Civil Servants plan leaflet 2016 Hospital plan v1

Transcription

1 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 1. 住院及手術計劃 Hospital & Surgical Plan 保障範圍 港幣 BENEFIT SCHEDULE (in HK$) A 住院及手術保障 Hospital & Surgical 每名受保人最高賠償額 港幣 Max. limit per insured person (HK$) 計劃 Plan A 計劃 Plan B 計劃 Plan C 大房半私家房 (semiprivate) 私家房 (ward) (private) 全年總賠償額 Overall Annual Policy Limit 150, , ,000 1 每日住院及膳食費用 Room & Board per day 550 1,000 1,800 每項病症最高日數 No. of days per disability 住院雜費 ( 每項病症最高賠償額 ) 8,000 15,000 25,000 Hospital Services per disability limit 3 深切治療費用 ( 每日 )Intensive Care per day limit 2,000 3,500 6,000 每項病症最高日數 No. of days per disability 出院後之私家護士費用 ( 每日 ) Home Nursing per day limit 每項病症最高日數 No. of days per disability 手術醫生費一每項病症 Surgeon's Fee per disability limit 繁複大型 Complex Major 30,000 40,000 55,000 超大型 Super Major 22,000 30,000 38,000 大型 Major 15,000 22,000 28,000 中型 Intermediate 8,000 12,000 16,000 小型 Minor 3,000 4,500 6,800 6 麻醉師費 -- 每項病症 Anaesthetist's Fee per disability limit 手術醫生費的 30% 30% of surgeon s fee payable 7 手術室費 -- 每項病症 Operating Theatre Fee per disability limit 手術醫生費的 30% 30% of surgeon s fee payable 8 住院醫生巡房費 -- 每日最高限額 550 1,000 1,800 In-patient Physician Consultation per day limit No. of days per disability 每項病症最高日數 In-patient Specialist Fee + per disability limit 2,000 3,000 5,000 + 住院專科醫生費 -- 每項病症最高賠償額 10 公立醫院普通病房每日現金賠償 Alternative Daily Cash for hospitalization at General Ward of HA Hospitals per day limit (in lieu of other benefits) 每項病症最高日數 No. of days per disability 出院後覆診費用 -- 每項病症最高賠償額 Post-hospitalization Out-patient Follow-up per disability limit (Consultation/Treatment by Attending Doctor within 6 weeks after date of discharge) 1,000 2,000 2, 洗腎 化療 放射性治療 非住院 毎年 Renal Dialysis/ Chemotherapy/ Radiotherapy (Outpatient 10,000 20,000 30,000 only) - Per year limit 13 緊急門診治療 ( 於意外發生後 72 小時內於醫院門診部接受的治療 ) - 1,000 2,000 3,000 - 每項病症最高賠償額 Emergency outpatient treatment (received within 72 hours of the accident in the outpatient department of a hospital) per disability 14 意外身故賠償 Accidental Death Benefit 10,000 20,000 30,000 Page 1

2 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 B 附加嚴重醫療保障 -- SUPPLEMENTARY MAJOR MEDICAL optional Accommodation restriction 住房限制 計劃 Plan A Ward 大房 計劃 Plan B Semi-Private 半私家房 計劃 Plan C Private 私家房 Deductible per disability 每項病症扣除額 1,000 1,000 1,000 Reimbursement % 賠償額 80% 80% 80% Max. amount per disability 每項病症最高賠償額 30,000 50, ,000 每日住院及膳食費丶住院醫生巡房費於住院日數 90 天後始賠償 (daily Room and Board charge, doctor fee will be reimbursed after 90 days in hospital) 註 : 所有費用必須合理及慣常 海外保障只限每次離港後的連續九十日內 忠利保險有限公司保留修定每年續保的保費率 保障及條款細則的權利 * 投保人如入住超過住房費用最高限額的病房, 有關醫療費用將會按比例作出賠償 有關細則請參閱保單條款 + 不適用於非住院洗腎及癌病治療 離院後治療 家庭看護及緊急門診治療 毎份保單的最低保費為 HK$500 家庭成員同時投保可享九折優惠 NB: All expenses must be reasonable and customary. Overseas cover is limited to 90 consecutive days per trip, outside Hong Kong SAR. Policy is subject to annual renewal and Generali reserves its right to amend premium rates, benefits, terms and conditions. * If the Insured stays in a room exceeding the daily room & board limit, the relevant medical expenses will be adjusted subject to the applicable terms and conditions of the policy. + Recommended or referred by the attending Not applicable for Outpatient Kidney Dialysis, Outpatient Cancer Treatment, Post-hospitalisation Treatment, Home Nursing and Emergency Outpatient Treatment The minimum premium per policy is HK$ % discount is offered to family application. 投保條款 本計劃適用於公務員 / 非公務員及其家屬 ( 包括配偶 父母 外父母 祖父母 子女 女婿 媳婦 兄弟姊妹 孫 ) 初次投保年齡必須為 18 至未滿 61 歲的全職 / 合約公務員或非公務員合約僱員 你亦可以同時為你的家庭成員投保, 包括年齡為 18 至 60 歲合法配偶 出生超過 14 天至 17 歲的未婚子女 ( 或未滿 23 歲但現正接受全日制教育的未婚子女 ) 此計劃可續保至 70 歲 投保人於 70 歲後可選擇 智康健 個人醫療保險計劃 若投保人於續保期間, 已不屬公務員或非公務員合約僱員, 仍可申請續保 Eligibility: This plan is available for Civil Servants &/or Non-Civil Servants and their family members including spouse, parents, grandparents, mother-in-law, father-in-law, son, son-in-law, daughter, daughter-in-law, sibling & grandchild(ren). Civil Servants or Non-Civil Servants aged between 18 and below 61 can apply You can also include your legal spouse aged between 18 and below 61 and any unmarried child(ren) aged over 14 days to 17 years (or below 23 if in full time education) in the application The plan is renewable up to age 70. The Insured can opt for our GenHealth Individual Health Insurance plan at age 70. Insured can apply renewal for the policy even if he/she is not a Civil Servant at the time of renewal. Page 2

3 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 主要不受保項目 本計劃的不受保項目包括 : 在本保單首 6 個月內需接受治療的下列疾病 : 任何種類腫瘤 肛門屢管 膽囊炎 腎結石 尿道結石或膀胱結石 糖尿病 胃潰痬 十二指腸潰痬 拇趾外翻 高血壓或心血管疾病 肺結核 白內障 子宮內膜異位 須接受手術的扁桃腺病 痔瘡 甲狀腺機能亢進 鼻中隔或鼻甲骨病變 須接受手術的竇症 受保前已存在的疾病 先天性的疾病 吸毒及酗酒 牙科治療 ( 意外引致除外 ) 自殺或蓄意自殘 美容及整容手術 懐孕及分娩 節育及醫治不育 性病 愛滋病及其他併發症 例行健康檢查 / 療養 專業及危險運動 戰爭或任何類似戰爭行動 罷工 暴亂或民事騷亂 其他不受保項目以本公司的承保決定為凖 Major Exclusions: Some of the exclusions under this Plan are : The following conditions that require treatment within the first six months of the policy : Tumours of any kind, anal fistulae, cholecystitis, calculi of kidney, urethra or bladder, diabetes mellitus, gastric or duodenal ulcer, hallux valgus, hypertension or cardio-vascular disease, tuberculosis, cataracts, endometriosis, diseased tonsils requiring surgery, hemorrhoids, hyperthyroidism, pathological abnormalities of nasal septum or turbinates, sinus conditions requiring surgery. Pre-existing conditions Congenital anomalies Drug addiction or alcoholism Dental treatment (except caused by accident) Suicide or self-inflicted injury Cosmetic or plastic surgery Pregnancy, childbirth, birth control and treatment for infertility Sexually transmitted diseases, AIDS or HIV-related conditions Routine health checks, rest cure Professional and hazardous sports War or warlike operation, strike, riot and civil revolution Other exclusions as per our underwriting decisions Page 3

4 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 Annual Premium rate table (in Hong Kong dollars) 年繳保費表 港幣 : (A) 住院及手術保障 Hospital & Surgical plan 年齢 計劃 Plan A 計劃 Plan B 計劃 Plan C Age band M F M F M F 14 days 5 1,428 1,532 2,641 3,039 4,529 5, ,007 1,123 1,587 2,341 2,740 4, ,111 1,617 2,339 2,783 4, ,038 1,234 1,779 2,691 3,087 4, ,132 1,471 1,955 3,321 3,396 5, ,305 1,705 2,266 3,887 3,825 6, ,410 1,978 2,451 4,448 4,368 8, ,601 2,380 2,864 5,255 5,161 9, ,889 2,630 3,490 5,898 6,297 10, ,393 2,829 4,296 6,419 7,706 11, ,081 3,397 5,539 7,526 9,828 14, * 3,996 4,327 7,145 9,579 12,344 17, * 5,095 5,496 8,827 12,037 15,172 22,705 (B) 自選附加嚴重醫療保障 Optional SMM benefit 年齢 計劃 Plan A 計劃 Plan B 計劃 Plan C Age band M F M F M F 14 days , , , ,053 1, ,004 1,240 1, ,100 1,306 2, ,195 1,434 2, ,353 1,616 2, ,006 1,528 1,888 2, ,137 1,190 1,919 2,217 3, ,468 1,577 2,614 2,860 4, * 1,247 1,847 2,059 2,826 3,565 5, * 1,726 2,355 2,681 3,506 4,673 6,907 Page 4

5 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 b) Prestigio Health Plan 忠利優晉醫療計劃 (I) BENEFITS SCHEDULE 保障範圍 港幣 Maximum Lifetime Limit per Insured Person 每受保人終身賠償限額 HK$75,000,000 Maximum Annual Limit per Insured Person 每受保人每保單年度賠償限額 HK$25,000,000 Hospitalization and Surgical Benefits 住院及手術保障 Daily Room and Board Actual room and board charges for a Standard Private Room 每日病房及膳食費標準私家房的實際病房及膳食開支 Intensive Care Actual charges for stay in Intensive Care Unit (ICU) of a hospital 深切治療費入住深切治療病房的實際開支 Physician s Visit Actual charges billed by the attending physician during stay in a hospital 醫生巡房費住院期間醫生巡房的實際開支 Specialist s Fee Actual charges billed by a specialist during stay in a hospital 專科醫生巡房費住院期間接受專科醫生治療的實際開支 Surgeon s Fee Actual charges billed by the surgeon for a surgery 外科醫生費外科醫生進行外科手術的實際開支 Anesthetist's Fee Actual charges billed by an anaesthetist for the services rendered during a surgery 出院後之輔助護理費 出院後六十日內之脊椎治療 物理治療 職業治療及言語治療的實際開支 Operating Theatre Fee Actual charges for the use of an operating room for surgery 出院後之家中看護費 手術後或調出深切治療病房後接受家中看護服務的實際開支 Day-Case Surgery Fee Actual charges for a surgery (including consultation and medication) performed on an out-patient basis 出院後之復康治療費 出院後六十日內在復康中心接受復康治療之開支 Hospital Services Fee Actual charges made by the hospital for specified services normally rendered by a hospital 住院雜費住院提供的指定慣常服務 18 的實際開支 Maximum Coverage Limits per Insured Person 每受保人最高賠償額 Full Cover 全數受保 Full Cover 全數受保 Full Cover 全數受保 Full Cover 全數受保 Full Cover 全數受保 Full Cover 全數受保 Full Cover 全數受保 Full Cover 全數受保 Full Cover 全數受保 Page 5

6 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 Mental or Psychiatric Treatment Actual charges for hospitalisation in a mental or psychiatric hospital or in the mental or psychiatric unit of a hospital 精神或神經疾病治療費於心理或精神病醫院或醫院內之心理或精神科病房或部門入住及接受治療的實際費用 Medical Appliances Actual charges for prosthetic device implanted during surgery and/or for replacement of body organs or parts (a) Specified Items (b) Other Items 醫療裝置費於手術期間植入或於置換手術中所用的醫療物料或裝置的實際開支 (a) 指定裝置項目 (b) 其他裝置項目 Private Nurse's Fee Actual charges for private nursing services during hospitalisation recommended by the attending physician 私家看護費住院期間經醫生指定的私家看護服務的實際開支 Hospital Companion Bed Actual charges for one extra bed for the insured person s immediate family member during his/her stay in a hospital 住院陪床費住院期間, 為其陪伴的直系家屬 Pre and Post Hospitalization Benefits 入院前及出院後保障 22 而設的一張額外床的實際開支 Pre-Hospitalization/Day-Case Surgery Out-patient Consultation Actual charges for physician and specialist visits within 30 days before 1.14 hospitalisation or day-case surgery for pre-admission consultation 住院 / 日間手術前之門診費住院或日間手術前三十日內之醫生及專科醫生門診診症的實際開支 Post-Hospitalization/Day-Case Surgery Out-patient Follow-up Actual charges for physician and specialist visits within 60 days after hospitalization 1.15 or day-case surgery for follow-up consultation 出院 / 日間手術後之門診費出院或日間手術後六十日內之醫生及專科醫生門診診症的實際開支 Post-Hospitalization Ancillary Treatment Actual charges for chiropractic treatment, physiotherapy, occupational therapy and 1.16 speech therapy received within 60 days after hospitalization 出院後之輔助護理費出院後六十日內之脊椎治療 物理治療 職業治療及言語治療的實際開支 Post-Hospitalization Home Nursing Actual charges for home nursing service within 60 days after hospitalisation 1.17 following a surgery or admission to ICU 出院後之家中看護費手術後或調出深切治療病房後接受家中看護服務的實際開支 Post-Hospitalization Rehabilitation Actual charges for treatment received in a rehabilitation centre within 60 days after 1.18 hospitalisation 出院後之復康治療費出院後六十日內在復康中心接受復康治療之開支 Extended Benefits 擴展保障 HK$50,000 per policy year, and up to 30 days per policy year 每保單年度 50,000 港元, 及 每保單年度最多 30 天 (a) Full cover (b) HK$50,000 per policy year, and HK$150,000 per lifetime (a) 全數受保 (b) 每保單年度 50,000 港元, 及終身賠償限額 150,000 港元 Full Cover, and up to 30 days per policy year 全數受保, 及每保單年度最多 30 天 Full Cover 全數受保 Maximum Coverage Limits per Insured Person 每受保人最高賠償額 Full Cover, and up to 10 visits per policy year 全數受保, 及每保單年度最多 10 次 Full Cover, and up to 15 visits per policy year 全數受保, 及每保單年度最多 15 次 HK$50,000 per policy year 每保單年度 50,000 港元 Full Cover, and up to 180 days per policy year 全數受保, 及每保單年度最多 180 天 HK$50,000 per policy year 每保單年度 50,000 港元 Maximum Coverage Limits per Insured Person 每受保人最高賠償額 Page 6

7 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants Chemotherapy and Radiotherapy Actual charges for chemotherapy (including target therapy) or radiotherapy performed on in-patient or out-patient basis 化療及電療費於門診或住院期間接受化療 ( 包括標靶治療 ) 或電療的實際開支 Kidney Dialysis Actual charges for kidney dialysis performed on an in-patient or out-patient basis 腎透析費於門診或住院期間接受透析治療的實際開支 Organ Transplant Actual charges for heart, kidney, liver, lung or bone marrow transplant as a recipient 器官移植接受心臟 腎 肝 肺或骨髓移植的實際開支 Emergency Out-patient Treatment Actual charges for emergency out-patient treatment in the out-patient or emergency department of a hospital within 24 hours from an accident 意外急症門診治療費於意外發生後 24 小時內因該意外受傷進行緊急門診或醫院急症室治療的實際開支 Emergency Dental Treatment Actual charges for emergency dental treatment in a dental clinic or hospital within 14 days from an accident 意外緊急牙齒治療費於意外發生後 14 日內因該意外而導致的牙齒創傷在牙科診所或醫院進行緊急牙齒治療的實際開支 Hospice and Palliative Care Actual charges for staying in and receiving palliative care and nursing services provided by a hospice commencing within 90 days following hospitalisation 23 善終關懷及緩痛護理費入住善終院舍及接受善終院舍提供的關懷及護理服務的實際開支 Maternity and Newborn Treatment Actual charges for : Normal delivery or Caesarean Section Miscarriage or Therapeutic Abortion recommended by the attending specialist in obstetrics Complications of Pregnancy Newborn Treatment 生育及新生嬰兒治療費以下發生的實際開支 : 自然分娩或手術分娩 流產或產科專科醫生指定的治療性墮胎 妊娠期併發症 新生嬰兒治療 Worldwide Emergency Assistance Services Services include emergency medical evacuation & repatriation and return of mortal remains or local burial 環球緊急支援服務支援服務包括緊急醫療運送及醫療遣返 遺體運返或當地安葬 Vaccinations and Health Check Up Actual charges for vaccinations and health check-up 疫苗接種及常規健康檢查疫苗接種及健康檢查的實際開支 Emergency Treatment outside Selected Coverage Area Actual charges for emergency medical treatment received in a hospital while travelling outside the selected coverage area 選擇區域範圍以外的緊急治療費在選擇區域範圍以外的地域旅遊 / 公幹時因須在醫院接受緊急治療的實際開支 公務員及非公務員合約僱員醫療保障計劃 Full Cover 全數受保 Full Cover 全數受保 Full Cover 全數受保 Full Cover 全數受保 Full Cover 全數受保 HK$250,000 per lifetime 終身限額 250,000 港元 HK$150,000 per policy year 每保單年度 150,000 港元 Full Cover 全數受保 HK$2,500 per policy year, and up to one health check-up per policy year 每保單年度 2,500 港元, 及每保單年度一次健康檢查 Full cover 全數受保 Page 7

8 Out-patient Benefits optional 門診保障 自選 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants Physician & Specialist Out-patient Consultation Actual charges for physician or specialist consultation visit on an out-patient basis 醫生及專科醫生門診諮詢費醫生及專科醫生門診諮詢的實際開支 Prescribed Western Medicine and Drugs Actual charges for purchase of western medicine or drugs prescribed by a physician or specialist and within 60 days from the date of the prescription 處方藥物費由醫生及專科醫生處方並於該處方日期 60 日內購買的西藥 Diagnostic Procedures and Laboratory Tests Actual charges for diagnostic procedures and laboratory tests recommended by the attending physician or specialist 診斷程序及化驗室測試由醫生或專科醫生指定所進行的診斷程序及化驗室測試的實際開支 Physiotherapy & Chiropractic Treatment and Traditional Chinese Medicine Actual charges for Physiotherapy or chiropractic treatment recommended by the attending physician Traditional Chinese medicine, bone-setting or acupuncture 物理治療 脊醫治療及中醫治療費以下發生的實際開支 : 醫生或專科醫生指定的物理治療或脊椎治療 中醫 跌打或針灸 Mental and Psychiatric Treatment Actual charges for psychiatric consultation from a psychiatrist on an out-patient basis 精神或神經疾病治療由精神科專科醫生提供以門診形式之精神病治療的實際開支 Dental Benefits optional 牙科保障 自選 Oral examination, Scaling & Polishing Actual charges for clinical oral examination, scaling and polishing 口腔檢查及洗牙臨床牙科檢查及洗牙的實際開支 Routine Dental Treatment Actual charges for the following dental treatments performed by a dentist: Tooth pain relief Tooth fillings Tooth extraction (except removal of wisdom tooth or impacted tooth) X-ray Inlays and onlays (except gold and other precious and semi-precious materials) Drainage of abscesses Root canal work Periodontal surgery other than for cosmetic purposes 一般牙科治療由牙科醫生進行以下治療的實際開支 : 舒緩牙痛 公務員及非公務員合約僱員醫療保障計劃 Maximum Coverage Limits per Insured Person 每受保人最高賠償額 Full Cover, and Up to 1 visit per day of physician, and 1 visit per day of specialist, and up to 60 visits in total per policy year 全數受保, 及每日醫生 專科醫生最多各一次, 及每保單年度最多 60 次 Full Cover 全數受保 Full Cover 全數受保 HK$25,000 per policy year, and up to 30 visits per policy year 每保單年度 25,000 港元, 及每保單年度最多 30 次 HK$2,500 per visit, and up to 1 visit per day, and up to 15 visits per policy year 每次 2,500 港元, 及每天最多一次, 及每保單年度最多 15 次 Maximum Coverage Limits per Insured Person 每受保人最高賠償額 Full Cover, and up to 2 times per policy year 全數受保, 及每保單年度最多 2 次 HK$16,000 per policy year 每保單年度 16,000 港元 Page 8

