Article 1 Composition of an insurance contract

China Life Women's Disease Insurance (II) This Contract (hereinafter referred to as the Contract) consists of the insurance policy and its attached clauses, statements, opinions and approvals, as well as the insurance application, application for reinstatement, health statement and other written agreements related to this Contract.

Article 2 Insurance coverage

All healthy women who are over 16 years old but under 40 years old (such as less than 16 weeks pregnant) can be the insured, and I or people who have insurance interests can apply for this insurance for the insured by China Life Insurance Company (hereinafter referred to as the Company). Babies born after the insured has lived for more than seven days within the validity period of this contract are "incidental insured" (except as otherwise agreed in this contract, excluding the insured mentioned below? Quot Attached to the Insured ").

Article 3 Commencement of Insurance Liability

This contract shall come into effect as of the date when the company agrees to underwrite, collect the first premium and issue an insurance policy. Unless otherwise agreed, the effective date of this contract is the date when the Company begins to assume the insurance liability.

Article 4 Period of insurance

The insurance period of this contract for the insured is from the effective date of this contract to the date when the insured survives to the age of 70; The insurance period of the "insured" in this contract is from seven days to six years after his birth and survival.

Article 5 Insurance liability

During the validity of this contract, the Company shall undertake the following insurance responsibilities:

1. If the insured dies or has a high degree of physical disability, our company will pay the death insurance premium or high degree of disability insurance premium according to the basic insurance amount, and our insurance liability to the insured will be terminated.

2. If the insured dies or has a high degree of physical disability, such as the "collateral insured" still exists, this contract will continue to be valid, and the insurance premium for subsequent periods of this contract will be exempted.

3. When the insured occurs for the first time after the contract comes into effect (or comes into effect) 180 days, and is diagnosed as having one of the specific cancers by a medical institution designated or recognized by the company, the company will pay the cancer medical insurance premium at 40% of the basic insurance amount, but the medical insurance premium payment for each specific cancer is limited to one time.

Four. If the insured occurs for the first time after the contract comes into effect (or comes into effect) 180 days, and is diagnosed as systemic lupus erythematosus by a medical institution designated or recognized by the company, the company will pay 20% of the basic insurance amount of systemic lupus erythematosus medical insurance, but the payment is limited to one time.

5. When the insured suffers from accidental injury or illness 80 days after this contract comes into effect (or comes into effect) 1, and accepts the operation listed in the attached table1,our company will pay the medical insurance premium for the operation according to 5% of the basic insurance amount. However, when the insured receives the operation listed in Schedule 1 at the same operation site due to accidental injury or the same disease, the Company will only pay the medical insurance premium for the operation once.

The insured's first hip fracture was diagnosed as osteoporosis by a medical institution designated or recognized by our company. Our company will pay medical insurance for hip fracture according to 5% of the basic insurance amount, but the payment is limited to one time.

7. When the insured is diagnosed with the diseases listed in Schedule 2 by a medical institution designated or recognized by the Company during pregnancy, the Company will pay the medical insurance premium for pregnancy diseases according to the basic insurance amount multiplied by the compensation ratio corresponding to the diseases listed in Schedule 2.

8. Within seven days after birth, the "collateral insured" is diagnosed with one of the specific congenital diseases by a medical institution designated or recognized by our company before the age of six, and our company pays 65,438+05% of the basic insurance premium for congenital diseases. However, regardless of whether the collateral insured suffers from one or more specific congenital diseases, and regardless of the number of births, the payment of congenital disease insurance money is limited to once per person.

9. If the "collateral insured" dies seven days after birth but before the age of six, the Company will pay the death insurance premium at 10% of the basic insurance amount, and the Company's insurance liability for the "collateral insured" will be terminated.

