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‘乐康健’ 手术保障计划.pdf

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1、樂康健 手術保障計劃 “MediEase” Surgical Benefit PlanAM0114/1701樂康健手術保障計劃疾病或意外往往引致龐大的手術費用,富通保險誠意推出樂康健手術保障計劃,讓您得到更完善的保障。計劃專為初生15日- 65歲人士而設,並提供保障至100歲。只需於保障期內按時繳付保費,計劃便會於保單週年日續保。特高手術賠償額 盡享安枕無憂 計劃設有特高賠償額,保障範圍除手術費外,更包括麻醉師費及 手術室費,讓您安枕無憂。保障範圍 每次住院最高賠償額 ( 港元 )手術費 $200,000- 住院手術費 $200,000- 門診手術費1$20,000麻醉師費 $70,000手術

2、室費 $70,000賠償率 90%身故恩恤津貼 $1,000器官捐贈者額外身故津貼2$2,000請注意:- 本公司保留修訂、調整、取消及 /或補加本計劃的保障及/或任何條款/細則的權利。本公司會在保單週年日最少30天前以書面通知閣下改變後的保費率、保障、條款/細則(如適用)及其生效日期。- 只有在受保人保單生效30天後所出現之疾病而引致之醫療費用,方可包括在本計劃之承保範圍。1 門診手術費包括手術前90天內進行的化驗。如就相同的原因在門診手術後90天內入院,有關的門診手術費將計算在住院手術費的最高賠償額內。2 只適用於在香港進行器官捐贈手術之香港居民。身故恩恤津貼 送上真摯關懷無論因意外離世或

3、不幸身故,我們將提供身故恩恤津貼,為您的 家人送上關懷, 我們更為器官捐贈者送上額外身故津貼。免費環球緊急支援服務 您只要投保樂康健手術保障計劃,無論身在何地,都可享有特別為尊貴客戶而設的 24 小時免費環球緊急支援服務,獲得即時支援。欲知樂康健手術保障計劃的詳情,請致電客戶服務熱線:2866 8898或與閣下的富通保險顧問聯絡。不保項目不論直接或間接,完全或部份,自願或非自願,因下列情況所導致的住院、手術、治療、檢驗的費用、損失及/或賠償,本計劃均不作賠付:1. 任何對有關疾病或受傷所作出的診斷及治療不符合之醫療服務;2. 受保人自殺,自致的受傷,不論當時神智是否清醒;受保人在或因酒精,毒藥

4、,藥物,毒品或鎮靜劑的影響下,或受保人因任何企圖實施或實施的非法或違法行為而引起的受傷或疾病;3. 不育包括體外受孕或其他人工受孕、絕育、懷孕、分娩、墮胎、流產、節育或性機能失常;4. 於受保人17歲前已顯現病徵或症狀或已被診斷之先天性畸型或異常發展之疾病,包括但不限於自閉症、過度活躍症、語言障礙、精神與體能異常及/或其他發展障礙;5. 牙科護理或牙科手術,惟因受傷以致必需進行此類護理或手術者除外;但賠償不包括替換真牙、或牙套或義製器官(例如牙橋或牙冠)之裝設、拆除或替換或有關費用;6. 一般身體檢查、療養、特別看護或靜養、整容或整形手術、非必需施行的手術、口腔頜面外科之手術及/或主要為作診斷

5、掃描、影像學檢驗或物理治療的醫療服務; 7. 扁桃腺、腺樣增殖體、疝氣之治療或手術。但若受保人在接受此類治療或手術時,本計劃已持續生效120天或以上不在此限;8. 有關人體免疫力缺乏病毒(HIV)及/或人體免疫力缺乏病毒的相關疾病(包括後天性免疫缺乏症候群(愛滋病)或其相關的疾病)的治療或檢查;9. 因戰爭(不論已宣戰與否)、內戰、暴動、叛亂、革命或恐佈襲擊而引致的受傷;10. 所有非醫療服務,包括一切可再用物品但不限於輪椅、步行輔助器、支架、各類抽吸器及洗腎機等之醫療物品。重要提示1. 冷靜期權益閣下可於保單發出後21天內,或本公司向閣下或閣下的代表發出通知書後的21天內,以較先者為準,取消