9 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 補牙 脫牙 ( 智齒或嵌入性齒除外 ) X 光 鑲牙 ( 金及其他貴重和半貴重填料除外 ) 牙瘡 齒根管治療 美容除外的牙周手術 公務員及非公務員合約僱員醫療保障計劃 Major Restorative Treatment Actual charges for the following dental treatments performed by a dentist: Surgery for removal of wisdom tooth or impacted tooth Implants Pins for cusp restoration Anaesthesia Soft-tissue/bony impaction Apicoectomy 主要牙齒復修治療由牙科醫生進行以下治療的實際開支 : 智齒或嵌入性齒拔除手術 植入牙齒 修復齒尖的牙冠釘 麻醉 軟組織阻生 齒根尖切除術 HK$24,000 per policy year 每保單年度 24,000 港元 Three Coverage Areas to fit your best needs. You can tailor your needs of coverage during your life by choosing from three different geographical areas: 提供三個保障區域, 切合您的個人需要 : Worldwide 環球 Worldwide excluding the USA 環球 ( 美國除 外 ) Asia 亞洲 Optional Extra Benefits. You can also choose to add to your plan optional benefits to fit your personal needs. 提供自選附加保障項目, 滿足您的需要 : Out-patient Benefits 門診保障 Out-patient Benefits and Dental Benefit 門診保障 及牙科保障 Three Levels of Annual Deductibles and Three Levels of Coinsurance To suit your budget and any other insurance policies you may have, you can choose from three levels of annual deductibles for Core Benefits 提供 3 個年自付額度,3 個自付率, 以配合您的預算及其他保險安排 with three corresponding levels of coinsurance for the Optional Out-patient Benefits cover. 對應 3 個適用於自選門診保障的自付率 : No deductible No coinsurance HK$ 10,000 10% coinsurance HK$ 25,000 20% coinsurance 投保條款 本計劃適用於公務員 / 非公務員及其家屬 ( 包括配偶 父母 外父母 祖父母 子女 女婿 媳婦 兄弟姊妹 孫 ) 初次投保年齡必須為 18 至未滿 61 歲的全職 / 合約公務員或非公務員合約僱員 你亦可以同時為你的家庭成員投保, 包括年齡為 18 至 70 歲合法配偶 出生超過 14 天至 17 歲的未婚子女 ( 或未滿 23 歲但現正接受全日制教育的未婚子女 ) 此計劃保證終身續保 若投保人於續保期間, 已不屬公務員或非公務員合約僱員, 仍可申請續保 Eligibility: This plan is available for Civil Servants &/or Non-Civil Servants and their family members including spouse, parents, grandparents, mother-in-law, father-in-law, son, son-in-law, daughter, daughter-in-law, sibling & grandchild(ren). Civil Servants or Non-Civil Servants aged between 18 and 70 can apply You can also include your legal spouse aged between 18 and 70 and any unmarried child(ren) aged over 14 days to 17 years (or below 23 if in full time education) in the application Page 9

10 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 The plan is guaranteed lifetime renewal Insured can apply renewal for the policy even if he/she is not a Civil Servant at the time of renewal. 主要不受保項目 已存在病症 出生時或 12 歳前顯現的先天性疾病 愛滋病, 人類免疫缺陷病毒及相關狀況 酗酒, 濫用藥物及其它成癮狀況 性機能失常 以美容為目的之整容或整形治療 營養補充劑 因不育而進行的診斷及治療 以捐贈者身份進行器官捐贈 危險運動及職業運動引致之傷害 實驗性治療 因戰爭 恐怖主義 核輻射或化學物污染引致的治療 自我毀傷 不是醫療必需 合理或慣常的治療 保單生效日期或保單之最近期的生效日期 ( 以較後者為準 ) 起計 30 日內患上的疾病 有關扁桃腺 腺樣增殖體 疝氣 包皮手術或女性生殖器官疾病而進行的檢驗 治療或手術, 有關該檢驗 治療或手術發生在保單持續生效 120 日内 其他不受保項目以本公司的承保決定為凖 Major Exclusions: Any pre-existing conditions Congenital conditions existing at the time of birth or pre-natal physical and mental abnormalities which become apparent within 12 years of birth HIV/AIDS and related conditions Alcohol abuse, drug abuse and other addictive conditions Sexual dysfunction Services for beautification purposes or cosmetic treatment Dietary supplements Diagnostic tests and treatment for infertility Organ donation as a donor Hazardous and professional sports injuries Experimental treatment Treatment required as a result of war, terrorism or contamination by radioactivity or chemicals Self-inflicted injury Treatment not medically necessary and/or usual, customary and reasonable Illness that commences within 30 days after the later of the policy effective date or the last commencement date of the policy Investigation or treatment or surgery for tonsil, adenoids, hernia, circumcision or diseases related to female reproductive organs within 120 days from the effective date, reinstatement date or issue date Congenital anomalies Drug addiction or alcoholism Dental treatment (except caused by accident) Suicide or self-inflicted injury Cosmetic or plastic surgery Pregnancy, childbirth, birth control and treatment for infertility Sexually transmitted diseases, AIDS or HIV-related conditions Routine health checks, rest cure Professional and hazardous sports War or warlike operation, strike, riot and civil revolution Other exclusions as per our underwriting decisions Page 10

11 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 CORE BENEFITS 核心保障 Annual Premium Table (HK$) 年繳保費表 ( 港元 ) Coverage Area 保障區域 Worldwide 環球 Worldwide excluding the USA 環球 ( 美國除外 ) Asia 亞洲 Annual Deductible 年自付额 No Deductible 無自付額 HK$10,000 10,000 港元 HK$25,000 25,000 港元 No Deductible 無自付額 HK$10,000 10,000 港元 HK$25,000 25,000 港元 No Deductible 無自付額 HK$10,000 10,000 港元 HK$25,000 25,000 港元 Attained Age 實際年齡 0 22,554 16,731 11,556 11,727 8,361 7,668 10,746 8,280 7, ,141 15,831 10,827 11,016 8,307 7,515 10,080 8,055 7, ,196 15,228 10,350 10,548 8,244 7,434 9,630 7,830 7, ,783 14,319 9,819 9,837 7,956 7,425 8,964 7,542 7, ,838 13,716 9,513 9,639 7,866 7,371 8,613 7,443 7, ,460 13,473 9,495 9,486 7,821 7,317 8,433 7,398 6, ,325 13,230 9,477 9,342 7,776 7,308 8,334 7,353 6, ,235 13,167 9,432 9,288 7,731 7,290 8,289 7,308 6, ,145 13,131 9,378 9,252 7,686 7,236 8,244 7,263 6, ,055 13,077 9,297 9,207 7,641 7,218 8,172 7,218 6, ,938 13,041 9,090 9,135 7,587 7,155 8,154 7,173 6, ,767 13,014 8,991 9,153 7,632 7,245 8,163 7,209 6, ,731 12,987 8,928 9,171 7,704 7,290 8,244 7,281 6, ,560 12,969 8,928 9,189 7,713 7,335 8,325 7,290 6, ,101 12,942 8,802 9,207 7,857 7,380 8,406 7,425 6, ,191 12,978 9,090 9,702 7,920 7,425 8,586 7,497 6, ,236 12,996 9,108 10,044 8,010 7,497 8,892 7,668 7, ,290 13,005 9,162 10,386 8,172 7,551 9,198 7,839 7, ,389 13,023 9,225 11,169 8,433 7,560 9,810 8,172 7, ,461 13,050 9,342 11,367 8,523 7,605 9,990 8,271 7, ,118 13,059 9,720 11,826 8,937 7,758 10,377 8,739 7, ,766 13,095 10,269 11,961 9,117 7,911 10,503 8,919 7, ,458 13,671 10,368 12,159 9,162 8,073 10,683 8,955 7, ,592 13,734 10,971 12,627 9,243 8,280 11,115 9,045 7, ,834 13,860 11,286 13,167 9,486 8,325 11,601 9,297 8, ,364 14,850 12,141 14,976 10,746 9,405 12,285 10,044 8, ,723 15,768 12,861 15,534 11,034 9,450 12,483 10,251 8, ,785 16,245 13,473 15,876 11,268 9,504 12,753 10,458 8, ,009 17,559 13,896 16,326 11,574 9,693 13,122 10,611 9, ,981 18,441 14,733 16,875 11,952 9,837 13,581 10,773 9, ,458 19,278 15,336 17,838 12,744 10,296 14,454 11,475 9, ,818 19,404 15,552 18,171 12,969 10,494 14,679 11,700 9, ,106 19,431 15,570 18,270 13,041 10,593 14,751 11,862 9, ,232 19,440 15,588 18,342 13,086 10,647 14,796 11,898 9, ,448 19,611 15,687 18,567 13,239 10,674 14,949 11,898 9, ,529 20,754 15,741 18,576 13,239 10,683 14,976 11,916 9, ,583 20,907 15,804 18,621 13,302 10,683 15,039 11,925 9, ,727 21,060 15,813 18,711 13,374 10,692 15,075 11,934 9, ,672 21,861 16,380 19,134 13,419 10,692 15,372 11,952 9, ,401 22,482 16,821 19,413 13,608 10,719 15,561 11,979 9, ,139 22,977 16,983 19,503 13,626 10,737 15,606 12,024 10, ,066 23,103 17,343 19,602 13,698 10,764 15,651 12,033 10, ,002 23,400 17,901 19,791 13,761 10,782 15,759 12,060 10, ,145 24,327 18,594 20,358 13,959 10,800 16,371 12,078 10,089 Page 11

12 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 44 36,729 25,605 19,548 21,213 14,544 10,971 16,965 12,168 10, ,647 26,973 20,052 21,618 14,769 12,240 18,486 13,437 11, ,808 27,918 20,754 22,194 15,165 12,357 18,891 13,500 11, ,663 28,962 21,267 22,581 15,426 12,627 19,629 13,788 12, ,824 29,907 21,960 23,157 15,813 12,861 20,043 13,968 12, ,624 31,473 22,473 23,544 16,452 12,951 20,322 14,364 12, ,585 32,382 22,977 24,156 17,640 13,275 21,519 14,409 12, ,421 33,939 23,679 24,912 18,450 13,788 21,951 14,895 12, ,140 35,883 24,759 25,983 18,990 14,121 24,021 15,228 13, ,327 38,223 26,082 26,901 19,656 14,985 24,795 15,642 14, ,532 41,022 28,368 28,359 20,601 15,309 26,325 16,488 14, ,746 43,236 30,141 29,736 21,546 16,029 27,441 17,109 15, ,095 45,657 32,121 31,338 22,761 16,560 28,710 17,766 15, ,678 48,969 33,102 33,246 24,372 17,766 31,194 18,045 16, ,657 52,641 34,101 34,767 25,587 18,225 33,687 18,963 17, ,202 53,658 35,766 36,909 27,063 19,611 35,118 20,448 19, ,422 56,151 37,431 39,348 28,953 20,655 36,540 21,987 20, ,866 62,271 39,096 42,399 32,589 22,212 37,971 22,968 21, ,384 67,680 42,417 45,819 35,550 24,327 39,708 23,949 22, ,881 77,193 47,763 50,697 39,357 26,532 42,246 25,911 23, ,351 81,774 49,572 56,502 44,010 29,133 43,677 26,892 25, ,460 88,002 55,710 62,298 48,519 32,256 47,844 28,773 26, ,937 93,177 58,059 67,491 52,749 34,677 49,716 30,159 27, , ,609 61,020 68,715 53,595 35,361 51,588 31,572 29, , ,395 63,396 70,236 54,873 36,378 53,982 32,679 30, , ,309 65,763 72,531 56,565 37,566 55,872 34,128 31, , ,276 70,029 74,511 58,257 38,925 60,993 36,540 32,949 Premium figures for ages 71 to 99 apply to renewals only 以下 71 至 99 歲年保費僅為續保年保費 , ,764 72,306 80,766 63,045 42,048 63,432 38,106 34, , ,029 75,285 82,944 65,169 43,641 65,871 39,672 35, , ,285 78,264 85,212 67,419 44,910 68,301 41,247 37, , ,550 81,243 86,706 68,553 46,179 71,685 42,813 39, , ,177 83,313 88,191 70,101 47,286 75,321 43,902 40, , ,556 87,210 93,645 74,475 49,824 80,649 48,690 43, , ,543 91, ,116 79,551 53,163 83,691 50,643 45, , ,269 95, ,014 81,945 54,270 86,733 52,596 46, , ,354 98, ,227 84,483 57,285 89,766 54,558 48, , , , ,901 85,752 58,554 93,267 56,511 50, , , , ,202 89,847 59,508 97,929 58,464 51, , , , ,335 91,683 60, ,322 60,417 54, , , , ,324 93,231 61, ,479 62,379 56, , , , ,457 94,779 63, ,709 64,332 58, , , , ,590 96,471 63, ,869 66,285 59, , , , ,732 98,172 64, ,342 68,238 61, , , , ,865 99,864 65, ,780 70,200 63, , , , , ,412 66, ,559 72,153 64, , , , , ,960 68, ,538 74,106 66, , , , , ,796 69, ,931 78,651 67, , , , , ,344 70, ,046 80,343 70, , , , , ,901 72, ,008 85,068 72, , , , , ,593 74, ,112 86,472 74, , , , , ,285 76, ,551 87,876 75, , , , , ,833 77, ,248 88,920 77,508 Page 12

13 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 , , , , ,525 79, ,460 90,441 79, , , , , ,082 80, ,989 91,422 80, , , , , ,774 82, ,320 91,422 81, , , , , ,610 82, ,320 91,422 82,386 CORE BENEFITS plus OPTIONAL OUT-PATIENT BENEFITS 核心保障加自選門診保障 Annual Premium Table (HK$) 年繳保費表 ( 港元 ) Coverage Area Worldwide Worldwide excluding the USA Asia 保障區域 Annual Deductible (core benefits) 年自付额 ( 核心保障 ) No Deductible 無自付額 環球 HK$10,000 10,000 港元 HK$25,000 25,000 港元 No Deductible 無自付額 環球 ( 美國除外 ) HK$10,000 10,000 港元 HK$25,000 25,000 港元 No Deductible 無自付額 亞洲 HK$10,000 10,000 港元 HK$25,000 25,000 港元 Attained Age 實際年齡 0 55,161 45,225 36,117 40,203 32,742 29,754 37,872 32,184 29, ,430 38,754 30,555 33,858 27,837 25,200 31,833 27,207 24, ,166 33,453 26,010 28,629 23,679 21,393 26,847 22,968 21, ,343 28,665 22,113 24,003 20,025 18,333 22,455 19,377 18, ,888 24,966 19,134 20,673 17,253 15,831 19,125 16,641 15, ,917 23,301 17,892 18,270 15,273 14,022 16,803 14,697 13, ,883 21,375 16,416 16,569 13,878 12,789 15,219 13,338 12, ,650 20,295 15,480 15,570 13,023 12,033 14,265 12,492 11, ,930 19,701 14,940 15,012 12,528 11,574 13,725 12,015 11, ,930 19,737 14,940 15,048 12,555 11,619 13,734 12,033 11, ,065 19,953 14,976 15,318 12,798 11,826 14,040 12,276 11, ,407 20,412 15,300 15,849 13,284 12,321 14,544 12,753 11, ,109 21,060 15,840 16,560 13,950 12,906 15,282 13,401 12, ,694 21,726 16,434 17,262 14,553 13,482 16,011 13,995 12, ,658 22,095 16,659 18,054 15,363 14,139 16,830 14,778 13, ,180 22,509 17,271 19,359 16,119 14,805 17,784 15,534 14, ,369 22,662 17,406 20,322 16,740 15,363 18,684 16,227 14, ,963 23,148 17,874 21,204 17,361 15,831 19,503 16,848 15, ,449 23,508 18,225 22,383 17,955 16,137 20,493 17,505 15, ,773 23,742 18,522 22,770 18,198 16,317 20,844 17,757 16, ,997 24,111 19,116 23,436 18,900 16,488 21,438 18,504 16, ,185 24,615 19,980 23,760 19,215 16,650 21,744 18,819 16, ,615 25,713 20,547 24,336 19,485 17,082 22,275 19,080 16, ,415 26,298 21,762 25,371 20,070 17,577 23,256 19,665 17, ,719 26,901 22,554 26,307 20,907 18,180 24,120 20,493 17, ,861 28,332 23,949 28,872 22,608 19,593 25,524 21,672 18, ,579 30,078 25,587 30,186 23,490 20,196 26,442 22,464 19, ,397 31,536 26,811 31,455 24,534 21,069 27,594 23,463 20, ,395 33,804 27,711 32,472 25,560 21,807 28,503 24,327 21, ,871 35,280 28,755 33,597 26,442 22,239 29,511 24,984 21, ,825 36,369 29,547 34,983 27,378 23,004 30,789 25,821 22, ,401 36,630 29,916 35,523 27,747 23,211 31,203 26,190 22, ,788 36,774 30,078 35,991 28,179 23,589 31,626 26,703 22, ,193 36,891 30,240 36,423 28,701 23,913 32,013 27,207 23, ,625 37,413 30,771 37,206 29,088 24,210 32,697 27,432 23, ,868 38,916 30,960 37,548 29,421 24,480 33,048 27,774 23, ,030 39,330 31,167 37,791 29,934 25,029 33,291 28,224 24, ,291 39,654 31,473 38,250 30,141 25,038 33,687 28,377 24,156 Page 13

14 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 38 52,641 40,734 32,364 39,060 30,555 25,326 34,353 28,755 24, ,676 41,580 32,976 39,537 30,762 25,362 34,731 28,791 24, ,981 42,489 33,417 39,762 30,960 25,623 34,902 29,016 24, ,457 43,092 34,101 40,248 31,491 26,199 35,316 29,475 25, ,951 43,965 35,262 40,824 31,923 26,505 35,793 29,871 25, ,949 45,549 36,576 42,327 32,940 27,351 37,296 30,681 26, ,532 47,637 38,160 44,496 34,524 28,089 39,141 31,752 27, ,845 50,004 39,339 46,188 35,685 30,177 41,886 33,939 29, ,428 52,227 41,211 48,204 37,251 31,392 43,668 35,154 30, ,111 54,297 42,597 49,338 38,448 32,481 45,117 36,360 31, ,316 55,998 44,172 50,859 39,519 33,543 46,422 37,215 32, ,322 58,500 45,279 52,353 41,013 34,182 47,763 38,439 33, ,063 62,622 48,609 53,712 42,786 35,055 49,671 39,060 34, ,563 66,798 51,435 55,413 44,676 36,396 50,994 40,608 35, ,947 69,705 53,244 57,807 45,954 37,296 54,333 41,670 36, ,931 76,257 58,428 59,868 47,673 39,276 56,196 43,110 38, ,377 80,973 62,289 62,901 49,977 40,734 59,220 45,288 39, ,742 84,933 65,250 65,808 52,164 42,309 61,803 47,124 41, ,746 89,694 69,120 69,327 55,071 44,235 64,890 49,446 43, ,506 95,976 72,612 73,620 58,905 47,349 69,651 51,903 46, , ,997 75,771 77,193 61,875 49,455 74,088 54,540 48, , ,011 80,352 81,963 65,574 53,046 78,030 58,212 52, , ,888 84,582 87,399 69,993 56,034 82,305 62,226 55, , ,094 89,847 94,167 76,689 60,336 87,273 66,204 59, , ,786 97, ,024 83,628 66,006 93,240 71,082 63, , , , ,896 92,538 72, ,484 78,048 69, , , , , ,185 80, ,548 84,906 75, , , , , ,706 88, ,555 92,682 82, , , , , ,552 95, ,412 99,576 88, , , , , ,631 97, , ,195 90, , , , , , , , ,075 93, , , , , , , , ,756 96, , , , , , , , , ,224 Premium figures for ages 71 to 99 apply to renewals only 以下 71 至 99 歲年保費僅為續保年保費 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,040 Page 14