Article 6 Exemption from liability

If the insured dies or suffers from a high degree of physical disability due to one of the following circumstances, the Company shall not be liable for paying death insurance or high degree of disability insurance:

I. Intentional behaviors of the insured and the beneficiary towards the insured;

2. The insured intentionally commits a crime or resists arrest;

3. The insured smokes, smokes or injects drugs;

Four. The insured commits suicide or self-injury within two years from the effective date (or reinstatement) of this contract;

Five, the insured drunk driving, driving without a valid driver's license, or driving a motor vehicle without a valid driver's license;

6. Infected with HIV (HIV positive) or suffering from AIDS during the insurance period;

Seven. The insured dies of illness or causes a high degree of physical disability within 180 days from the effective date (or reinstatement) of this contract;

8. War, military action, riot or armed rebellion;

Nine, nuclear explosion, nuclear radiation or nuclear pollution and diseases caused by it.

When the insured suffers from specific cancer, systemic lupus erythematosus or receives the operation listed in Schedule 1 due to illness within 180 days from the effective date (or reinstatement) of this contract, the Company is not responsible for paying the cancer medical insurance, systemic lupus erythematosus medical insurance or surgical medical insurance.

In any of the above circumstances, this contract is terminated. If the applicant has paid the insurance premium for more than two years, the company will refund the cash value of the insurance policy; If the insured fails to pay the insurance premium for two years, the company will refund the insurance premium after deducting the handling fee.

In any of the following circumstances, the Company shall not be liable for paying the insurance premium for congenital diseases:

1. The applicant or the insured knows that the fetus has a specific congenital disease when concluding this contract;

2. The insured gets married and gives birth in violation of the Marriage Law of the People's Republic of China;

3. The insured gives birth in violation of the Law of the People's Republic of China on Maternal and Infant Health Care;

4. "collateral insured" was diagnosed with specific congenital diseases after six years old.

If the insured or beneficiary's intentional behavior towards the "collateral insured" leads to his death, the Company will not be responsible for paying insurance benefits for the death of the "collateral insured".

Article 7 Insurance premium

The delivery methods of insurance premiums are divided into batch delivery and annual delivery. The payment period of annual insurance premium is divided into five years, 10 years, 15 years and 20 years. The delivery method and payment period of insurance premium shall be selected by the insured at the time of insurance.

Article 8 After the first payment, the insurance premium delivery, grace period and contract effectiveness shall be suspended.

If the insurance premium is paid annually, the insurance premium after the first installment shall be delivered to the company on the corresponding date when this contract takes effect every year. If the applicant fails to pay the insurance premium on time, the grace period is 60 days from the next day; In the event of an insurance accident within the grace period, the Company shall still bear the insurance liability; If the insurance premium is not paid within the grace period, this contract shall be suspended from the day after the expiration of the grace period.

Article 9 Restoration of Contract Effectiveness

Within two years from the date of termination of this contract, the applicant can fill in the application form for reinstatement, and provide the health statement of the insured or the medical report issued by the medical institution designated or recognized by the company to apply for reinstatement of the contract. With the consent of our company, this contract will resume its effectiveness from the day after the insured pays the insurance premium and interest owed.

If both parties fail to reach an agreement within two years from the date of termination of this contract, the company has the right to terminate this contract. If the applicant has paid the insurance premium for more than two years, the company will refund the cash value of the insurance policy; If the insured fails to pay the insurance premium for two years, the company will refund the insurance premium after deducting the handling fee.

Article 10: Tell the truth.

When concluding this contract, the Company shall clearly explain the terms of this contract, especially the exemption clauses, and may make written inquiries to the applicant and the insured, and the applicant and the insured shall truthfully inform them.

If the applicant intentionally conceals the facts, fails to fulfill the obligation of telling the truth, or fails to fulfill the obligation of telling the truth due to negligence, which is enough to affect the company's decision on whether to agree to underwrite or increase the insurance premium rate, the company has the right to terminate this contract.

If the applicant intentionally fails to fulfill the obligation of telling the truth, the company will not be responsible for paying the insurance premium or returning the insurance premium for the insurance accident that occurred before the termination of this contract. If the insured fails to fulfill the obligation of telling the truth due to negligence, which has a serious impact on the occurrence of the insured accident, the company will not be responsible for paying the insurance premium for the insured accident that occurred before the termination of this contract, but can refund the insurance premium.

