Comprehensive Medical Insurance & Protection Scheme for
Foreigners Staying in China of Ping An Annuity Insurance Co., Ltd.
To participate in conditions:
International students in China, students from Hongkong, Macao and Taiwan, as well as overseas
Chinese students (identities of overseas Chinese could be proved by relative authority) in healthy
condition, able to participate in study normally from 8 years old to 69 years old, are eligible to this
policy.
Insurance Liabilities:
Ping An shall undertake the following insurance liabilities during the valid period of insurance
(Insurance period (from the valid date of the policy to the expiry date of the insurance period))
1. Death insurance:
Ping An shall pay the stipulated amount of insurance compensation if the Insured dies of an
accident or disease. Insurance liabilities thus terminate.
2. Accidental disability insurance:
If the Insured suffers from an accident which results in any disability listed in the Standards
and Codes for Personal Insurance Disability Assessment (JR/T 0083-2013) (issued by China
Banking and Insurance Regulatory Commission, BJF [2014] No. 6) within 180 days since the
occurrence of the accident, Ping An shall assess the injury and disability according to the assessment
principles stipulated by this Criteria, unless otherwise stipulated, Ping An shall pay the accidental
disability insurance money, whose amount shall be calculated based on the multiplication of the
proportion stipulated in this Criteria, which is corresponding to the assessment result, by the
sum insured, which is corresponding to insurer’s responsibilities. If medical treatment is still not
over on the 180 th day, disability evaluation shall be made on the basis of the Insured’s physical
condition on that day and the Insurance of Accidental Disability shall be paid in accordance with the
evaluation results.
If with the disability resulted from this accident and the previous disability combined as a more
serious disability according to the Standards and Codes for Personal Insurance Disability
Assessment (JR/T 0083 — 2013), the insurance shall be paid in accordance with the standard for the
more serious disability, but the insurance of accidental disability which has been paid previously
(disabilities listed in the Standards and Codes for Personal Insurance Disability Assessment (JR/T
0083-2013) have taken place before purchase of insurance or caused by events under Liability
Exemption, shall be deemed as having been compensated already) shall be deducted therefrom.
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The accumulative payment amount of accidental disability insurance, and death due to any
accidental injury or disease shall not exceed the corresponding insured sum of the Insured. If the
accumulative amount of payment exceeds the insured sum of the Insured, then the insurance liabilities
to the insured thus terminate.
Note: Standards and Codes for Personal Insurance Disability Assessment (JR/T 0083-2013) is
accessible from the website of Insurance Association of China.
3. Accidental Medical Insurance:
If the Insured, who suffers from the accidental incident, receives medical treatment within 180
days since the occurrence of the accident, the Insurer shall be liable for the full amount of the
reasonable and necessary expenses actually paid by the Insured for the medical treatment, but the
accumulative amount of payment shall not exceed RMB 20,000. Whether an accident happens to the
Insured for once or several times, the Insurer shall pay the "accidental medical insurance" respectively
in accordance with the aforesaid provisions, but the accumulative amount of payment shall not exceed
the insured sum of the accidental medical insurance of the Insured. When the accumulative amount of
payment reaches the insured sum of the accidental medical insurance of the Insured, the said insurance
liability for the said Insured shall be terminated.
For example, the accidents such as bruises of bumps, burns, sprained ankle, accidental cut-wound
when cutting vegetables, scratches or bites by cats and dogs.
Reimbursement equation: total amount of reasonable expenditure * 100%=reimbursable amount
(the total amount of reasonable expenditures shall exclude the self-paid or partly self-paid items and
expenses stipulated by the local regulations of the basic medical insurance).