15 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,555 CORE BENEFITS plus OPTIONAL OUT-PATIENT and DENTAL BENEFITS 核心保障加自選門診保障及牙科保障 Annual Premium Table (HK$) 年繳保費表 ( 港元 ) Coverage Area 保障區域 Annual Deductible (core benefits) 年自付额 ( 核心保障 ) Attained Age 實際年齡 No Deductible 無自付額 Worldwide 環球 HK$10,000 10,000 港元 HK$25,000 25,000 港元 Worldwide excluding the USA No Deductible 無自付額 環球 ( 美國除外 ) HK$10,000 10,000 港元 HK$25,000 25,000 港元 No Deductible 無自付額 Asia 亞洲 HK$10,000 10,000 港元 HK$25,000 25,000 港元 0 55,161 45,225 36,117 40,203 32,742 29,754 37,872 32,184 29, ,430 38,754 30,555 33,858 27,837 25,200 31,833 27,207 24, ,166 33,453 26,010 28,629 23,679 21,393 26,847 22,968 21, ,343 28,665 22,113 24,003 20,025 18,333 22,455 19,377 18, ,888 24,966 19,134 20,673 17,253 15,831 19,125 16,641 15, ,917 23,301 17,892 18,270 15,273 14,022 16,803 14,697 13, ,104 25,596 20,637 20,790 18,099 17,010 19,440 17,559 16, ,871 24,516 19,701 19,791 17,244 16,254 18,486 16,713 15, ,151 23,922 19,161 19,233 16,749 15,795 17,946 16,236 15, ,151 23,958 19,161 19,269 16,776 15,840 17,955 16,254 15, ,286 24,174 19,197 19,539 17,019 16,047 18,261 16,497 15, ,628 24,633 19,521 20,070 17,505 16,542 18,765 16,974 16, ,330 25,281 20,061 20,781 18,171 17,127 19,503 17,622 16, ,915 25,947 20,655 21,483 18,774 17,703 20,232 18,216 17, ,879 26,316 20,880 22,275 19,584 18,360 21,051 18,999 17, ,401 26,730 21,492 23,580 20,340 19,026 22,005 19,755 18, ,590 26,883 21,627 24,543 20,961 19,584 22,905 20,448 19, ,184 27,369 22,095 25,425 21,582 20,052 23,724 21,069 19, ,670 27,729 22,446 26,604 22,176 20,358 24,714 21,726 20, ,994 27,963 22,743 26,991 22,419 20,538 25,065 21,978 20, ,218 28,332 23,337 27,657 23,121 20,709 25,659 22,725 20, ,406 28,836 24,201 27,981 23,436 20,871 25,965 23,040 20, ,836 29,934 24,768 28,557 23,706 21,303 26,496 23,301 20, ,636 30,519 25,983 29,592 24,291 21,798 27,477 23,886 21, ,940 31,122 26,775 30,528 25,128 22,401 28,341 24,714 21, ,082 32,553 28,170 33,093 26,829 23,814 29,745 25,893 22, ,800 34,299 29,808 34,407 27,711 24,417 30,663 26,685 23, ,618 35,757 31,032 35,676 28,755 25,290 31,815 27,684 24, ,616 38,025 31,932 36,693 29,781 26,028 32,724 28,548 25, ,092 39,501 32,976 37,818 30,663 26,460 33,732 29,205 25, ,046 40,590 33,768 39,204 31,599 27,225 35,010 30,042 26, ,622 40,851 34,137 39,744 31,968 27,432 35,424 30,411 26,550 Page 15

16 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 32 54,009 40,995 34,299 40,212 32,400 27,810 35,847 30,924 26, ,414 41,112 34,461 40,644 32,922 28,134 36,234 31,428 27, ,846 41,634 34,992 41,427 33,309 28,431 36,918 31,653 27, ,089 43,137 35,181 41,769 33,642 28,701 37,269 31,995 27, ,251 43,551 35,388 42,012 34,155 29,250 37,512 32,445 28, ,512 43,875 35,694 42,471 34,362 29,259 37,908 32,598 28, ,862 44,955 36,585 43,281 34,776 29,547 38,574 32,976 28, ,897 45,801 37,197 43,758 34,983 29,583 38,952 33,012 28, ,202 46,710 37,638 43,983 35,181 29,844 39,123 33,237 28, ,678 47,313 38,322 44,469 35,712 30,420 39,537 33,696 29, ,172 48,186 39,483 45,045 36,144 30,726 40,014 34,092 29, ,170 49,770 40,797 46,548 37,161 31,572 41,517 34,902 30, ,753 51,858 42,381 48,717 38,745 32,310 43,362 35,973 31, ,066 54,225 43,560 50,409 39,906 34,398 46,107 38,160 33, ,649 56,448 45,432 52,425 41,472 35,613 47,889 39,375 34, ,332 58,518 46,818 53,559 42,669 36,702 49,338 40,581 35, ,537 60,219 48,393 55,080 43,740 37,764 50,643 41,436 36, ,543 62,721 49,500 56,574 45,234 38,403 51,984 42,660 37, ,284 66,843 52,830 57,933 47,007 39,276 53,892 43,281 38, ,784 71,019 55,656 59,634 48,897 40,617 55,215 44,829 39, ,168 73,926 57,465 62,028 50,175 41,517 58,554 45,891 40, ,152 80,478 62,649 64,089 51,894 43,497 60,417 47,331 42, ,598 85,194 66,510 67,122 54,198 44,955 63,441 49,509 44, ,963 89,154 69,471 70,029 56,385 46,530 66,024 51,345 45, ,967 93,915 73,341 73,548 59,292 48,456 69,111 53,667 47, , ,197 76,833 77,841 63,126 51,570 73,872 56,124 50, , ,218 79,992 81,414 66,096 53,676 78,309 58,761 52, , ,232 84,573 86,184 69,795 57,267 82,251 62,433 56, , ,109 88,803 91,620 74,214 60,255 86,526 66,447 59, , ,728 95,481 99,801 82,323 65,970 92,907 71,838 64, , , , ,658 89,262 71,640 98,874 76,716 69, , , , ,530 98,172 78, ,118 83,682 75, , , , , ,819 85, ,182 90,540 81, , , , , ,340 93, ,189 98,316 87, , , , , , , , ,210 93, , , , , , , , ,829 96, , , , , , , , ,709 99, , , , , , , , , , , , , , , , , , ,858 Premium figures for ages 71 to 99 apply to renewals only 以下 71 至 99 歲年保費僅為續保年保費 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,957 Page 16

17 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,189 Page 17

18 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 3. 住院現金計劃 Hospital Cash Plan 保障範圍 港幣 Benefit schedule (in HK$) 計劃 Plan A 計劃 Plan B 每日住院現金 ( 每項病症最高賠償 1,000 日 ) 500 1,000 Daily Hospital cash - 1,000 days per disability 額外每日住院現金 Double hospital cash if : - 入住醫院深切治療 ( 每項病症最高日數 90 日 ) ICU hospitalization (up to 90 days per disability) - 受保人及受保配偶因同一意外而需住院 the insured and insured spouse have confined in hospital due to same accident - 接受心臓 肺 肝臓 胰臓 腎臓或骨膸移殖手術而需住院 major organ transplant (heart, lung, liver, pancreas, kidney or bone marrow) 1,000 2,000 * 若受保人在中國內地住院, 則所得賠償額將為所選擇的保障額的一半 hospitalization in mainland China is subject to 50% benefit limit. 子女的保障額為成人的一半 Child s benefit is 50% of the benefit limit of adult. 註 : 本計劃適用於公務員 / 非公務員及其家屬 ( 包括配偶 父母 外父母 祖父母 子女 女婿 媳婦 兄弟姊妹 孫 ) 海外保障只限每次離港後的連續九十日內 忠利保險有限公司保留修定每年續保的保費率 保障及條款細則的權利 家庭成員同時投保可享九折優惠 毎份保單的最低保費為 HK$500 NB: This plan is available for Civil Servants &/or Non-Civil Servants and their family members including spouse, parents, grandparents, mother-in-law, father-in-law, son, son-in-law, daughter, daughter-in-law, sibling & grandchild(ren). Overseas cover is limited to 90 consecutive days per trip, outside Hong Kong SAR. Policy is subject to annual renewal and Generali reserves its right to amend premium rates, benefits, terms and conditions. 10% discount is offered to family application. Minimum premium per policy is HK$500. 投保條款 初次投保年齡必須為 18 至未滿 61 歲的全職 / 合約公務員或非公務員合約僱員 你亦可以同時為你的家庭成員投保, 包括年齡為 18 至未滿 61 歲合法配偶 出生超過 14 天至 17 歲的未婚子女 ( 或未滿 23 歲但現正接受全日制教育的未婚子女 ) 此計劃可續保至 60 歲 若投保人於續保期間, 已不屬公務員或非公務員合約僱員, 仍可申請續保 Eligibility: Civil Servants or Non-Civil Servants aged between 18 and below 61 can apply You can also include your legal spouse aged between 18 and below 61 and any unmarried child(ren) aged over 14 days to 17 years (or below 23 if in full time education) in the application The plan is renewable up to age 60 Insured can apply renewal for the policy even if he/she is not a Civil Servant at the time of renewal Civil servant scheme p.18

19 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 主要不受保項目本計劃的不受保項目包括 : 在本保單首 6 個月內需接受治療的下列疾病 : 任何種類腫瘤 肛門屢管 膽囊炎 腎結石 尿道結石或膀胱結石 糖尿病 胃潰痬 十二指腸潰痬 拇趾外翻 高血壓或心血管疾病 肺結核 白內障 子宮內膜異位 須接受手術的扁桃腺病 痔瘡 甲狀腺機能亢進 鼻中隔或鼻甲骨病變 須接受手術的竇症 受保前已存在的疾病 先天性的疾病 吸毒及酗酒 牙科治療 ( 意外引致除外 ) 自殺或蓄意自殘 美容及整容手術 懐孕及分娩 節育及醫治不育 性病 愛滋病及其他併發症 例行健康檢查 / 療養 專業及危險運動 戰爭或任何類似戰爭行動 罷工 暴亂或民事騷亂 其他不受保項目以本公司的承保決定為凖 Major Exclusions: Some of the exclusions under this Plan are : The following conditions that require treatment within the first six months of the policy : Tumors of any kind, anal fistulae, cholecystitis, calculi of kidney, urethra or bladder, diabetes mellitus, gastric or duodenal ulcer, hallux valgus, hypertension or cardio-vascular disease, tuberculosis, cataracts, endometriosis, diseased tonsils requiring surgery, hemorrhoids, hyperthyroidism, pathological abnormalities of nasal septum or turbinates, sinus conditions requiring surgery Pre-existing conditions Congenital anomalies Drug addiction or alcoholism Dental treatment (except caused by accident) Suicide or self-inflicted injury Cosmetic or plastic surgery Pregnancy, childbirth, birth control and treatment for infertility Sexually transmitted diseases, AIDS or HIV-related conditions Routine health checks, rest cure Professional and hazardous sports War or warlike operation, strike, riot and civil revolution Other exclusions as per our underwriting decisions 年繳保費表 港幣 Annual Premium rate table (in Hong Kong dollars): 住院現金計劃 Hospital Cash plan 年齢 計劃 Plan A 計劃 Plan B Age band M F M F ,454 1, ,030 1,576 2, ,114 1,670 2, ,183 1,810 2, ,181 1,574 2,369 3, ,279 1,673 2,566 3, ,002 2,669 4,010 5, ,168 2,836 4,345 5,681 Child rate Civil servant scheme p.19

20 Voluntary Insurance Scheme for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員醫療保障計劃 有關忠意集團 自 1970 年代起, 忠意集團旗下的公司在香港一直為個人及企業提供全面的保險及投資保障服務 多年以來, 我們了解到客戶不同的個別需求, 並不斷隨時代改進去迎合客戶的真正所需 忠意是世界最大的保險集團之一, 並擁有超過 180 年歷史 2015 年, 集團總保費收入超過 740 億歐羅, 成功並列 財富 世界 50 強 現有超過 7 萬 6 千員工遍佈全球超過 60 多個國家, 為 7 千 2 百萬客戶提供優質專業服務 集團在西歐市場佔有領先地位, 業務更擴展至中東歐及亞洲等地 忠意集團獲惠譽國際授予保險公司財務實力評級 A- ^ 憑著集團雄厚的財政實力, 屢獲獨立評級公司的高度評價 2015 年, 忠意集團榮登 麻省理工學院科技評論雜誌 全球最聰明公司 50 強, 而且是榜上唯一的保險公司 公司資料截至 2016 年 3 月 ^ 惠譽確認評級截至 2016 年 1 月 About Generali Our Generali entities in Hong Kong have been providing comprehensive insurance and investment protection to individuals and organizations since the 1970s. Over the years, we have come to understand the individual requirements of our clients, and are continuously adapting and innovating to meet their changing needs. The Generali Group is one of the largest global insurance providers. We pride ourselves for our history of over 180 years and we are listed amongst the Fortune Global Top 50 companies with 2015 total premium income of more than 74 billion. With above 76,000 employees worldwide serving 72 million insured persons in more than 60 countries, the Group occupies a leadership position in Western European markets and an increasingly important place in Asia and Central and Eastern Europe. Generali and its core subsidiaries have been affirmed A- ^ Insurer Financial Strength ( IFS ) Rating by Fitch Ratings. For our Group s financial strength, we have consistently received high ratings by independent agencies. Generali is also ranked among the world s 50 smartest companies in 2015 according to the MIT Technology Review and we are the only insurer on the list. Company information as at March 2016 ^Rating affirmed by Fitch as at January 忠意保險有限公司香港分行 Assicurazioni Generali S.p.A., Hong Kong Branch 電話 Tel (852) 傳真 Fax: (852) 電郵 網址 Website [email protected] 香港皇后大道東 8 號忠意保險大廈 5 樓 5/F, Generali Tower, 8 Queen s Road East, Hong Kong Civil servant scheme p.20

21 Personal Accident Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員人身意外人身意外保障計劃 保障範圍 Scope of Coverage 提供全球二十四小時意外保障 24 Hour Worldwide Coverage of accident 計劃特點 Product Highlights 本計劃適用於公務員 / 非公務員及其家屬 ( 包括配偶 父母 外父母 祖父母 子女 女婿 媳婦 兄弟姊妹 孫 ) Protection available for Civil Servants &/or Non Civil Servant employees and their family members including spouse, parents, grand parents, mother-in-law, father-in-law, son, son-in-law, daughter-in-law, sibling & grand child(ren). 個人意外計劃之保障額低至港幣 250,000 Personal Accident Plan offers the lowest entry Sum Insured HK$250,000 年繳保費之每張保單保費低至港幣 $300 Annual Premium is as low as HK$300.- 受益人可自由選擇 Beneficiary either estate or designated 個人意外計劃之續保年齡高至 75 歲 ; 並提供最高之意外保障額港幣 500,000 予年屆 歲之同事 Personal Accident Plan offers renewal up to age of 75. For aged 71-75, we offer the highest Sum Insured HK$500,000. 全球二十四小時保障 24 Hour Worldwide Coverage 夫婦同時投保可享有九折優惠 ; 家庭計劃 子女更可獲免費保障 10% Discount will be offered if a couple applies together; Free for Children for Family Plan 投保前毋須體格檢驗 No medical Examination required 所有保障均不設自負金額 No Excess under the policy 提供中醫 西醫醫療保障, 包括針炙及跌打 Covering both Western & Chinese Medical Practitioner including Acupuncturist or Chinese Bonesetter 保障全面 : 包括氣體及食物中毒 暴動及民亂 劫機 失蹤 恐怖活動 天然災難 ( 例如 : 地震 海潚 ) 等 Broader Cover, including Gas and Food Poisoning, Riot and Civil Commotion, Hijacking, Disappearance, Terrorism activities. 保障一切業餘及消閒運動 Cover for all amateur sports 免費保障 : 續保紅利 二級及三級燒傷保障 海外發生之意外死亡 殮葬費用保障等 Free benefits: No claim Renewal Bonus, Burns Benefit (2nd&3rd Degree), Accident Death occurs outside HK & Funeral Expenses. Civil servant scheme p.1

22 Personal Accident Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員人身意外人身意外保障計劃 計劃內容 Benefits 保障項目 Coverage 投保額 ( 港幣 ) Sum Insured (HK$) 每人年繳保費 ( 港幣 ) Annual Premium Per Person (HK$) A. 意外死亡及永久完全或部份傷殘 計劃一 Plan 1: 250,000 計劃一 Plan 1: 300 Accidental Death, Permanent Total or 計劃二 Plan 2: 500,000 計劃二 Plan 2: 590 Partial Disablement 計劃三 Plan 3: 750,000 計劃三 Plan 3: 保障受保人不幸因意外導致永久傷殘或死亡 Covers the Insured Person(s) pass 計劃四 Plan 4: 1,000,000 計劃四 Plan 4: 1,140 away or disability arising from accident 計劃五 Plan 5: 1,500,000 計劃五 Plan 5: 1,625 B. 意外醫療費用 Accidental Medical 計劃一 Plan 1: 5,000 包括 Included Expenses 計劃二 Plan 2: 10,000 - 保障受保人不幸因意外而需接受治療 計劃三 Plan 3: 15,000 Covers the Insured Person s medical 計劃四 Plan 4: 20,000 expenses caused by accident 計劃五 Plan 5: 25,000 - 每次意外最高賠償額 Max. per accident; - 包括跌打及針灸 Includes Bonesetter & Acupuncturist: $200 每日每次 per day per visit, 最高賠償額 max. up to 80% ; $1,500/ 每宗意外 Disability; $2,000/ 每保單年度 Policy Year C. 燒傷保障 ( 二級及三級 ) Burns Benefit(2nd&3rd Degree) - 保障因意外導致損害 Covers the Insured Persons injury arising from burns D. 海外發生之意外死亡 Accident Death occurs outside HK - 額外保障受保人不幸於海外因意外導致永久傷殘或死亡 Additional cover if Insured pass way outside Hong Kong E. 殮葬費用保障 Funeral Expenses 只限意外 Accident Only - 保障受保人不幸因意外死亡而導致之殮葬費用 Covers the funeral expenses if the Insured Person(s) pass away arising from accident F. 續保紅利 No Claim Renewal Bonus G. 子女免費保障 ( 只限父母同時投保 ) Free coverage for child(ren) (If Insured + Spouse enrolled together) 100,000 免費 Free 100,000 免費 Free 5,000 免費 Free 首三年每年可獲保障項目 A) 原本保額之 5% 增益, 直至最高 15% 並以港幣 $ 250,000 為限 For the first 3 years, 5% increase per policy year on the initial amount of benefit A), up to 15% and subject to max. $250,000 父母保障項目 A) 之 15% Free benefit A) 15% of parent 免費 Free 免費 Free *24 小時全球緊急支援服務 Free 24-hour Worldwide Emergency Assistance Hotline Service Civil servant scheme p.2

