Comprehensive Medical Insurance & Protection Scheme for
Foreigners Staying in China of Ping An Annuity Insurance Co., Ltd.
To participate in conditions:
Foreign teachers and foreign experts: foreign teachers and experts with formal employment
contracts in healthy condition and from 18 to 69 are eligible to this policy, and experts from Hong
Kong, Macao and Taiwan as well as overseas Chinese (identities are needed to be proved by relative
authority) are also 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 policy to the expiry date of the insurance period))
1. Death insurance: (applicable to the basic program and medium program)
Ping An shall pay the stipulated amount of insurance compensation if the Insured dies of any
accident or disease. Insurance liabilities thus terminate.
2. Accidental disability insurance: (applicable to the basic program and medium program)
If the Insured suffers from any accident which results in any disability listed in the Injury and
Disability Assessment Criteria for Personal Insurances 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 Injury and Disability Assessment Criteria for Personal Insurances,
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 Injury
and Disability Assessment Criteria for Personal Insurances 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.
The accumulative amount of accidental injury and disability insurance payment shall not exceed
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the 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: Injury and Disability Assessment Criteria for Personal Insurances, is accessible from the
website of INSURANCE ASSOCIATON OF CHINA.
The accumulative amount of insurance payment of each insured for accidental disability,
accidental death or death of disease shall not exceed the insured sum of the insured’s total insurance
for the accidental disability, accidental death or death of disease.
3. Medical Insurance for Accidental Injury: (applicable to the basic program and medium
program)
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 accidental injury happens
to the Insured for once or several times, the Insurer shall pay the “medical insurance for accidental
injury” respectively in accordance with the foresaid provisions, but the accumulative amount of
payment shall not exceed the insured sum of the Insured. When the accumulative amount of payment
reaches the insured sum of the Insured, the said insurance liability for the said Insured shall be
terminated.
That is: the accidental injuries such as bruises of bumps, burns, sprained ankle, accidental cut-
wound when cutting vegetables, scratches and 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 social 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 time , the daily limit for
outpatient is RMB600. (that said, for the medical expense of the day exceeding RMB 600 shall be
calculated as RMB600, for the medical expense of the day not exceeding RMB600 shall be
calculated by the actual amount). The remaining amount of the medical expenses exceeding the
deductible RMB900 yuan on the basis of the daily limit 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, isolation due to infectious diseases that is certified by the public hospital or
department of public health and epidemic prevention, 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 treatment.
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That is: 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
-900)*85%=reimbursable amount (the total amount of the reasonable expense excludes the self-paid or
partly self-paid items and expenses stipulated by the local regulations of the social basic medical
insurance)
Notes:
Daily limit: The top claim limit of available medical cost
Deductible: RMB 900 yuan (A total of RMB900 yuan is deducted accumulatively for one
time during an insurance period). Below the deductible, 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 30 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.
That is : 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 social 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 the Mainland China;
However, for the insured who are treated in sub-branch of public hospitals, 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, shall be excluded from the insurance, then all medical expenses
incurred by such shall not be covered by the insurer.
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 social 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
continuously insured, the first 30 days since the purchase of the insurance is waiting period
(observation period). Where the insured is hospitalized or treated in outpatient during the
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waiting period and related medical cost is occurred, the insurer bears no liability of
compensation. The treatment for the insured of continuously insured or 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 social basic medical insurance. But the limited portion
of the fees for the bed, nursing, outpatient and emergence 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 social
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 Disability Insurance
Ping An shall be exempted from the insurance liabilities for death and 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 law on the part of the Insured;
3. Fighting, drunkenness and active taking, sucking or injection of drugs on the part of the
Insured;
4. Driving under the influence, driving without a legal and valid driving license or driving
a motor vehicle without a 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,
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;
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10. During the period when the Insured suffers from AIDS or is infected with 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 disable outside the mainland China.
