适用于该被保险人的特别条件及特别责任免除。若您方接
受所列条件,保险责任将于我方确认同意接受该申请之日起
生效。我方将会提供更新的保险凭证以确认新增被保险人并
发送给您方。
If at least one parent has been covered by the policy for a
continuous period of 10 months or more prior to the newborn's
birth and the application is received by usmore than 30 days after
the newborn's date of birth, the newborn will be subject to medical
underwriting. We will then tell you whether we will offer cover to
the newborn and, if so, any special conditions and exclusions which
would apply. If you accept the offered terms, cover will begin when
we confirm acceptance of the application.We will send you an
updated certificate of insurance confirming that the new
IGAB1212 寰球至尊A
6
beneficiary has been added.
7.3.4 如果新生儿的父母中没有一位能满足"在新生儿出生前的10
个月或更长期间内,已经持续有效地作为我方被保险人"的条
件。该新生儿则须经医疗核保。我方将及时通知您方是否同
意增加,以及适用于该被保险人的特别条件及特别责任免
除。若您方接受所列条件,保险责任将于我方确认同意接受
该申请之日起生效。我方将会提供更新的保险凭证以确认新
增被保险人并发送给您方。
If neither parent has been covered by the policy for a period of 10
consecutive months or more prior to the newborn's birth, the
newborn will be subject to medical underwriting. We will then tell
you whether we will offer cover to the newborn and, if so, any
special conditions and exclusions which would apply. If you accept
the offered terms, cover will begin when we confirm acceptanceof
the application. We will send you an updated certificate of
insurance confirming that the new beneficiary has been added.
8. 保障范围
What is covered?
8.1 本保险合同承担经专科医生建议并由我方医疗团队所确认,因损伤
或疾病而导致的、属于医疗必要的护理及治疗费用给付责任,以及
特定服务费用给付责任。
This policy covers certain costs of services or supplies which are
recommended by a medical practitioner, and which are medically necessary
for the care and treatment of an injury or sickness, as determined by our
medical team.
8.2 保险条款中所列的费用。这些费用的支付须符合本保险合同的规定
及保险凭证所载的限额及责任免除。
The costs which are covered are set out in the provision. These costs are
subject to the limits and exclusions which are set out in the provision and
your certificate of insurance.
8.3 我方可能给予个别被保险人特别责任免除。特别责任免除详细内容
在保险凭证上明示。
Special exclusions, imposed on an individual basis, may apply. Details of
these special exclusions will be shown on your certificate of insurance.
8.4 任何理赔均须符合既定的免赔额,以及保险条款与保险凭证所载的
给付限额。
Any claim is subject to the applicable deductible and limits of cover set out
in the provision and your certificate of insurance.
8.5 本保险合同将不承担任何发生在保险合同开始前与终止后相关治疗
的费用,即使该治疗在保险合同终止前已经获得了我方的批准。
This policy will not cover any costs relating to treatment received before the
cover starts, or after the cover ends (even if that treatment was approved by
us before the cover ends).
9. 保障选项
Coverage options
9.1 国际医疗保障为被保险人的必选保障,具体责任(参考适用的条
款、规定、限额及责任免除)详见本保险合同中"保障利益表"所
载。
The International Medical Insurance plan is provided to every beneficiary.
The benefits which are available (subject to the applicable terms, conditions,
limits and exclusions) are set out in 'list of benefits' in the provision.
9.2 您方可以为任一被保险人选择下述一个或以上的可选保障,以附加
于国际医疗保障,并交纳相应的附加保险费:
You may (for additional premium) add to the cover provided under the
IGAB1212 寰球至尊A
7
International Medical Insurance plan by choosing one or more from the
following extra coverage options for any beneficiary or beneficiaries:
9.2.1 国际医疗补充保障;
International Medical Insurance Plus;
9.2.2 国际健康与体检保障;
International Health and Wellbeing; and
9.2.3 国际眼科与牙科保障。
International Vision and Dental.
9.3 可选保障的保险责任具体详见本保险合同"保障利益表"所载。
Details of the extra coverage options are set out in 'list of benefits' in the
provision.