23 Personal Accident Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員人身意外人身意外保障計劃 備註 Remarks 1) 投保人之投保年齡為 6 個月 65 歲 可續保至 75 歲 ; 歲保障不變 ; 唯 歲之個人意外保障額為原來之 50% 及上限為港幣 500,000, 以較小者為準 ; 此外, 不提供 意外醫療費用 之保障 Age limit: 6 months - 65 (Renewal up to 75; same coverage up to 70. For age 71-75, AD&D sum insured will be reduced by 50% of original amount and subject to max. HK$500,000, whichever is lesser, no AMR will be offered.) 2) 子女年齡 :6 個月至 17 歲之未婚及未就業子女 ( 全日制學生至 25 歲 ) Children Age Limit: unmarried and unemployed child between age 6 個月 17 (or up to age 25 if full time student) 3) 年繳保費之每張保單最低保費為港幣 $ 300 Annual Premium is HK$ ) 夫婦同時投保可享有保費總和 10% 的折扣優惠 夫婦投保計劃必須相同 10% discount will be offered on spouse plan. Spouse s benefit selection must be same as the Principle Insured. 5) 父母之保障額必須等如或低於主要投保人 ( 公務員 ) Parents cover & limits must be either the same or lower than the main Policyholder. 6) 子女投保只限於計劃一或二 Children can only choose Plan 1 & 2 7) 本計劃不接受內地人投保, 除非他 / 她受僱於香港公司並持有香港簽發之工作證及身份證 this Policy will not cover (i) PRC citizens who reside and work within the territory of PRC and/or ii) local citizens who work in local countries unless he/she is employed by the Policyholder in Hong Kong with working permit in Hong Kong and Hong Kong Identity Card issued. 主要不承保事項 Main Exclusions 受保前已存在之損傷或疾病 自我毀傷 任何戰爭引致疾病或受傷 直接參與暴動 內亂 服兵役 任何電子或核子燃料或廢料之污染或輻射 參與職業運動 一切違法行為引致之受傷 懷孕或節育 精神病或智力不健全 因酒精或服食藥物引致之傷害 牙科護理 整容 先天性缺陷或疾病 愛滋病 性病 定期健康檢查或休養 非以乘客身份乘搭飛機所引致的傷害以及列於保單上的不保職業 Pre-existing conditions, self-inflicted injury, acts of war, direct participation in strike, riot, civil commotion, service in military, Nuclear waster, fuel and weapons, radiation, radioactivity, professional sports, illegal acts, pregnancy or treatment pertaining to infertility, mental disorders, conditions caused by chronic, alcoholism or drug addiction, surgical or treatment of dental or cosmetic purpose, congenital anomalies or sickness, AIDS, sexually transmitted diseases, periodic check-up or rest cures, traveling except as fare-paying passenger. Civil servant scheme p.3

24 Personal Accident Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員人身意外人身意外保障計劃 投保書 Application Form 公務員 Civil Servant 非公務員 Non Civil Servant 申請人資料 ( 必須為 18 至 65 歲 ) Applicant Information (Applicant should be aged 18 to 65) 投保人英文姓名 Name of insured in English 投保人中文姓名 Name of insured in Chinese 性別 Sex 聯絡電話 Tel No. 日間 Day Time 夜間 Night Time 通訊地址 Correspondence Address 電郵地址 address Effective Date 生效日期 (dd 日 / mm 月 / yy 年 ): 受保人資料 Insured Person s Personal Information 姓名 Name 出生日期 Date of Birth (DDMMYY) 性別 Sex 身份証號碼 ID Card No. 與第一受保人關係 Relationship with 1st Insured 職業 / 職位 Occupation/ Position ( 實際職務 Nature of Duties) 身高 ( 厘米 ) Height (cm) 體重 ( 公斤 ) Weight (Kg) 第一受保人 基本投保人 ( 公務員 ) 資料 英文及中文姓名 : 政府部門 : 現有保單號碼 : 保費表 Premium Table 計劃一 Plan 1 計劃二 Plan 2 計劃三 Plan3 計劃四 Plan 4 計劃五 Plan5 保費合共 ( 港幣 ) Total Premium (HK$): (Please make payment together with the proposal Cheque should be made payable to 保費需與投保書一併遞交 支票抬頭請付 : Assicurazioni Generali S.p.A. ) 其他保險及健康狀況資料 Past Experience and Insurance History 請將各問題答妥 All questions must be answered fully. 倘各項問題中, 若果答案是 是 者, 請在以下空間提供詳細資料, 註明有關問題號碼, 並提供有關之醫生姓名及地址 ( 如需要更多空間填寫, 可另加紙張, 並須附有簽署 ) If any of the answer is Yes, please give further details in the space below, noting the question number(s), the name(s), address(es) of any doctor(s) consulted (if more space is required, please write on a separated sheet and sign your name on the original application form). Civil servant scheme p.4

25 Personal Accident Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員人身意外人身意外保障計劃 1) 閣下或其他受保人有否已投保或現正申請投保人壽 意外身故 傷殘 或醫療保險? 如有, 請註明保險公司 保障項目 投保額等 Do you or other covered members currently have or are you applying for any life, accident or medical insurance? If yes, please state the Insurer, benefit, sum insured, etc. Yes 有 No 無 2) 閣下或其他受保人有否已投保意外 疾病 傷殘 醫療或人壽保險被拒保 延擱或撤銷? 或曾持有該種保險或證書, 而於事後曾被修正 增加保費 取消 或被拒絕續保? 如有, 請註明保險公司 保障項目 投保額 原因 現狀等. Have your or other covered members applications of life, accident or medical insurance ever been declined or postponed, or your insurance ever been modified, rated-up, cancelled or refused invitation for renewal? If yes, please state the Insurer, benefit, sum insured, reason, condition, etc. Yes 有 No 無 3) 閣下或其他受保人之身體或四肢有無任何殘缺? 如有, 請註明殘缺部位或病徵等 Do you or other covered members have any physical or mental impairment or condition? If yes, please state the suffered area or diagnosis, etc. Yes 有 No 無 4) 閣下或其他受保人曾否患有或曾治療以下疾病 : 心臟病 高血壓 糖尿 癌症 腫瘤 潰瘍 肺結核 哮喘 癲癇 氣腫 肋膜炎 結腸炎 風濕性高熱病 梅毒 或任何腦部 中樞神經系統 腸胃 肝臟 胰 或生殖泌尿器等疾病? Have you or other covered members ever suffered from hypertension, heart disease, mental disorder, diabetes mellitus, cancer, tumour, ulcer, tuberculosis, asthma, epilepsy, stroke, emphysema, pleurisy, colitis, rheumatic fever, venereal disease; or any other disease of brain, central nervous system, gastro-intestinal tract, liver (or is Hepatitis B Carrier), pancreas, kidney, genito-urinary organs, back, spinal column, etc? If yes, please state suffered date, extent of recovery or any recurrence, etc Yes 有 No 無 5) 閣下或其他受保人於過去五年是否曾經或打算將來接受任何醫藥治療 外科手術或服食任何藥物? 如有, 請註明手術及藥物種類 主診醫生姓名及地址 Have you or other covered members received in the past 5 years, currently receiving or will you contemplate to receive any medical, surgical treatment or medication? If yes, please state the type of surgery and medicine, doctor s name and address. Yes 有 No 無 Civil servant scheme p.5

26 Personal Accident Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員人身意外人身意外保障計劃 聲明 本人 / 吾等提供的資料, 為忠意保險提供業務所需, 並可能使用於下列目的 :(i) 任何與保險或財務有關的產品或服務 或該等產品或服務的任何更改 變更 取消或績期 ;(ii) 任何索償 或該等索償的調查或分析 ;(iii) 行使任何代位權 ; 及可能移轉予 :a) 任何有關的公司 或任何其他從事與保險或再保險業務有關公司 或與保險業務有關的中介人或索償或調查或其他服務提供者, 以達到任何上述或有關的 ;(b) 現存或不時成立的任何保險公司協會或聯會或類同組織 ( 聯會 ), 以達到任何上述或有關目的 或以便 聯會 執行其監管職能 或其他基於保險保險業或任何 聯會 會員的利益而不時在合理要求下賦予 聯會 的職能 ; 及 / 或 (c) 透過 聯會 移轉予任何 聯會 的會員, 以達到任何上述或有關目的 此外, 在此授權忠意保險由 聯會 從保險業內收集的資料中查閱及 / 或核對本人 / 吾等任何資料 本人 / 吾等有權查閱及更正由忠意保險持有有關本人 / 吾等的個人資料, 如有需要, 可向忠意保險個人資料保護主任提出 ( 忠意保險有限公司香港分公司 : 香港皇后大道東 8 號忠意保險大廈 5 樓 ) The information I/We provide to Generali is collected to enable Generali to carry on insurance business and may be used for the purpose of: (i) any insurance or financial related product or service or any alternations, variations, cancellation or renewal of such product or service; (ii) any claim or investigation or analysis of such claim; and (iii) exercising any right of subrogation; and may be transferred to: (a) any related company or any other company carrying on insurance or reinsurance related business or an intermediary or a claims or investigation or other service provider providing services relevant to insurance business for nay of the above or related purposes; (b) any association, federation or similar organisation of insurance companies ("Federation") that exists or is formed from time to time for any of the above or related purposes or to enable the Federation to carry out its regulatory functions or such other functions that may be assigned to the Federation from time to time and are reasonably and/or to verify any of my/our data with the information collected by the Federation form the insurance industry. 申請人明白 確知及同意, 忠意保險有限公司會就申請人購買及接受其簽發的保單, 於保單有效期內 ( 包括續保期 ) 向負責安排有關保單的獲授權保險經紀支付佣金 假如申請人為法人團體, 代表申請人簽署的獲授權人員須向忠意保險有限公司確認他她已獲該法人團體授權 申請人亦明白忠意保險有限公司必須取得申請人的同意, 才可以處理其保險申請 I/We have the right to obtain access to and to request correction of any personal information concerning myself/ourselves held by Generali. Requests for such access can be made to Generali's Personal Data Protection Officer. Assicurazioni Generali S.p.A.: 5/F., Generali Tower, 8 Queen s Road East, Hong Kong.) The applicant understands, acknowledges and agrees that, as a result of the applicant purchasing and taking up the policy to be issued by Assicurazioni Generali S.p.A. Assicurazioni Generali S.p.A. will pay the authorized insurance broker commission during the continuance of the policy including renewals, for arranging the said policy. Where the applicant is a body corporate, the authorized person who signs on behalf of the applicant further confirms to Assicurazioni Generali S.p.A. that he or she is authorized to do so. The applicant further understands that the above agreement is necessary for Assicurazioni Generali S.p.A. to proceed with the application. 申請人簽署 Applicant Signature 日期 Date (DDMMYY) 代理人 / 中介人簽署 Producer Signature 公司專用 For Office Use Only Civil servant scheme p.6

27 Personal Accident Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員人身意外人身意外保障計劃 收集個人資料聲明 a) 閣下須要不時向忠意保險有限公司香港分行 ( 本公司 ) 提供關於閣下自己 保單持有人 受保人 受益人 索償人及 / 或其他有關人士的資料 ( 個人資料 ), 以讓本公司為閣下提供保險及 / 或相關產品與服務, 處理經由本公司發出及 / 或安排的保單之下的索償事宜, 及 / 或處理閣下提出的任何或所有其他要求 查詢和投訴 b) 閣下是自願向本公司提供個人資料的 然而, 若閣下未能提供個人資料, 可能導致本公司不能夠為閣下提供保險及 / 或相關產品與服務, 處理經由本公司發出及 / 或安排的保單之下的索償事宜, 及 / 或處理閣下提出的任何或所有其他要求 查詢和投訴 c) 個人資料可被用於以下用途 :i) 處理 ( 包括但不限於承保 ) 及 / 或審批保險及 / 或相關產品與服務的申請, 以及該等產品與服務的任何附加 更改 變更 取消 續期及 / 或復效 ;ii) 管理經由本公司發出及 / 或安排的保單 ;iii) 處理 ( 包括但不限於調查 分析 評估和裁定 ) 及 / 或理賠經由本公司發出及 / 或安排的保單之下的索償事宜 ;iv) 如適用的話, 行使代位權 ;v) 向客戶追收尚欠金額 ( 如有 );vi) 經由本公司發出及 / 或安排的保單之下籌劃共同保險及 / 或再保險 ;vii) 透過電話 郵件 電郵 傳真及其他通訊方式與客戶通訊 ;viii) 客戶服務 ( 包括但不限於處理查詢和投訴 ) 推銷, 以及其他相關活動 ;ix) 進行資料核對程序 ;x) 設計保險及 / 或相關產品與服務供客戶使用 ;xi) 推銷本公司及 / 或本公司的關聯公司 ( 包括但不限於本集團的公司 母公司 本母公司的信託公司 ( 該等關聯公司在下文合稱為 關聯公司 )) 的保險及 / 或其他相關產品與服務 ;xii) 就閣下事前訂明的同意 ( 如有 ) 約束之下, 直接促銷保險及 / 或其他相關產品與服務, 而閣下可在任何時間知會本公司以行使撤回同意的權利 ;xiii) 本公司 關聯公司 相關的保險業協會或聯會 監管當局 政府部門及 / 或其他法定監管機構的統計或精算研究 ;xiv) 遵從任何法律 規則 規例 守則 指引 法院命令 合規政策和程序的規定, 以及本公司及 / 或關聯公司應要遵守的任何其他有關規定, 包括但不限於披露有關資料 ; 及 xv) 實現與上述 (i) 至 (xiv) 直接有關的任何其他用途 d) 由本公司持有的個人資料將受到保密, 但本公司可依據以上 (c) 段所列的用途向以下各方 ( 不論在香港特別行政區境內還是境外 ) 提供個人資料, 事前無須知會閣下及 / 或該等個人資料所涉及的任何其他有關人士 :i) 就本公司的業務營運向本公司提供行政 電訊 電腦 付款 推銷 調查 諮詢及 / 或其他服務的代理人 中介人 索償調查公司 共同保險公司 再保險公司 第三方服務提供商 銀行及信用卡公司 健康及醫療機構 專業顧問 承包商 業務夥伴及 / 或任何其他有關各方, 以適用者為準 ;ii) 相關的保險業協會或聯會, 及 / 或該等協會或聯會的成員 ;iii) 本公司及 / 或關聯公司的海外辦事處或分行, 以適用者為準 ;iv) 根據任何法律 規則 規例 守則 指引 法院命令 合規政策和程序的規定, 以及應要遵守的任何其他有關規定之下, 本公司及 / 或關聯公司負有義務須向其作出披露的人士 ;v) 根據對本公司及 / 或關聯公司有約束力的任何法律之下, 本公司及 / 或關聯公司須向其提供資料的任何法院 監管當局 政府部門或其他法定監管機構 ( 包括但不限於稅務局 );vi) 本公司的合法繼承人或受讓人 ; 及 vii) 對本公司及 / 或關聯公司負有保密責任的人士 e) 本公司可使用由相關的保險業協會或聯會及 / 或該等協會或聯會的成員所收集及發放或轉移的資料, 來核實任何或所有個人資料 f) 根據 個人資料 ( 私隱 ) 條例 :i) 任何人士均有權 :A) 查詢本公司有沒有持有其資料, 如有的話, 可取得一份該等資料 ;B) 要求本公司改正其任何不正確的個人資料 ; 及 C) 查明關於本公司的個人資料政策和處事常規, 並可獲通知有關本公司所持個人資料的種類 ; 及 ii) 本公司有權就處理任何查閱個人資料的要求之下收取合理的費用 g) 如欲查閱及 / 或改正個人資料及 / 或查詢關於本公司的政策和處事常規及所持個人資料的種類, 請向以下人員提出要求 : 個人資料保護主任忠意保險有限公司香港分行香港皇后大道東 8 號忠意保險大厦 5 樓 Personal Information Collection Statement a) From time to time, it is necessary for you to supply Assicurazioni Generali S.p.A., Hong Kong Branch (the Company ) with data about yourself(ves), policyholder(s), life insured(s), beneficiary(ies), claimant(s), and/ or other relevant individuals (the Personal Data ) in connection with the provision of insurance and/ or related products and services to you, the processing of claims under insurance policies issued and/ or arranged by the Company, and/ or the processing of any or all other requests, enquiries and complaints from you. b) Provision of the Personal Data to the Company by you is voluntary. However, failure to supply the Personal Data may result in the Company being unable to provide insurance and/ or related products and services to you, process claims under insurance policies issued and/ or arranged by the Company, and/ or process any or all other requests, enquiries, or complaints from you. c) The purposes for which the Personal Data may be used are as follows: i) processing (including, without limitation, underwriting) and/ or approving applications for insurance and/ or related products and services, and any addition, alteration, variation, cancellation, renewal and/ or reinstatement of such products and services; ii) administering insurance policies issued and/ or arranged by the Company; iii) processing (including, but not limited to, investigating, analyzing, assessing and adjudicating) and/ or settlement of claims under insurance policies issued and/ or arranged by the Company; iv) exercising rights of subrogation, if applicable; v) collection of amounts outstanding (if any) from customers; vi) arranging coinsurance and/ or reinsurance in respect of the insurance policies issued and/ or arranged by the Company; vii) communicating with customers via telephone, mail, , facsimile and other communication means; viii) customer services (including, but not limited to, processing enquiries and complaints), marketing, and other related activities; ix) conducting data matching procedures; x) designing insurance and/ or related products and services for customers use; xi) marketing insurance and/ or other related products and services of the Company and/ or its affiliated companies (which includes, but are not limited to, its group companies, parent company, trust companies of the Company s parent company (hereinafter such affiliated companies are collectively referred to as the Affiliated Companies )); xii) direct marketing of insurance and/ or other related products and services subject to your prior prescribed consent (if any), and you can exercise the right of opt-out by notifying the Company at any time; xiii) statistical or actuarial research of the Company, its Affiliated Companies, relevant insurance industry associations or federations, supervisory authority, government department and/ or other competent authority; xiv) complying with the requirements under any laws, rules, regulations, codes, guidelines, court orders, compliance policies and procedures, and any other relevant requirements which the Company and/ or its Affiliated Companies are expected to comply with, including, without limitation, making disclosures of the relevant information; and xv) fulfilling any other purposes directly relating to (i) to (xiv) above. d) The Personal Data held by the Company shall be kept confidential, but the Company may provide the Personal Data to the following parties (whether within or outside the Hong Kong Special Administrative Region) for the purposes set out in paragraph (c) above, without prior notification to you and/ or any other relevant individuals to whom the Personal Data is related: i) agents, intermediaries, claims investigation companies, coinsurance companies, reinsurance companies, third party service providers, banks and credit-card companies, health and medical organizations, professional advisers, contractors, business partners, and/ or any other relevant parties, as appropriate, who provide administrative, telecommunication, computer, payment, marketing, investigation, advisory and/ or other services to the Company in connection with the operation of its business; ii) relevant insurance industry associations or federations, and/ or members of such industry associations or federations; iii) overseas locations or branches, as appropriate, of the Company and/ or its Affiliated Companies; iv) persons to whom the Company and/ or its Affiliated Companies are under an obligation to make disclosure under the requirements of any laws, rules, regulations, codes, guidelines, court orders, compliance policies and procedures, and any other relevant requirements which the Company and/ or its Affiliated Companies are expected to comply with; v) any court, supervisory authority, government department or other competent authority (including, without limitation, tax authority) under any laws binding on the Company and/ or its Affiliated Companies; vi) lawful successors or assigns of the Company; and vii) persons who owe a duty of confidentiality to the Company and/ or its Affiliated Companies. Civil servant scheme p.7