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 (Medical Treatment of Accidental Injury,
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 law on the part of the Insured;
3. Fighting, drunkenness and active taking, sucking or injection of drugs on the part of the
Insured;
4. Driving under the influence, driving without a legal and valid driving license or driving
a motor vehicle without a 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
(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, 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
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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 Insured;
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 the Mainland China or in private hospitals within
the Mainland China, and expenses incurred in drug stores and companies of medical
apparatus and instruments;
16. Charge of telephone, transportation, etc. on the part of the Insured;
17. 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.
18. Experimental treatment and costs incurred for medical experiment purpose.
19. The insurant should turn to medical treatment in strict accordance with the hospital
admissions standards. If not, the insurer does not reimburse the cost of hospitalization.
20. Medical treatment fees incurred without consulting in advance by dialing 400 telephone
numbers or not approved.
Insurance premium
Insurance liabilities and insurance premium of the basic program III for foreign teachers and
foreign experts
Insurance Liabilities
Insurance
Amount
(Yuan) RMB
Age 18-45 Age 46-69
Insurance
Premium
(Yuan per
half a year
per person)
Insurance
Premium
(Yuan per
year per
person)
Insurance
Premium
(Yuan per
half a year
per person)
Insurance
Premium
(Yuan per
year per
person)
Liability for Death +
Accidental Disability
100000
900 1500 1200 1900
Medical Treatment for
Accidental Injury
20000
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Medical Treatment for
Outpatient and
Emergency
(With daily limit up to
RMB 600 yuan, the
medical expenses
exceeding the deductible
RMB 900 yuan will be
reimbursed at a
percentage of 85%)
20000
Hospitalization Medical
Treatment
400000
Note: Matters not mentioned herein shall be executed according to “Ping An Additional Disability
Guarantee Group Accident Insurance (2013) (Clause D)”, “Ping An One-year Group Term Life
Insurance”, “Ping An Additional Accidental Injury Group Medical Insurance”, “Ping An Inpatient,
Outpatient and Emergency Comprehensive Group Medical Insurance” and “Ping An Inpatient Group
Medical Insurance”.
If any dispute arises concerning the contents mentioned above, the Chinese interpretation shall
prevail.
Do be sure to firstly call 4008105119 to make a diagnosis inquiry before you go to see a
doctor.
Dear customers:
If you want to learn about the services of settlement of 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 occurrence of insurance accident:
1. Please call directly 4008105119 for medical consultation due to disease or accident. The rescue
doctor will provide consultation, diagnose, and medical guidance and instructions on 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.
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2. Major accident can be reported through the following contact information
Telephone number for claim consultation and reporting: 4008105119.
You cannot get compensated without reporting through the 400 call or following the standard
procedures.
(2) Document to be presented for settlement of claims:
1)．Death or accidental disability
A. Copies 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 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) Medical treatment for accidental injuries
A. Copies of passport and visa page of the Insured
B. Process and certificate of accident (in case of 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 (date of examination and 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 (date of examination and date of invoice shall be corresponding
with each other).
If the fees reaches the deductible of RMB900 Yuan, then the original invoice, medical record,
detailed expenditure sheet and copy of examination report and laboratory test report of
treatment that costs below 900 Yuan are also required to be presented..
4)．Hospitalization
A. Copies of passport and visa page of the Insured
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B. Certificate of accident in case of an accident (in case of 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 the mainland China and accurate information of this account,
including account No. , name, opening bank information, which can be obtained from copy of deposit
book and bank costumer table, i must be attached to the claim settling documents for each request for
compensation; (For 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, and requested items and expenses that can be reimbursed should in accordance with the scope
of local regulations of social basic medical insurance.
5)． Application for nursing fee
Original Invoices of nursing fee issued by hospital or by nursing service company
Materials for claims of 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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This material is for your information; the final right of interpretation of above content belongs to Ping
An Annuity Insurance Company, Ltd.
Chinese explanation prevails in case of contradiction arising out of the aforementioned contents.