Article 1 Composition of an insurance contract

This insurance contract (hereinafter referred to as this contract) consists of insurance policies or other insurance certificates and attached clauses, insurance applications, insurance documents related to this contract, health notices, statements, comments, attached approval forms and other written agreements.

Article 2 Insurance coverage

1. Insurance coverage: All urban and rural residents who are over one year old but under sixty years old and are in good health can participate in this insurance as the insured.

Two. Scope of Insured: The insured or any other person who has insurable interest with the insured can apply for this insurance with new china life insurance co Co., Ltd. (hereinafter referred to as the Company) as the insured.

Article 3 Insurance liability

1. During the validity period of this contract, the Company shall bear the insurance liability (except renewal) for the hospitalization medical expenses incurred by the insured in the designated hospital within 60 days after the effective date of this contract:

1. hospitalization fee guarantee: hospitalization fee insurance premium is paid according to the actual hospitalization bed fee of the insured, with the daily payment limit of 20 yuan, and the longest payment day for each hospitalization is 180 days.

2. Guarantee of hospitalization miscellaneous expenses and operation expenses: For the incidental expenses and operation expenses incurred by the insured for each hospitalization, the Company will calculate and pay the insurance premium exceeding 400 yuan according to the proportion specified in Schedule 2. That is to say, the insured must pay 400 yuan for the incidental expenses and operation expenses incurred in each hospitalization, and our company is only responsible for paying the insurance premium exceeding 400 yuan. Miscellaneous expenses and operation expenses refer to general nursing expenses, medical expenses, treatment expenses, diagnosis and treatment expenses, examination expenses, laboratory expenses, radiation expenses, anesthesia expenses, blood transfusion expenses, oxygen delivery expenses, material expenses and operation expenses.

2. During the validity period of this contract, regardless of one or more hospitalization expenses incurred by the insured, the Company shall pay the insurance premium separately according to the provisions in the first paragraph of this article. When the accumulated insurance premium reaches the total insured amount, the effectiveness of this contract will be terminated.

Article 4 Exemption from liability

The Company shall not be responsible for the hospitalization expenses paid by the insured due to one of the following circumstances:

1. The insured intentionally causes the insured to be injured or hospitalized;

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

3. The insured fights, gets drunk, commits suicide, intentionally injures himself, takes drugs or injects drugs;

4. Accidents caused by the influence of alcohol, drugs and controlled drugs on the insured;

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

6. Pre-existing diseases, congenital diseases and hereditary diseases;

Seven, the insured was diagnosed with AIDS or infected with HIV (HIV-positive) period;

Eight, the insured pregnancy, abortion, childbirth, birth control and the resulting injury or disease;

Nine, cosmetic surgery, plastic surgery, congenital malformation correction surgery, dental treatment surgery;

Ten, buy transplanted organs, install artificial organs, buy wheelchairs, pacemakers, hearing AIDS and glasses;

Eleven, the insured engaged in diving, skydiving, rock climbing, adventure activities, martial arts competitions, wrestling competitions, stunts, horse racing, car racing and other high-risk sports;

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

Thirteen, nuclear explosion, nuclear radiation or nuclear pollution and diseases caused by it;

Fourteen, general physical examination, recuperation, rehabilitation, special care or rest;

Fifteen, the social medical insurance management department should pay for drugs, inspection, surgery, treatment and other projects;

Sixteen, without the approval of the health management department of medical charges.

Article 5 Period of insurance

The insurance period of this contract is one year, which will take effect from 0: 00 the day after the company agrees to underwrite, collect insurance premiums and issue insurance policies, until 24: 00 on the agreed termination date.

Article 6 Insurance amount and insurance premium

1. The minimum insured amount of this contract is RMB10,000.00 Yuan. Once the insured amount is determined, it shall not be changed during the insurance period.

2. The insurance premium of this contract shall be paid in one lump sum according to the insured's age and personal hospitalization medical insurance rate table (see Annex 1 for details).

Article 7 Insurance renewal

1. Upon the expiration of the insurance period, the applicant may apply for renewal with the consent of the Company.

Second, the renewal insurance premium is calculated at the rate corresponding to the age at the time of renewal and paid in one lump sum.

3. The Company has the right to adjust the premium rate of this insurance, and the adjusted premium rate will be notified to the applicant, which will be applicable from the date of renewal.

4. If the insured is hospitalized during the insurance period and has not been discharged until the expiration of the insurance period, the hospitalization medical expenses shall be borne by the original policy and the new policy respectively according to the actual occurrence time; If the company does not agree to renew the insurance, the company shall still be liable for the medical expenses incurred in hospitalization within one month after the expiration of the insurance period, and the accumulated insurance premium shall not exceed the insured amount.

Article 8 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 or the insured intentionally fails to fulfill the obligation of telling the truth, the Company has the right to terminate this contract, and 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 applicant and the insured fail to fulfill the obligation of truthful disclosure 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 occurrence of the insured accident is seriously affected, the Company will not be liable for paying the insurance premium for the insured accident that occurred before the termination of this contract, and will refund the unexpired insurance premium after deducting the handling fee.

Article 9 beneficiaries

The beneficiary of the insurance premium under this contract is the insured himself, and the company does not accept other designation or change.