28 Personal Accident Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員人身意外人身意外保障計劃 e) The Company may verify any or all of the Personal Data by using information collected and released or transferred by relevant insurance industry associations or federations, and/ or members of such industry associations or federations. f) In accordance with the Personal Data (Privacy) Ordinance: i) any individual has the right to: A) check whether the Company holds data about him/ her and, if so, obtain a copy of such data; B) require the Company to correct any data relating to him/ her that is inaccurate; and C) ascertain the Company s policies and practices in relation to data and to be informed of the kind of data held by the Company; and ii) the Company has the right to charge a reasonable fee for the processing of any data access request. g) The person to whom requests for access to data and/ or correction of data and/ or for information regarding policies and practices and kinds of data held are to be addressed as follows: Personal Data Protection Officer, Assicurazioni Generali S.p.A., Hong Kong Branch, 5/F, Generali Tower, 8 Queen s Road East, Hong Kong. 使用及提供個人資料作直接促銷 ( 本節條文是組成 收集個人資料聲明 的一部分 ) 1) 個人資料, 包括但不限於, 姓名 聯絡的詳細資料 其他產品及服務組合資料 交易模式及行為, 財務背景及人口統計資料可被用作於直接促銷 :i) 本公司及關聯公司的保險及 / 或其他相關產品與服務 ;ii) 本公司跟聯名品牌夥伴的保險及 / 或其他相關產品與服務 ( 聯名品牌夥伴之名稱將載於相關產品及服務的申請表 建議書 宣傳小冊子及 / 或廣告單張 / 海報, 以適用者為準 ) 及 / 或本公司所選定的第三方 ;iii) 本公司, 關聯公司及聯名品牌夥伴的獎賞 忠誠及 / 或優惠項目 / 計劃 2) 就以上 (1) 段所述的用途, 個人資料亦可被提供予本公司的關聯公司, 聯名品牌夥伴及本公司所選定的第三方服務提供商, 包括但不限於, 客戶服務中心 3) 本公司須獲閣下允許 ( 包括表示不反對 ) 本公司可按照本節條文所述的用途使用個人資料 若閣下不希望本公司使用或向第三方提供個人資料作直接促銷用途, 閣下可於下方行使退出權利或於日後任何時間知會本公司 如閣下不同意個人資料用作下列直接促銷用途, 請在以下方格內加上剔號 ( ) : 本人 / 我們不允許貴公司向本文所述的第三方提供個人資料作直接促銷用途 本人 / 我們不允許貴公司使用個人資料作直接促銷用途 ( 若閣下沒有在方格內加上剔號但簽署本表格 / 文件, 閣下會被視之為不反對 ( 即閣下允許 ) 本公司使用或向第三方提供個人資料作直接促銷用途 ) 附註 : 本收集個人資料聲明的英文及中文版本之間如有任何歧義, 概以英文版本為準 聲明 : 本人 / 我們確認, 本人 / 我們已獲提供一份由忠意保險有限公司香港分行 ( 忠意保險 ) 發出的收集個人資料聲明 ( 該聲明 ) 本人 / 我們確認已經閱讀並且明白該聲明 本人 / 我們同意忠意保險可依照該聲明的條款收集 使用 儲存 披露 轉移及以其他方式處理本人 / 我們的個人資料 本人 / 我們進一步確認, 本人 / 我們已獲得受保人和任何其他有關人士 ( 如適用的話 ) 的明示同意, 可以按照該聲明所述的用途將他們的個人資料提供給忠意保險, 並允許忠意保險可依照該聲明的條款收集 使用 儲存 披露 轉移及以其他方式處理該等個人資料 Use and Provision of Personal Data in Direct Marketing (This section forms part of the Personal Information Collection Statement.) 1) The Personal Data, including but not limited to, name, contact details, other products and services portfolio information, transaction pattern and behavior, financial background and demographic information may be used for the purpose of direct marketing: i) insurance and/ or other related products and services of the Company and its Affiliated Companies; ii) insurance and/ or other related products and services of the Company s co-branding partners (the names of such co-branding partners can be found in the application form(s), proposals, brochures and/ or advertising leaflet(s)/ poster(s) for the relevant products and services, as appropriate) and/ or third parties selected by the Company; iii) reward, loyalty and/ or privileges programs/ plans of the Company, its Affiliated Companies and co-branding partners. 2) The Personal Data may also be provided to the Company s Affiliated Companies, co-branding partners and third party service providers selected by the Company for the purpose set out in paragraph (1) above, including, without limitation, call centres. 3) The Company requires your consent (which includes an indication of no objection) to the use of Personal Data for the purpose set out in this section. If you do not wish the Company to use or provide to other parties the Personal Data for the purpose of direct marketing, you may exercise the opt-out right below or by notifying the Company at any time thereafter. Please tick ( ) the boxes below if you do not agree with the following use(s) of the Personal Data in direct marketing. I/ We do not consent to the provision of the Personal Data to the third parties as described herein for the purpose of direct marketing. I/ We do not consent to the use of the Personal Data by the Company for the purpose of direct marketing. (If you do not tick the boxes but sign the Form/ document, you will be regarded as having indicated you have no objection (i.e. you consent) to the use or transfer to third parties of the Personal Data for the purpose of direct marketing by the Company.) Note: In case of discrepancies between the English and Chinese versions of this Personal Information Collection Statement, the English version shall prevail. Declaration: I/ We acknowledge that I/ we have been provided with a copy of the Personal Information Collection Statement (the Statement ) issued by Assicurazioni Generali S.p.A., Hong Kong Branch ( Generali ). I/ We confirm that I/ we have read and understood the Statement. I/ We agree that Generali may collect, use, store, disclose, transfer and otherwise process my/ our personal data in accordance with the terms of the Statement. I/ We further confirm that I/ we have obtained the express consent of the life insureds and any other relevant individuals (where applicable) for providing their personal data to Generali for the purposes stated in the Statement and for allowing Generali to collect, use, store, disclose, transfer and otherwise process such personal data in accordance with the terms of the Statement.. 投保人 / 索償人 / 保單持有人 / 受保人簽署 Signature of Applicant/Claimant/Policyholder(s)/Life Insured(s) 日期 Date Civil servant scheme p.8

29 Personal Accident Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員人身意外人身意外保障計劃 忠意集團 Generali Group 有關忠意集團自 1970 年代起, 忠意集團旗下的公司在香港一直為個人及企業提供全面的保險及投資保障服務 多年以來, 我們了解到客戶不同的個別需求, 並不斷隨時代改進去迎合客戶的真正所需 忠意是世界最大的保險集團之一, 並擁有超過 180 年歷史 2015 年, 集團總保費收入超過 740 億歐羅, 成功並列 財富 世界 50 強 現有超過 7 萬 6 千員工遍佈全球超過 60 多個國家, 為 7 千 2 百萬客戶提供優質專業服務 集團在西歐市場佔有領先地位, 業務更擴展至中東歐及亞洲等地 忠意集團獲惠譽國際授予保險公司財務實力評級 A- ^ 憑著集團雄厚的財政實力, 屢獲獨立評級公司的高度評價 2015 年, 忠意集團榮登 麻省理工學院科技評論雜誌 全球最聰明公司 50 強, 而且是榜上唯一的保險公司 公司資料截至 2016 年 3 月 ^ 惠譽確認評級截至 2016 年 1 月 About Generali Our Generali entities in Hong Kong have been providing comprehensive insurance and investment protection to individuals and organizations since the 1970s. Over the years, we have come to understand the individual requirements of our clients, and are continuously adapting and innovating to meet their changing needs. The Generali Group is one of the largest global insurance providers. We pride ourselves for our history of over 180 years and we are listed amongst the Fortune Global Top 50 companies with 2015 total premium income of more than 74 billion. With above 76,000 employees worldwide serving 72 million insured persons in more than 60 countries, the Group occupies a leadership position in Western European markets and an increasingly important place in Asia and Central and Eastern Europe. Generali and its core subsidiaries have been affirmed A- ^ Insurer Financial Strength ( IFS ) Rating by Fitch Ratings. For our Group s financial strength, we have consistently received high ratings by independent agencies. Generali is also ranked among the world s 50 smartest companies in 2015 according to the MIT Technology Review and we are the only insurer on the list. Company information as at March 2016 ^Rating affirmed by Fitch as at January 2016 忠意保險有限公司 Assicurazioni Generali S.p.A. 香港皇后大道東 8 號忠意保險大廈 5 樓 5/F, Generali Tower, 8 Queen s Road East, Hong Kong 電話 Tel: (852) 傳真 Fax: (852) 香港分行電郵 : A&[email protected] Hong Kong Branch A&[email protected] 香港分行網址 : Hong Kong Branch Website: Civil servant scheme p.9

30 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 保障範圍 Scope of Coverage 保障受保人於外地旅行時發生意外或遇上疾病 Protect the Insured Persons from accident and sickness in worldwide. 計劃特點 Product Highlights 1) 本計劃適用於公務員 / 非公務員及其家屬 ( 包括配偶 父母 外父母 祖父母 子女 女婿 媳婦 兄弟姊妹 孫 ) Protection available for Civil Servants &/or Non Civil Servant employees and their family members including spouse, parents, grandparents, mother-in-law, father-in-law, son, son-in-law, daughter-in-law, sibling & grandchild(ren). 2) 保障全面 : 包括氣體及食物中毒 暴動及民亂 劫機 失蹤 恐怖活動 天然災難 ( 例如 : 地震 海潚 ) 等 Extensive Coverage including Gas & Food Poisoning, Riot and Civil Commotion, Hijacking, Disappearance, Terrorist Activities, Natural Disasters (e.g. Earthquake, Tsunami, etc) 3) 年繳保費之每張保單保費低至港幣 $735 Annual Premium is as low as HK$ ) 受益人可自由選擇 Beneficiary either estate or designated. 5) 所有保障均不設自負金額 No Excess under the policy 6) 全年保障, 無次數旅程限制 Full year cover with unlimited no. of trips. 7) 每次旅程保障最長可達 120 日 Covering trips up to 120 days. 8) 適合任何 18 歲至 72 歲人士申請 Applicant can be aged 18 to 72. 9) 24 小時全球緊急支援服務, 包括海外入院現金保證 24-hours Worldwide Emergency Assistance Services including overseas hospital admission guarantee. 10) 保障包括恐怖襲擊引致之醫療費用 人身意外 行李 / 證件遺失等 Terrorist Act cover including Medical Expenses, Personal Accident, Loss of Baggage/ Travel Document. 11) 醫療費用高達港幣一百萬, 回港後之覆診費用包括中醫治療 跌打及針灸 18 歲以下的受保人 ( 適用於 家庭 計劃 ) 於此項目保障更可享有全額的保障 Medical Expenses Benefit up to HK$1,000,000, follow-up medical cover, including Chinese medicine, bonesetter & acupuncture. In this benefit item, full reimbursement is applied to those travelers aged below 18 (applicable to "Family" plan). 12) 人身意外保障高達港幣一百萬元 Personal Accident Benefit up to HK$1,000, ) 可附加中國醫療保證咭 China Medical Guarantee Card is available at optional. 14) 提供中醫 西醫醫療保障, 包括針炙及跌打 Covering both Western & Chinese Medical Practitioner including Acupuncturist or Chinese Bonesetter 15) 保障一切業餘及消閒活動 ( 包括滑雪 水肺潛水 激流 高空彈簧跳繩 高山遠足 跳傘及騎馬等 ) Covering all kinds of leisure sports (e.g. skiing, scuba diving, rafting, bungee jumping, hiking, parachuting, horse riding, etc). 16) 個人行李保障包括高爾夫球用品及手提電腦 Personal Baggage cover including golf equipment and lap-top computer. 17) 旅程於不能避免的情況下延期, 保障期將自動延長至最多 10 天 Automatic cover extension for up to 10 days if the trip is unavoidably delayed. 計劃內容 Benefits Coverage 保障範圍 1. Emergency Medical 緊急醫療 Premier Plan 尊貴計劃 Maximum Limit (HK$) 最高賠償額 ( 港幣 ) Classic Plan 優越計劃 Standard Plan 標準計劃 a. Medical Expenses 醫療費用 1,000, , ,000 b. Overseas Hospital Cash (500/day) 8,000 5,000 2,500 海外住院現金 ( 每日港幣 500) c. Medical Facility Extension 醫療設施津貼 20,000 15,000 10,000 Civil servant scheme p.1

31 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 2 Personal Accident 人身意外 3. Worldwide Emergency Assistance Service 全球緊急支援服務 4. Travel Inconvenience 旅程受阻 a. Personal Accident 人身意外 1,000, , ,000 b. Burns Benefit 燒傷保障 300, , ,000 a. Emergency Medical Evacuation Actual Actual Actual 緊急醫療運送 Cost Cost Cost b. Repatriation of Mortal Remains Actual Actual Actual 遺體運返 Cost Cost Cost c. 24-hours Worldwide Emergency Included Included Included Assistance Service 24 小時全球緊急支援服務 a. Trip Cancellation 取消旅程 30,000 30,000 25,000 b. Trip Curtailment or Re-arrangement 30,000 30,000 25,000 縮短旅程或更改旅程 c. Travel Delay (500 per 6 hours) 2,000 2,000 2,000 旅程延誤 ( 每六小時港幣 500) d. Baggage Delay (over 6 hours) 1,000 1,000 1,000 行李延誤 ( 超過六小時 ) 5. Personal Belongings a. Personal Baggage 個人行李 20,000 15,000 10,000 個人財物 b. Personal Money 個人金錢 3,000 2,500 2,000 c. Loss of Travel Document 10,000 7,500 5,000 證件遺失 d. Emergency Cash 應急現金 10,000 7,500 5, Special Care a. Compassionate Visit 親屬探望 20,000 15,000 10,000 附加保障 b. Child Escort 子女護送 20,000 15,000 10,000 c. Credit Card Protection 50,000 30,000 20,000 信用咭保障 d. Consolation Benefit 恩恤保障 20,000 15,000 10,000 e. Hospital Income Plus 8,000 5,000 2,000 附加住院現金 f. Rental Vehicle Excess 5,000 5,000 5,000 租車自負額保障 g. Compulsory Quarantine Cash 5,000 5,000 5,000 Allowance 強制隔離現金津貼 7. Legal Liability 法律責任 a. Personal Liability 個人責任 3,000,000 2,000,000 1,000, Optional Benefit 自選附加保障 Annual Premium (HK Dollars) 全年保費 ( 港幣 ) Additional Upgrade Personal Accident Benefits 星級個人意外附加保障 i) Upgrade Additional Personal Accident Benefit 星級個人意外保障 長表 Scale 2 長表 Scale 2 長表 Scale 2 ii) Scarring of the Face Benefit 20,000 20,000 20,000 臉部疤痕保障 iii) Kidnap Benefit 綁架保障 15,000 15,000 15,000 Individual 個人 1,995 1, Family 家庭 3,590 2,460 1,325 Optional: Additional Upgrade Personal Premium of Basic Plan x 1.25 Accident Benefit 星級個人意外附加保障 基本保障保費 Civil servant scheme p.2

32 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 基本保障 Basic Plan 保障範圍 Table Of Coverage 1) 緊急醫療 EMERGENCY MEDICAL A. 醫療費用 - 在受保旅程期間因意外受傷或疾病所支付的醫療費用, 包括住院 門診及手術, 均可獲得賠償 - 覆診費用 如受保人於海外接受診治後, 回港後 90 日內繼續接受治療的醫療費用, 亦可獲得賠償 因意外受傷之最高賠償金額為保障餘額的 100%; 而因患病之最高賠償金額為保障餘額的 10% 覆診並包括註冊 / 表列中醫 跌打及針灸治療, 每日每症的最高限額為 HK$150, 最高為 HK$3,000 Medical Expenses - Reimbursement of medical expenses, including outpatient, surgery and hospitalization arising from accident or sickness during the period of insurance - Follow-up medical treatment incurred within 90 days after returning to Hong Kong will be covered up to 100% of unused portion of sum insured for injury, and will be covered up to 10% of unused portion of sum insured for sickness. This benefit also includes expenses for registered / listed chinese herbalist, chinese bonesetter and acupuncturist up to HK$150 per visit per day, max. HK$3,000 B. 海外住院現金 - 在受保旅程期間因意外或疾病而需入院接受治療, 住院期間每天可獲現金 HK$500 補償 Overseas Hospital Cash - HK$500 per day will be payable if necessarily confined in a hospital due to accident or sickness overseas during the period of insurance C. 醫療設施津貼 - 因意外導致傷殘而需要安裝家居及日常活動輔助設施的項目 Medical Facility Extension - Reimbursement on cost of medical facilily equipment and installation for household and daily purpose, as a result of accidental permanent total disablement 2) 人身意外 PERSONAL ACCIDENT A. 人身意外 - 如受保人在外地因意外導致死亡或永久完全傷殘, 將可獲得賠償 (17 歲或以下人士之保障額為原本的 50%) Personal Accident - In the event of death or disablement arising as a result of an accident abroad, maximum benefits up to the limit stated in the coverage will be payable (For those aged 17 or below, coverage will be 50%) B. 燒傷保障 - 受保人在外地因意外導致身體燒傷程度達二級或三級 Burns Benefit - Compensation for Second or Third Degree Burn of body surface arising from accident abroad. 3) 全球緊急支援服務 WORLDWIDE EMERGENCY ASSISTANCE SERVICE A. 緊急醫療運送 - 因應緊急醫療而需運送嚴重受傷或患病之受保人至就近地區或返回香港進行治療, 賠償額並不設上限, 確保受保人得到最充分的保障 Emergency Medical Evacuation - Necessary evacuation to Hong Kong or nearest place for appropriate medical treatment due to serious injury or sickness. Payment on actual cost basis without any limit so to ensure adequate protection Civil servant scheme p.3

33 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 B. 遺體運返 - 安排運送在外地身亡的受保人之遺體或骨灰返回香港 Return of Mortal Remains - Necessary arrangement to return deceased insured person's mortal remains to Hong Kong C. 24 小時全球緊急熱線支援服務 - 包括代付入院保證金 電話醫療諮詢 醫生及醫院轉介 法律服務轉介及緊急旅遊服務 24-hours Worldwide Emergency Assistance Services - Including hospital admission guarantee, phone medical advice and evaluation, referral to doctors and hospitals, medical evacuation and repatriation, referral to legal service and emergency travel service 4) 旅程受阻 TRAVEL INCONVENIENCE A. 取消旅程 ( 此保障在保單簽發後及出發前 30 天內生效 ) 受保人如因以下原因而必須取消旅程, 其不能退回的旅行團費用 訂金 住宿及 / 或機票費用, 均可獲得賠償 : - 受保人 其直系親屬 商業夥伴或同行夥伴之身故 嚴重受傷或病重 ; - 受保人於出發前 7 天內目的地突然發生航運機構員工之罷工 暴亂 民亂 天然災難 恐怖襲擊或爆發傳染病 ; - 受保人因法庭傳召履行陪審團責任 證人或需被政府強制性隔離 ; - 受保人出發前 7 天住所因火災 水災或天然災難而嚴重損毀並需受保人逗留在家中 Trip Cancellation (This coverage is effected within 30 days before commencement of the insured trip or after policy issuance, whichever is later) Reimbursement for the loss of travel expenses, including travel fare, tour fee and/or accommodation expenses paid in advance, in the event of cancellation of the trip due to : - death or serious injury or serious sickness of the insured person, immediate family member, close business partner or traveling companion; - sudden occurrence of strike by the employees of a public common carrier, unanticipated outbreak of riot, civil commotion, terrorism, natural disaster or epidemic at the planned destination within one week before the departure date; - witness summons, jury service or compulsory quarantine of the insured person; - serious damage to insured person's home arising from fire, flood or natural disaster within one week before the departure date Bi) 縮短旅程受保人如因以下原因引致旅程提早返港, 其不能退回之未享用旅遊費 訂金及 / 或額外住宿及交通費用, 均可獲得賠償 : - 如啟程後, 受保人 其直系親屬 商業夥伴或同行夥伴身故 嚴重受傷 病重或劫持 ; - 目的地突然發生航運機構員工之罷工 暴亂 民亂 惡劣天氣 天然災難 恐怖襲擊或爆發傳染病或 ii) 更改旅程因以下原因而必需更改行程, 其額外之住宿及交通費用均可獲得賠償 : - 如啟程後, 目的地突然發生航運機構員工之罷工 暴亂 民亂 惡劣天氣 天然災難 恐怖襲擊或爆發傳染病 - 所乘班機因嚴重延誤 24 小時以上而不能接駁另一班航機所引致的額外交通費用可獲得賠償 B. i) Trip Curtailment Reimbursement for the additional or forfeited travel fare and/or accommodation expenses incurred arising from: - death, serious injury, serious sickness or hijack of the insured person, immediate family member, close business partner or travelling companion; - sudden occurrence of strike by the employees of a public common carrier, unanticipated outbreak of riot or civil commotion, adverse weather conditions, natural disasters, terrorism or epidemic at the planned destination OR ii) Trip Re-arrangement Civil servant scheme p.4

