Transcription

1 Domestic Helper Insurance Policy

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3 Domestic Helper Insurance Policy N.B. For your own protection you are requested to read this Policy and the Provisions, Exclusions and Conditions contained herein in order to ascertain that it is in accordance with your intentions. You are also requested to check that the particulars given in the Policy Schedule are true and complete and they will form the basis of your contract with QBE General Insurance (Hong Kong) Limited. If it is not, kindly return immediately for alteration or cancellation, or otherwise, it means you agree to be bound by the following policy terms and conditions. Whereas the Insured carrying on the Business by a Proposal and Declaration which shall be the basis of this contract and is deemed to be incorporated herein has applied to QBE General Insurance (Hong Kong) Limited (hereinafter called the Company) for the insurance herein contained and has paid or agreed to pay the Premium specified herein as consideration for such insurance. SECTION I EMPLOYEES' COMPENSATION Now this Policy witnesseth that if any employee in the Insured's immediate employ shall sustain bodily injury or death by Accident or Disease occurring during the Period of Insurance within the Geographical Area and arising out of and in the course of his employment by the Insured in the Business. The Limit of Indemnity for this Section is maximum HK$100 million any one Accident or Disease. The Company will subject to Policy Limit of Indemnity and to the terms exclusions and conditions contained in or endorsed on this Policy (all of which are hereinafter collectively referred to as "the Terms of this Policy") indemnify the Insured against his legal liability in respect of such bodily injury or death under the Employees' Compensation Ordinance and independently of the Ordinance to pay compensation and damages and claimant's costs and expenses and also indemnify the Insured against costs and expenses incurred by or on behalf of the Insured with the Company's written consent in connection therewith. SECTION II HOSPITAL AND SURGICAL EXPENSES The Company agrees that if as a direct result of bodily injury occurring or sickness contracted and commencing during the Period of Insurance the employee is confined in a hospital on the recommendation and approval of a registered western medical practitioner the Company will subject to written Employment Contract and receipt of satisfactory proofs shall pay to the Insured necessary expenses in respect of doctors' visits and hospital services including all daily room and board expenses incurred by the employee whilst as an inpatient of a hospital but not exceeding HK$300 per day. The Company shall also pay surgical expenses (surgeon's fee, anaesthetist's fee and operating theatre charge) incurred by the employee for surgical procedures performed in the hospital during confinement not exceeding HK$12,000 for each surgery. The overall limit of Hospital and Surgical expenses shall not exceed HK$25,000 during any one period of insurance. The Company shall not be liable for the first HK$300 of a claim in respect of any one accident, injury or confinement. Waiting period: Benefits under this Section shall only be payable in respect of illness contracted after a period of 14 days from the commencement date of this Policy. 1

4 2 SECTION III REPATRIATION EXPENSES The Company agrees that it will indemnify the Insured subject to written Employment Contract to repatriate the employee to his/her home country before the expiry of the employee's term of employment under the following circumstances: 1) In the event of the employee's death, the actual cost incurred in returning the remains, subject to a maximum limit of liability of HK$10,000 during the Period of Insurance; or 2) In the event of a registered western medical practitioner certifying the employee to be medically unfit to complete the term of the contract of employment with the Insured, an economy class air fare from Hong Kong to the employee's home country, subject to a maximum limit of liability of HK$10,000 during the Period of Insurance. SPECIAL EXCLUSIONS TO SECTIONS II AND III No payment shall be made under Sections II and Ill as a result of: a) Bodily injury or sickness, caused directly or indirectly, wholly or partly by: I. self-destruction or intentional self-inflicted injury or any attempt threat, whilst sane or insane; II. Ill. war, declared or undeclared, strikes, riots, civil war, revolutions or any war-like operations; military or naval service in time of declared or undeclared war or while under orders for war-like operations or restoration of public order; IV. any violation or attempted violation of the law or resistance to lawful arrest; V. motorcycling as a passenger or driver, mountaineering or racing (other than on foot); VI. ionizing radiation or contamination by radioactivity; and VII. the employee engaging in air travel, except as a fare-paying passenger in a properly licensed multi-engined aircraft being operated by a licensed commercial air carrier or owned and operated by a commercial concern; b) I. pregnancy, miscarriage or childbirth or complications therefrom; II. mental or nervous disorders, chronic alcoholism, drug addiction, pulmonary tuberculosis after diagnosis as such; Ill. cosmetic surgery unless due to injury, general check-up, physical therapy, convalescence or rest care; IV. installation and cost of hearing aids, eye examination for the correction of vision or fitting of glasses; V. bodily injury or sickness sustained or infirmity existed prior to the date of commencement of this Policy; VI. dental care or surgery unless due to injury; and VII. infertility or complications therefrom. c) Sexually transmissible disease including AIDS (Acquired Immune Deficiency Syndrome) and ARC (AIDS Related Complex). SECTION IV CLINICAL EXPENSES If during the Period of Insurance the employee necessarily seeks medical attention from a registered western medical practitioner in Hong Kong and the Insured is responsible for the expenses actually incurred according to the terms of the written Employment Contract, the Company shall reimburse the Insured the cost of consultation and medicine subject to the following: 1) The Company's liability not to exceed HK$150 per visit per day; and 2) The Company's liability under this Section shall not exceed HK$2,000 during the Period of Insurance. "Visit" shall mean a visit by a registered western medical practitioner to the residence or place of work in Hong Kong of the employee or by the employee to the office, clinic or surgery of a registered western medical practitioner or to the out-patient department of any hospital. The cost of such visit shall be inclusive of any charge for prescribed medicines and drugs from any legitimate source and of any laboratory and x-ray charges incurred on the advice of a registered western medical practitioner but excluding any such charges incurred whilst the employee is an

