团体人身意外伤害保险 - 【艺龙旅行网】酒店预订 机票查 …

团体人身意外伤害保险 - 【艺龙旅行网】酒店预订 机票查 … HUATAI INSURANCE COMPANY OF CHINA LIMITED OVERSEAS TRAVEL PERSONAL ACCIDENT INSURANCE GENERAL PRINCIPLES ARTICLE 1 COMPOSITION OF INSURANCE CONTRACT This Insurance Contract (hereinafter referred to as “this Contract”) is composed of insurance clause, proposal form, insurance policy, insurance certificate and endorsement. Any agreement refers to this Contract should be in written form. ARTICLE 2 THE INSURED The Insured should be a natural person, who is more than 1 year's old (refer to Definition 28.1) but less than 80 year’s old (including 1 year’s old and 80 year’s old), in healthy condition, who can work and live normally, who travels individually or with tour group out of territory of the People’s Republic of China (refer to Definition 28.2) ARTICLE 3 THE POLICYHOLDER 3.1 A person with full capacity for civil acts and having an overseas trip or any other person who has insurable interest in the body of the insured. 3.2 A lawful agency, enterprise, public institution or organization that has insurable interest in the body of the insured. ARTICLE 4 THE BENEFICIARY 4.1 Beneficiary of Death Benefit The Insured/Policyholder may designate one or more persons as the Insured’s beneficiary (beneficiaries) at the time the Contract if concluded. In case of many beneficiaries the Insured may determine benefit sequence and shares. In the event of no benefit share, each beneficiary in the event of the Insured’s death will receive an equal share. The designation of the beneficiary (beneficiaries) by the Policyholder should be authorized by the Insured. Under any of the following situations, the insurance amount shall be deemed as the estate of the insured party upon the death of the insured party and the insurer shall perform the obligation of paying the insured amount in accordance with the Law of the PRC on Inheritance: 4.1.1 No beneficiary is designated, or the designation of beneficiary is unclear and incapable of being determined; 4.1.2 The beneficiary passed away before the insured party and there is no other beneficiary; 4.1.3 The beneficiary forfeits his beneficiary interest in accordance with laws and there is no other beneficiary. If the beneficiary and the Insured have passed away in the same event and the sequence of death is incapable of being determined, it shall be deemed that the beneficiary passed away before the Insured. The Insured or policyholder may change the beneficiary (beneficiaries) and notify the Insurer of any such changes in writing. The Insurer shall make the necessary endorsement on the insurance policy upon receipt of written notification in respect of change of beneficiary (beneficiaries). The 1 Insurer will not be held liable for legal disputes arising from the designation of or modification to the beneficiary. The Policyholder may designate and change the Beneficiary of the Death Benefit subject to the written consent of the Insured or his/her custodian. The guardian of the Insured may designate and change the Beneficiary when the Insured is without full capacity for civil acts or limited capacity for civil acts. 4.2 Beneficiary of the Disability Benefit The beneficiary of the Disability Benefit should be the Insured, unless specified otherwise in the insurance contract. BENEFITS ARTICLE 5 POLICY BENEFITS Where the Insured with valid identity certificate dies, disabled or burned due to accidental injury during the overseas trip, the Insurer shall pay the following benefits: 5.1 Accidental Death During the Insurance Period, the Insured with valid identity certificate encounters an accident during an overseas trip and died within 180 days directly due to the occurrence of such accident, the Insurer shall pay the Accidental Death Benefit, and the insurance liabilities of the Insurer to the Insured hereunder shall be terminated upon payment of such Accidental Death Benefit. During the Insurance Period, the Insured with valid identity certificate encounters an accident on an overseas trip and disappears directly due to the occurrence of such accident, as a result of an accident and is pronounced dead by the People’s Court, the Insurer will pay the death benefit to the beneficiary. If the Insured subsequently found to be living then all benefits paid to the beneficiary must be refunded to the Insurer by the receiver of the accident benefit within 30 days upon the Insured is found alive. Where the Insured has received the Accidental Disability or Burns Benefit (refer to Definition 28.5) as specified in Article 5.2 and 5.3 hereof prior to his or her death, the Accidental Death Benefit shall be the balance of the insured amount specified in the insurance policy or the insurance certificate deducting the paid Accidental Disability Benefit. 5.2 Accidental Disability Benefit During the Insurance Period, if the Insured encounters an accident on an overseas trip, resulting the injury and disability to the Insured as listed in the Schedule of Benefits for Dismemberment (short as Schedule 1) attached hereto within 180 days directly due to the occurrence of such accident, the Insurer shall pay the Accidental Disability Benefit by multiplying the proportion of payment as listed in the said Schedule by the insured amount as specified in the insurance policy or insurance certificate. If the medical treatment thereon yet to be finished, a disability thappraisement on the Insured shall be made on the 180 day upon occurrence of such accident, and the Company shall pay the Accidental Disability Benefit to the Insured based on the result of such disability appraisement. 