34 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 Reimbursement for the additional travel fare and/or accommodation expenses incurred upon having to re-route the planned trip arising from: - sudden occurrence of strike by the employees of a public common carrier, unanticipated outbreak of riot and civil commotion, terrorism, adverse weather conditions, natural disaster or epidemic at the planned destination - Reimbursement for additional transportation expenses due to the scheduled flight suffers serious delay over 24 hours and has to re-route the flight to catch up with another scheduled flight C. 旅程延誤 - 因惡劣天氣 天然災難 恐怖襲擊 機件故障 劫持或所乘坐之航運機構員工之罷工而引致所乘坐之公共交通工具延誤, 每 6 小時可獲 HK$500 現金補償 Travel Delay - HK$500 cash for each full 6 hours delay if the scheduled public common carrier is delayed due to adverse weather conditions, natural disasters, equipment failure, hijacking or strike by the employees of the public common carrier D. 行李延誤 - 受保人隨行之寄運行李因運送延誤達 6 小時或以上, 可獲得賠償購買必需品應急 ( 第 4B(ii) 更改旅程及第 4C 旅程延誤不能在同一事件下索償 ) Baggage Delay - Compensation for emergency purchases due to over 6 hours delay of accompanied baggage abroad (No benefit will be provided for the claim under both coverage 4B(ii) Trip Rearrangement and coverage 4C Travel Delay due to same event.) 5) 個人財物 PERSONAL BELONGINGS A. 個人行李 - 旅程期間受保人隨行之行李因意外損壞 遺失 被竊或搶劫, 每項 / 套 / 對物品最高賠償額為 HK$3,000; 運動用品為 HK$5,000 及個人電腦為 HK$10,000, 手提電話保障額為 HK$2,500 Personal Baggage - Indemnify for loss of or damage to personal baggage arising from accident, theft or robbery during the trip. Every set/pair of item up to HK$3,000; sports equipment up to HK$5,000 per set/pair; laptop computer up to HK$10,000 per set/item; mobile phone up to HK$2,500 per item B. 個人金錢 - 旅程期間因意外遺失 被竊 搶劫導致現金 旅行支票或匯票等之損失, 均可獲得賠償 Personal Money - Reimburse for the loss of cash, bank notes, traveler's cheques and/or money order as a result of accidental loss, theft, robbery or burglary C. 證件遺失 - 旅程期間受保人的旅遊證件被竊 搶劫或意外遺失所引致的額外交通 酒店住宿及有關之證件補領費用均可獲得賠償 Loss of Travel Document - Reimburse for the additional transportation, accommodation and document replacement cost arising from loss of essential travel documents abroad D. 應急現金 - 在外地因意外損毀或遺失重要旅行證件而需滯留當地, 並於 24 小時內報警, 辦理補領證件手續期間每天可獲得 HK$500 補償 ( 如索償 5A 5B 5C 5D, 須於 24 小時內於當地報警及出示報案紙正本 ; 第 4D 行李延誤及 5A 個人行李不能在同一事件下索償 ) Civil servant scheme p.5

35 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 Emergency Cash - If the insured person has to necessarily stay behind due to loss of or damage to essential travel documents abroad, the company shall pay HK$500 each calendar day until the documents are recovered, or the insured person can leave the place where loss occurred (For the claims of coverage 5A, 5B, 5C, 5D, police report must be obtained locally within 24 hours and submitted with original copy and receipts; No benefit will be provided for the claim under coverage 4D Baggage Delay and coverage 5A Personal Baggage due to same event.) 6) 附加保障 SPECIAL CARE A. 親屬探望 Compassionate Visit - 受保人在外地如不幸身故 嚴重受傷或病重而需住院超過 24 小時, 經審核後因應緊急需要可獲安排一名直系親屬前往探望或一名同行伙伴逗留照顧受保人, 保障包括來回交通及住宿酒店費用 - Indemnify for the additional traveling and accommodation expenses necessarily incurred by an immediate family member to fly over or by one accompanying traveling companion to stay behind with the insured person who is hospitalized or passed away abroad B. 子女護送 Child Escort - 受保人在外地如不幸身故或入院, 因應緊急需要, 無人照顧的 17 歲或以下之同行子女可獲安排護送返港 - Indemnify for the additional traveling and accommodation expenses for returning the insured person's accompanying child(ren) who is (are) aged 17 or below and no other adult accompanied the child(ren) back to Hong Kong if the insured person passes away or sustains serious injury or sickness abroad C. 信用咭保障 Credit Card Protection - 受保人在外地因意外身故, 在旅程期間以信用咭簽賬購物之未繳結餘及費用可獲賠償 - In the event of death of the insured person due to accident abroad, the unsettled credit card purchases during the period of insurance and charges incurred will be compensated D. 恩恤保障 Consolation Benefit - 受保人於旅程期間因意外或疾病而導致死亡 - Compensation will be payable for the insured person's immediate family member if the insured person passed away as a result of sudden injury or sickness abroad within the period of insurance E. 附加住院現金 Hospital Income Plus - 因在外地嚴重受傷或疾病導致回港後需入院繼續治療, 回港後 90 日內之住院期間每天可獲 HK$300 補償 - HK$300 cash per day within a 90 days period after returning to the home country if the insured person is confined to a hospital due to serious injury or sickness sustained abroad F. 租車自負額保障 Rental Vehicle Excess - 若受保人在旅遊期間駕駛租用車輛而發生意外碰撞或意外損毀或在停泊時車輛被偷竊, 受保人須負責的自負額可獲賠償特別條款受保人必須購買由有關出租車輛機構安排的汽車綜合保險以保障於租車期間對出租車輛之損失 - Reimbursement for the excess, which the insured person is liable under part of hiring agreement, if the insured person rents or hires a rental vehicle during the period of insurance and the vehicle is involved in a collision whilst under his/ her control, or it is damaged, or stolen during parking Special Condition: The insured person must purchase relevant comprehensive motor vehicle insurance arranged by the rental organization against loss of or damage to the rental vehicle during the rental period Civil servant scheme p.6

36 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 G. 強制隔離現金津貼 Compulsory Quarantine Cash Allowance - 於旅程期間或於回港後 7 天內因感染傳染病而被強制隔離, 每天可獲 HK$500 的現金津貼 - HK$500 per day will be payable for each complete day of compulsory quarantine due to infection with an infectious disease during the covered trip or within 7 days upon return to Hong Kong 7) 法律責任 LEGAL LIABILITY A. 個人責任 - 因疏忽導致第三者受傷或財物損毀而負上的法律責任 有關之責任必須由本公司代為處理 ( 保障不適用於駕駛或租用汽車 飛機及任何水上機動遊戲 ) Personal Liability - Covers the insured person against legal liability for bodily injury or properly damage to a third party due to the insured person's negligence. The company shall take over for any settlement that is being made (Not applicable for any driving or rental of automobile, aircraft and watercraft) 自選附加保障 Optional Benefits 8) 星級個人意外附加保障 Additional Upgrade Personal Accident Benefit 投保人只需額外繳付保費之 25%, 即可享有以下附加保障, 令旅程更加放心 : i. 星級個人意外保障 ii. 臉部疤痕保障 iii. 綁架保障 Insured person can gain the following extensive protection by only paying an extra 25% of the original premium, so as to enjoy a wonderful trip with no worry i. Upgrade Additional Personal Accident Benefit ii. Scarring Of The Face Benefit iii. Kidnap Benefit i) 星級個人意外保障 UPGRADE ADDITIONAL PERSONAL ACCIDENT BENEFIT 現時一般之旅遊保險保單只會在受保人意外死亡 單肢或雙肢永久完全傷殘 永久完全失聰及失明等方可作出賠償, 此星級個人意外保障大幅增加保障範圍至 19 項, 就算意外傷殘種類不在損害事項表列中, 本公司亦會以註冊西醫診斷之傷殘程度作參考而予以賠償, 令保障更為全面 Unlike most of the similar travel products in the market which only indemnify for accidental death, permanent total disablement of one limb or both limbs caused by accident, permanent total loss of sight or hearing, the "Upgrade Additional Personal Accident Cover" provides a wider coverage for personal accident compensation 個人意外賠償表 Compensation Table 意外死亡及傷殘 最高賠償額 百分比 Events Percentage of Amount of Benefits 1 意外死亡 Loss of Life 100% 2 永久完全殘廢 Permanent Total Disablement 100% 3 四肢永久癱瘓及無法痊癒 Permanent and Incurable Paralysis of all Limbs 100% 4 永久完全喪失雙眼視力 Permanent Total Loss of Sight of both Eyes 100% 5 永久完全喪失一眼視力 Permanent Total Loss of Sight of one Eye 100% 6 喪失任何雙肢或任何雙肢完全失去功能 100% Loss of or the Permanent Total Loss of use of two Limbs 7 喪失任何一肢或任何一肢完全失去功能 Loss of or the Permanent Total Loss of use of one Limb 右手 Right Hand 100% Civil servant scheme p.7

37 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 左手 Left Hand 100% 一足 One Foot 100% 8 雙耳完全失聰及完全喪失言語能力 Loss of Speech and Hearing 100% 9 永久及無法痊癒之精神錯亂 Permanent and incurable Insanity 100% 10 永久完全失聰 Permanent Total Loss of Hearing in 雙耳 both Ears 75% 單耳 one Ear 15% 11 完全喪失言語能力 Loss of Speech 50% 12 永久完全喪失一眼晶狀體 Permanent Total Loss of the Lens of one Eye 50% 13 喪失或永久完全喪失四隻手指及拇指功能 Loss of or the Permanent Total Loss of use of four Fingers and Thumb of 右手 Right Hand 70% 左手 Left Hand 50% 14 喪失或永久完全喪失四隻手指功能 Loss of or the Permanent Total Loss of use of four Fingers of 右手 Right Hand 40% 左手 Left Hand 30% 15 喪失或永久完全喪失一隻拇指功能 Loss of or the Permanent Total Loss of use of one Thumb 兩個右關節 both Right Joints 30% 一個右關節 one Right Joint 15% 兩個左關節 both Left Joints 20% 一個左關節 one Left Joint 10% 16 喪失或永久完全喪失手指功能 Loss of or the Permanent Total Loss of use of Fingers 三個右關節 three Right Joints 15% 兩個右關節 two Right Joints 10% 一個右關節 one Right Joint 7.5% 三個左關節 three Left Joints 10% 兩個左關節 two Left Joints 7.5% 一個左關節 one Left Joint 5% 17 喪失或永久完全喪失腳趾功能 Loss of or the Permanent Total Loss of use of Toes 所有腳趾 - 一隻腳 all toes - one Foot 20% 腳拇趾 - 兩個關節 great - both Joints 7.5% 腳拇趾 - 一個關節 great - one Joint 5% 18 折斷腿部或膝蓋而無法聯合 15% Fractured Leg or Patella with established non-union 19 腿部因意外而做手術後導致縮短五厘米或以上 10% Shortening of Leg by at least 5cm 20. 一切在上述第 10 至 19 項損害事項以外的永久殘缺, 忠意保險有限公司有絕對判斷權利決定該永久殘缺的保額百 分率, 但不會與以上第 10 至 19 項之百分率不一致 Permanent Disablement not otherwise provided for under Events 10 to 19 inclusive. Such percentage of the Principal Sum Insured as the Company shall in its absolute discretion determine and being in its opinion not inconsistent with the Compensation provided under Events 10 to 19 inclusive Civil servant scheme p.8

38 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 ii) 臉部疤痕保障 SCARRING OF THE FACE BENEFIT 若受保人不幸因意外導致永久性毀容或臉部永久性疤痕, 最高賠賞額為 HK$20,000 In the event of the insured person suffers bodily injury results in permanent disfigurement or permanent scarring of the face of at least, one square centimeter or two centimeters in length to be certified by physician, the company will pay the amount insured up to HK$20,000. The amount of insured payable will not take into account any psychological effects iii) 綁架保障 KIDNAP BENEFIT 若受保人在旅程中不幸被綁架挾持, 每天可獲賠償 HK$500, 最長為 30 天 If during the period of insurance an insured person is kidnapped, the company shall pay a daily benefit of HK$500 for each completion of twenty-four (24) hours or subsequent endorsement(s) (if any) per any one accident subject to a maximum of thirty (30) days. Kidnapped means the illegal abduction and holding hostage of one or more insured person for the purpose of demanding. Police report for such kidnapping must be obtained 中國醫療保證咭 全面國內認可醫院網絡, 毋須繳付入院保證金 全部認可之醫院網絡均通過實地考察 保障因意外或疾病住院之醫療費用 另設 24 小時緊急援助熱線 全國 全年通用註 : 若有關疾病或意外不屬保障範圍, 本公司有權向受保人追討全部有關費用主要不承保事項 China Medical Guarantee Card Comprehensive hospital network in PRC, no admittance deposit needed All recognized hospital network has undergone medical facilities evaluation Cover medical expenses in hospital for both accident and sickness 24 hours hotline services inclusive Comprehensive cover applicable anytime, anywhere in PRC. Remarks: If the accident/sickness or relevant expenses are not covered under the insurance, the insured person Shall be fully responsible for all relevant expenses on his/her behalf. 備註 * 包括所有 17 歲或以下同行之子女 受保人年齡為滿 18 歲, 應選擇計劃 " 個人 " 計劃 " 家庭 " 計劃包括受保人及其配偶及其所有年齡為 17 歲或以下同行之子女 年齡為 17 歲或以下之同行子女, 其保障利益 2A 則為 50% 全年旅遊計劃的 家庭 計劃總賠償額以不超過一位成人投保利益之 300% 為限 此保單不適用於海外全日制留學生或居住於海外之學生 Remarks Include all accompanying children aged 17 or below Aged 18 or over should choose "Individual" plan "Family" plan includes insured person and his/her legal spouse and all accompanying child(ren) aged 17 or below For accompanying child(ren) aged 17 or below, Coverage 2A is 50% For Annual Travel Plan the maximum limit per "Family" plan will be subject to 300% of one single adult insured The Policy is not applicable to overseas full time student or student lives at overseas Civil servant scheme p.9

39 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 重要提示 全年旅遊計劃每次旅程可長達 120 天 非由香港出發之旅程或行程不包括香港, 必須通知保險公司作個別批核 全年旅遊計劃之投保年齡為 18 至 72 歲 如投保人在同一次旅遊中投保多於一份由忠意保險有限公司 ( 香港分行 ) 承保的自購綜合旅遊保險, 本公司只會根據其中一份最高保障作出賠償 保單簽發後, 概不發還保費 如旅程在無可避免之情況下延期, 保期將自動延長最多 10 天 此保險只適用於渡假或商務旅遊 ( 只限文職工作 ), 並不適用於以導遊或領隊身份旅遊及非文職商務旅遊 ( 如表演 機械操作等 ) 本小冊子僅提供保單摘要, 保單承保範圍請參照保單條款及細則, 及以英文版本為準 此保險不適用於中國公民於中國境內旅遊 Important Notes The maximum period of protection of Annual Travel Plan is 120 days If the covered trip does not originate or via Hong Kong, please contact us for approval For Annual Travel Plan, the age limit is If the insured person is covered by more than comprehensive voluntary travel insurance policies underwritten by Assicurazioni Generali S. p. A., Hong Kong Branch for the same trip, only the travel insurance policy with the greatest compensation will apply and benefits thereunder be payable No refund of premium is allowed once the policy has been issued Cover will automatically be extended up to a maximum of 10 calendar days in the event the covered trip is being unavoidably delayed This insurance is only valid for the purpose of leisure travel or business travel (limited to administrative duty) only and not applicable to tour guide/escort (eg. performance, machine operation) This brochure provides only a summary of the policy benefits. Coverage should be subject to the terms and conditions of the policy This insurance is not applicable to PRC citizen traveling within the PRC territory 主要不承保事項 任何已存在之損傷或疾病 遺傳或先天性狀況 ( 不論受保人知道與否 ) 自殺 企圖自殺或自我傷害 ; 任何違反醫生意見之旅遊 或以醫療為目的之旅遊 懷孕或分娩 ; 牙齒之損害 ( 除因意外損害天然及健全之牙齒 ); 精神失常或神經錯亂 ; 受酒精或藥物影響 ; 愛滋病 (AIDS) 或於 HIV 抗體測試中呈陽性反應 ; 性病 任何戰爭行動 內戰 參與革命運動 暴動或受保人參與任何持械或紀律工作 軍事服務或執法行為 ; 任何電子或核子燃料或廢料之污染或輻射 參與任何職業性運動 任何競賽 ( 跑步除外 ) 輔以繩索之爬山或攀岩活動及比賽活動; 以非乘客身份乘搭商業航機 ; 參與任何體力勞動或從事任何危險 離岸採礦 處理爆炸品或高空攝影之工作 海關 政府或有關當局所頒佈之禁令或規條 充公 扣留或毀壞所引致之損失 ; 受保人之違法行為, 固意或惡意破壞 ; 受保人干犯嚴重罪行期間或被捕期間 Major Exclusions (applicable to all coverages) pre-existing, congenital or heredity condition (whether aware or not) suicide, attempted suicide or intentional self-infliction of bodily injury; contrary to doctor's advice, or the purpose of trip is for obtaining medical treatment abortion, miscarriage, pregnancy or resulting childbirth; dental care (unless resulting from accidental injury to sound and natural teeth); mental or nervous disorders, insanity; under the influence of alcohol or drugs; AIDS, HIV seropositive or related disease, sexually transmitted diseases Civil servant scheme p.10

40 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 War or warlike actions, civil war, participate in revolution, riot and strike, performing armed forces duties, police, volunteer and engaged in war or crime suppression; nuclear weapons, radiation, radioactivity Professional sports, racing except on foot, mountaineering and competition; riding in any aircraft except as a passenger in a property licensed aircraft flown by a qualified pilot; manual labour or hazardous works, offshore drilling, mineral extraction, handling of explosives and aerial photography Prohibition or regulation by any government, or customs detention; unlawful, willful, malicious acts of the insured person; committing a felony or while under arrest because of commission of a felony Civil servant scheme p.11

41 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 投保書 Application Form 公務員 Civil Servant 非公務員 Non Civil Servant Applicant Details 申請人資料 Name of Applicant 申請人姓名 H.K.I.D/Passport No. 香港身份證 / 證件號碼 Correspondence Address in HK 香港通訊地址 Contact No. 聯絡電話 Address 電郵地址 Annual Travel Details 全年旅遊資料 (please tick as appropriate 請在所選空格內加 ) Plan Selected 保險計劃 Premier 尊貴 Classic 優越 Standard 標準 Premium Plan 保費類別 Individual 個人 HK$1,995 HK$1,365 HK$735 Family 家庭 HK$3,590 HK$2,460 HK$1,325 Additional Upgrade Personal Accident Benefits 星級個人意外附加保障 (Premium of Basic Plan x 1.25) Effective Date 生效日期 (dd 日 / mm 月 / yy 年 ): ** 基本投保人 ( 公務員 ) 資料 : 英文及中文姓名 : 政府部門 : 保單號碼 : CHINA MEDICAL GUARANTEE CARD 中國醫療保證咭 : 每人 HK$100 per person Insured Persons Details 受保人資料 Name 姓名 Date of Birth 出生日期 (d/m/yy) H.K.I.D/ Passport No. Relationship with Applicant 申請人之關係 Occupation 職業 China Medical Guarantee Re-entry Permit No. 回鄕證號碼 ( 日 / 月 / 年 ) 香港身份證 / 證件號碼 Card 中國醫療保證咭 1. 本人 Please make payment together with the proposal Cheque should be made payable to 保費需與投保書一併遞交 支票抬頭請付 : Assicurazioni Generali S.p.A. Any person who, knowingly and with intent to defraud any insurance company or other person files a proposal for insurance containing any false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime. The signing of this proposal does not bind the undersigned to effect insurance, the undersigned agrees that this proposal and its attachments shall be the basis of the contract should a policy be issued and shall be deemed to be attached to and shall form part of any such policy. The Company is hereby authorized to make any investigation and enquiry in connection with the proposal that it deems necessary. 任何人知情地及蓄意欺騙保險公司或第三者, 提供虛假或隱瞞任何有關資料以投保保險及騙取保險, 均屬違法 投保書上的簽署並不代表保險巳告生效, 但簽署人同意若保單獲簽發, 此投保書及所有附件將為合約的基礎並成為保單的一部份 本公司現獲授權於必要時調查及詢問與投保書有關的事項 Civil servant scheme p.12