Article 11 designation and change of beneficiaries

The insured or the applicant may designate one or more persons as beneficiaries. If there are several beneficiaries, the order and share of benefits can be determined; If the benefit share is not determined, the beneficiary shall enjoy the benefit right according to the equal share.

The insured or the applicant may change the beneficiary, but it shall notify the Company in writing, which will take effect after the Company annotates the insurance policy.

When the applicant designates or changes the beneficiary, he must obtain the written consent of the insured. If the insured is a person without or with limited capacity for civil conduct, his guardian shall designate the beneficiary.

The beneficiary of high disability insurance, various medical insurance, death insurance with the insured and congenital disease insurance is the insured, and the Company does not accept other designations and changes.

Article 12 Identification of High Physical Disability

If the insured suffers from a high degree of physical disability due to accidental injury or illness, it shall be appraised by an institution designated or recognized by the Company after the treatment. If the insured fails to complete the treatment within 180 days from the date of accidental injury or illness, it will be identified according to the physical condition on 180 days.

Article 13 Notice of Insurance Accident

The applicant, the insured or the beneficiary shall notify the Company in writing within 10 days from the date of knowing the accident, otherwise, except for the delay caused by force majeure, the applicant, the insured or the beneficiary shall bear the additional survey expenses due to the notice delay.

Article 14 Application for insurance money

1. When the beneficiary applies for receiving the death insurance money of the insured or the death insurance money of the "accidental insured", he/she shall fill in the application form for payment of insurance money and submit the following documents and materials:

1, insurance contract and payment voucher of the latest premium;

2, the beneficiary's household registration certificate and identity documents;

3. The death certificate of the insured issued by the public security department or the hospital at or above the county level (including the county level)? Quot Attach the death certificate and birth certificate of the insured;

4, the insured or "mortgage insured" household registration cancellation certificate.

Two, the beneficiary to apply for high disability insurance, should fill in the application for payment of insurance benefits, and submit the following certificates and materials:

1, insurance contract and payment voucher of the latest premium;

2, the beneficiary's household registration certificate and identity documents;

3. Appraisal of the degree of physical disability of the insured by the institution designated or recognized by the Company.

Three. When applying for receiving various medical insurance benefits or congenital disease insurance benefits agreed in this contract, the beneficiary shall fill in an application for payment of insurance benefits and submit the following documents and materials:

1, insurance contract and payment voucher of the latest premium;

2, the beneficiary's household registration certificate and identity documents;

3. Birth certificate or household registration certificate of the "accidental insured" (applying for congenital disease insurance);

4. The diagnosis certificate, relevant examination, pathological section and operation report issued by the medical institution designated or recognized by the company.

When necessary, the company has the right to review the disease diagnosis results of the insured or the "collateral insured", and the expenses shall be borne by the company. When the insured or beneficiary disagrees with the diagnosis result of the company, the medical technical appraisal organization established by the local people's government at or above the prefecture level shall conduct medical technical appraisal.

4. After receiving the applicant's application for payment of insurance benefits and the above-mentioned certificates and materials, the Company shall fulfill its obligation to pay insurance benefits within 10 days after reaching an agreement with the applicant on payment of insurance benefits; For those who do not belong to the insurance liability, the company will issue a notice of refusal to pay insurance money to the insured.

5. The right of the insured or beneficiary to claim the payment of insurance money from the Company shall be extinguished if it is not exercised within five years from the date of knowing the occurrence of the insured accident.

Article 15 Deduction of arrears

When the company pays the insurance premium and returns the cash value or insurance premium of this contract, if the insured owes the insurance premium, the company has the right to deduct the arrears in advance.

Article 16 Changes of Contract Contents

During the validity period of this contract, the applicant can fill in an application for change and make changes to the relevant contents of this contract. After the approval of the company, the company will annotate the original insurance policy, issue an approval form or conclude a written change agreement with the applicant.

Article 17 Change of domicile or address

When the applicant's domicile or mailing address changes, it shall promptly notify the company in writing. If the applicant fails to notify in writing, the company will issue the relevant notice according to the last known residence or mailing address.