4. Outpatient and Emergency Medical Insurance:
The reasonable and necessary expenses incurred by the Insured for receiving outpatient or
emergency medical treatment because of illness, within each insurance period, the daily limit for
outpatient is RMB600, (that means, if medical expense exceeding RMB 600 per day, shall be
calculated as RMB600; if the medical expense not exceeding RMB600 per day, shall be calculated by
the actual amount). Once the medical expenses exceeding the starting line of RMB650, the remaining
amount of the medical expenses exceeding the deductible RMB650 yuan on the basis of the daily
limit rules will be reimbursed at a percentage of 85%, and the accumulative payment shall not exceed
the limit of RMB20000. The insurance liability shall be terminated once the accumulative amount of
payment reaches the sum insured.
Medical expenses of outpatient and emergency treatment: The related expenses incurred from
general outpatient treatment, emergency treatment, outpatient surgery, hospitalization for observation,
emergency rescue, and expense or cost of outpatient and emergency treatment before and after
hospitalization that arise from the same cause of disease are also deemed as outpatient and emergency
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treatment.
For example, being treated in the outpatient or emergency for fever, sudden abdominal pain, faint,
and inflammation etc.
Reimbursement equation: (the expense of each day within the daily limit RMB600 yuan add
up-650 yuan) * 85%=reimbursable amount (the total amount of reasonable expenditures shall
exclude the self-paid or partly self-paid items and expenses stipulated by the local regulations of the
basic medical insurance)
Definitions:
Daily limit: The top claim limit of available medical cost.
Deductible: RMB 650 yuan (A total of RMB650 yuan is deducted accumulatively for one time
during an insurance period). Below the starting line, there is no compensation.
5. Hospitalization and Medical Insurance:
If diagnosis confirms that the Insured must be hospitalized for treatment because of suffering
from the accident or the illness, Ping An shall pay 100% of the “hospitalization and medical
insurance” to the insured with regard to the actual and reasonable expenses for medical treatment,
including reasonable and necessary fees for nursing (limited to RMB200 Yuan per day and
accumulate up to 60 days), medical record, heating, air-conditioning, bed, examination, special
examination and treatment, operation, medicine, treatment, laboratory test, radiation, etc.
During one valid insurance period, whether the Insured is hospitalized for once or several times,
the Insurer shall pay the insurance payment as per compensation rule, but the insurance liability shall
be terminated once the accumulative amount of payment reaches the limitation of RMB 400,000.
In another word: if diagnosis confirms that the insured must be hospitalized for treatment because
of suffering from the injury or illness, the insured may apply online for advanced payment by the
hospital or at his own expense of medical expense for hospitalization and reimburse later.
Reimbursement equation: reasonable hospitalization expenditure * 100%=reimbursable amount
(the total amount of reasonable expenditures shall exclude the self-paid or partly self-paid items and
expenses stipulated by the local regulations of the basic medical insurance).
Note:
1) Medical organizations which are involved in all the foregoing medical insurance liabilities
are limited to the public hospitals established within the border of Mainland China; However,
for the insured who are treated in the ward area for foreigners, ward area for VIPs, private
room, Class A ward, separate ward room, ward area for special treatment and needs, ward for
special treatment and needs, ward for high-ranking officials, or similar ward area of the public
hospitals,, shall be excluded from the insurance, then all medical expenses incurred by such shall
not be covered by the insurer.
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2) Medical treatment expenses generated by all the foregoing medical insurance liabilities
are limited to the items and expenses that can be reimbursed in accordance with the local
regulations of basic medical insurance, the self-paid or partly self-paid items and expenses
cannot be reimbursed by the insurer.
3) For the insured who apply for the insurance for the first time or the insured who is not
renewal of insurance, the first 30 days from the effective date of the insurance is the waiting
period (observation period). Where the insured is hospitalized or treated in outpatient during
the waiting period and related medical cost occurs, the insurer bears no liability of
compensation. Insurance renewal or the treatment for the Insured suffered from an accident is
not subject to any waiting period.