6、已購買的保單及取回已繳之保費金額。通知書應說明保單已備妥,並列明冷靜期的屆滿日期。請參閱香港保險業聯會就冷靜期權益不時發出的最新指引。如閣下決定行使冷靜期權益,閣下需以書面知會本公司有關取消保單的決定。該通知必須由閣下簽署及直接送達本公司(地址:香港干諾道中111號永安中心27樓)。2. 主要產品風險i. 保費調整保費將每年根據受保人已屆的年齡調整,而保費率*將由本公司於續保時釐定。* 保費率會因以下因素而影響,包括但不限於過去的索償紀錄、利率、持續率和費用。本公司將於續保前不少於30日預先以書面通知閣下有關之保費金額。ii. 保單終止在下列情況下最早發生時,本公司有權在保障期結束前終止閣下的

7、計劃:樂康健手術保障計劃為基本計劃樂康健手術保障計劃為附加契約 ( 附加於基本計劃 ) 應繳之保費在 31日的寬限期結束當日仍然未繳清。 應繳之保費在 31日的寬限期結束當日仍然未繳清;或 基本計劃已被取消或退保或終止;或 基本計劃被轉換為清繳保險或展期保險(如適用)。本公司保留不為本計劃續保的權利,惟須於保單週年日30天前發出書面通知。iii. 通脹風險當閣下查閱利益說明表的各項價值時,請注意由於通貨膨脹,未來生活的成本可能會比現時較高。在該等情況下,即使本公司完成所有其保單下的合同義務,閣下可能獲得比實質價值少。3. 其他主要產品風險 樂康健手術保障基本計劃以港元為保單貨幣,附加契約以美元

8、或港元為保單貨幣。閣下可選擇以港元或保單貨幣支付保費。閣下可於投保時指定保單貨幣,但保單一經發出,閣下便不能更改保單貨幣。若閣下以保單貨幣以外的其他貨幣支付保費,本公司會以其參考市場匯率後不時決定的當時的匯率,將有關保費兌換為保單貨幣。本公司將以港元或應閣下要求以保單貨幣發放所有本保單應付的款項。若本公司以保單貨幣以外的其他貨幣向閣下發放款項,該等款項亦將按本公司參考市場匯率後不時決定的當時的匯率兌換。兌換貨幣存在外幣匯兌風險。 樂康健手術保障計劃是由本公司發出的保單,閣下的保單利益受本公司的信貸風險影響。此文件乃資料摘要,僅供參考之用,絕不構成財務、投資、稅務或任何形式的意見。如有需要,請向

9、獨立專業人仕尋求建議。請參閱計劃的條款及細則以獲取更多資料。此文件只適宜於香港分發,不應被詮釋為在香港以外地區提供本公司的任何產品,或就其作出要約或招攬。如在香港境外之任何司法管轄區的法律下提供或出售或游說購買任何富通保險有限公司的產品屬違法,富通保險有限公司在此聲明無意在該司法管轄區提供或出售或游說購買該產品。非保單的立約人(包括但不限於受保人及受益人)不享有執行保單任何條款的權利。合約(第三者權利)條例不適用於保單及以保單為依據而簽發的任何文件。保費表Premium Table年繳保費 ( 港元 ) Annual Premium (HKD)年齡 男性 女性 年齡 男性 女性Age Male

10、 Female Age Male Female0 2,375 1,836 51 2,902 3,7871 2,375 1,836 52 2,993 3,8292 2,222 1,660 53 3,089 3,8783 2,016 1,603 54 3,194 3,9344 1,801 1,368 55 3,332 4,0015 905 887 56 3,475 4,0746 905 887 57 3,631 4,1447 905 887 58 3,781 4,2138 905 887 59 3,964 4,2829 905 887 60 4,194 4,39810 859 887 61 4,4

