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“留学中国”医疗保险计划及投保确认书“StudyinginChina”ExpatriatesInsurancePlan&ApplicationLetter保障对象/Abouttheinsured:常驻大陆地区的境外人士(留学生)且未满60足岁均可参加本保险计划。Foreignresidentsunder60yearsoldlivinginMainlandChina保障特点/Benefitsadvantage:（1）专业完善-保障完善的专属境外人士(留学生)（含港澳台）保险计划Elitechoice–DesignedspeciallyforforeignresidentslivinginMainlandChina(includingHongKong,Taiwan,Macaucitizen).（2）综合保障-结合人寿险、意外险、医疗险为一体的超值保障Comprehensivecoverage–Includedinoneinsuranceplan:Life,Accidental,andMedicalbenefits.（3）轻松就医-由医疗服务公司为您提供24小时家庭医生咨询，门急诊及住院引导就医服务（注1）Medicalguide–24hoursmedicalservicehotlineprovidingexperts’guidesforemergencytreatmentandchoosinghospitals.(SeeNote.1)（4）代垫费用-于网络医院或特约医疗机构就医时，由医疗机构代垫医疗费用Directbilling–Directbillingavailableinnetworkhospitals.（5）免费体检-一年一次免费身体检查（注2）Freemedicalcheck-up–Onefreemedicalcheck-upofferedperyear(Note.2)（6）全球保障-境外就诊亦可获得理赔Globalcover–MedicalbillsincurredoutsideMainlandChinacanalsobeclaimed.（7）全球救援-全球紧急急难援助GlobalAssistance–worldwideemergencyassistanceprovided.（8）手续简便-参加本保险，无须健康检查Simplifiedpolicyapplicationprocedure–nopremedicalcheck-uprequiredforpolicyapplication1保障内容/BenefitsSchdedule:保障专案/Benefits保障金额/BenefitAmount/Limit(RMB)1.1疾病身故或全残保险金DiseaseDeath/TotalDisability30万元RMB300K2.1意外身故保险金（除特定交通工具意外）AccidentalDeath（Excludingspecifictrafficaccidents）60万元RMB600K2.2意外残疾保险金（除特定交通工具意外）AccidentalDisability（Excludingspecifictrafficaccidents）30万元RMB300K3.1特定交通工具意外身故保险金AccidentalDeathinspecifictrafficaccidents飞机-100万元陆上公共交通工具或轮船-80万元Flight–RMB1000Kboatsorothercommoncarriers–RMB800K3.2特定交通工具意外残疾保险金AccidentalDisabilityinspecifictrafficaccidents飞机-70万元陆上公共交通工具或轮船-50万元Flight–RMB700Kboatsorothercommoncarriers–RMB500K4.重大疾病保险金（29种疾病）CriticalIllness（29Types）10万元RMB100K5.门急诊医疗保险金In-patientreimbursement每次限额800元每年限额1万元Limitpervisit:RMB800Limitperyear:RMB10K给付比例90%Reimbursementrate90%6.住院医疗保险金Out-patientreimbursement每年限额5万元Limitperyear:RMB50K给付比例100%Reimbursementrate100%会员费/每人/每年（含医疗咨询服务费）Premium/Person/Year4000元RMB4000保障须知/PolicyApplicationNotice:1.本保险计划保险期限为1年，第二年可办理续保；参加本保险计划最高投保年龄60周岁，续保可放宽投保年龄至65周岁；TheeffectiveperiodofthePolicyisoneyear,renewalpossible;Theinsuredshouldbeunder60yold.Forrenewal,theagecanbeextendedto65yold.2.本会员保险费采用每年交付的方式；Premiumpayableannually.3.本保险计划身故保险金以法定继承人为受益人；残疾保险金、医疗保险金及重大疾病保险金的受益人为被保险人本人；ThebeneficiaryofdeathbenefitsforthePolicyislegalbeneficiary.ThebeneficiaryofAccidentalDisability,In-patient,Out-patientandCriticalIllnessbenefitsistheinsuredhim/herself.4.如现被保险人现在或过去患有恶性肿瘤、心脏病、中慢性肾功能衰竭、白血病、肝硬化、高血压II期及以上、糖尿病II期及以上、癫痫病、精神病、中风、再生障碍性贫血、帕金森氏病、血友病、红斑狼疮及结缔组织疾病、艾滋病等病症须提供个人健康告知声明书。