Eighteenth age calculation and age error processing

The insured's insurance age is calculated at one year old. When applying for this insurance, the applicant should fill in the true age of the insured on the insurance application form. If there is any mistake, the company shall handle it according to the following provisions:

1. If the age of the insured declared by the applicant is not true, and its true age does not reach the age limit agreed in this contract, the Company may terminate this contract and refund the insurance premium to the applicant after deducting the handling fee, except that it has been more than two years since the effective date of this contract.

2. If the age of the insured declared by the applicant is untrue, resulting in the actually paid insurance premium being less than the payable insurance premium, the Company has the right to correct and require the applicant to pay the insurance premium and interest, or pay the insurance premium in proportion to the actually paid and payable insurance premium.

3. If the age of the insured declared by the applicant is untrue, resulting in the insurer actually paying more insurance premiums than the insurance premiums payable, the Company shall return the overcharged insurance premiums to the applicant without interest.

Article 19 Handling of the Applicant's Termination of the Contract

After the establishment of this contract, the applicant may request to terminate this contract in writing, but the applicant shall not terminate this contract if the company has paid any insurance benefits agreed in this contract. When the applicant proposes to terminate this contract, it shall submit the insurance contract, the latest insurance premium payment certificate, and the applicant's household registration certificate and identity certificate.

This contract shall be terminated as of the date when the Company receives the application for termination of the contract. If the applicant requests to terminate the contract within ten days after signing the insurance policy, the company will refund all the insurance premiums received, but the medical examination fee shall be deducted if the applicant passes the medical examination. If the applicant has paid the insurance premium for more than two years, the company will refund the cash value of the insurance policy; If the insured fails to pay the insurance premium for two years, the company will refund the insurance premium after deducting the handling fee.

Article 20 Dispute settlement

The settlement of contract disputes shall be agreed by the parties to the contract to choose one of the following two ways:

1. Any dispute arising from the performance of this contract shall be settled by both parties through consultation; If negotiation fails, it shall be submitted to the Arbitration Commission for arbitration;

2. Disputes arising from the performance of this contract shall be settled by both parties through consultation. If negotiation fails, a lawsuit shall be brought to the people's court with jurisdiction in the place where the insurance policy is issued.

Article 21 Interpretation

In this article, the terms are defined as follows:

Effective date: the corresponding date of the annual effective date is the corresponding date of the annual effective date of this contract.

Basic insurance amount: refers to the insurance amount specified in the insurance policy.

Accidental injury: refers to the injury to the body caused by external, sudden, unintentional and non-disease objective events.

AIDS: refers to acquired immunodeficiency syndrome (AIDS).

HIV: refers to human immunodeficiency virus (HIV). The definition of acquired immunodeficiency syndrome should be based on the definition formulated by the World Health Organization. If the HIV antibody is positive in serological test, it can be determined that it is infected with HIV or suffering from AIDS.

Force majeure: refers to unforeseeable, unavoidable and insurmountable objective circumstances.

Interest: refers to the interest of overdue insurance premium, which is calculated by the amount of overdue insurance premium, the number of days and the interest rate. The interest rate is announced by the company once a year.

Handling fee: refers to the sum of the average operating expenses and commissions undertaken by each policy, as well as the fees charged by the company for the insurance responsibilities undertaken by the policy.

High physical disability: refers to one of the following situations:

1. Permanent complete blindness; (Note 1)

Two, two upper limbs above the wrist or two lower limbs above the ankle;

Three, the upper limb is more than one wrist and the lower limb is more than one ankle;

Four, one eye is completely blind forever, and one upper limb above the wrist joint is missing;

Five, one eye is completely blind forever, and one lower limb is missing above the ankle joint;

Six, limb joint function permanently completely lost; (Note 2)

Seven, chewing, swallowing function permanently completely lost; (Note 3)

Eight, the central nervous system function or the function of the chest and abdomen organs is extremely damaged, and you can't engage in any work for life and need help from others to maintain your life. (Note 4)

Precautions:

1. Blindness includes eyeball loss or removal, or inability to distinguish between light and dark, or only eyes and hands. The best corrected visual acuity is lower than 0.02 of the international standard visual acuity chart, or the visual field radius is less than 5 degrees, and the qualified ophthalmologist designated by our company will issue a medical diagnosis certificate.