9.4 保险期间内不能变更已选定的可选保障。如果您方希望增加或减少
可选保障选项,请于年度续保日前及时通知我方。
Coverage options cannot be changed at your request during the period of
cover. If you want to add or remove coverage options, you should let us
know before the annual renewal date.
9.5 若您方增加新的可选保障选项,请向我方提交一份详细的健康问
卷,我方可能对您方新增的保障选项责任适用新的特殊规定或除外
责任。
If you want to add new coverage options, we may ask for a completed
medical history questionnaire, and we may apply new special restrictions or
exclusions on the new coverage options.
9.6 您方可以根据被保险人的需要来选择以下任一保障区域:
You may choose between two options, which determine where in the world
beneficiaries will be covered.
9.6.1 全球不含美国
Worldwide, excluding USA.
9.6.2 全球含美国
Worldwide, including USA.
10. 保险费及其他
费用的交纳
Premium and
other charges
10.1 保险费及其他应支付的费用(如税费),及其应支付的时间与方式
均已载明于您方的保险凭证中。
Your certificate of insurance sets out the premium and any other charges
(such as taxes) which are payable, and states when and how they must be
paid.
10.2 支付货币为人民币。
Payments must be made in Chinese Yuan (CNY).
10.3 您方应准时交纳保险凭证详细载明的保险费及任何其他费用。
You are responsible for paying the premium and any other charges as
detailed on your certificate of insurance, and are also responsible for
making sure they are made on time.
10.4 如果您未支付首期保险费,本保险合同自始无效。如果您未如期缴
清到期的续期保险费,自该到期日起60 日内若发生保险事故,我方
仍负保险责任,但在给付保险金时会扣减应缴的续期保险费;超过
该到期日起60 日的24 时仍未缴清的,本保险合同效力终止。
If you do not pay first premium, this policy will be ineffective from all the
beginning. If you do not pay any following premium when it is due, we will
still be responsible for cover of treatment within the 60 days after the due
date. But we will deduct any following premium due when making payment
IGAB1212 寰球至尊A
8
for treatment. If the aforementioned overdue premium remains outstanding
upon the end of the 60th day after the due date, this policy will be
terminated.
10.5 我方将根据每年的医疗费用通胀情况对保险费率进行调整。我方将
在年度续保日前书面通知您方关于下一保险期间内将发生的保险费
及其他费用的变更信息。请注意每年的保险费或/及其他费用均可能
有所不同。
We will adjust the premium rates each year according to medical cost
inflation. We will write to you before the annual renewal date to tell you
about any proposed changes in premium and/or other charges which will
apply during the next period of cover. The premium and/or other charges
may vary from year to year.
11. 免赔额
Deductible
11.1 对国际医疗保障或国际医疗补充保障的支付,如果被保险人的保障
计划中选择了免赔额,我方将对保险期间内有关治疗的每一次理赔
均扣除免赔额,直到累积免赔达到了年度免赔额。
We will reduce the amount which we will pay towards the cost of treatment
in respect of each claim which is made under the International Medical
Insurance or International Medical Insurance Plus option (if applicable) by
the amount of any deductible until the deductible for the period of cover is
reached.
11.2 免赔额将按每一被保险人、每个保险选项及每个保险期间单独计
算。
The deductible applies separately to each beneficiary, each coverage option,
and each period of cover.
11.3 您方有对国际医疗保障及国际医疗补充保障选择免赔���的权利,选
择有免赔额的保险费将低于选择无免赔额的保险费。若您方计划选
择免赔额,请在投保申请中注明。
You can choose to have a deductible on the International Medical Insurance
or International Medical Insurance Plus option. If you do so, your premium
will be lower than it otherwise would be. If you would like to apply a
deductible, you should tell us so in your application.
11.4 住院津贴保险责任、新生儿护理保险责任无免赔额。
No deductible applies to 'Inpatient Cash Benefits' or 'Newborn Care
Benefits'.