5 in-patient of any hospital, infirmary or nursing home. SPECIAL EXCLUSIONS TO SECTION IV The Company shall not be liable under this Section in respect of: a) More than one visit per day; b) Infertility or treatment thereof, pregnancy including childbirth, caesarean operation, abortion, miscarriage whether natural or accidental and all complications therefrom; c) Blood and blood plasma; d) Cosmetic or plastic surgery unless due to injury resulting from accident; e) injury or illness sustained or infirmity existed prior to the date of commencement of this Policy; f) Sexually transmissible disease including AIDS (Acquired Immune Deficiency Syndrome) and ARC (AIDS Related Complex); g) Rest cure, physical therapy or general check-up; h) Dental work or treatment unless due to injury resulting from an accident; i) Installation and cost of hearing aids, eye examination for the correction of vision or fitting of glasses; and j) Injury sustained whilst engaging and taking part in any works other than the routine duties of general domestic or household work. SECTION V DENTAL EXPENSES The Company will subject to written Employment Contract reimburse the Insured two-thirds of the actual expenses reasonably and necessarily incurred in respect of emergency dental attention by a legally qualified and registered dentist for the employee up to a maximum of HK$1,000 during the Period of Insurance. SPECIAL EXCLUSIONS TO SECTION V The Company shall not pay any expenses related to: a) Routine examination; b) Scaling, polishing or cleaning; c) Crowning, bridges, braces and dentures; and d) Dental prosthetics involving precious alloy restorations. SECTION VI PERSONAL ACCIDENT The Company agrees during the Period of Insurance if the employee shall sustain any bodily injury caused solely and directly by violent accidental external and visible means and such injury shall be the sole and direct cause of death and disablement occurring within 12 months from the date of accident, the Company shall pay the compensation to the insured upon trust for the employee as follows: Accidental Death HK$100,000 Loss of Two or More Limbs HK$ 100,000 Loss of Sight of Both Eyes HK$ 100,000 Loss of One Limb and Sight of One Eye HK$ 100,000 Loss of One Limb HK$ 50,000 Loss of Sight of One Eye HK$ 50,000 (Loss of limb shall mean physical severance of a hand or a foot at or above the wrist or ankle or of an arm or leg at or above elbow or knee. 3

