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Instruction for claims

First Part

1. What if you sick?

Feel uncomfortable? If you need to see the doctor, please call 400 810 5119 first.

2. Where to see a doctor?

Please go to the public hospital of the Mainland China and get the treatment in the outpatient department first, if the situation is getting complicated, please call the hotline.

3. Notices for Registration

When you are in the hospital, please just register in the normal department.

NO special need or international service for the insured.

Buy a booklet and ask the doctor to write the medical record for you everytime.

4. Pay attention to the name your register

Please use the accurate name to register.

You can use one part of your English name to register

5. Other notes

a) Types of expense, need to choose business insurance or self-paid.

b) Go to corresponding department for medical treatment.

Second Part

1. What kind of materials should collect for outpatient?

       a) Outpatient medical record.It is imperative for the doctor to write the outpatient medical record every time.

       b) The original invoice with two stamps.Please collect the original invoices with two seals. In the case of invoice losing, you can’t get reimbursed.

       c) Please keep your laboratory test report, examination report and prescription and then submit all of materials for reimbursement.

       d) Please write a report to show us clearly where, when and how you get injured. Your clear handwritten signature is required.

2. Outpatient policy

Example as plan 2

Within each insurance period, the daily limit for outpatient is RMB600. For the medical expenses exceeding the starting line of RMB650, The remaining amount of the medical expenses exceeding the deductible RMB650 yuan on the basis of the daily limit will be reimbursed at a percentage of 85%.

Example as plan 2

If you have paid an insurance fee at RMB 800,then you have paid RMB 900 on February 1st,2018,paid RMB 400 on May 3rd,and RMB 700 on July 15th all the fees for clinical service are rationaldue to being treated in a local hospital within the insurance period.

The formula for claim settlement{600+400+600-650}*85%=807.50UnitRMB Yuan

3. Requirement for advanced payment

If diagnosis confirms that the insured must be hospitalized and need to apply for the advanced payment,please make sure that you call us before hospitalized.

4. Clarify the reimbursement notices with the doctor.

When you choose selected medicine or treatment which not include in your local Social Insurance category, this part of fee will not be covered by the insurance company. You shall pay for the selective medicine and treatment by yourself.

       Insurance company can only cover insured who treated in general ward.

5. What kind of materials should collect for hospitalization?

The following materials need to be provided when discharge from hospital
(1) Stamped original invoices
(2) Detailed medical expenditure sheet
(3) Copy of hospital discharge summary or medical record of hospitalization

6. How to apply for reimbursement

       a) Application for claim--Necessary materials for claim

       b) Passport Copy

       c) Name of certification--You are required to provide the name of certification in case of the name in the invoices is different from the passport.

       d) Please write a report to show us clearly where, when and how you get injured. Your clear handwritten signature is required.

       e) Information letter of Bank Account--Please go to the bank with your passport and bank card, and ask bank staff to print out your bank account information, which will be used to receive money from insurance company. The information includes: Usernameaccount numberbank name(Bank staff will help you once you show this information to them)

7. Liability Exemption Tips

       a) Private hospital

       b) Ward area for special treatment and needs

       c) Ward area for foreigners

       d) Ward area for high-ranking officials

       e) Driving under the influence,driving without a legal and valid driving license a motor   vehicle without a valid driving license on the part of the Insured.

       f) Pregnancy,miscarriage or delivery on the part of the Insured,infertility treatment,artificial insemination,prenatal and postnatal check,birth control,abortion and complications caused by above-mentioned causes

       g) DeductibleRMB 650,below the deductible,there is no claim (outpatient and emergency medical insurance)

       h) The self-paid or partly self-paid items and expenses cannot be reimbursed

       i) Expenses of orthopaedics,diorthosis,face-lift or rehabilitation therapy by the Insured

       j) Congenital diseases,hereditary diseases,existing disease (disease or symptoms that already exist prior to the date of insurance)

The policy terms and conditions shall be in accordance with Cmprehensive Insurance &Protection Scheme for Foreigners Staying in China of Ping An Annuity Insurance Co.,Ltd.