5.2.1 If the Insured encounters an accident, resulting two or more instances of injury and disability to the Insured as listed in the Schedule of Benefits for Dismemberment attached hereto, the Company shall pay the total amount of these payable Accidental Disability Benefit to the Insured. Provided, however, if the aforesaid instances of injury and disability occur to the same hand or 2 same foot (refer to the Definition 28.6), the Insured is only entitled to the sum of one of Accidental Disability Benefits receivable therein. If the degrees of such disabilities are different, the Insured is entitled to the Accidental Disability Benefit whichever higher. 5.2.2 If accidental Disability Benefit(s) paid for the previous accident(s) shall be deducted. For this purpose, the disability benefit corresponding to the disability listed in the Schedule 1 caused by any accidental injury prior to the effectiveness of this insurance or caused by any event of exclusions, or the Accidental Disability Benefit(s) paid by the Company, shall all be deemed as the Accidental Disability Benefit(s) paid for the previous accident(s). So it shall be deducted from the Disability benefit. 5.3 Accidental Burn/Scald Benefit During the insurance period if the Insured with valid identity certificate encounters an accident on an overseas trip, resulting the disability to the Insured as listed in the Schedule of Benefits for Third Degree Burn/Scald attached hereto within 180 days directly due to the occurrence of such accident, the Company shall pay the Accidental Burn/Scald Benefit by multiplying the proportion of payment as listed in the said Schedule by the insured amount as specified in the insurance policy or insurance certificate. If the medical treatment thereon yet to be finished, a disability thappraisement on the Insured shall be made on the 180 day upon occurrence of such accident, and the Company shall pay the Accidental Burn/Scald Benefit to the Insured based on the result of such disability appraisement. If the Insured encounters an accident, resulting two or more instances of disability to the Insured as listed in the Schedule of Benefits for Third Degree Burn/Scald attached hereto, the Company shall pay the total amount of these payable Accidental Burn/Scald Benefit to the Insured. If the Insured is entitled to an Accidental Burn/Scald Benefit of a higher degree of disability by combining the disability suffered in an accident with the disability suffered in the previous accident(s), the Company shall pay such benefit according to the proportion of payment for the higher degree of disability, provided that the Accidental Burn/Scald Benefit(s) paid for the previous accident(s) shall be deducted. For this purpose, the disability benefit corresponding to the disability listed in the Schedule of Benefits for Third Degree Burn/Scald caused by any accidental injury prior to the effectiveness of this insurance or caused by any event of exclusions, or the Accidental Burn/Scald Benefit(s) paid by the Company, shall all be deemed as the Accidental Burn/Scald Benefit(s) paid for the previous accident(s). 5.4 Optional Benefit The Insured can add insurance benefits by the means of specified provisions in the insurance policy; the Company shall pay the Insured the insurance benefits for the death, disablement, burns or scald caused by accidents under the following circumstances or in the insurance period, based on the provisions from clause 5.1 to 5.3. 5.4.1 Outdoor activities and entertainment: non-competitive, non-professional, non-commercial sporting activities participated by the Insured organized by the entity with formal operating license 5.4.2 Seasonal sporting activities: non-competitive, non-professional, non-commercial sporting activities participated by the Insured organized by the entity with formal operating license and these activities can only be carried out in certain seasons. EXCLUSIONS 3 ARTICLE 6 EXCULSION BY REASONS The Insurer shall be exempted from the insurance liabilities for the death, burn or disability of the Insured directly or indirectly due to any of the following causes: 6.1 The Insured’s claim arises from deliberate act of the Insured; 6.2 The Insured’s claim arises from self-inflicted injuries or suicide by the Insured, except that the Insured has no ability of civil acts while suicide; 6.3 The Insured’s claim arises from fighting, being attacked or being murdered resulted from the provocative by the Insured’s intentional actions; 6.4 The Insured’s claim arises from pregnancy, miscarriage, abortion, childbirth, sickness or drug allergy; 6.5 Accident caused by any physical check, anaesthesia, plastic surgery or other surgery or medical surgery on the Insured; 6.6 Taking, daubing or injecting drugs not in conformity with doctor’s advice; 6.7 The Insured’s claim arising from any explosion, burning or radiation