4) If any third party has partially or fully paid any above-mentioned medical treatment fees,
Ping An shall be liable for the remaining amount of reasonable fees that are within the
reimbursable payment scope of the local basic medical insurance. But the limited portion of the
fees for the bed, nursing, outpatient and emergency treatment within the daily limitation is also
limited; if the third party has a specified proportion for payment of the limited sum, Ping An
shall be liable only for the remaining amount after deducting the already paid amount from the
limited sum. If the third party has no specified proportion for payment, then Ping An shall be
liable for the remaining amount, but not exceeding the insured sum, after deducting the
standard amount of this item from the limited sum which takes the regulations of the local basic
medical insurance as the standard.
5) If the Insured suffers from a major disease or a chronic disease before the purchase of
this insurance, the Insurer shall not bear the liability of payment.
Liability Exemption
I. Liability Exemption for Death and Accidental Disability Insurance
Ping An shall be exempted from the insurance liabilities for death and accidental disability
caused by any of the following circumstances on the part of the Insured:
1. Deliberate killing or injury conducted by the policy-holder or beneficiary to the
Insured;
2. Deliberate self-harm, suicide, intentional crime, resistance to criminal compulsory
measures taken according to the law on the part of the Insured;
3. Fighting, drunkenness or affected by alcohol, and active taking, sucking or injection of
drugs on the part of the Insured;
4. Driving a motor vehicle under the influence, driving a motor vehicle without a legal and
valid driver’s license or driving a motor vehicle without a legal and valid driving license
on the part of the Insured;
5. War, military conflict, riot or armed rebellion;
6. Nuclear explosion, nuclear radiation or nuclear pollution;
7. Pregnancy, abortion, miscarriage, delivery (including caesarean birth), birth control,
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treatment of infertility, contraceptive sterilization, artificial impregnation and related
complication on the part of the Insured;
8. Medical accident occurring to the Insured because of cosmetic surgery or other surgical
operations;
9. Taking of medicine (excluding OTC medicine taken according to instructions) without
permission of doctor on the part of the Insured;
10. During the period when the Insured suffers from AIDS or is infected with the AIDS
virus (HIV-positive);
11. The Insured engages in high-risk activities such as diving, parachuting, mountain
climbing, bungee jumping, paragliding, expedition, wrestling, martial art, stunt
performance, horse racing, car racing, etc.
12. The Insured passes away or becomes disability because of an accident outside mainland
China.
13. Providing false insurance information, or non-overseas students insured as an overseas
student.
14. Those accidents that occur during the time when the Insured do their part-time job;
If the Insured is caused dead in any of the foregoing circumstances, Ping An shall terminate
the insurance liability of the Insured.
II. Liability Exemption for Medical Insurance Liability (Accidental Medical Treatment,
Outpatient, Emergency and Hospitalization)
Ping An shall be exempted from the insurance liabilities for medical expenses caused by any
of the following circumstances on the part of the Insured:
1. Deliberate killing or injury conducted by the policy-holder or beneficiary to the
Insured;
2. Deliberate self-harm, intentional crime or resistance to criminal compulsory measures
taken according to the law on the part of the Insured;
3. Fighting, drunkenness or affected by alcohol, and active taking, sucking or injection of
drugs on the part of the Insured;
4. Driving a motor vehicle under the influence, driving a motor vehicle without a legal and
valid driver’s license or driving a motor vehicle without a legal and valid driving license
on the part of the Insured;
5. War, military conflict, riot or armed rebellion;
6. Nuclear explosion, nuclear radiation or nuclear pollution;
7. The insured suffers from congenital diseases, hereditary diseases, existing disease
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(disease or symptoms that already exist prior to the date of insurance and
non-continuous within the insurance period);