42 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 The applicant understands, acknowledges and agrees that, as a result of the applicant purchasing and taking up the policy to be issued by Assicurazioni Generali S.p.A. Assicurazioni Generali S.p.A. will pay the authorized insurance broker commission during the continuance of the policy including renewals, for arranging the said policy. Where the applicant is a body corporate, the authorized person who signs on behalf of the applicant further confirms to Assicurazioni Generali S.p.A. that he or she is authorized to do so. The applicant further understands that the above agreement is necessary for Assicurazioni Generali S.p.A. to proceed with the application. 申請人明白 確知及同意, 忠意保險有限公司會就申請人購買及接受其簽發的保單, 於保單有效期內 ( 包括續保期 ) 向負責安排有關保單的獲授權保險經紀支付佣金 假如申請人為法人團體, 代表申請人簽署的獲授權人員須向忠意保險有限公司確認他她已獲該法人團體授權 申請人亦明白忠意保險有限公司必須取得申請人的同意, 才可以處理其保險申請 The information I/We provide to Generali is collected to enable Generali to carry on insurance business and may be used for the purpose of: (i) any insurance or financial related product or service or any alternations, variations, cancellation or renewal of such product or service; (ii) any claim or investigation or analysis of such claim; and (iii) exercising any right of subrogation; and may be transferred to: (a) any related company or any other company carrying on insurance or reinsurance related business or an intermediary or a claims or investigation or other service provider providing services relevant to insurance business for nay of the above or related purposes; (b) any association, federation or similar organisation of insurance companies ("Federation") that exists or is formed from time to time for any of the above or related purposes or to enable the Federation to carry out its regulatory functions or such other functions that may be assigned to the Federation from time to time and are reasonably and/or to verify any of my/our data with the information collected by the Federation form the insurance industry. I/We have the right to obtain access to and to request correction of any personal information concerning myself/ourselves held by Generali. Requests for such access can be made to Generali's Personal Data Protection Officer. Assicurazioni Generali S.p.A.: 5/F., Generali Tower, 8 Queen s Road East, Hong Kong.) 本人 / 吾等提供的資料, 為忠意保險提供業務所需, 並可能使用於下列目的 :(i) 任何與保險或財務有關的產品或服務 或該等產品或服務的任何更改 變更 取消或績期 ;(ii) 任何索償 或該等索償的調查或分析 ;(iii) 行使任何代位權 ; 及可能移轉予 :a) 任何有關的公司 或任何其他從事與保險或再保險業務有關公司 或與保險業務有關的中介人或索償或調查或其他服務提供者, 以達到任何上述或有關的 ;(b) 現存或不時成立的任何保險公司協會或聯會或類同組織 ( 聯會 ), 以達到任何上述或有關目的 或以便 聯會 執行其監管職能 或其他基於保險保險業或任何 聯會 會員的利益而不時在合理要求下賦予 聯會 的職能 ; 及 / 或 (c) 透過 聯會 移轉予任何 聯會 的會員, 以達到任何上述或有關目的 此外, 在此授權忠意保險由 聯會 從保險業內收集的資料中查閱及 / 或核對本人 / 吾等任何資料 本人 / 吾等有權查閱及更正由忠意保險持有有關本人 / 吾等的個人資料, 如有需要, 可向忠意保險個人資料保護主任提出 ( 忠意保險有限公司香港分公司 : 香港皇后大道東 8 號忠意保險大廈 5 樓 ) Declaration 聲明 I/We hereby declare that I am/we are in good health and agree that any pre-existing conditions will not be covered under this insurance. Furthermore, obtaining medical treatment is not a purpose of this trip. I/we further declare that all the above information is true to the best of my/our knowledge. I/we consent that the personal information collected or held by Assicurazioni Generali S.p.A. is provided and may be held, used and disclosed to enable Generali for reference, communication and provide information believed may be of my/our interest. 本人 / 吾等聲明本身 / 吾等健康良好並同意任何巳存在的損傷或疾病均不在承保之列 此外, 本旅遊之目的並非醫療 本人 / 吾等聲明上述資料均屬正確無訛 本人 / 吾等同意忠意保險有限公司收集, 持有本人 / 吾等之個人資料以忠意保險有限公司作諮詢 聯絡及提供可能於本人 / 吾等有利之資料 申請人簽署 Applicant Signature 日期 Date (DDMMYY) 代理人 / 中介人簽署 Producer Signature 公司專用 For Office Use Only Civil servant scheme p.13

43 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 收集個人資料聲明 a) 閣下須要不時向忠意保險有限公司香港分行 ( 本公司 ) 提供關於閣下自己 保單持有人 受保人 受益人 索償人及 / 或其他有關人士的資料 ( 個人資料 ), 以讓本公司為閣下提供保險及 / 或相關產品與服務, 處理經由本公司發出及 / 或安排的保單之下的索償事宜, 及 / 或處理閣下提出的任何或所有其他要求 查詢和投訴 b) 閣下是自願向本公司提供個人資料的 然而, 若閣下未能提供個人資料, 可能導致本公司不能夠為閣下提供保險及 / 或相關產品與服務, 處理經由本公司發出及 / 或安排的保單之下的索償事宜, 及 / 或處理閣下提出的任何或所有其他要求 查詢和投訴 c) 個人資料可被用於以下用途 :i) 處理 ( 包括但不限於承保 ) 及 / 或審批保險及 / 或相關產品與服務的申請, 以及該等產品與服務的任何附加 更改 變更 取消 續期及 / 或復效 ;ii) 管理經由本公司發出及 / 或安排的保單 ;iii) 處理 ( 包括但不限於調查 分析 評估和裁定 ) 及 / 或理賠經由本公司發出及 / 或安排的保單之下的索償事宜 ;iv) 如適用的話, 行使代位權 ;v) 向客戶追收尚欠金額 ( 如有 );vi) 經由本公司發出及 / 或安排的保單之下籌劃共同保險及 / 或再保險 ;vii) 透過電話 郵件 電郵 傳真及其他通訊方式與客戶通訊 ;viii) 客戶服務 ( 包括但不限於處理查詢和投訴 ) 推銷, 以及其他相關活動 ;ix) 進行資料核對程序 ;x) 設計保險及 / 或相關產品與服務供客戶使用 ;xi) 推銷本公司及 / 或本公司的關聯公司 ( 包括但不限於本集團的公司 母公司 本母公司的信託公司 ( 該等關聯公司在下文合稱為 關聯公司 )) 的保險及 / 或其他相關產品與服務 ;xii) 就閣下事前訂明的同意 ( 如有 ) 約束之下, 直接促銷保險及 / 或其他相關產品與服務, 而閣下可在任何時間知會本公司以行使撤回同意的權利 ;xiii) 本公司 關聯公司 相關的保險業協會或聯會 監管當局 政府部門及 / 或其他法定監管機構的統計或精算研究 ;xiv) 遵從任何法律 規則 規例 守則 指引 法院命令 合規政策和程序的規定, 以及本公司及 / 或關聯公司應要遵守的任何其他有關規定, 包括但不限於披露有關資料 ; 及 xv) 實現與上述 (i) 至 (xiv) 直接有關的任何其他用途 d) 由本公司持有的個人資料將受到保密, 但本公司可依據以上 (c) 段所列的用途向以下各方 ( 不論在香港特別行政區境內還是境外 ) 提供個人資料, 事前無須知會閣下及 / 或該等個人資料所涉及的任何其他有關人士 :i) 就本公司的業務營運向本公司提供行政 電訊 電腦 付款 推銷 調查 諮詢及 / 或其他服務的代理人 中介人 索償調查公司 共同保險公司 再保險公司 第三方服務提供商 銀行及信用卡公司 健康及醫療機構 專業顧問 承包商 業務夥伴及 / 或任何其他有關各方, 以適用者為準 ;ii) 相關的保險業協會或聯會, 及 / 或該等協會或聯會的成員 ;iii) 本公司及 / 或關聯公司的海外辦事處或分行, 以適用者為準 ;iv) 根據任何法律 規則 規例 守則 指引 法院命令 合規政策和程序的規定, 以及應要遵守的任何其他有關規定之下, 本公司及 / 或關聯公司負有義務須向其作出披露的人士 ;v) 根據對本公司及 / 或關聯公司有約束力的任何法律之下, 本公司及 / 或關聯公司須向其提供資料的任何法院 監管當局 政府部門或其他法定監管機構 ( 包括但不限於稅務局 );vi) 本公司的合法繼承人或受讓人 ; 及 vii) 對本公司及 / 或關聯公司負有保密責任的人士 e) 本公司可使用由相關的保險業協會或聯會及 / 或該等協會或聯會的成員所收集及發放或轉移的資料, 來核實任何或所有個人資料 f) 根據 個人資料 ( 私隱 ) 條例 :i) 任何人士均有權 :A) 查詢本公司有沒有持有其資料, 如有的話, 可取得一份該等資料 ;B) 要求本公司改正其任何不正確的個人資料 ; 及 C) 查明關於本公司的個人資料政策和處事常規, 並可獲通知有關本公司所持個人資料的種類 ; 及 ii) 本公司有權就處理任何查閱個人資料的要求之下收取合理的費用 g) 如欲查閱及 / 或改正個人資料及 / 或查詢關於本公司的政策和處事常規及所持個人資料的種類, 請向以下人員提出要求 : 個人資料保護主任忠意保險有限公司香港分行香港皇后大道東 8 號忠意保險大厦 5 樓 Personal Information Collection Statement a) From time to time, it is necessary for you to supply Assicurazioni Generali S.p.A., Hong Kong Branch (the Company ) with data about yourself(ves), policyholder(s), life insured(s), beneficiary(ies), claimant(s), and/ or other relevant individuals (the Personal Data ) in connection with the provision of insurance and/ or related products and services to you, the processing of claims under insurance policies issued and/ or arranged by the Company, and/ or the processing of any or all other requests, enquiries and complaints from you. b) Provision of the Personal Data to the Company by you is voluntary. However, failure to supply the Personal Data may result in the Company being unable to provide insurance and/ or related products and services to you, process claims under insurance policies issued and/ or arranged by the Company, and/ or process any or all other requests, enquiries, or complaints from you. c) The purposes for which the Personal Data may be used are as follows: i) processing (including, without limitation, underwriting) and/ or approving applications for insurance and/ or related products and services, and any addition, alteration, variation, cancellation, renewal and/ or reinstatement of such products and services; ii) administering insurance policies issued and/ or arranged by the Company; iii) processing (including, but not limited to, investigating, analyzing, assessing and adjudicating) and/ or settlement of claims under insurance policies issued and/ or arranged by the Company; iv) exercising rights of subrogation, if applicable; v) collection of amounts outstanding (if any) from customers; vi) arranging coinsurance and/ or reinsurance in respect of the insurance policies issued and/ or arranged by the Company; vii) communicating with customers via telephone, mail, , facsimile and other communication means; viii) customer services (including, but not limited to, processing enquiries and complaints), marketing, and other related activities; ix) conducting data matching procedures; x) designing insurance and/ or related products and services for customers use; xi) marketing insurance and/ or other related products and services of the Company and/ or its affiliated companies (which includes, but are not limited to, its group companies, parent company, trust companies of the Company s parent company (hereinafter such affiliated companies are collectively referred to as the Affiliated Companies )); xii) direct marketing of insurance and/ or other related products and services subject to your prior prescribed consent (if any), and you can exercise the right of opt-out by notifying the Company at any time; xiii) statistical or actuarial research of the Company, its Affiliated Companies, relevant insurance industry associations or federations, supervisory authority, government department and/ or other competent authority; xiv) complying with the requirements under any laws, rules, regulations, codes, guidelines, court orders, compliance policies and procedures, and any other relevant requirements which the Company and/ or its Affiliated Companies are expected to comply with, including, without limitation, making disclosures of the relevant information; and xv) fulfilling any other purposes directly relating to (i) to (xiv) above. d) The Personal Data held by the Company shall be kept confidential, but the Company may provide the Personal Data to the following parties (whether within or outside the Hong Kong Special Administrative Region) for the purposes set out in paragraph (c) above, without prior notification to you and/ or any other relevant individuals to whom the Personal Data is related: i) agents, intermediaries, claims investigation companies, coinsurance companies, reinsurance companies, third party service providers, banks and credit-card companies, health and medical organizations, professional advisers, contractors, business partners, and/ or any other relevant parties, as appropriate, who provide administrative, telecommunication, computer, payment, marketing, investigation, advisory and/ or other services to the Company in connection with the operation of its business; ii) relevant insurance industry associations or federations, and/ or members of such industry associations or federations; iii) overseas locations or branches, as appropriate, of the Company and/ or its Affiliated Companies; iv) persons to whom the Company and/ or its Affiliated Companies are under an obligation to make disclosure under the requirements of any laws, rules, regulations, codes, guidelines, court orders, compliance policies and procedures, and any other relevant requirements which the Company and/ or its Affiliated Companies are expected to comply with; v) any court, supervisory authority, government department or other competent authority (including, without limitation, tax authority) under any laws binding on the Company and/ or its Affiliated Companies; vi) lawful successors or assigns of the Company; and vii) persons who owe a duty of confidentiality to the Company and/ or its Affiliated Companies. Civil servant scheme p.14

44 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 e) The Company may verify any or all of the Personal Data by using information collected and released or transferred by relevant insurance industry associations or federations, and/ or members of such industry associations or federations. f) In accordance with the Personal Data (Privacy) Ordinance: i) any individual has the right to: A) check whether the Company holds data about him/ her and, if so, obtain a copy of such data; B) require the Company to correct any data relating to him/ her that is inaccurate; and C) ascertain the Company s policies and practices in relation to data and to be informed of the kind of data held by the Company; and ii) the Company has the right to charge a reasonable fee for the processing of any data access request. g) The person to whom requests for access to data and/ or correction of data and/ or for information regarding policies and practices and kinds of data held are to be addressed as follows: Personal Data Protection Officer, Assicurazioni Generali S.p.A., Hong Kong Branch, 5/F, Generali Tower, 8 Queen s Road East, Hong Kong. 使用及提供個人資料作直接促銷 ( 本節條文是組成 收集個人資料聲明 的一部分 ) 1) 個人資料, 包括但不限於, 姓名 聯絡的詳細資料 其他產品及服務組合資料 交易模式及行為, 財務背景及人口統計資料可被用作於直接促銷 :i) 本公司及關聯公司的保險及 / 或其他相關產品與服務 ;ii) 本公司跟聯名品牌夥伴的保險及 / 或其他相關產品與服務 ( 聯名品牌夥伴之名稱將載於相關產品及服務的申請表 建議書 宣傳小冊子及 / 或廣告單張 / 海報, 以適用者為準 ) 及 / 或本公司所選定的第三方 ;iii) 本公司, 關聯公司及聯名品牌夥伴的獎賞 忠誠及 / 或優惠項目 / 計劃 2) 就以上 (1) 段所述的用途, 個人資料亦可被提供予本公司的關聯公司, 聯名品牌夥伴及本公司所選定的第三方服務提供商, 包括但不限於, 客戶服務中心 3) 本公司須獲閣下允許 ( 包括表示不反對 ) 本公司可按照本節條文所述的用途使用個人資料 若閣下不希望本公司使用或向第三方提供個人資料作直接促銷用途, 閣下可於下方行使退出權利或於日後任何時間知會本公司 如閣下不同意個人資料用作下列直接促銷用途, 請在以下方格內加上剔號 ( ) : 本人 / 我們不允許貴公司向本文所述的第三方提供個人資料作直接促銷用途 本人 / 我們不允許貴公司使用個人資料作直接促銷用途 ( 若閣下沒有在方格內加上剔號但簽署本表格 / 文件, 閣下會被視之為不反對 ( 即閣下允許 ) 本公司使用或向第三方提供個人資料作直接促銷用途 ) 附註 : 本收集個人資料聲明的英文及中文版本之間如有任何歧義, 概以英文版本為準 聲明 : 本人 / 我們確認, 本人 / 我們已獲提供一份由忠意保險有限公司香港分行 ( 忠意保險 ) 發出的收集個人資料聲明 ( 該聲明 ) 本人 / 我們確認已經閱讀並且明白該聲明 本人 / 我們同意忠意保險可依照該聲明的條款收集 使用 儲存 披露 轉移及以其他方式處理本人 / 我們的個人資料 本人 / 我們進一步確認, 本人 / 我們已獲得受保人和任何其他有關人士 ( 如適用的話 ) 的明示同意, 可以按照該聲明所述的用途將他們的個人資料提供給忠意保險, 並允許忠意保險可依照該聲明的條款收集 使用 儲存 披露 轉移及以其他方式處理該等個人資料 Use and Provision of Personal Data in Direct Marketing (This section forms part of the Personal Information Collection Statement.) 1) The Personal Data, including but not limited to, name, contact details, other products and services portfolio information, transaction pattern and behavior, financial background and demographic information may be used for the purpose of direct marketing: i) insurance and/ or other related products and services of the Company and its Affiliated Companies; ii) insurance and/ or other related products and services of the Company s co-branding partners (the names of such co-branding partners can be found in the application form(s), proposals, brochures and/ or advertising leaflet(s)/ poster(s) for the relevant products and services, as appropriate) and/ or third parties selected by the Company; iii) reward, loyalty and/ or privileges programs/ plans of the Company, its Affiliated Companies and co-branding partners. 2) The Personal Data may also be provided to the Company s Affiliated Companies, co-branding partners and third party service providers selected by the Company for the purpose set out in paragraph (1) above, including, without limitation, call centres. 3) The Company requires your consent (which includes an indication of no objection) to the use of Personal Data for the purpose set out in this section. If you do not wish the Company to use or provide to other parties the Personal Data for the purpose of direct marketing, you may exercise the opt-out right below or by notifying the Company at any time thereafter. Please tick ( ) the boxes below if you do not agree with the following use(s) of the Personal Data in direct marketing. I/ We do not consent to the provision of the Personal Data to the third parties as described herein for the purpose of direct marketing. I/ We do not consent to the use of the Personal Data by the Company for the purpose of direct marketing. (If you do not tick the boxes but sign the Form/ document, you will be regarded as having indicated you have no objection (i.e. you consent) to the use or transfer to third parties of the Personal Data for the purpose of direct marketing by the Company.) Note: In case of discrepancies between the English and Chinese versions of this Personal Information Collection Statement, the English version shall prevail. Declaration: I/ We acknowledge that I/ we have been provided with a copy of the Personal Information Collection Statement (the Statement ) issued by Assicurazioni Generali S.p.A., Hong Kong Branch ( Generali ). I/ We confirm that I/ we have read and understood the Statement. I/ We agree that Generali may collect, use, store, disclose, transfer and otherwise process my/ our personal data in accordance with the terms of the Statement. I/ We further confirm that I/ we have obtained the express consent of the life insureds and any other relevant individuals (where applicable) for providing their personal data to Generali for the purposes stated in the Statement and for allowing Generali to collect, use, store, disclose, transfer and otherwise process such personal data in accordance with the terms of the Statement.. 投保人 / 索償人 / 保單持有人 / 受保人簽署 Signature of Applicant/Claimant/Policyholder(s)/Life Insured(s) 日期 Date Civil servant scheme p.15