caused by biological, chemical, atomic energy weapons, atomic or nuclear equipment; 6.8 Tourists attack; 6.9 Criminal offence or arrest resistance by the Insured; 6.10 Accident caused by the delirium or abnormality of the Insured; 6.11 The Insured is infected with bacteria, viruses or parasites (except abscess in the cut due to injury); or the heat stroke and food poisoning of the Insured; 6.12 Directly or indirectly caused by epidemic (refer to Definition 28.7) or pandemic disease (refer to Definition 28.7); 6.13 The Insured’s claim arises from parachute, glide, expedition (refer to 28.9), martial (refer to 28.10) arts competition, wrestling competition, stunt performance, horse racing, equestrianism, motor racing, boxing, or any other high-risk sports or activities; 6.14 The Insured participates in any professional or semi-professional sports activity or the one with bonus or reward; 6.15 The Insured engages or serves in the military missions or any other mission in the capacity of law enforcement officer; 6.16 The Insured is employed and serves on merchant vessels, or engages in naval or air force service; or operates or tests any kind of conveyance as the career; or engages in the occupational activities, such as oil rigging, mining, aerial photography or handling explosives; or engages in occupational activities like mining, oilstone or petroleum or chemical industry, forest harvesting, construction engineering, transportation and working on the water or operating at height; or engages in activities involves any physical labor or mechanic operation; 6.17 The Insured takes a passenger transportation vehicle in an illegal way or hitchhikes a vehicle which is not properly registered with the competent local authority where the accident occurs; 6.18 The Insured participates in aviation or flying activities, including where the Insured serves as a pilot or aircrew, except where the Insured is on a civil flight as a passenger with a paid ticket; 6.19 When the Insured is on a trip for the purpose of receiving medical treatment or 4 recuperation, or the Insured is on a trip against the advice of his or her doctor (refer to 28. 12) or when his or her physical condition is not suitable for a trip; 6.20 Loss caused by the deterioration of disease due to further treatment within the territory of China (refer to 28.13), when the Insured’s physical condition is suitable for trip, but the Insured fails to follow the advice of his or her attending doctor and immediately returns to China. ARTICLE 7 EXCULSION BY PERIODS The Insurer shall be exempted from the insurance liabilities for the death, disability or burns of the Insured resulting from an accidental injury due to any of the following causes or during the following periods: 7.1 War (declared or not), civil war, military action, terrorist action, riot or any other similar armed rebellion; 7.2 The Insured is under the influence of alcohol, drugs or controlled drugs; 7.3 The Insured drives while intoxicated, without valid license (refer to 28.15) or driving any motor-driven vehicle without valid driving certificate thereof; 7.4 When the Insured is arrested or sentenced to imprisonment by the local judicial authority; Upon occurrence of any of the causes mentioned above, which results in the death of the Insured, the insurer shall refund the unearned premium (refer to 28.17) for the Insured. INTERNATIONAL TRAVEL ASSISTANCE SERVICE ARTICLE 8 If the Insured encounters any emergent event or need during the overseas trip, he/she may obtain free information by calling the assistance hotline number indicated in the insurance policy or the insurance certificate and with the scope of assistance provided by the assistance institution or its authorized representative (“Assistance Institution”) designated by the Company, provided that the costs and expenses incurred from use of any of the following assistance services and paid to any service provider shall be solely borne by the Insured. The Assistance Institution will not guarantee the quality of services provided by such third-party service providers, and choice of such services shall be subject to the Insured. 8.1 Medical Assistance 8.1.1 Telephone Medical Consultation 24 hours telephone services can provide medical advice to users. 8.1.2 Recommendation of Medical Service Institution Upon the request of the Insured, to provide the name, address, telephone number, working hours and other information about the doctors, hospitals, clinics, dentists and dentist's clinics (collectively as “Medical Service Provider”). The assistance institution will not provide medical diagnosis or treatment to the Insured. 8.1.3 Appointment for Consultation with Doctors To assisted the Insured in making appointment with the local doctors, provided that all costs and expenses incurred therefrom shall be paid by the Insured. 8.1.4 Arrangement of Hospitalization 5 If the Insured is in serious illness and needs treatment by hospitalization, the assistance institution may assist the Insured in arranging the hospitalization, provided that all costs and expenses incurred therefrom shall be paid by the Insured. 