8. The insured suffers from AIDS or HIV infection, sexually transmitted diseases;
9. Pregnancy, miscarriage or delivery on the part of the Insured, infertility treatment,
artificial insemination, prenatal and postnatal check, birth control (including
sterilization), abortion and complications caused by above-mentioned causes;
10. Medical accident occurring to the Insured because of cosmetic surgery or other surgical
operations;
11. The medical expenses incurred by the Insured for dental care, such as washing teeth,
dentures, dental implants, false filling, porcelain teeth, etc., as well as expenses incurred
in oral restoration, orthodontics, oral health care and beauty; the reasonable medical
expenses of the Insurer's dental fillings, tooth nerve treatment, tooth pulling, tooth
impaction treatment and periodontal diseases (such as, periodontitis, gingivitis,
periapical inflammation, except for teeth cleaning) due to dental caries, dental pulp
disease and cracked teeth are within the insurance liability of the Insurer;
12. Expenses of orthopedics, correct procedure, plastic surgery or rehabilitation therapy
received by the Insurer;
13. Items such as physical examination and disease screening for the Insured; various
medical treatment items for prevention, health care, recuperation, rest and special care:
such as various vaccines vaccination, foot reflexology massage therapy, fitness massage
and other items;
14. Taking, application or injection of medicine without the permission of doctor on the
part of the Insured;
15. Medical expenses incurred outside Mainland China or in private hospitals within
Mainland China, and expenses incurred in drug stores and companies of medical
apparatus and instruments;
16. Accidents that occur outside Mainland China and the follow-up treatments as a
consequent on the part of the Insured;
17. Charge of telephone, transportation, meals, etc. on the part of the Insured;
18. Sports and athletic activities of high risk only professionals participate. (The Insured
engages in high-risk activities such as diving, parachuting, paragliding, roller skating,
skiing, skating, bungee jumping, rock climbing, wrestling, judo, taekwondo, martial art,
karate, fencing, etc.
19. Providing false insurance information, or non-overseas students insured as an overseas
student.
20. Experimental treatment and costs incurred for medical experiment purpose.
21. The insurant should turn to medical treatment in strict accordance with the hospital
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admissions standards. If not, the insurer does not reimburse the cost of hospitalization.
22. Medical treatment fees incurred without reporting in advance by dialing 400 telephone
numbers or not approved.
23. Relevant expenses incurred by the Insured during the time when they do their part-time
work.
Insurance premium
Insurance Liabilities
Insurance Amount
(Yuan) RMB
Age 8—69
Insurance Premium
(Yuan per half a year
per person)
Insurance Premium
(Yuan per year per
person)
Liability for Death + Accidental Disability 100000
400 800
Accidental Medical Treatment 20000
Medical Treatment for Outpatient and
Emergency
(With a daily limit of 600 yuan; the medical
expenses exceeding 650 yuan can apply for a
claim, that excess portion will be reimbursed
at a proportion of 85%)
20000
Hospitalization Medical Treatment 400000
Note: Matters not mentioned herein shall be executed according to Ping An One-year Group Term Life
Insurance (RELEASED BY PING AN ANNUITY INSURANCE COMPANY OF CHINA, LTD [2021]
No.602), Ping An Additional Accidental Injury Group Medical Insurance (RELEASED BY PING AN
ANNUITY INSURANCE COMPANY OF CHINA, LTD [2020] No.413), Ping An Inpatient Group
Medical Insurance (RELEASED BY PING AN ANNUITY INSURANCE COMPANY OF CHINA,
LTD [2020] No.413), Ping An Inpatient, Outpatient and Emergency Comprehensive Group Medical
Insurance (RELEASED BY PING AN ANNUITY INSURANCE COMPANY OF CHINA, LTD [2020]
No.413), and Ping An Inpatient Reassuring Group Medical Insurance (Clause A) (RELEASED BY
PING AN ANNUITY INSURANCE COMPANY OF CHINA, LTD [2021] No.605).
If any dispute arises concerning the contents mentioned above, the Chinese interpretation shall
prevail.
Please be sure to call 4008105119 firstly to make a diagnosis inquiry before you go to see a
doctor.
Dear customers:
If you want to learn about the services of the settlement of a claim of comprehensive
insurance for people coming to China of Ping An Endowment Insurance Co., Ltd., please read
this guide carefully.