11.5 您方应直接负责向医院、诊所或执业医生支付免赔额,具体金额我
方会通知您方。
You will be responsible for paying the amount of any deductible directly to
the hospital, clinic or medical practitioner. We will let you know what this
amount is.
11.6 您方可于年度续保日要求变更免赔额。如果您方希望取消或减少您
方的免赔额,我方有可能要求您方提供健康问卷,并可能附加特别
承保条件或特别责任免除。
You can request a change to the deductibles with effect from your annual
renewal date each year. If you wish to remove or reduce your deductible,
we may require a medical history questionnaire, and we may apply new
special restrictions or exclusions.
12. 保险合同的终

Termination of
cover
12.1 在下面情况下,我方将终止保险合同:
We may terminate this policy if:
12.1.1 在续期保险费或其他应缴的费用(包括税收等)的应缴日期
后60 天内,未及时支付上述费用。如果我方因为此原因解
IGAB1212 寰球至尊A
9
除本保险合同,我方将书面向您方发出通知。本保险合同不
承担任何发生在保险合同开始前与终止后相关治疗的费用,
即使该治疗已经在保险合同终止前获得了我方的批准;或
any premium or other charge (including any relevant tax) is not paid
in full within 60 days of the date on which it is due. We will give you
written notice if we are going to terminate the policy for this
reason. This policy will not cover any costs relating to treatment
received before the cover starts, or after the cover ends (even if
that treatment was approved by us before the cover ends); or
12.1.2 本保险合同所提供的保障违反了相关法律法规;或
it becomes unlawful for us to provide any of the cover available
under this policy; or
12.1.3 被监管机构处罚而不适宜成为被保险人;或
any beneficiary is identified on any sanctions listings of regulator; or
12.1.4 向我方告知的信息存在信息误导,或因不如实告知而影响到
我方对本保险合同所承保风险的评估。
we have been given misleading information or not told something
which we should have been told which would have affected our
assessment of the risks to be insured under this policy.
12.2 犹豫期内解除保险合同
Cancellation during cooling off period
12.2.1 若本保险合同未能满足您方的需求,或达不到您方的预期,
您可以在收到保险合同并书面签收之日起10 天内联系我方
并取消本保险合同。如果在此期间内未发生理赔、付款担保
或未取得预先批准,我方将全额退还您方已交纳的全部保险
费。
If the policy does not meet your needs, or has not been issued in
accordance with your intention, you may ask us to cancel it within
ten (10) days upon your receipt of your certificate of insurance. If
no claims have been made, and no guarantees of payment or prior
approvals have been put in place, we will refund any premium
which has been paid.
12.3 如果您方计划解除本保险合同及所有被保险人的保障,请至少提前7
天书面通知我方。
If you want to terminate this policy and end cover for all beneficiaries, you
may do so at any time by giving us at least seven days' notice in writing.
12.4 如您方要求在保单终止日前解除本保险合同,只要确认在此保险期
间内无理赔、付款担保或预授权审核,我方将向您方退还未满期净
保费。
If this policy ends before the normal end date, unearned net premiumwill
be refunded, so long as no claims have been made and no guarantees of
payment or prior approvals have been put in place during the period of
cover.
12.5 即使某项治疗已经获预先审核同意,如果该项治疗的发生在保险合
同终止或某被保险人离开保单之后,我方不承担该项费用。
If treatment has been authorised, Cigna will not be held responsible for any
treatment costs if the policy ends or a beneficiary leaves the policy before
treatment has taken place.
12.6 如果我方不同意续保本保险合同,我方将在保单到期前至少一个月
书面通知您本保险合同在保单期满后不再续保。
IGAB1212 寰球至尊A
10
We will wherever possible, write to you at least one month before the end
date to give you written notice that the policy will not be renewed with
effect from the end date.