8.1.5 Monitoring Physical Condition during and after Hospitalization Subject to the confidentiality obligation and the applicable conditions of authorization, the assistance institution will monitor the physical condition of the Insured during his/her hospitalization and before he/she returns to the territory of China. 8.2 Traveling Service 8.2.1 Information relating to Vaccination and Visa To provide information about the requirements for visa and vaccination in various countries 8.2.2 Recommendation of Translation Service To provide the address, telephone number, working hours and other information about the local translation service providers at the destination of the trip. 8.2.3 Assistance in Finding the Lost Luggage To assist the Insured who lost his/her luggage during the overseas trip, and contact the relevant entities to find the lost luggage. 8.2.4 Assistance in Finding the Lost Passport To assist the Insured who lost his/her passport during the overseas trip, and contact the relevant entities to find the lost passport. 8.2.5 Information of Embassy and Consulate To provide the address, telephone number, working hours and other information about the suitable embassy or consulate closest to the Insured. 8.2.6 Emergent Message Transmission Service Upon the request of the Insured when he/she is hospitalized during the overseas trip, to transmit the emergent message of the Insured to his/her family, friend or company. INSURED AMOUNT AND PREMIUM ARTICLE 9 The insured amount refers to the maximum amount for compensation or insurance money payment to be paid by the insurer. The insured amount is to be agreed upon by the Applicant and the Insured and shall be expressly indicated in the insurance policy. The Insured shall pay the insurance premium to the Insurer according to thus Contract. The Insurer could stipulate the deductible with the Insured under the clause of this Contract. INSURANCE PERIOD ARTICLE 10 The insured period is to be agreed upon by the Applicant and the Insured and shall be subject to the insurance period indicated in the insurance policy. For a full-year multiple return trips insurance plan, the insurance liability shall be effective at each time when the Insured leaves his/her habitual residence or habitual working place within China directly for the destination of an overseas trip during the insurance period, and shall expire on the following date (whichever is earlier): 6 10.1 The date when the Insured directly returns to his/her habitual residence or habitual working place within China after the overseas trip completes; or 10.2 Upon expiration of the insurance period as specified in the insurance policy or insurance certificate. The Insurer could stipulate the maximum covered days of each trip with the Insured under the clause of this Contract. For a single trip insurance plan, the insurance liability shall be effective on the following date (whichever is later): (1) The effective date of the insurance period as specified in the insurance policy; or (2) The date when the Insured leaves his/her habitual residence or habitual working place within China directly for the destination of an overseas trip during the insurance period. The insurance liability shall end on the following date (whichever is earlier): (1) Upon expiration of the insurance period as specified in the insurance policy or insurance certificate; or (2) The date when the Insured directly returns to his/her habitual residence or habitual working place within China after the overseas trip completes. DUTY OF THE INSURER ARTICLE 11 DUTY OF ISSUING POLICY Upon the formation of this Contract, the Insurer shall issue the insurance policy or the other insurance certificates to the Insured. ARTICLE 12 COMPLEMENT OF EVIDENGCE AND INFORMATION OF CLAIM Where the Insurer deems that the evidence and information provided is incomplete in accordance with the insurance contract, the Insurer shall timely notify the Applicant and the Insured just one time for the request of additional evidence and information. ARTICLE 13 DUTIES OF ASSESSING AND PAYING TIMELY Upon receipt of a claim request from the Insured, the Insurer shall promptly assess if the claim arising from the insured event; If the circumstances are complicated, the assessment shall be done within 30 days, unless specified otherwise in this Contract. The insurer shall notify the Insured result of the assessment; If the claim fall within insurance liability, the Insurer shall pay the insurance amount or claim in respect of insurance liability within 10 days from agreement with the Insured; Upon receipt of a claim by an insurer from the Insured which does not fall within insurance liability, the insurer shall, within 3 days starting from the assessment date, the notification for rejection of the claim by explaining the reasons. ARTICLE 14 ADVANCE PAYMENT If the Policyholder is entitled to the insurance indemnity but the amount of such indemnity can not be ascertained, the Insurer shall, within sixty (60) days upon receipt of the aforesaid Claim for Insurance Indemnity and relevant evidences and materials furnished by the Policyholder, pay to the Policyholder in advance the minimum amount of indemnity ascertainable on the given evidences and materials, and shall pay the remaining difference therein to the Policyholder when 7 the amount of insurance indemnity