Article 10 Notice of Insurance Accident

The applicant and the insured shall notify the Company within ten days from the date when they know or should know the occurrence of the insured accident. Otherwise, in addition to the delay caused by force majeure, the insured and the insured shall bear the increased exploration and inspection expenses due to the delay in notification.

The insured must obtain the company's consent before seeking medical treatment in non-designated hospitals, otherwise the company will not bear the insurance liability.

Article 11 Application for insurance money

1. When the insured pays the medical expenses within the scope of insurance liability, the insured, as the insured, shall fill in the application for payment of insurance benefits within 30 days after the insured leaves the hospital, and apply to the Company for payment of insurance benefits with the following documents and materials:

1, insurance policy and payment voucher;

2. The household registration certificate and identity certificate of the insured;

3. The medical diagnosis certificate issued by the hospital designated by the company (indicating the full name of diagnosis, brief medical history and treatment process) and the original voucher, settlement list and prescription of hospitalization medical expenses;

4. Other certificates and materials related to confirming the nature, cause and degree of injury of the insured accident.

2. After receiving the application for insurance payment from the insured and the above-mentioned certificates and materials, the Company shall perform the insurance payment within ten days after reaching an agreement with the insured on the amount of insurance. For those who do not belong to the insurance liability, a notice of refusing to pay the insurance money shall be issued to the applicant.

3. If the insured's right to claim insurance money from the Company is not exercised within two years since he knew or should have known that the insured accident occurred, the right shall be extinguished.

4. Where an application is filed by an agent, the power of attorney of the principal and the identity certificate of the agent shall be provided.

Article 12 age determination and error handling

1. The age of the insured is calculated as one year old.

2. When applying for insurance, the applicant shall fill in the true age of the insured on the application form. If there is any mistake, it shall be handled 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 the contract and refund the insurance premium to the applicant after deducting the handling fee.

2. If the age of the insured declared by the applicant is untrue, resulting in the insurance premium actually paid by the applicant being less than the insurance premium payable, the Company has the right to correct it and require the applicant to pay the insurance premium; In the event of an insurance accident, the company will pay the insurance premium according to the ratio of the actually paid insurance premium to the payable insurance premium.

3. If the age of the insured declared by the applicant is untrue, resulting in the insured actually paying more insurance premiums than the insurance premiums payable, the Company shall return the overcharged insurance premiums to the applicant.

Article 13 Change of address

If 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 send the relevant notice according to the last residence or mailing address indicated in this contract.

Article 14 Changes of Contract Contents

During the validity of this contract, the relevant contents of this contract can be changed with the consent of the applicant and the company through consultation. If there is any change in this contract, the Company shall endorse or attach an approval form to the original insurance policy or other insurance documents, or the applicant and the Company shall conclude a written agreement on the change.

Article 15 Handling of the Applicant's Termination of the Contract

After the establishment of this contract, the applicant is unwilling to continue to apply for insurance and no insurance payment has occurred. The applicant may request to terminate this contract by written notice.

1. When the applicant requests to terminate this contract, he shall provide the following certificates and materials:

1, insurance contract;

2. Insurance premium receipt;

3. Application for termination of the contract;

4. The identity certificate of the insured.

2. If the applicant requests to terminate the contract, the insurance liability will be terminated from the date when the Company receives the notice of termination of the contract, and the Company will refund the unexpired insurance premium after deducting the handling fee within 30 days from the date of receiving the above certificates and materials.

Article 16 Dispute settlement

In case of any dispute during the performance of this contract, both parties shall settle it through consultation. If negotiation fails, a lawsuit may be brought to the people's court where the insurance policy is issued.

Article 17 Interpretation

Designated hospital: refers to the public hospital at or above the county level designated or agreed by the company.

Hospitalization: refers to that the insured is admitted to the regular ward of the hospital designated by our company for treatment due to illness or accidental injury, and has gone through the admission and discharge procedures, excluding hospitalization in outpatient department, emergency observation room, other irregular wards or hanging bed.

Disease: refers to the disease that occurs within 60 days after the contract comes into effect (except for regular renewal).

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

Aids: short for acquired immunodeficiency syndrome.

Aids virus: short for acquired immunodeficiency syndrome virus. The definition of acquired immunodeficiency syndrome should be based on the definition formulated by the World Health Organization. If the acquired immune deficiency syndrome virus or its antibody is found in blood samples, it can be considered as infected with AIDS or HIV.

Diving: refers to the underwater movement in rivers, lakes, seas, reservoirs, canals and other waters with the help of auxiliary breathing equipment.

Rock climbing refers to climbing cliffs, building external walls, artificial cliffs, ice cliffs, icebergs and other sports.

Wushu competition: refers to the antagonistic competition between two or more people in judo, karate, taekwondo, Sanda, boxing and other boxing methods and various equipment.

Adventure: refers to the act of deliberately putting yourself in it knowing that there is a danger of losing your life or hurting your body under certain natural conditions. For example, river rafting, hiking through deserts or virgin forests with few people.

Special effects: refers to engaging in equestrian, acrobatics, animal training and other special skills activities.

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

Advance insurance premium: insurance premium ×( 12- the number of months that have passed in this contract) ÷ 12, and less than one month is counted as one month.

Handling fee: 25% of the unexpired premium.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.