6 Loss of sight shall mean entire and irrecoverable loss of all sight). Provided that the aggregate liability of the Company under this Section shall not exceed HK$100,000 - any one employee insured during the Period of Insurance. SPECIAL EXCLUSIONS TO SECTION VI No compensation shall be payable in respect of any injury sustained consequent upon or directly or indirectly caused by: a) Motorcycling as a passenger or driver, racing of any kind (other than on foot), hunting, underwater activities involving use of breathing apparatus, diving or any other hazardous sports; b) Whilst engaging and taking part in any hazardous occupation or unlawful activities; c) Flying except as a fare-paying passenger in a fully licensed passenger aircraft; d) Influence of or affected by alcohol, intoxicants or drugs or suffering from venereal disease or insanity or directly or indirectly caused by or contributed to or aggravated by childbirth or pregnancy or the result or consequence thereof; e) Pre-existing physical or mental defect or infirmity existed prior to the date of commencement of this Policy; and f) Suicide (whether sane or insane) or any attempt thereat or intentionally self-inflicted injuries or wilfully exposing to any needless perils except in an attempt to save human life. SECTION VII INFIDELITY The Company shall reimburse the Insured for direct loss of money or property, through any dishonest or criminal act committed by the employee, whilst residing at the residence or address specified in the Policy Schedule and during the Period of Insurance. Provided that: 1) The Company shall not be liable for any loss unless the Company is notified within 15 days of the discovery of the loss; and 2) The Insured must report such dishonest or criminal act committed by the employee to the police immediately. The Company shall then indemnify the Insured on conviction of the employee of such act. The maximum liability of the Company under this Section is HK$10,000 during the Period of Insurance; and Money due by the Insured to the employee shall be deducted from the adjusted loss amount. SECTION VIII UNAUTHORISED TELEPHONE CALLS The Company shall pay the telephone charges resulting from unauthorised telephone calls committed by the employee, whilst residing at the residence or address specified in the Policy Schedule up to a limit of HK$3,000 during the Period of Insurance. Provided that: 1) This dishonest act must be committed during the Period of Insurance; 2) This dishonest act must be discovered during the Period of Insurance or within 30 days after the expiration of this Policy; 3) This dishonest act must be discovered within 30 days after death, dismissal or expiry of the written Employment Contract of the employee; 4) Money due by the Insured to the employee shall be deducted from the adjusted loss amount; 5) Discovery of any dishonest act must be reported to the police within 24 hours; and 6) The burden of proof rests on the Insured that the Insured's financial loss is a result of such dishonest act committed by the employee. 4

7 SECTION IX PUBLIC LIABILITY The Company shall indemnify the Insured for the employee's legal liability in Hong Kong to a third party up to a limit of HK$200,000 any one accident arising during the Period of Insurance as a result of: a) Accidental bodily injury (including death or disease) to any person other than member of the Insured's household; and b) Accidental loss of or damage to property belonging to any person other than member of the Insured's household. The Insured shall bear the first HK$500 in each and every third party property damage claim. SPECIAL EXCLUSIONS TO SECTIONS IX Claim arising directly or indirectly from or in respect of or due to:- a) Any wilful, malicious or unlawful act; b) Pursuit of trade, business, profession or occupation; c) Ownership or occupation of land or building (other than occupation of any temporary residence); d) Ownership, possession or use of vehicles, aircraft or watercraft; and e) Any criminal activity. SECTIONS X REPLACEMENT EXPENSES The Company shall subject to the maximum limit of HK$5,000 in any one Period of Insurance pay the necessary and reasonable expenses incurred by the Insured in hiring a replacement domestic helper in the event of death or repatriation to the country of residence of the insured employee who has been certified by a registered western medical practitioner as medically unfit to complete the written Employment Contract with the Insured. SECTION XI TEMPORARY HELPER ALLOWANCE The Company shall reimburse the Insured for the actual expenses incurred upon submission of receipt evidencing the engagement of service of a temporary domestic helper necessitated by the insured employee's. a) death during the Period of Employment; b) hospitalization as an in-patient for treatment or surgery for a period of 2 consecutive weeks or more; c) repatriation to the country of residence following certification by a registered western medical practitioner that the insured employee is medically unfit to complete the written Employment Contract with the Insured. Provided that the expenses incurred shall not exceed HK$200 a day for a period of 30 days or less and a maximum limit of HK$6,000 in any one Period of Insurance. GENERAL EXCLUSIONS The Company shall not be liable in respect of: a) Any liability of the Insured which attaches by virtue of an agreement but which would not have attached in the absence of such agreement; b) Any sum which the Insured would have been entitled to recover from any party but for an agreement between the Insured and such party; c) Any injury by accident or disease sustained outside the Geographical Area; d) Any injury or sickness sustained or infirmity existed prior to the date of commencement of this Policy; e) Any person who is not an "employee" within the meaning of the Legislation; 5