is finally ascertained. DUTY OF INSURED/POLICYHOLDER ARTICLE 15 PAYMENTS Unless specified otherwise, the Insured shall pay the premium completely upon the confirmation of this Contract. ARTICLE 16 FAITHFUL DISCLOSURE In the conclusion of an insurance contract, the insurer may request relevant information on the insured subject matter or the insured party. The policyholder shall make full and accurate disclosure. Where the policyholder willfully or grossly negligently fails to perform the obligation to make full and accurate disclosure as provided in the preceding paragraph and as a consequence the insurer is required to reconsider underwriting of the insurance or decide on raising the insurance premium, the insurer shall have the right to terminate the insurance contract. The right to terminate an insurance contract as provided in the above paragraph shall be extinguished if the insurer does not exercise such right within 30 days after it has knowledge of the cause for termination of the contract. Where the policyholder fails to perform the obligation to make full and accurate disclosure willfully, the insurer shall not be liable to pay insurance amount or claims for insured events which occurred prior to termination of the insurance contract and shall not refund the insurance premiums. Where the policyholder fails to perform the obligation to make full and accurate disclosure due to negligence and such negligence bears serious effects on the occurrence of insured events, the insurer shall not be liable to pay insurance amount or claims for insured events which occurred prior to termination of the insurance contract but may refund the insurance premiums. An insurance event shall refer to an event which falls within the scope of insurance liability agreed upon in the contract. ARTICLE 17 NOTIFICATION OF MAILING ADDRESS AND RESIDENCE CHANGING The policyholder shall give a written notice to the Insurer in timely manners when the mailing address or the residence of the policyholder is changed; otherwise, all notices sent by the insurer to the last mailing address of the policyholder as indicated herein shall be deemed as duly delivered. ARTICLE 18 NOTIFICATION OF ACCIDENT The Policyholder, the Insured or the Beneficiary shall notify the Insurer within five (5) days upon the occurrence of any insured accident once it becomes aware of or should have become aware of such accident;. If the Policyholder, the Insured or the beneficiary delays to give a notice and so causes the loss of necessary evidence or difficulty in ascertainment of the reason and nature of an accident, the Insurer will not be held liable for the portion that can not be 8 verified except that the Insurer is aware of or shall be expected aware of the accident in another ways. The agreements above exclude the accident arising from force majeure. APPLICATION AND PAYMENT OF INSURANCE AMOUNT ARTICLE 19 APPLICATION OF INSURANCE AMOUNT The Application of the insurance amount must offer sufficient information the Insurer reasonably ask for to support the Insured’s claim. In special circumstances the Insured can not offer the following materials, the Insured shall off other legitimate and valid materials. Where the Insurer fails to verify the truth of evidence and content thereof due to the failure of the claim applicant to provide such evidence timely, the Insurer shall not be liable to pay for the portion that cannot be verified. 19.1 Claim of Accidental death Benefit 19.1.1 Declare of insurance amount payment (declare of claim settlement); 19.1.2 Original insurance policy; 19.1.3 Identification of the Application 19.1.4 Certificate of deregistration of the Insured’s registered permanent residence issued by the public security department, or a death certificate issued by second and above or recognized by the Insurer hospital. If the Insured is pronounced dead, the Applicant shall offer the Certificate of death issued by the People’s Court. If the Insured passed away outside of China, the death certificate or postmortem report of the Insured issued by the embassy or consulate of the People’s Republic of China at the country where the accident occurs or the local government authority where the accident occurs; 19.1.5 Any other evidences and materials required by the Company to identify the nature and cause of the insured accident and the extent of loss. 19.1.6 If the Insured delegates others to make the claim, the Applicant shall offer the document as original proxy contest, identification of client and trustee. 19.2 Claims for Accidental Disability and Burns Benefit 19.2.1 Original insurance policy; 19.2.2 Identification if the Insured; 19.2.3 Disability or burns diagnose testimonial issued by a second or above hospital or medical organization recognized by the Insurer or a judicial expertise institution; 19.2.4 Other related documents provided by the Applicant; 19.2.5 If the Insured delegates others to make the claim, the Applicant shall offer the document as original proxy contest, identification of client and trustee. ARTICLE 20 IDENTIFICATION OF DISABILITY Where the Insured is disabled due to any accidental injury, he/she shall be given a medical identification made by an institution recognized by the Company and with a Judicial Identification License issued by the competent administrative authority, after the end of his/her medical treatment. 