(1) Procedures for insurance claims:
Standard procedures of insurance claims after the occurrence of insurance accident:
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Telephone for consultation and report: 4008105119
Please call directly 4008105119 for medical consultation due to disease or accident. The rescuing
doctor will provide consultation, diagnose, and medical guidance and instructions on the insurance
claim. After consulting the doctor and getting outpatient treatment, if the doctor confirms that further
hospitalization is required, the insured can apply for advanced payment of medical expense for
hospitalization to the rescue company. After communication and confirmation between the rescue
company and hospital, it will be decided whether the advanced payment procedures shall be started. If
the insured is directly hospitalized without being inquired, recorded by the doctor of the rescue
company as well as not being treated by the outpatient (including those whose conditions do not
meet the requirements of hospitalization but require the outpatient doctor to agree with
hospitalization), the rescue company will not be responsible for advanced payment of medical
expense for hospitalization. If advanced payment for medical expenses is made without the
above procedures, the insured will not be able to get compensation.
(2) Document to be presented for settlement of claims:
1) Death or accidental disability
A．Copy of passport and visa page of the Insured
B．Disability certificate when the Insured is disabled (an evaluation report shall be issued by the
assigned evaluation body)
C．Death certificate of the Insured
D．Copies of certificates of the relationship between the Insured and all the beneficiaries, and copies of
identification proofs of the beneficiaries
E．Certificate of accident in case of an accident (in case of traffic accident, the traffic unit should issue
a liability confirmation of traffic accident; in case of falling from the height and drowning, the public
security organs or relevant departments shall issue the materials determining whether it is accidental or
suicidal; in case of alcohol-induced accident, a quantitative report on the alcohol concentration shall be
issued.)
2) Accidental medical treatment
A．Copies of passport and visa page of the Insured
B．Process and certificate of accident (in case of a traffic accident, the traffic unit should issue a
liability confirmation of traffic accident, which is needed.)
C．Original of receipt
D．Medical record, detailed expenditure sheet and copies of examination report and laboratory test
report of each respective treatment (The date of the medical record and the date of invoice shall be
corresponding with each other).
3) Medical treatment for outpatient and emergency
A．Copies of passport and visa page of the Insured
B．Original of receipt
C．Medical record, detailed expenditure sheet and copies of examination report and laboratory test
report of each respective treatment (The date of the medical record and the date of invoice shall be
corresponding with each other).
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If the fees reach the deductible of RMB650 Yuan, then the original invoice, medical record,
detailed expenditure sheet and copy of examination report and laboratory test report of
treatment that costs below RMB650 Yuan are also required to be presented.
4) Hospitalization
A．Copies of passport and visa page of the Insured
B．Certificate of the accident in case of an accident (in case of the traffic accident, the traffic unit
should issue a liability confirmation of traffic accident)
C．Original of receipt and detailed expenditure sheet for hospitalization
D．Copy of hospital discharge summary or medical record of hospitalization
Special instructions to item 2) to item 4) above:
(1) The Insured’s bank account opened in mainland China and accurate information of this account,
including account number, name, opening bank information, which can be obtained from a copy of
deposit book and bank customer table, it must be attached to the claim settling documents for each
request for compensation (For more details, please call 4008105119).
(2) Where the insured treated in two or more hospitals (including two hospitals) respectively for one
insured incident, relevant documents such as diagnosis certificate and medical record from
relevant hospitals of each treatment shall be presented.
(3) Hospitals for treatment shall be limited to the public hospitals within the territory of Mainland
China, requested items and expenses that can be reimbursed should in accordance with the scope
of local regulations of basic medical insurance.
5) Application for nursing fee
Original Invoices of nursing fee issued by the hospital or by a nursing service company
Materials for claims settlement sent to 北京市西城区金融街 23 号平安大厦 9 层（邮编 100033）
Addressee: 来华项目组
Please Dial: 4008105119
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Ping An Annuity Insurance Company, Ltd.
Chinese explanation prevails in case of contradiction arising out of the aforementioned contents.