Ifpreviouslyhavinganyseriousillness,thePolicyapplicantneedstoprovideDOH(DeclarationofHealth)*以上未尽事宜以保险合同条款为准。Formoredetails,pleaserefertothePolicyprovisions.申请人签字/InsuredSignature:要保单位盖章/Policyholder:投保数据（务必填写完整且真实的数据，以确保投保利益，如有变更，请及时办理）PolicyApplicationDocuments(Pleasefillcorrectlyallinformationrequested.Ifthereisanychange,pleaseinformtheinsurancecompanyinstantly)姓名InsuredName出生日期DateofBirth性别Sex证件种类ID.Type证件号码ID.No.国内居住地LocationinPRCChina地址InsuredAddress电话Tel:开户银行：银行账号：（供理赔转帐）BankName：BankAccount：（Forclaimpurpose）日期：年月日Date：DMMYYYY保障说明/ThePolicyNotice:1.疾病身故保险金/DiseaseDeathBenefit：保险生效日起30天后被保险人发生疾病身故或疾病全残的，保险公司依照保险合同约定给付保险金。duringtheeffectiveperiodofthePolicy,ifdeathortotaldisabilityoccurstotheinsuredduetodisease30daysaftertheeffectivedateofthePolicy,thesumAssuredwillbegiventotheInsuredortheBeneficiary.2.意外身故保险金/AccidentalDeathBenefit：保险有效期间内，被保险人因遭受意外伤害（除特定交通工具意外），自意外事故发生之日起180日内身故，保险公司给付意外伤害身故保险金。duringtheeffectiveperiodofthePolicy,ifdeathoccurstotheInsuredwithin180dayssincetheaccidentalinjuryoccurs,theSumAssuredasDeathbenefitwillbegiventotheBeneficiary.3.意外残疾保险金/AccidentalDisabilityBenefit：保险有效期间内，被保险人因遭受意外伤害（除特定交通工具意外）事故，自意外伤害发生之日起180日内导致残疾，比照残疾给付等级，保险公司给付意外伤害残疾保险金。2duringtheeffectiveperiodofthePolicy,theInsuredbecomesdisabledwithin180dayssincetheaccidentalinjuryoccurstotheinsured,theCompanywillpaythebenefitaccordingtothe“disabledegree&benefitpaymenttable”.4.特定交通工具意外伤害保险金/AccidentalDeathinspecifictrafficaccidents：保险有效期间内，被保险人以乘客身份搭乘飞机、陆上交通工具或轮船时,遭受意外伤害，自意外事故发生之日起180日内身故，保险公司给付特定交通工具意外身故保险金。duringtheeffectiveperiodofthePolicy,ifdeathoccurstotheInsuredwithin180dayssincetheaccidentalinjuryoccurstotheinsuredwhoistaking(Note.4)aflight,boatsorothercommoncarriers(Note.5)asapassenger(Note.3),theSumAssuredasDeathbenefitwillbegiventotheBeneficiary.5.特定交通工具意外残疾保险金/AccidentalDisabilityinspecifictrafficaccidents：保险有效期间内，被保险人以乘客身份搭乘飞机、陆上交通工具或轮船时遭受意外伤害，自意外伤害发生之日起180日内导致残疾，比照残疾给付等级，保险公司给付特定交通工具意外残疾保险金。duringtheeffectiveperiodofthePolicy,TheInsuredbecomesdisabledwithin180dayssincetheaccidentalinjuryoccurstotheinsuredtakingaflight,boatsorothercommoncarriersasapassenger,theCompanywillpaythebenefitifthedisablementsarelistedin“disabledegree&benefitpaymenttable”.6.重大疾病保险金/CriticalIllnessBenefit:：保险生效日起，30天后被保险人经医院明确诊断初次患有本合同所定义的重大疾病，且生存28天以上者，保险公司将给付重大疾病保险金。duringtheeffectiveperiodofthePolicy,theinsuredwhosurviveafter28daysfrombeingfirsttimediagnosedassufferingfromacriticalillness(type1totype29)listedintherider,willbepaidthesumassuredasthelivingbenefit.Andthep