9 If the medical treatment is not ended after 180 days upon occurrence of the said accident, the thInsured shall be given a medical appraisement on the physical status on the 180 day upon occurrence of the said accident. ARTICLE 21 PHYSICAL CHECKS AND DEATH IDENTIFICATION During the period of application for claims, the Insurer may demand the Insured to receive a physical check or submit relevant examination report. If the Insured is dead, the Insurer shall have the right to request identification on the insured accident. ARTICLE 22 LIMITATION OF EACH OCCURRENCE The insurance benefit paid by the Insurer for each occurrence will not exceed the limitation of each occurrence of accident as specified in the insurance policy or the insurance certificate. If the amount of insurance benefit payable for an accident hereunder is insufficient to distribute among all the Insured in such an accident according to the amount of insurance benefit per capita as specified in the insurance policy or the insurance certificate, the insurance benefit payable to each Insured shall be reduced at a same proportion. ARTICLE 23 SPECIAL LIMITATION OF INDEMNITY The Insured is only entitled to the benefit under an insurance contract with respect to the insurance indemnity of the same coverage subscribed by Insurer for the same trip. Where the Insurer has subscribed more than one insurance contract with same coverage, the Insurer is only subject to the insurance liability for such coverage under the insurance contract with the highest insured amount. If the insured amounts in such insurance contracts are same, the Insurer is only subject to the insurance liability under one of such insurance contracts. The premiums paid under the remaining insurance contracts shall be refunded. STATUTE OF LIMITATIONS ARTICLE 24 The right of the Applicant to claim from the Insurer for insurance amount shall be extinguished if the right is not exercised within 2 years from the date on which the insured party or beneficiary becomes aware of or should be aware of the occurrence of the insured event. TERMINATION OF THE CONTRACT ARTICLE 25 Upon execution of this Contract and prior to the commencement of insurance period, the Applicant may cancel this Contract by sending a written notice to the Company. When the Applicant intends to cancel this Contract, it shall furnish the following documents and materials: 25.1 Application for cancellation of this Contract 25.2 Original of insurance policy; 25.2 Insurance certificate of premium; 25.3 Identity certificate of the Applicant. Where the Applicant cancels this Contract, the Company will bear no insurance liabilities upon receipt of an application from the Applicant for cancellation of this Contract. Upon 30 days the 10 Insurer receives all the documents and materials above, the insurer shall refund the entire insurance premium. SETTLEMENT OF DISPUTE AND APPLICATION OF LAW ARTICLE 26 If there is any dispute arising from performance of this Contract, it shall be settled by both parties through friendly negotiations; in case no settlement can be reached, both parties shall submit such dispute to the arbitration committee indicated in the insurance policy; in case there is not any arbitration committee indicated in the insurance policy or no settlement can be reached, either party may file an action before the competent people’s court according to law. ARTICLE 27 All disputes related to this Contract and arising from performance of this Contract shall be governed by the applicable laws of the People’s Republic of China (exclude laws of Hong Kong, Macau and Taiwan). ARTICLE 28 DEFINITIONS 28.1 One Full Year of Age means chronological age calculated by the born date of the Insured subject to the date indicated on the valid identity certificate of the Insured. 28.2 Outside of China means the jurisdiction other than the Mainland of the People’s Republic of China, including Hong Kong SAR, Macau SAR and Taiwan Province. 28.3 The Insurer means all the branches of Huatai Insurance Company of China Limited who sign this Contract with the Insurer. 28.4 Accidental Injury means any bodily injury directly and solely caused by any extraneous, sudden, unintentional and non-disease event. 28.5 Accidental burns means burns to the body soft tissue suffered during your journey as a result of Accidental Injury. The burns shall fall under the two or third degree, standards for which are injury of skin (epidermis and underlying tissues, incidental injuries of bones and muscles, soft tissue necrosis, incrustation, and falling out at last) of all layers. Calculation of degree and area of burns shall be subject to evaluation in accordance with the clinical identification standards-the New Nine Classification. 28.6 Limbs mean limbs of human body, including left and right upper limbs, left and right lower limbs. 28.7 Epidemic Refers to a sudden development and rapid spreading of a contagious disease in a region where it developed in an endemic state or within a previously unscathed community. 28.8 Large-scale prevalence of infectious disease refers to a disease in the entire continent or the whole of humanity in the popular. 