11、50 4,50011 859 887 62 4,762 4,62412 859 887 63 5,067 4,80713 859 887 64 5,358 5,00214 859 887 65 5,654 5,20615 883 887 16 908 979 66 5,958 5,41017 931 1,054 67 6,260 5,62018 959 1,113 68 6,575 5,83319 989 1,185 69 6,893 6,06920 1,046 1,287 70 7,225 6,32821 1,077 1,362 71 7,576 6,60622 1,108 1,439 72

12、 7,948 6,91023 1,140 1,514 73 8,346 7,24424 1,169 1,587 74 8,774 7,60425 1,238 1,667 75 9,232 7,99326 1,288 1,752 76 9,722 8,41027 1,339 1,828 77 10,242 8,85528 1,393 1,907 78 10,792 9,32829 1,449 1,993 79 11,372 9,83030 1,510 2,071 80 11,770 10,17331 1,562 2,195 81 12,147 10,50032 1,619 2,276 82 12

13、,499 10,80333 1,670 2,345 83 12,825 11,08534 1,708 2,413 84 13,120 11,33935 1,753 2,474 85 13,383 11,56736 1,796 2,561 86 13,610 11,76337 1,837 2,646 87 13,800 11,92738 1,878 2,734 88 13,951 12,05939 1,950 2,826 89 14,064 12,15540 2,025 2,924 90 14,134 12,21741 2,105 3,033 91 14,161 12,24242 2,181 3

14、,154 92 14,188 12,26643 2,247 3,282 93 14,215 12,29144 2,311 3,379 94 14,242 12,31745 2,397 3,444 95 14,267 12,34246 2,477 3,516 96 14,295 12,36747 2,564 3,579 97 14,321 12,39248 2,657 3,644 98 14,346 12,41749 2,740 3,708 99 14,374 12,44250 2,824 3,754以下保費只適用於續保 Below Premiums are for Renewal Only富通

15、保險有限公司於百慕達註冊成立之有限公司FTLife Insurance Company LimitedA company incorporated in Bermuda with limited liabilitiesAM0114/1701“MediEase” Surgical Benefit PlanSerious illnesses and accidents often result in expensive surgical fees. Our “MediEase” Surgical Benefit Plan provides you with better protection an

16、d greater peace of mind. This plan is specially designed for those aged 15 days 65 years, and provides protection up to age 100. The plan will be renewed on the policy anniversary date upon your payment of premium throughout the protection period.Ultra-high Surgical Benefit for Total ProtectionYoull

17、 never need to worry about the bills for your surgery, because the Plan includes a special ultra-high surgical benefit. Besides the surgical expenses, it will also cover the costs for the anesthetist and operating theatre. Benefit Coverage Maximum Benefit perConfinement (HK$)Surgical Benefit $200,00

18、0- In-patient Surgical Expenses $200,000- Out-patient Surgical Expenses1$20,000Anesthetists Fee $70,000Operating Theatre Fee $70,000Reimbursement Percentage 90%Compassionate Death Benefit $1,000Additional Death Benefit for Organ Donor2$2,000Please note:- We reserve the right to revise, adjust, withd

19、raw and/or supplement the benefits payable and/or any clauses/conditions under this plan. We shall notify you in writing at least 30 days before the policy anniversary about the revised premium rates, benefits, clauses/conditions (if applicable) and their effective date(s).- Only medical expenses ar

20、ising from illnesses happen after 30 days of policy effective date are covered in this plan.1 Out-patient Surgical Expenses include laboratory tests performed within 90 days before the operation. If the insured is confined in hospital for the same cause within 90 days after the Out-patient operation

21、, the total amount of the Out-patient Surgical Expenses and the In-patient Surgical Expenses should not exceed the maximum total benefit for the In-patient Surgical Expenses.2 The benefit is only applicable to Hong Kong Residents who have the organ donation operation carried out in Hong Kong.Compass

22、ionate Death Benefit for Extra CareRegardless of the cause of death, whether accidental or natural, a Compassionate Death Benefit will be paid to your family. An additional death benefit will also be provided to organ donor.Free Worldwide Emergency Assistance ServicesWhen you enroll in the “MediEase