2. Loss of joint function means that the joint is permanently and completely stiff, or paralyzed, or the joint cannot follow conscious activities.

3. Loss of chewing and swallowing function refers to the state that it is impossible to chew and swallow due to organic disorder or dysfunction caused by reasons other than teeth, and it is impossible to ingest or swallow except liquid food.

In order to maintain the activities of daily life necessary for life, all the help of others means eating, defecating, undressing, living, walking, bathing, etc. These are things that you can't do by yourself and need help from others.

Cancer: refers to a malignant tumor with the characteristics of abnormal proliferation and metastasis of tissues and cells, which is confirmed by pathological examination to be in line with the international classification standard of disease damage and cause of death of the Ministry of Health, and belongs to malignant tumor.

Specific cancer: refers to malignant tumors originating from female reproductive organs and mammary glands, including breast cancer, cervical cancer, endometrial cancer, ovarian cancer, primary vulvar cancer and primary vaginal cancer, but excluding carcinoma in situ.

Systemic lupus erythematosus refers to an autoimmune inflammatory connective tissue disease involving multiple organs, and its diagnostic criteria must meet the following conditions at the same time:

1. The following clinical manifestations and four or more positive laboratory results are required:

1, butterfly erythema or discoid erythema;

2, mild allergies;

3. Oral ulcer;

4. Non-malformed arthritis or joint pain;

5. Serositis (pleurisy or pericarditis);

6. Nephritis (proteinuria or tubular urine or hematuria);

7. Hematological abnormalities (leukopenia or thrombocytopenia or hemolytic anemia);

8, nervous system damage (convulsions or mental symptoms).

Two, to achieve the following two laboratory test results are positive;

1, ANA (antinuclear antibody positive);

2. More than one of the following four:

(1) lupus band test was positive; (2) Lupus cells or antibodies against double-stranded DNA are positive; (3) Anti-Sm antibody was positive; (4) The complement is lower than the normal value.

Hip fracture: refers to femoral neck fracture, intertrochanteric fracture and femoral head fracture.

Osteoporosis refers to a group of bone diseases caused by various reasons and characterized by the decrease of bone tissue volume per unit volume. The main manifestations are persistent bone pain and easy fracture. X-ray plain film showed that trabecular bone became thinner and bone skin became thinner. Diagnostic criteria are clinical symptoms plus physical and chemical indicators. Physical and chemical indexes: the thickness of clavicle cortex decreased to 3.5-4. X-ray film showed that the thickness of cortical bone was 0 mm.

Severe pregnancy-induced hypertension syndrome (preeclampsia and eclampsia); It means that pregnant women have clinical symptoms such as hypertension, edema and proteinuria after 24 weeks of pregnancy, severe convulsions and heart and kidney failure. The manifestations of preeclampsia are blood pressure ≥160/10mmhg (21.3/14.6kpa), proteinuria ┿ to ┿ ┿, edema. Eclampsia is a convulsion based on pregnancy-induced hypertension.

Ectopic pregnancy: refers to the pregnancy in which fertilized eggs are implanted outside the uterine cavity.

Benign hydatidiform mole: an abnormal pregnancy, which is caused by the change of embryonic trophoblast, the proliferation of embryonic trophoblast, the interstitial edema of villi, the disappearance of villi capillaries, a series of blisters of different sizes and the death of embryos. However, the lesion is confined in the uterine cavity, does not invade the myometrium, and does not move to a distant place.

Malignant hydatidiform mole: also known as "invasive or destructive hydatidiform mole", characterized by the invasion of hydatidiform mole tissue into the deep myometrium of uterus or its transfer to other organs, causing local tissue destruction or bleeding, which is quite destructive.

Choriocarcinoma: It is a highly malignant trophoblastic tumor. Trophoblasts lose the original structure of villi or hydatidiform mole, and can be transferred to the whole body through blood at an early stage, destroying organs or tissues.