28.9 Expedition means any actions intentionally put oneself into dangers, with the knowledge of dangers of losing life or suffering from injury under some special natural conditions. Such as driftage in rivers, crossing desert on foot, and exploring virgin forest without traces of human presence. 28.10 Martial Arts means any contest between two or more than two persons, such as judo, karate, tae kwon do, Sanda and boxing, with or without help of any accessory equipment. 11 28.11 Stunt Performance means the special skills such as equestrianism, acrobatics and animal training 28.12 Doctor means a person who is duly registered and providing medical services with a practicing certificate recognized by the applicable laws of the jurisdiction where he/she is practicing, other than the Insured and his/her family members and any person has direct interests with the Insured. 28.13 Within China means the Mainland of the People’s Republic of China, excluding Hong Kong SAR, Macau SAR and Taiwan Province. 28.14 Controlled Medicine means any medicines defined as specially controlled medicines by the Pharmaceutical Administration Law of the People’s Republic of China and any other relevant laws and regulations, including but not limited to any narcotic drugs, psychotropic drugs, toxic drugs and radioactive drugs. 28.15 No valid Driver license means the Insured has one of the following cases: 28.15.1 Do not have the driver license or the driver license has expired; 28.15.2 The vehicle specified in the driver license is not the same with the vehicle the Insured is driving; 28.15.3 Driving bus or business passenger car during probationary period; having explosives, flammable and explosive chemical materials, toxic or radioactive dangerous article on board; towing vehicles during probationary period; 28.15.4 Driving with driver license which is not examined according to the law, detained, withhold, suspend and unregistered; 28.15.5 The driver of all kinds of special or mechanical vehicles without operation certificate issued by relevant department and the driver of business passenger car without qualification certificate issued by relevant department; 28.15.6 Driving during the period that is forbidden to drive according to the law and regulations or relevant regulations of traffic department. 28.16 No Valid Vehicle License indicates one of the following cases: 28.16.1 The vehicle’s registration is cancelled according to the law; 28.16.2 The vehicle with no vehicle license, number plate, temporary number plate or temporary moving license issued by Traffic Control Department of Public Security Organs; 28.16.3 Not taking or passing the technical examination of vehicle safety within the limited examination period. Not taking or passing the technical examination of vehicle safety on time according to law. 28.17 Unearned premium Unearned Insurance Premium = Insurance Premium * (1 - Days from Effectives Date of this Contract)/Insurance Period)*(1 – X%); Day from Effectives Date which is not a full day is equal to a full day; X% means commission rate. 28.18 Force Majeure means the unpredictable, unavoidable and insurmountable objective circumstances. 28.19 The Applicant of the Insurance amount means the heir or the other natural person who has the right of claim according to law of the Insured or the Beneficiary. 12 SCHEDULE OF BENEFITS FOR DISMEMBERMENT (China Insurance Regulatory Commission [1999] No.237) Proportion of Class Item Dismemberment Degree Payment 1 Permanent and total blindness of both eyes (Note 1) Loss of both upper limbs above the wrist or loss of both lower limbs above the ankle 2 Loss of one upper limb above the wrist or loss of one lower limb above the Class 1 ankle 100% 3 Permanent and total blindness of one eye and loss of one upper limb above the wrist 4 Permanent and total blindness of one eye and loss of one lower limb above the ankle 5 Permanent and total loss of functions of arthroses in four limbs (Note 2) 6 Permanent and total loss of functions of mastication or deglutition (Note 3) 7 Extreme malfunctions of central nerve or organs in chest or abdomen, 8 permanent loss of ability to work, total need of others’ assistance to do daily activity necessary for maintaining life existence (Note 4) Class 2 9 Permanent and total loss of functions of two arthroses among three major arthroses of two upper limbs, or two lower limbs, or one upper limb and one 75% lower limb (Note 5) 10 Permanent loss of two thumbs and eight fingers (Note 6) 11 Loss of one upper limb above the wrist, or permanent and total loss of Class 3 functions of three major arthroses of one upper limb 12 Loss of one lower limb above the ankle, or permanent and total loss of 13 functions of three major arthroses of one lower limb 50% 14 Permanent and total loss of functions of binaural hearing (Note 7) 15 Permanent and total loss of functions of ten fingers (Note 8) Loss of ten toes (Note 9) 16 Permanent and total blindness of one eye 17 Permanent and total loss of functions of two arthroses among three major Class 4 arthroses in one upper limb 18 Permanent and total loss of functions of two arthroses among three major arthroses in one lower limb 30% 19 Loss of