13. 明确说明和如
实告知
Truthful and Full
Disclosure
订立本保险合同时,我方应向投保人明确说明本保险合同的条款内容。对
保险条款中免除责任的条款,我方在订立保险合同时应当在投保申请、保
险凭证或者其他保险凭证上作出足以引起投保人注意的提示,并对该条款
的内容以书面或者口头形式向投保人作出明确说明,未作提示或者明确说
明的,该条款不产生效力。我方可以就投保人、被保险人或家属的有关情
况提出书面询问,投保人应当如实告知。
When concluding the policy, the company shall explicitly describe the contents of
the policy provision and conditions to the policyholder for the insurance. Especially
for the exclusion clauses, the company shall have striking notes in application form,
certificate of Insurance and other documents, as well as make clear explanations to
the applicant in oral or written; otherwise, the exclusion clauses won't be effective.
We may put forward written inquiry about the relevant information of the
policyholder and each beneficiary. The policyholder shall disclose the information
fully and truthfully.
14. 未如实告知的
处理
False or withheld
information
14.1 投保人故意或者因重大过失未履行如实告知义务,足以影响我方决
定是否同意接受投保申请或者提高保险费率的,我方有权解除本保
险合同。
If the policyholder intentionally or due to gross negligence, fails to perform
the duty of truthful and full disclosure, which suffices to influence our
decision as to whether to accept the application or to raise the insurance
premium rate, we have the right to terminate the policy.
14.2 投保人故意不履行如实告知义务的,我方对于本保险合同解除前发
生的保险事故,不负担保险责任的给付,不退还保险费。
If the policyholder fails to perform its obligation of truthful and full
disclosure intentionally, we shall not be liable to pay insurance benefits or
refund the insurance premiums for insured events that occurred before the
termination of the policy.
14.3 投保人因重大过失未履行如实告知义务,对保险事故的发生有严重
影响的,我方对本保险合同解除前发生的保险事故,不负担保险责
任的给付,但退还未满期净保费。
If the policyholder fails to perform the duty of truthful and full disclosure
due to gross negligence, which failure has a material bearing on the
occurrence of an insured event, we have the right to terminate the policy,
and shall not be liable to pay insurance benefits for the insured events that
occurred before the termination of the policy, but shall refund the unearned
net premium.
14.4 我方在保险合同订立时已经知道投保人未如实告知的情况的,不会
解除保险合同;发生保险事故的,我方承担给付保险金的责任。
When concluding the policy, we have aware that the policyholder fails to
perform the duty of truthful and full disclosure, we shall not terminate the
policy; and shall pay insurance benefits for occurred events which are
covered in the benefit coverage.
14.5 上述规定的保险合同解除权,自我方知道有解除事由之日起,超过
三十日不行使而消灭。
The right to terminate the policy as specified in the preceding paragraph
shall be extinguished if it is not exercised within 30 days after the date on
which we learnt of the reason for termination.
15. 本国国民及常 15.1 被保险人须在投保申请时告知其常住地地址,我方将其常住地所在
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11
住国
Nationals and
country of
habitual
residence
的常住国作为保费计算的必要依据之一。
Beneficiaries are required to fill in the application form about the habitual
residence; we will calculate out due premium according to country of
habitual residence as one necessary factor.
15.2 被保险人变更常住国的,根据新常住国法律法规,我方保留要求您
方补充个人信息、变更/终止保障、或改变保费的权利。如果保费有
所增加,我方将提供终止保险合同的选择给您方。如果保险合同在
保单终止日前终止,只要在此期间内未发生任何理赔、付款担保或
未取得预先批准,我方将向您方退还未满期净保费。
We reserve the right to ask you for further information, to vary or end the
cover, or to vary the premium if any beneficiary changes their country of
habitual residence, having regard to the laws and regulations of the new
country of habitual residence. If the premium increases, we will give you the
option to terminate the policy. If the policy is terminated before the end
date, unearned net premiumwill be refunded, so long as no claims have
been made, and no guarantees of payment or prior approvals have been put
in place during the period of cover.
16. 变更地址与国

Changes of
address and
nationality
16.1 我方将按您方投保申请上载明的地址寄送与本保险合同有关的书信
及通知。如果您方及其他被保险人的地址、常住地或常住国发生了
任何变更,请务必通知我方。
We will send any communications and notices in relation to this policy to the
address which you give us in your application. Youmust tell us if you or any
other beneficiary change your address, country of habitual residence, or
nationality.