Specific congenital diseases: refers to one of the following diseases diagnosed by medical institutions designated or recognized by the company:

1. specific trisomy: refers to one of the following three diseases diagnosed by chromosome examination in the hospital:

1. 13 trisomy syndrome: chromosome 13 is abnormal, and three chromosomes appear.

2. 18 trisomy syndrome: Chromosome 18 is abnormal, and three chromosomes appear.

3.2 1 trisomy syndrome: Chromosome 2 1 is abnormal, and three chromosomes appear.

2. Specific congenital heart disease: refers to those who have been examined by echocardiography or cardiac catheterization in the hospital and have been diagnosed as one of the following nine diseases by pediatric cardiac surgery or cardiology:

1. Ventricular septal defect: the ventricular septum separating the left and right ventricles, and there is still a hole after birth.

2. Atrial septal defect: The atrial septum separating the left and right atria still has a hole after birth.

3. Patent ductus arteriosus: After the fetus is born, the ductus arteriosus connecting the pulmonary artery and aorta cannot be closed.

4. Pulmonary valve stenosis: the valve (pulmonary valve) at the junction of the right ventricle and the pulmonary artery is narrowed, resulting in blood flowing out of the right ventricle.

5. Aortic valve stenosis: the valve (aortic valve) at the junction of the left ventricle and the aorta is narrowed, resulting in blood flowing out of the left ventricle.

6. Tetralogy of Fallot: ventricular septal defect, pulmonary artery outlet stenosis, aortic straddle and right ventricular hypertrophy.

7. Complete transposition of the aorta: the pulmonary artery and aortic blood vessels are misaligned with each other, and the connection relationship between the aorta and ventricle is reversed, that is, the aorta comes from the right ventricle and the pulmonary artery comes from the left ventricle.

8. Tricuspid atresia: The valve separating the right heart from the right atrium is underdeveloped, resulting in blood flowing from the right atrium to the right ventricle.

9. Aortic arch stenosis: Aortic blood vessels become narrower at the aortic arch.

3. Congenital hypospadias: refers to the development disorder of the distal urethra of penis in embryonic period, which leads to the downward bending of penis, and the external urethral orifice is located in different abnormal parts on the ventral side of penis.

4. Congenital cataract: refers to different degrees and forms of lens opacity formed during fetal development.

5. Cleft lip and palate: Congenital facial deformity refers to incomplete healing of the upper lip and palate (soft palate or hard palate) at the same time (cleft lip with cleft palate), which was diagnosed by plastic surgery in the hospital.

6. Congenital dislocation of hip joint (surgical treatment): There is no obvious history of trauma after birth, hip instability caused by congenital dysplasia or abnormality of acetabulum and femoral head, and dislocation of hip joint after weight bearing, which was diagnosed by orthopedic examination in the hospital and treated by surgery at the same time.

Albinism: Congenital hypopigmentation, with white or pale pink skin, white hair, nystagmus, photophobia and astigmatism, often accompanied by stunting and mental retardation.

Eight, phenylketonuria: congenital metabolic disease refers to phenylalanine hydroxylase deficiency, leading to phenylalanine metabolism disorder. The clinical manifestations were mental retardation, seizures and hypopigmentation, which were diagnosed by hospital examination.

9. Open spina bifida or fissure: Open spina bifida is a congenital spinal deformity caused by spinal canal insufficiency in embryonic stage, accompanied by myelitis meningocele; Cranial fissure is a congenital abnormal skull development, which is caused by neural tube insufficiency in embryonic stage, accompanied by brain tissue or meningeal tissue bulging. Hospital neurology and neurosurgery diagnosed as open spina bifida and crania.

X. Cerebral palsy: Infants' limb movements are limited due to brain lesions before, during and shortly after birth, which are generally characterized by non-progressive central motor dysfunction, such as hemiplegia, paraplegia, quadriplegia, dyskinesia, ataxia, etc., and have been diagnosed by neurology and neurosurgery of the hospital.