four fingers in one hand, including thumb and forefinger 20 Permanent contraction of over 5 centimeters in one lower limb 21 Permanent and total loss of functions of language (Note 10) 22 Permanent and total loss of functions of ten toes 23 Permanent and total loss of functions of one arthrosis among three major arthroses in one upper limb Class 5 24 Permanent and total loss of functions of one arthrosis among three major arthroses in one lower limb 20% 25 Loss of thumbs of both hands 13 26 Loss of five toes in one foot 27 Notable loss of eyelids of both eyes (Note 11) 28 Permanent and total loss of functions of one ear's hearing (Note 7) 29 Loss of nose and notable malfunction of olfaction (Note 12) Class 6 30 Loss of thumb and forefinger in one hand, or loss of three or more than three fingers in on hand, including thumb or forefinger 15% 31 Permanent and total loss of functions of three or more than three fingers in 32 one hand, including thumb or forefinger Permanent and total loss of functions of five toes in one foot Class 7 33 Loss of thumb or forefinger in on hand, or loss of two or more than two fingers in one hand among middle finger, ring finger and little finger 10% 34 Permanent and total loss of functions of thumb and forefinger in one hand Notes: (1) Blindness refers to the situation of loss or extirpation of eyeball, or the inability to discern dark and light, or only having the ability to discern hand motion before the eyes, with its best corrected visual acuity below 0.02 as defined in the International Standard Visual Testing Chart, or with its eyeshot radius lower than 5 degree, which shall be evidenced by a certificate of diagnosis issued by a qualified ophthalmologist. (2) Loss of functions of arthrosis refers to the situation that an arthrosis becomes ankylosis or paralysis permanently and entirely, or can not function according to the consciousness. (3) Loss of functions of mastication or deglutition refers to the situation that any malfunction or dysfunction of organs due to any reasons other than the reason caused by teeth, which caused the inability of mastication or deglutition, and the inability of ingesting or swallowing any foods other than liquid diet. (4) The status of total need of others’ assistance to maintain the necessary everyday life activity to sustain the life shall refer to the situation that the inability of ingesting foods, doing urination and defecation, dressing and undressing, getting out of bed and going to bed, walking and bathing by the patient itself, which all need others’ assistance. (5) The three major joints of the upper limbs refer to the shoulder joint, elbow joint and wrist joint, and the three major joints of the lower limbs refer to the hip joint, knee joint and ankle joint. (6) Loss of finger refers to total amputation of the part above the proximal interphalangeal joint (in case of the thumb, it is the proximal interphalangeal joint). (7) Loss of function of hearing refers to the situation that loss of language frequency average hearing is over 90 dB. The said language frequency is 500 Hz, 1,000 Hz and 2,000 Hz. (8) Loss of functions of fingers refers to the situation of amputation of distal interphalangeal joint, or that the finger becomes ankylosis over the proximal interphalangeal joint or the joints of the finger is unable to do activity at random. (9) Loss of toe refers to the situation of amputation over the toe joint. (10) Loss of functions of language refers to the situation that one is unable to make any three 14 sounds of mouth and lip sound, dentilingual sound, mount covering sound and throat sound, which constituting the pronunciation of a language, total amputation of the plica vocalis, or suffering from alogia due to any injury in the language center, which shall be evidenced by a certificate of diagnosis issued by a qualified ENT (ear, nose and throat) doctor, but excluding alogia caused by any psychological disorder. (11) Evident loss of eyelids of two eyes shall refer to a circumstance that eyelids cannot completely cover corneas when eyes are shut. (12) Loss of nose and notable malfunction of olfaction refers to the situation that all or most nasal cartilage is lost and nasal passages of both sides are blocked, causing the difficulty in nasal respiration, which can not be corrected and cured, or loss of function of olfaction in both nasal passages. The “permanent and total” as mentioned above refers to the situation of loss of function remains after 180 days upon occurrence of an accident, but does not refer to the situation of amputation of eyeball, which can be recovered and restored. 15 HUATAI INSURANCE COMPANY OF CHINA LIMITED SCHEDULE OF BENEFITS FOR THIRD DEGREE BURN/SCALD Degree of Burn/Scald Proporti Body Part Item (Third-degree burn/scald area as a percentage of the on of body surface area) Payment 1 No less than 8% 100% Head, Neck and Hand 2 No less than 5% but less than 8% 75% 3 No less than 2% but less than 5% 50% 4 No less than 20% 100% Body (Excluding Head, 5 No less than 15% but less than 20% 75% Neck and Hand) 6 No less than 10% but less than 15% 50% Note: Third degree burn and scald shall mean the injury of surface skin or subcutaneous tissue, and even more serious injury. 16