8 6 f) Any liability arising from pneumoconiosis and noise-induced deafness; g) Any late payment surcharge for which the Insured may become liable under the Employees' Compensation Ordinance; h) Any liability of whatsoever nature directly or indirectly caused by or contributed to by or arising from: I. Nuclear weapons material; II. Ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel and for the purposes of this exception combustion shall include any self-sustaining process of nuclear fission. i) Any liability directly or indirectly caused by or contributed to by or arising from unlawful act or illegal activity. War and Terrorism Exclusion (Including Contamination and Explosives) Excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any of the following regardless of any other cause or event contributing concurrently or in any other sequence to the loss: (1) war, invasion, acts of foreign enemies, hostilities or warlike operations (whether war be declared or not), civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power; or (2) any act of terrorism; or (3) biological or chemical contamination, missiles, bombs, grenades, explosives due to any act of Terrorism. For the purpose of this insurance: (a) an "act of terrorism" means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisation(s) or government(s), committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear; (b) "contamination" means the contamination, poisoning, or prevention and/or limitation of the use of objects due to the effects of chemical and/or biological substances. This insurance also excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to (1), (2) and/or (3) above. If the Company alleges that by reason of this exclusion, any loss, damage, cost or expense is not covered by this insurance the burden of proving the contrary shall be upon the Insured. In the event any portion of this exclusion is found to be invalid or unenforceable, the remainder shall remain in full force and effect. LEVIES The "levy" shown on the Schedule of this Policy include Employees Compensation Insurers Insolvency Bureau Contribution, Employees' Compensation Insurance Levy and The Government Terrorism Facility Charge calculated at 2%, 5.8% and 3% respectively on the premium of this Policy. TERRORISM ENDORSEMENT (Applicable to Section I only) Notwithstanding any provision to the contrary in this Policy or any endorsement thereto it is hereby declared and agreed that this Policy excludes, and no amount shall be payable by the Company in respect of any loss, damage, cost, expense or claim of whatsoever nature ("Loss") directly or indirectly caused by, resulting from or in connection with terrorism (except Terrorism otherwise specified below) regardless of any other cause or event contributing concurrently or in any other sequence to the Loss. The Company shall only be liable to make any payment in respect of any Loss caused by, resulting from or in connection with Terrorism (regardless of any other cause or event contributing concurrently or in any other sequence to the Loss) subject to the following terms and conditions: a) The Policy Limit of indemnity shall be such amount which the Company actually receives from the Government of the Hong Kong Special Administrative Region of the People's Republic of China ("the Government") pursuant to an Agreement for Provision of Facility date

9 11th January 2002 between the Government and the Company under which the Government agreed to make available to the Company and other direct insurance companies authorized to underwrite employees' compensation insurance business in Hong Kong a facility to enable them to meet claims for Loss under employees' compensation insurance policies arising out of an event of Terrorism ("the Facility Agreement"); b) The Company will only be required to make payment after it has received from the Government (i) an approval letter confirming that the Company should settle the claim and (ii) payment under the Facility Agreement; c) For the avoidance of doubt, the Company shall have no obligation to make payment if for whatever reason it does not receive payment from the Government under the Facility Agreement, whether or not due to the Government's contention that the Loss does not fall within the scope of the Facility Agreement or the Company's breach of the Facility Agreement; and d) The Company's liability is limited to the minimum cover required under the Employees' Compensation Ordinance. "Terrorism" means the use of force or violence or other means or the threat thereof, of any person or persons, whether acting alone or on behalf of or in connection with any organization or government, for political, religious, or ideological purposes with an intention to influence any government and/or to put the public, or any section of the public, in fear. If the Company alleges that the Loss relating to Terrorism is not covered by this Policy, the burden of proving the contrary shall be upon the Insured. In the event any part of this Endorsement is found to be invalid or unenforceable, the remainder shall remain in full force and effect. Words and phrases in this Endorsement shall have the same meaning as in the Policy. RIGHTS OF THIRD PARTIES (1) Each party acknowledges that the other party has entered into this Policy on behalf of and for the benefit of itself and its Affiliates and each of the other party s Affiliates shall be entitled to enforce and take the benefit of the terms of this Policy in accordance with the Contracts (Rights of Third Parties) Ordinance (CAP. 623). (2) Subject to clause 1, any person who is not a party to this Policy has no rights under the Contracts (Rights of Third Parties) Ordinance (CAP. 623) or any other applicable law to enforce any term of this Policy. SANCTION LIMITATION AND EXCLUSION CLAUSE No (re)insurer shall be deemed to provide cover and no (re)insurer shall be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose that (re)insurer to any sanction, prohibition or restriction under United Nations Resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America. Subject otherwise to the terms, conditions and exceptions of the Policy. GENERAL CONDITIONS 1) Interpretation This Policy and the Policy Schedule shall be read together as one contract and any word or expression to which a specific meaning has been attached in any part of this Policy or of the Policy Schedule shall bear such meaning wherever it may appear. In this Policy any reference to the singular shall include the plural and vice versa and any reference to one gender shall include the other gender. 2) Observance The due observance and fulfilment of the Terms of this Policy in so far as they relate to anything to be done or complied with by the Insured 7