我方将给您方寄送更新信息后的保险凭证。
We will then send you an updated certificate of insurance.
16.2 ��于您方常住国或国籍国的任何变更请务必及时通知我方。
It is important that you tell us straight away if there is any change in any
beneficiary's country of habitual residence or country of nationality.
16.3 如果您方发生了常住国变更,我方将按照常住国变更后对应的保费
进行调整。
if your country of habitual residence be changed, we will charge or refund
the premium difference accordingly.
16.4 如果您方在一个保险年度内在常住国外的某国家停留超过90 天,我
方将视为您常住国临时变更;由此应该补缴保费的,在理赔前必须
先补缴保费。
If you visit a country other than your country of habitual residence for more
than 90 days, we will regard this as a change to your country of habitual
residence. Any premium shortfall should be made up before any claim
settlements.
16.5 在某些情况下,如果变更常住国将致使原有保障违反当地医疗保健
监管规定,我方有可能需要终止保险责任,具体的规定可能根据不
同国家及/或不同时期而变化。
In some instances, we may need to end the cover if such a change of country
of habitual residence would result in a breach of regulations governing the
provision of healthcare cover to local nationals, residents or citizens. The
details of regulations vary from country to country and may change from
time to time.
17. 联系您方
Contacting you
如果我方需要就本保险合同的有关事宜联系您方,或通知将终止或修改本
保险合同,我方将依据您方保险凭证载明的最新地址寄送书面通知,并视
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为已送达给您方。
If we need to contact you in relation to this policy, or if we need to give you notice
that we are going to amend or terminate this policy, we will write to you at the
address which you gave us in the latest certificate of insurance, and all notices sent
will be considered delivered..
18. 联系我方
Contacting us
18.1 在本规则所述中的某些情况下,如果您需要书面联系我方,请按照
您方持有的成员身份卡上的地址或电子邮箱地址向我方寄送相关资
料:
In some circumstances, which are explained in these rules, youmay need to
contact us in writing. If so, you should write to us or email us at the
addresses on yourmembership ID card.
18.2 如果在其他情况下您需要联系我方,请您发送电子邮件至您方所持
的成员身份卡上的电子邮箱地址,您也可拨打客户服务热线,客户
服务热线电话号码载于您方持有的成员身份卡上。
In any other circumstances, you may email us at the addresses on your
membership ID card or call our Customer Care Team at the phone number
on yourmembership ID card.
19. 保险合同变更
Changes to this
policy
19.1 除我方授权代表以外,任何人均无权更改本保险合同或取消其中的
任意条款,例如:销售代表、经纪人及其他中介方均无权擅自变更
或拓展本保险合同的任何规定。
No person other than an authorized executive officer of us has authority to
change this policy or to waive any of its provisions on our behalf, for
example, sales representatives, brokers and other intermediaries cannot
vary or extend the terms of the policy.
19.2 我方保留依照相关法律法规变更本保险合同的权利,在发生变更时
将书面通知您方。
We reserve the right to change this policy to comply with any changes to
relevant laws and regulations. If this happens, we will write and tell you of
the change.
19.3 我方同时保留变更续保条件的权利,变更将于年度续保日起生效,
我方将至少提前28 天书面通知您方。
We also reserve the right to make changes to the terms of cover on renewal.
We will give you at least 28 days' notice of such changes and the changes
will take effect from the annual renewal date.