23、” Surgical Benefit Plan, you will also enjoy 24-Hour Worldwide Emergency Assistance Services wherever you happen to be.Please call our Customer Service Hotline: 2866 8898 or contact our Insurance Consultant for more details of “MediEase” Surgical Benefit Plan.ExclusionsThis plan shall not cover the

24、expenses of any confinement, surgery, treatment, examination, loss and/or benefit caused directly or indirectly, wholly or partly, voluntarily or involuntarily by any of the following:1. Any medical service that is not consistent with the diagnosis and treatment for the illness or injury;2. Suicide,

25、 self-inflicted injury, while sane or insane; any injury or disease suffered under or because of the influence of alcohol, poison, medication, drug, and sedatives or resulting from any unlawful or illegal act (whether attempted or committed) of the insured;3. Any condition resulting from infertility

26、 including in-vitro fertilisation or any other artificial induction methods, sterilization, pregnancy, childbirth, abortion, miscarriage, birth control or sexual dysfunction;4. Any congenital anomalies or developmental problems including but not limited to Autism, Attention Deficit Hyperactivity Dis

27、order, language disorders, mental/physical disorders and/or other developmental disabilities of which signs and symptoms have manifested or diagnosis has been made before the insured attains the age of 17;5. Dental care or surgery unless necessitated by Injury and not being replacement of natural te

28、eth or installation, removal or replacement of denture or prosthesis such as bridges and crowns or related expenses;6. General check-up, convalescence, custodial or rest care or any cosmetic or plastic surgery or elective surgery, oral and maxillofacial surgeries, and/or any medical service that is

29、primarily for diagnostic scanning and examination or physical therapy;7. Treatment or surgery for tonsils, adenoids, hernia until the insured has been continuously covered under this Plan for a period of 120 days immediately preceding such treatment or surgery;8. Treatment or tests related to Human

30、Immunodeficiency Virus (HIV) and/or HIV-related illness including Acquired Immune Deficiency Syndrome (AIDS) or AIDS-related complex;9. Any injury resulted from war, declared or undeclared, civil war, strike, riots, revolution or terrorists acts;10. Any non-medical services including all reusable it

31、ems but not limited to wheelchairs, walking aids, braces, aspirators of any kind, haemodialysis machine and so forth.Disclosure of Important Information1. Cooling Off RightYou may cancel your policy and get back your premium paid within the earlier of 21 days after the delivery of the policy or the

32、issue of a notice to you or your representative. Such notice should inform you of the availability of the policy and expiry date of the cooling-off period. Please refer to the cooling off initiative issued by the Hong Kong Federation of Insurers from time to time for reference. You have to tell us b

33、y giving a written notice if you determine to exercise your cooling off right. Such written notice must be signed by you and received directly by us at 27/F, Wing On Centre, 111 Connaught Road Central, Hong Kong.2. Key Product Risksi. Premium AdjustmentWe will adjust premiums yearly according to the

34、 attained age of the insured and at a rate* to be determined by us at the time of renewal.* Rates are determined based on factors including but not limited to the actual experience of claims, interest rate, persistency and expense.We will issue a written notice to inform you the premium amount at le

35、ast 30 days in advance of premium renewal.ii. TerminationWe have the right to terminate the plan before the end of the protection period upon the earliest occurrence of the following circumstances:“MediEase” Surgical Benefit Plan as a Basic Plan“MediEase” Surgical Benefit Plan as a Rider (which will

36、 be attachedto a basic plan) Non-payment of premiums at the end of the grace period of 31 days from its due date. Non-payment of premiums at the end of the grace period of 31 days from its due date; or the basic plan is cancelled or surrendered or terminated; or the basic plan is converted into paid

37、-up or extended term insurance plan (if applicable).We reserve the right not to renew this plan by giving at least 30 days notice in writing to you before any policy anniversary.iii. Inflation RiskWhen you review the values shown in the benefit illustrations, please note that the cost of living in t

