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Claim Guide (Effective since August 1, 2014)

时间:2015年11月28日 22:15 来源: 作者:wangjun 点击:
Claim Guide (Effective since August 1, 2014)Dear customers: If you want to learn about the services of settlement of claim of comprehensive insurance for people coming to China of Ping An Endowment Insurance Co., Ltd., please read this guid

Dear customers:

If you want to learn about the services of settlement of claim of comprehensive insurance for people coming to China of Ping An Endowment Insurance Co., Ltd., please read this guide carefully.

(1)Procedures for insurance claims:

Standard procedures of insurance claims after occurrence of insurance accident:

1. Please call directly 4008105119 EXT 1 for medical consultation due to disease or accident. The rescue doctor will consult, diagnose, and provide medical guidance and precautions for insurance claim. After consulting diagnosis and outpatient treatment, if the doctor confirms that further hospitalization is required, the insured can apply for advanced payment of medical expense for hospitalization to the rescue company. After communication and confirmation of the rescue company and hospital, it will be decided whether the advanced payment procedures shall be started. If the insured is directly hospitalized without consulting, diagnosis and recording of doctor of the rescue company and outpatient treatment (including those whose conditions do not meet the requirements of hospitalization but require the outpatient doctor to agree with hospitalization), the rescue company will not be responsible for advanced payment of medical expense for hospitalization. If advanced payment for medical expenses is made without the above procedures, the insured will not be able to get compensation.

2. Major accident can be reported with the following contact information

Telephone number for claim consultation and reporting: 4008105119 EXT 1. You can call 010-67185217 in the areas without telephone number beginning with 400.

You cannot get compensated without reporting through the 400 call or following the standard procedures.

(2)Document to be presented for settlement of claims:

1).One-year term life insurance

A Copy of passport and visa page of the Insured

B Disability certificate when the Insured is disabled (an evaluation report shall be issued by the assigned evaluation body)

C Death certificate of the Insured

D Certificate of relationship between the Insured and all the beneficiaries, and copy of identification proof of the beneficiaries

E Certificate of accident, in case of an accident (in case of traffic accident, the traffic unit should issue a liability confirmation of traffic accident)

F Copy of valid insurance certificate

2).Medical treatment for accidental injuries

A Copy of passport and visa page of the Insured

B Course and certificate of accident (in case of traffic accident, the traffic unit should issue a liability confirmation of traffic accident)

C Original of receipt

D Medical record, detailed expenditure sheet and copy of examination report and laboratory test report of each respective treatment

F Copy of valid insurance certificate

3).Medical treatment for outpatient and emergency

A Copy of passport and visa page of the Insured

B Original of receipt

C Medical record, detailed expenditure sheet and copy of examination report and laboratory test report of each respective treatment

D  Copy of valid insurance certificate

If the fees have exceeded the minimum payment line of RMB650 Yuan, then the medical record, detailed expenditure sheet and copy of examination report and laboratory test report of treatment that costs below 650 Yuan are also required to be presented.

4).Hospitalization

A Copy of passport and visa page of the Insured

B Certificate of accident, in case of an accident (in case of traffic accident, the traffic unit should issue a liability confirmation of traffic accident)

C Original of receipt and detailed expenditure sheet for hospitalization

D Copy of hospital discharge summary or medical record of hospitalization

E Copy of valid insurance certificate

Special instructions to item 2) to item 4) above:

(1) Besides, the Insured’s bank account with signature or school-assigned bank account with school stamp must be attached to the claim settling documents. ( Specific content please dial 4008105119 transfer 1 )

(2). Where in one insured incident, the Insured has to be treated in two or more hospitals, relevant documents such as diagnosis certificate and medical record from relevant hospitals shall be presented.

(3). Hospitals for treatment are limited to the public hospitals within the territory of the Chinese mainland, and items and expenses that can be reimbursed should in accordance with the scope of local regulations of social basic medical insurance.

5). Application for nursing fee

A Original Invoices of nursing fee issued by hospital or by nursing service company

B The application for nursing fee issued by the nursing unit shall be signed by the Insured him/herself and stamped with the official seal of the unit.

Materials for claims of settlement sent to: 北京市朝阳区东三环中路55号双子座B座303室(邮编100022)

Addressee: 来华项目理赔部

Please Dial: 4008105119 转 1

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