19.4 如果有被保险人存在特别责任免除,我方将可能在年度续保日重新
对该被保险人进行评估,以决定我方是否同意去除该特别责任免
除。如果我方可能进行评估以决定是否去除特别责任免除,我方将
在保险凭证上注明此重新评估的日期。如果您方有特别责任免除需
要进行重新评估,您方应该在收到续保通知后、年度续保日前至少
14 天期间通知我方。您方应该提供或告知在保单开始日或最近续保
日后重要风险因素的变化,以便于我方对特别责任免除进行重新评
估并决定相应的保单承保条件变更。如果我方对特别责任免除进行
了变更,我方将就此变更通知您方、并且在适当的情况下将变更后
的保险凭证发送您方。特别责任免除的变更将在相关的年度续保日
后生效。我方不承诺在续保时,特别责任免除一定会去除。
If special exclusion(s) have been applied to any beneficiary there may be
occasions when we can review them at a future annual renewal date, to
consider whether we are willing to remove the exclusion. If this is the case,
we will show the exclusions review date on the certificate of insurance. You
should contact us upon receipt of the renewal notification, and at least 14
days before the annual renewal date if there is an exclusion which is due for
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13
review at that date. You should provide information or disclose any changes
affecting risks where such changes have occurred since the policy inception
or last renewal, whichever is the latter, to help us review the exclusion and
any change to this policy. We will then advise you of changes (if any) we
have made to the special exclusion(s) and, where appropriate, issue an
amended certificate of insurance. Amendments to special exclusion(s) will
be effective from the relevant annual renewal date.We do not guarantee
that any special exclusion(s) will be removed on review.
20. 保险合同执行

Who can enforce
this policy?
本保险合同仅对您方与我方具有法律权益,只有您方或我方是本协议的合
同执行人(即使本保险合同赋予其他被保险人进行投诉的权利)。
Only we and you have legal rights in connection with this insurance. This means
that only we or you may enforce the agreement (although we will allow anyone
who is covered under this policy to use our complaints process).
21. 其他保险
Other insurance
如果其他保险公司也为您方提供了保障,我方将与其协商具体的赔付比
例。
If another insurer also provides cover, we will negotiate with them as regards who
pays what proportion of any claim.
22. 资料保护
Data protection
22.1 出于办理本保险合同事务、提供保险保障及其他在第22 条中所述的
目的或原因,我方需要收集及处理您方的个人资料及敏感信息,例
如:姓名、地址、出生日期、电话号码及健康信息等等。您方对我
方出于必要而合理的需求而按第22 条约定的情形收集及处理您方的
个人资料及敏感信息的行为予以认可。
We need to collect and process personal and sensitive data relating to you,
which includes all identifiable information that relates to you for example:
name, address, date of birth, telephone numbers and details of health
information relating to you, for the purposes of administering this policy and
providing the insurance and other purposes stated in provision 22. Pursuant
to the stipulation herein and to the extent reasonably necessary for these
purposes, you consent to us collecting and processing all personal and
sensitive data relating to you.
22.2 我方将会记录来电或去电以控制质量。
Telephone calls to and from usmay be recorded for quality control.
我方将出于履行本保险合同义务、遵守法律法规的规定、服从监管
机构、行业协会的要求等原因而使用或提供上述信息和资料,并有
可能需要与我方授权的第三方分享,在某些情况下需要传输资料到
中国大陆之外的地区。
The abovementioned information and data will be processed or provided by
us for reasons including carrying out our obligations, acting pursuant to laws
and regulations, or following industry regulator's and insurance association's
requests and we may need to share it with third parties authorised by us,
which may mean in certain instances we need to transfer data outside
Mainland China.
以上信息和资料的处理除应符合中国关于信息保护的法律规定外,
还须符合合同中关于机密性及安全性方面的规定。如果您方需要一
份我方持有的您方个人资料复印件,请书面告知我方您的成员编
号。我方可能对提供的信息收取合理的费用。
Such processing is subject to contractual restrictions with regard to
confidentiality and security in addition to the obligations imposed by
applicable data protection laws in China. If you would like a copy of the
information we hold about you, please write to us quoting yourmembership
number. Please note that we may charge a reasonable fee to provide this
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14
information.
22.3 为更好地防范与核查欺骗行为,我方有可能需要与其他保险商或机
构分享信息,但该分享仅限于关于欺骗或试图欺骗行为的信息分
享,不会涉及任何被保险人医疗信息的泄露。
To help us detect and prevent fraud, we may need to share information with
other insurers or organisations. If we need to share information for this
reason, we will only share information relating to fraud or attempted fraud,
and will not share information about any beneficiary's medical history.