10 and the truth of the statements and answers in the proposal shall be conditions precedent to any liability of the Company to make any payment under this Policy. 3) Precautions The Insured shall take all reasonable precautions to prevent accidents and disease and to comply with all statutory obligations and regulations imposed by any authority. 4) Claims Upon the happening of any accident or illness which might give rise to a claim under this Policy the Insured shall: I. As soon as possible after the accident or illness to ensure that proper medical and surgical advice is procured and followed on the part of the employee; II. Give notice thereof in writing to the Company as soon as possible but in any case within 2 weeks of the accident or onset of illness; Ill. Not make any admission of liability without the written consent of the Company; IV. Medical reports and all proof of loss as required by the Company shall be furnished at the expense of the Insured and shall be in such form and of such nature as the Company may prescribe; and V. For claims arising under Section I immediate notification should be made to the Labour Department in the format required under the Employees' Compensation Ordinance. 5) Claim Settlement All medical expenses claim settlement are on reimbursement basis. If any medical expenses are payable under more than one section, only the section with the greatest amount payable will apply. 6) Cancellation I. The Company may cancel this Policy by sending 7 days' notice by registered letter to the Insured at his last known address and in such event the Company shall be liable to repay a rateable proportion of the premium for the unexpired term from the date of cancellation; and II. The Insured may cancel this Policy by mailing written notice of cancellation to the Company but in such event no premium will be refunded. 7) Interest The Company shall be entitled to treat the Insured as the absolute owner of the Policy and shall not be bound to recognise any equitable or other claim to or interest in the Policy. 8) Notice Every notice or communication to be given or made under this Policy shall be delivered in writing to the Company. No admission offer promise or payment shall be made by or on behalf of the Insured without the written consent of the Company which shall be entitled if it so desires to take over and conduct in his name the defence or settlement of any claim or to prosecute in his name for its own benefit any claim for indemnity or damages or otherwise and shall have full discretion in the conduct of any proceedings and in the settlement of any claim and the Insured shall give all such information and assistance as the Company may require. 9) Other Insurance If at the time any claim arises under this Policy there be any other insurance covering the same liability the Company shall not be liable to pay or contribute more than its rateable proportion of any such claim and costs and expenses in connection therewith. 10) Age Limit The benefits under this Policy apply only to domestic helpers between the age of 18 to 60 years old. 8

11 11) Arbitration All differences arising out of this Policy shall be determined by arbitration in accordance with the Arbitration Ordinance as amended from time to time. If the parties fail to agree upon the choice of the arbitrator, then the choice shall be referred to the Chairman for the time being of the Hong Kong International Arbitration Centre. It is expressly stipulated that it shall be a condition precedent to any right of action or suit upon this Policy that an arbitration award shall be first obtained. If the Company shall disclaim liability to the Insured for any claim hereunder and such claim shall not within twelve calendar months from the date of such disclaimer have been referred to arbitration under the provisions herein contained then the claim shall for all purposes be deemed to have been abandoned and shall not thereafter be recoverable hereunder. 12) Governing Law This Policy is subject to the exclusive jurisdiction of Hong Kong and is to be construed according to the laws of Hong Kong. 13) Avoidance of Certain Terms and Right of Recovery If the Company is obliged by the Legislation to pay an amount for which the Company would not otherwise be liable under this Policy the Insured shall repay the amount to the Company. 14) Jurisdiction Clause The indemnity shall not apply in respect of judgments which are not in the first instance delivered by or obtained from a Court of competent jurisdiction in Hong Kong. 9

12 ,000 25,

13 1) 10,000 2) 10,000 a) I. II. III. IV. V. VI. VII. b) I. II. III. IV. V. VI. VII. c) ,000 X 11

14 12 a) b) c) d) e) f) g) h) i) j) 1,000 a) b) c) d) , , , ,000 50,000 50, ,000

15 a) b) c) d) e) f) 1) 15 2) 10,000 3,000 1) 2) 30 3) 30 4) 5) 24 6) 13

16 200,000 a) b) 500 a) b) c) d) e) 5,000 a) b) c) ,000 a) b) c) d) e) f) 14

17 g) h) i) I. II. j) 2% 5.8% 3% a) Agreement for Provision of Facilities b) (i) (ii) c) d) 15

18 (1) ( 623 ) (2) ( 623 ) 1) 2) 3) 4) I. II. III. IV. V. 5) 16

19 6) I. II. 7) 8) 9) 10) ) 12) 13) 14)

20 QBE GIHK-DOMESTICHELPER-R2 (DG) 07/15