38、he future is likely to be higher than it is today due to inflation. In that case you will receive less in real terms even if we meet all of our contractual obligations under the policy.3. Other Key Product Risks Basic plan of “MediEase” Surgical Benefit Plan is issued in HK dollar and the rider is i

39、ssued either in US dollar or HK dollar. Premiums shall be paid either in HK dollars or in policy currency only. You can specify the policy currency at the time of application. Policy currency cannot be altered once the policy has been issued.The premiums received by us in a currency different from y

40、our policy currency will be converted to the policy currency at the prevailing exchange rate determined by us from time to time with reference to market rates. All monies payable under your Policy will be paid in Hong Kong dollars, or in the policy currency upon your request. The amount payable by u

41、s in a currency different from your policy currency will be converted at the prevailing exchange rate determined by us from time to time with reference to market rates. Therefore it may be subject to foreign exchange risks in the process of currency conversion. “MediEase” Surgical Benefit Plan is an

42、 insurance policy issued by us. The insurance benefits are subject to the companys credit risks.The information in this document is intended as a general summary for your reference only and does not constitute financial, investment or taxation advice or advice of whatsoever kind. You are recommended

43、 to seek professional advice from your independent advisors if you find it necessary. Please refer to the policy provision for the full terms and conditions.This document is intended to be distributed in Hong Kong only and shall not be construed as an offer to sell or a solicitation to buy or provis

44、ion of any of our products outside Hong Kong. FTLife Insurance Company Limited hereby declares that it has no intention to offer to sell, to solicit to buy or to provide any of its products in any jurisdiction other than Hong Kong in which such offer to sell or solicitation to buy or provision of an

45、y product of FTLife Insurance Company Limited is illegal under the laws of that jurisdiction.A person who is not a party to the policy (including but not limited to the insured and the beneficiary) has no right to enforce any terms of the policy. The Contracts (Rights of Third Parties) Ordinance doe

46、s not apply to the policy nor any document issued pursuant to the policy. lPremium Table l Annual Premium (HKD) g g Age Male Female Age Male Female0 2,375 1,836 51 2,902 3,7871 2,375 1,836 52 2,993 3,8292 2,222 1,660 53 3,089 3,8783 2,016 1,603 54 3,194 3,9344 1,801 1,368 55 3,332 4,0015 905 887 56

47、3,475 4,0746 905 887 57 3,631 4,1447 905 887 58 3,781 4,2138 905 887 59 3,964 4,2829 905 887 60 4,194 4,39810 859 887 61 4,450 4,50011 859 887 62 4,762 4,62412 859 887 63 5,067 4,80713 859 887 64 5,358 5,00214 859 887 65 5,654 5,20615 883 887 16 908 979 66 5,958 5,41017 931 1,054 67 6,260 5,62018 95

48、9 1,113 68 6,575 5,83319 989 1,185 69 6,893 6,06920 1,046 1,287 70 7,225 6,32821 1,077 1,362 71 7,576 6,60622 1,108 1,439 72 7,948 6,91023 1,140 1,514 73 8,346 7,24424 1,169 1,587 74 8,774 7,60425 1,238 1,667 75 9,232 7,99326 1,288 1,752 76 9,722 8,41027 1,339 1,828 77 10,242 8,85528 1,393 1,907 78

49、10,792 9,32829 1,449 1,993 79 11,372 9,83030 1,510 2,071 80 11,770 10,17331 1,562 2,195 81 12,147 10,50032 1,619 2,276 82 12,499 10,80333 1,670 2,345 83 12,825 11,08534 1,708 2,413 84 13,120 11,33935 1,753 2,474 85 13,383 11,56736 1,796 2,561 86 13,610 11,76337 1,837 2,646 87 13,800 11,92738 1,878 2,734 88 13,951 12,05939 1,950 2,826 89 14,064 12,15540 2,025 2,924 90 14,134 12,21741 2,105 3,033 91 14,161 12,24242 2,181 3,154 92 14,188 12,26643 2,247 3,282 93 14,215 12,29144 2,311 3,379 94 14,242 12

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