23. 语言
Language
我方将可能会为您方提供本保险合同文件的中文版本和英文版本并且提供
中文服务及英文服务,但条款及文件均以中文版本为准。
Youmay have asked for all of the policy documents and all communications in
relation to this policy to be provided in Chinese and English. All such documents
and communications will be provided in Chinese and English. But all benefits and
details shall always be subject to Chinese version.
24. 申诉及争议处

Complaints &
Dispute
Settlement
24.1 任何申诉请第一时间寄送我方,具体地址载明于您方持有的成员身
份卡上:
Any complaint should in the first instance be sent to us at the addresses on
yourmembership ID card.
24.2 如果申诉未能解决时,可以从下列两种方式中选择一种争议处理方
式:
If the complaint is not resolved, the parties concerned shall resort to either
of the following two dispute settlement methods:
24.2.1 因履行本保险合同发生的争议,由当事人协商解决,协商不
成的,提交仲裁委员会仲裁;
The relevant disputing parties shall solve the disputes arising from
the performance of this policy through consultation. If the disputes
cannot be solved through consultation, they shall be submitted to
the arbitration committee for arbitration;
24.2.2 因履行本保险合同发生的争议,由当事人协商解决,协商不
成的,依法对本保险合同有管辖权的人民法院提起诉讼。
The relevant disputing parties shall solve the disputes arising from
the performance of this policy through consultation. If the disputes
cannot be solved through consultation, a lawsuit can be submitted
to the People's Court in accordance with legal regulations.
25. 适用的法律法

Applicable law
and jurisdiction
25.1 本保险合同依据中华人民共和国法律制定,并严格遵循该法律。
This policy is governed by, and will be interpreted in accordance with, laws
of the People's Republic of China.
25.2 关于本保险合同的任何争议包括合同的有效性、构成及终止条款,
将由中华人民共和国法庭管辖。
Any disputes about this policy, including disputes about its validity,
formation and termination, will be determined in the courts of People's
Republic of China.
第二章保险责任
Section 2 - Benefits
26. 国际医疗保障
International
Medical Benefit
国际医疗保障为您提供所需要的住院费用、日间病房的手术费用及病房膳
食费等费用的保障。另外,对癌症、妊娠责任和精神心理治疗,保障的范
围包括住院费用、门诊费用及日间病房费用。
International Medical Insurance protects you for as many everyday needs as
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15
possible including all inpatient, day-patient surgery and accommodation costs. You
will also have essential cover for cancer, maternity benefit and psychiatric
treatment on an inpatient, outpatient and day-patient basis.
26.1 住院或日间病
房的病房膳食

Accommodatio
n for inpatient
or day-patient
treatment
26.1.1 我方将支付满足下列条件之一的费用:
We will pay for:
(a) 被保险人接受住院或日间病房治疗期间的护理费、病房膳
食费;或
nursing care and accommodation whilst a beneficiary is receiving
inpatient or day-patient treatment; or
(b) 被保险人在接受门诊手术时所支付的手术治疗室收费。
the cost of a treatment room while a beneficiary is undergoing
outpatient surgery, if one is required.
26.1.2 仅在满足下列全部条件时,我方才支付上述费用:
We will only pay these costs if:
(a) 被保险人接受住院治疗或日间病房治疗是出于医疗必要;
it is medically necessary for the beneficiary to be treated on an
inpatient or day-patient basis;
(b) 被保险人住院的时间长度是合理的;
they stay in hospital for a medically appropriate period of time;
(c) 所接受的治疗由专科医生亲自执行或在其有效监控之下;
并且
the treatment which they receive is provided or managed by a
specialist; and
(d) 如果入住单人间,入住标准不超过带独立卫生间(或类似
设施)的标准单人房。
they stay in a standard single room with a private bathroom (or
equivalent).
26.1.3 如果有多规格的单人间病房且被保险人入住超过标准单人间规格
的病房的���我方将按照带独立卫生间(或类似设施)的标准单人
房的规格给付。
If a hospital's fees vary depending on the type of room which the
beneficiary stays in, then the maximum amount which we will pay is the
amount which would have been charged if the beneficiary had stayed in
a standard single room with a private bathroom (or equivalent).
26.1.4 如果主持被保险人治疗的执业医生决定需要延长留院治疗时间并
超出我方的预先批准时长,或者已获我方审核同意的治疗方案将
有所变动,必须尽快向我方寄送由主持治疗的执业医生出具的医
疗报告,并载明下列全部信息:
If the treating medical practitioner decides that the beneficiary needs to
stay in hospital for a longer period than we have approved in advance, or
decides that the treatment which the beneficiary needs is different to
that which we have approved in advance, then that medical practitioner
must provide us with a report, explaining:
(a) 被保险人预期需要留院治疗的时长;
how long the beneficiary will need to stay in hospital;
(b) 被保险人的诊断信息(如果诊断发生了变更);以及
the diagnosis (if this has changed); and
(c) 被保险人已经接受的治疗和需要接受的治疗。
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the treatment which the beneficiary has received, and needs to
receive.
26.2 手术室及麻醉
复苏室费用
Operating
theatre and
recovery room
costs
如果相应的手术费经我方审核可赔付,我方将支付与之相关的手术室及麻
醉复苏室费用。
We will pay any costs and charges relating to the use of an operating theatre or
recovery room, if the treatment being given is covered under this policy.
26.3 药品费及敷料

Medicines,
drugs and
dressings
26.3.1 我方将支付被保险人接受住院治疗或日间病房治疗期间发生的有
处方的药品费及敷料费;
We will pay for medicines, drugs and dressings which are prescribed for
the beneficiary whilst he or she is receiving inpatient or day-patient
treatment.
26.3.2 除非被保险人接受的是癌症治疗,否则,只有被保险人也选择了
国际医疗补充保障,我方才支付被保险人在门诊治疗发生的药品
费及敷料费。
We will only pay for medicines, drugs and dressings which are prescribed
for use at home if the beneficiary has cover under the International
Medical Insurance Plus option (unless they are prescribed as part of
cancer treatment).
26.4 重症监护室
Intensive care
26.4.1 如符合下列全部条件,我方承担被保险人入住重症监护室,重症
治疗室,加护病房或冠心病监护室的费用:
We will pay for a beneficiary to be treated in an intensive care, intensive
therapy, high dependency or coronary care facility if:
(a) 此病房是为被保险人提供恰当治疗的最佳场所;
that facility is the most appropriate place for them to be treated;
(b) 在此病房接受此治疗是所需治疗的必要部分;以及
the care provided by that facility is an essential part of their
treatment; and
(c) 在此病房所接受的治疗是与被保险人病情/伤情相仿者通常
接受的治疗、或相同的治疗。
the care provided by that facility is routinely required by patients
suffering from the same type of illness or injury, or receiving the
same type of treatment.
26.5 父母或监护人
陪护费
Hospital
accommodatio
n for a parent
or guardian
26.5.1 如果被保险人在接受住院治疗时为17 周岁或以下的未成年人,
符合下列全部条件时,我方将承担其父母中的一位或一位法定监
护人在同一医院中的陪同住宿费用:
If a beneficiary who is 17 years old or younger needs inpatient treatment
and has to stay in hospital overnight, we will also pay for hospital
accommodation for a parent or legal guardian, if:
(a) 该医院可以进行陪护;且
accommodation is available in the same hospital; and
(b) 其陪同住宿费用是合理的。
the cost is reasonable.
26.5.2 仅当被保险人接受的是属于本保险合同约定范围内的治疗时,我
方才承担此陪护费用;
We will only pay for hospital accommodation for a parent or legal
guardian if the treatment which the beneficiary is receiving during their
stay in hospital is covered under this policy.
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26.6 手术的外科医
生及麻醉师费

Surgeons' and
anaesthetists'
fees
26.6.1 我方将支付在住院、日间病房或门诊发生的下列费用:
We will pay for inpatient, day-patient or outpatient costs for:
(a) 手术中发生的外科医生及麻醉师费用;及
surgeons' and anaesthetists' surgery fees; and
(b) 手术前或手术后发生的与手术直接相关的治疗(与手术同