45 Annual Travel Package Insurance for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年全年旅遊旅遊綜合綜合保障計劃 忠意集團 Generali Group 有關忠意集團自 1970 年代起, 忠意集團旗下的公司在香港一直為個人及企業提供全面的保險及投資保障服務 多年以來, 我們了解到客戶不同的個別需求, 並不斷隨時代改進去迎合客戶的真正所需 忠意是世界最大的保險集團之一, 並擁有超過 180 年歷史 2015 年, 集團總保費收入超過 740 億歐羅, 成功並列 財富 世界 50 強 現有超過 7 萬 6 千員工遍佈全球超過 60 多個國家, 為 7 千 2 百萬客戶提供優質專業服務 集團在西歐市場佔有領先地位, 業務更擴展至中東歐及亞洲等地 忠意集團獲惠譽國際授予保險公司財務實力評級 A- ^ 憑著集團雄厚的財政實力, 屢獲獨立評級公司的高度評價 2015 年, 忠意集團榮登 麻省理工學院科技評論雜誌 全球最聰明公司 50 強, 而且是榜上唯一的保險公司 公司資料截至 2016 年 3 月 ^ 惠譽確認評級截至 2016 年 1 月 About Generali Our Generali entities in Hong Kong have been providing comprehensive insurance and investment protection to individuals and organizations since the 1970s. Over the years, we have come to understand the individual requirements of our clients, and are continuously adapting and innovating to meet their changing needs. The Generali Group is one of the largest global insurance providers. We pride ourselves for our history of over 180 years and we are listed amongst the Fortune Global Top 50 companies with 2015 total premium income of more than 74 billion. With above 76,000 employees worldwide serving 72 million insured persons in more than 60 countries, the Group occupies a leadership position in Western European markets and an increasingly important place in Asia and Central and Eastern Europe. Generali and its core subsidiaries have been affirmed A- ^ Insurer Financial Strength ( IFS ) Rating by Fitch Ratings. For our Group s financial strength, we have consistently received high ratings by independent agencies. Generali is also ranked among the world s 50 smartest companies in 2015 according to the MIT Technology Review and we are the only insurer on the list. Company information as at March 2016 ^Rating affirmed by Fitch as at January 2016 忠意保險有限公司 Assicurazioni Generali S.p.A. 香港皇后大道東 8 號忠意保險大廈 5 樓 5/F, Generali Tower, 8 Queen s Road East, Hong Kong 電話 Tel: (852) 傳真 Fax: (852) 香港分行電郵 : A&[email protected] Hong Kong Branch A&[email protected] 香港分行網址 : Hong Kong Branch Website: Civil servant scheme p.16

46 Annual Study Abroad Protector for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年海外留學保障全年海外留學保障計劃 保障範圍 Scope of Coverage 保障受保人於外地升學時發生意外或遇上疾病 Protect the Insured Persons from accident and sickness during studying abroad in worldwide. 計劃特點 Product Highlights 特高醫療費用港幣 1,500,000 元 High medical expenses up to HK$1,500,000 保障一切非職業運動 Cover all sports activities (except professional) 所有保障均無自負金額 No excess or deductible 緊急醫療援助及運返原居地 Emergency medical assistance and repatriation 親屬探望 Care visit 學業中斷保障 Study interruption cover 特設教育基金保障, 協助繼續學業 Education fund benefit 恐怖襲擊保障 Terrorism cover 連續 12 個月無間斷保障 12 consecutive months' cover without trip duration restriction 24 小時全球緊急支援服務 24 hours worldwide Generali emergency assistance services 計劃內容 Benefits Coverage 保障範圍 醫療費用 ( 包 25 次門診 ) Medical Expenses (including outpatient 25 visits) 緊急醫療運送及送返 Emergency Medical Evacuation & Repatriation 遺體運返 Repatriation of Mortal Remains 意外死亡及永久傷殘 Accidental Death and Permanent Disability Maximum Limit (HK$) 最高賠償額 ( 港幣 ) 1,500,000 不設上限 Unlimited 不設上限 Unlimited 500,000 燒傷保障 Major Burns 100,000 如受保人於受保旅程期間因意外受傷或疾病所支付的醫療費用, 包括住院 門診 (25 次 ) 及手術, 均可獲得賠償 覆診費用 - 受保人於海外接受診治後, 回港後 90 天內繼續接受治療的醫療費用, 亦可獲得賠償 最高賠償金額為 HK$100,000 如受保人回港作短暫逗留期間, 不幸因意外受傷或疾病而需住院, 住院期間的醫療費用可獲得賠償 最高賠償金額為 HK$50,000 於受保旅程期間因應緊急醫療而需運送嚴重受傷或患病之受保人至就近地區或返回香港進行治療, 賠償額並不設上限, 確保受保人得到最充分的保障 於受保旅程期間安排運送在外地身故的受保人之遺體或骨灰返回香港 如受保人於受保旅程期間因意外而導致死亡及 / 或永久傷殘, 將可根據保障金額獲得賠償 如受保人於受保旅程期間因意外導致身體燒傷程度達二級或三級 Civil servant scheme p.1

47 Annual Study Abroad Protector for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年海外留學保障全年海外留學保障計劃 親屬探望 Care Visit 50,000 學業中斷 Study Interruption 90,000 教育基金 Education Fund 300,000 個人行李 Personal Baggage 15,000 証件遺失 Document Loss 7,000 個人金錢 Personal Money 3,000 旅程延誤 ( 每 6 小時港幣 500) Travel Delay (HK$500 per 6 hours) 1,500 ( 每次旅程 ) 1,500 (per trip) ( 每保單年度最多港幣 6,000 Maximum $6,000 per policy year) 行李延誤 (6 小時後 ) Baggage Delay (after 6 hours) 1,000 個人責任 Personal Liability 2,000,000 海外住所 火險 Overseas Residence Guard Fire damage 10,000 如受保人於受保旅程期間不幸身故 嚴重受傷或病重而需住院連續超過 5 天, 經審核後因應緊急需要可獲安排一名直系親屬前往探望照顧受保人, 保障包括來回機票 ( 經濟客位 ) 及住宿酒店費用 ( 最長 5 天 ) 如受保人因下列情況而必須中繼學業, 被沒收或重讀之學費可獲得賠償 - 父或母因意外身故 ; 或 - 受保人因嚴重受傷或病重而需連續住院, 及暫時傷殘超過 30 天 如指定的受保人父或母或監護人因意外導致死亡及 / 或永久傷殘, 將支付教育基金以資助受保學生繼續學業 於受保旅程期間, 如受保人隨行之行李因意外損壞 遺失 被竊或搶劫, 每項 / 套 / 對物品最高賠償額為 HK$3,000; 及個人電腦為 HK$10,000 但不包括手提電話 於受保旅程期間, 如受保人的旅遊證件 身份證或其他清關所需的證件被竊 搶劫或意外遺失所引致的補領費用均可獲得賠償 於受保旅程期間, 如受保人因意外遺失 被竊 搶劫導致現金或旅行支票等之損失, 均可獲得賠償 因惡劣天氣 罷工 劫持 乘坐航班之機件故障或所乘坐之航運機構員工之工業行動而引致所乘坐之公共交通工具延誤, 每 6 小時可獲 HK$500 現金補償 於受保旅程期間, 如受保人隨行之寄運行李因運送延誤達 6 小時或以上, 可獲得賠償購買必需品應急 因疏忽導致第三者受傷或財物損毀而負上的法律責任 有關之責任必須由本公司代為處理 ( 保障不適用於駕駛或租用汽車 飛機及任何水上機動遊戲 ) 於受保旅程期間, 如受保人因出外旅行 ( 離開就讀的國家 ) 而期間空置的海外住所發生火災, 所引致的損失可獲得賠償 Civil servant scheme p.2

48 Annual Study Abroad Protector for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年海外留學保障全年海外留學保障計劃 24 小時全球緊急支援服務 24-hour Worldwide Emergency Assistance 免費 Free (852) 保費表 Premium Table 留學地區 Studying Location 美國 / 加拿大 USA/Canada 每人每年保費 ( 港幣 ) Annual Premium Per Person (HK$) 基本 Basic 學生 Student ( 年歲 Age 12-30) HK$4,320 自選保障 Optional 父 / 母 / 監護人 Father / Mother / Legal Guardian ( 年歲 Age 18-55) HK$5,688 其他 Rest of the World HK$3,528 HK$4,5800 主要不承保事項 已存在之醫療狀況 若受保人任職或參與危險工作包括空中服務員 漁民 持械工作 ( 包括臨時 持械工作 ) 騎師 消防員 鐵路維修員 建築工人 貨櫃場起重機操作員 等等 戰爭行動 Major Exclusions (applicable to all coverages) Pre-existing medical condition(s) If the Insured Person is employed as / or performs the duties of a Hazardous Occupation, including aircrew, fisherman, armed occupation (including temporarily armed occupation), jockey, fire fighter, railway installation and maintenance worker, construction worker, container terminal crane operator, etc. War Civil servant scheme p.3

49 Annual Study Abroad Protector for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年海外留學保障全年海外留學保障計劃 投保書 Application Form 公務員 Civil Servant 非公務員 Non Civil Servant 申請人明白 確知及同意, 忠意保險有限公司會就申請人購買及接受其簽發的保單, 於保單有效期內 ( 包括續保期 ) 向負責安排有關保單的獲授權保險經紀支付佣金 假如申請人為法人團體, 代表申請人簽署的獲授權人員須向忠意保險有限公司確認他她已獲該法人團體授權 申請人亦明白忠意保險有限公司必須取得申請人的同意, 才可以處理其保險申請 I/We have the right to obtain access to and to request correction of any personal information concerning myself/ourselves held by Generali. Requests for such access can be made to Generali's Personal Data Protection Officer. Assicurazioni Generali S.p.A.: 5/F., Generali Tower, 8 Queen s Road East, Hong Kong.) The applicant understands, acknowledges and agrees that, as a result of the applicant purchasing and taking up the policy to be issued by Assicurazioni Generali S.p.A. Assicurazioni Generali S.p.A. will pay the authorized insurance broker commission during the continuance of the policy including renewals, for arranging the said policy. Where the applicant is a body corporate, the authorized person who signs on behalf of the applicant further confirms to Assicurazioni Generali S.p.A. that he or she is authorized to do so. The applicant further understands that the above agreement is necessary for Assicurazioni Generali S.p.A. to proceed with the application. Civil servant scheme p.4

50 Annual Study Abroad Protector for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年海外留學保障全年海外留學保障計劃 收集個人資料聲明 a) 閣下須要不時向忠意保險有限公司香港分行 ( 本公司 ) 提供關於閣下自己 保單持有人 受保人 受益人 索償人及 / 或其他有關人士的資料 ( 個人資料 ), 以讓本公司為閣下提供保險及 / 或相關產品與服務, 處理經由本公司發出及 / 或安排的保單之下的索償事宜, 及 / 或處理閣下提出的任何或所有其他要求 查詢和投訴 b) 閣下是自願向本公司提供個人資料的 然而, 若閣下未能提供個人資料, 可能導致本公司不能夠為閣下提供保險及 / 或相關產品與服務, 處理經由本公司發出及 / 或安排的保單之下的索償事宜, 及 / 或處理閣下提出的任何或所有其他要求 查詢和投訴 c) 個人資料可被用於以下用途 :i) 處理 ( 包括但不限於承保 ) 及 / 或審批保險及 / 或相關產品與服務的申請, 以及該等產品與服務的任何附加 更改 變更 取消 續期及 / 或復效 ;ii) 管理經由本公司發出及 / 或安排的保單 ;iii) 處理 ( 包括但不限於調查 分析 評估和裁定 ) 及 / 或理賠經由本公司發出及 / 或安排的保單之下的索償事宜 ;iv) 如適用的話, 行使代位權 ;v) 向客戶追收尚欠金額 ( 如有 );vi) 經由本公司發出及 / 或安排的保單之下籌劃共同保險及 / 或再保險 ;vii) 透過電話 郵件 電郵 傳真及其他通訊方式與客戶通訊 ;viii) 客戶服務 ( 包括但不限於處理查詢和投訴 ) 推銷, 以及其他相關活動 ;ix) 進行資料核對程序 ;x) 設計保險及 / 或相關產品與服務供客戶使用 ;xi) 推銷本公司及 / 或本公司的關聯公司 ( 包括但不限於本集團的公司 母公司 本母公司的信託公司 ( 該等關聯公司在下文合稱為 關聯公司 )) 的保險及 / 或其他相關產品與服務 ;xii) 就閣下事前訂明的同意 ( 如有 ) 約束之下, 直接促銷保險及 / 或其他相關產品與服務, 而閣下可在任何時間知會本公司以行使撤回同意的權利 ;xiii) 本公司 關聯公司 相關的保險業協會或聯會 監管當局 政府部門及 / 或其他法定監管機構的統計或精算研究 ;xiv) 遵從任何法律 規則 規例 守則 指引 法院命令 合規政策和程序的規定, 以及本公司及 / 或關聯公司應要遵守的任何其他有關規定, 包括但不限於披露有關資料 ; 及 xv) 實現與上述 (i) 至 (xiv) 直接有關的任何其他用途 d) 由本公司持有的個人資料將受到保密, 但本公司可依據以上 (c) 段所列的用途向以下各方 ( 不論在香港特別行政區境內還是境外 ) 提供個人資料, 事前無須知會閣下及 / 或該等個人資料所涉及的任何其他有關人士 :i) 就本公司的業務營運向本公司提供行政 電訊 電腦 付款 推銷 調查 諮詢及 / 或其他服務的代理人 中介人 索償調查公司 共同保險公司 再保險公司 第三方服務提供商 銀行及信用卡公司 健康及醫療機構 專業顧問 承包商 業務夥伴及 / 或任何其他有關各方, 以適用者為準 ;ii) 相關的保險業協會或聯會, 及 / 或該等協會或聯會的成員 ;iii) 本公司及 / 或關聯公司的海外辦事處或分行, 以適用者為準 ;iv) 根據任何法律 規則 規例 守則 指引 法院命令 合規政策和程序的規定, 以及應要遵守的任何其他有關規定之下, 本公司及 / 或關聯公司負有義務須向其作出披露的人士 ;v) 根據對本公司及 / 或關聯公司有約束力的任何法律之下, 本公司及 / 或關聯公司須向其提供資料的任何法院 監管當局 政府部門或其他法定監管機構 ( 包括但不限於稅務局 );vi) 本公司的合法繼承人或受讓人 ; 及 vii) 對本公司及 / 或關聯公司負有保密責任的人士 e) 本公司可使用由相關的保險業協會或聯會及 / 或該等協會或聯會的成員所收集及發放或轉移的資料, 來核實任何或所有個人資料 f) 根據 個人資料 ( 私隱 ) 條例 :i) 任何人士均有權 :A) 查詢本公司有沒有持有其資料, 如有的話, 可取得一份該等資料 ;B) 要求本公司改正其任何不正確的個人資料 ; 及 C) 查明關於本公司的個人資料政策和處事常規, 並可獲通知有關本公司所持個人資料的種類 ; 及 ii) 本公司有權就處理任何查閱個人資料的要求之下收取合理的費用 g) 如欲查閱及 / 或改正個人資料及 / 或查詢關於本公司的政策和處事常規及所持個人資料的種類, 請向以下人員提出要求 : 個人資料保護主任忠意保險有限公司香港分行香港皇后大道東 8 號忠意保險大厦 5 樓 Personal Information Collection Statement a) From time to time, it is necessary for you to supply Assicurazioni Generali S.p.A., Hong Kong Branch (the Company ) with data about yourself(ves), policyholder(s), life insured(s), beneficiary(ies), claimant(s), and/ or other relevant individuals (the Personal Data ) in connection with the provision of insurance and/ or related products and services to you, the processing of claims under insurance policies issued and/ or arranged by the Company, and/ or the processing of any or all other requests, enquiries and complaints from you. b) Provision of the Personal Data to the Company by you is voluntary. However, failure to supply the Personal Data may result in the Company being unable to provide insurance and/ or related products and services to you, process claims under insurance policies issued and/ or arranged by the Company, and/ or process any or all other requests, enquiries, or complaints from you. c) The purposes for which the Personal Data may be used are as follows: i) processing (including, without limitation, underwriting) and/ or approving applications for insurance and/ or related products and services, and any addition, alteration, variation, cancellation, renewal and/ or reinstatement of such products and services; ii) administering insurance policies issued and/ or arranged by the Company; iii) processing (including, but not limited to, investigating, analyzing, assessing and adjudicating) and/ or settlement of claims under insurance policies issued and/ or arranged by the Company; iv) exercising rights of subrogation, if applicable; v) collection of amounts outstanding (if any) from customers; vi) arranging coinsurance and/ or reinsurance in respect of the insurance policies issued and/ or arranged by the Company; vii) communicating with customers via telephone, mail, , facsimile and other communication means; viii) customer services (including, but not limited to, processing enquiries and complaints), marketing, and other related activities; ix) conducting data matching procedures; x) designing insurance and/ or related products and services for customers use; xi) marketing insurance and/ or other related products and services of the Company and/ or its affiliated companies (which includes, but are not limited to, its group companies, parent company, trust companies of the Company s parent company (hereinafter such affiliated companies are collectively referred to as the Affiliated Companies )); xii) direct marketing of insurance and/ or other related products and services subject to your prior prescribed consent (if any), and you can exercise the right of opt-out by notifying the Company at any time; xiii) statistical or actuarial research of the Company, its Affiliated Companies, relevant insurance industry associations or federations, supervisory authority, government department and/ or other competent authority; xiv) complying with the requirements under any laws, rules, regulations, codes, guidelines, court orders, compliance policies and procedures, and any other relevant requirements which the Company and/ or its Affiliated Companies are expected to comply with, including, without limitation, making disclosures of the relevant information; and xv) fulfilling any other purposes directly relating to (i) to (xiv) above. d) The Personal Data held by the Company shall be kept confidential, but the Company may provide the Personal Data to the following parties (whether within or outside the Hong Kong Special Administrative Region) for the purposes set out in paragraph (c) above, without prior notification to you and/ or any other relevant individuals to whom the Personal Data is related: i) agents, intermediaries, claims investigation companies, coinsurance companies, reinsurance companies, third party service providers, banks and credit-card companies, health and medical organizations, professional advisers, contractors, business partners, and/ or any other relevant parties, as appropriate, who provide administrative, telecommunication, computer, payment, marketing, investigation, advisory and/ or other services to the Company in connection with the operation of its business; ii) relevant insurance industry associations or federations, and/ or members of such industry associations or federations; iii) overseas locations or branches, as appropriate, of the Company and/ or its Affiliated Companies; iv) persons to whom the Company and/ or its Affiliated Companies are under an obligation to make disclosure under the requirements of any laws, rules, regulations, codes, guidelines, court orders, compliance policies and procedures, and any other relevant requirements which the Company and/ or its Affiliated Companies are expected to comply with; v) any court, supervisory authority, government department or other competent authority (including, without limitation, tax authority) under any laws binding on the Company and/ or its Affiliated Companies; vi) lawful successors or assigns of the Company; and vii) persons who owe a duty of confidentiality to the Company and/ or its Affiliated Companies. Civil servant scheme p.5

51 Annual Study Abroad Protector for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年海外留學保障全年海外留學保障計劃 e) The Company may verify any or all of the Personal Data by using information collected and released or transferred by relevant insurance industry associations or federations, and/ or members of such industry associations or federations. f) In accordance with the Personal Data (Privacy) Ordinance: i) any individual has the right to: A) check whether the Company holds data about him/ her and, if so, obtain a copy of such data; B) require the Company to correct any data relating to him/ her that is inaccurate; and C) ascertain the Company s policies and practices in relation to data and to be informed of the kind of data held by the Company; and ii) the Company has the right to charge a reasonable fee for the processing of any data access request. g) The person to whom requests for access to data and/ or correction of data and/ or for information regarding policies and practices and kinds of data held are to be addressed as follows: Personal Data Protection Officer, Assicurazioni Generali S.p.A., Hong Kong Branch, 5/F, Generali Tower, 8 Queen s Road East, Hong Kong. 使用及提供個人資料作直接促銷 ( 本節條文是組成 收集個人資料聲明 的一部分 ) 1) 個人資料, 包括但不限於, 姓名 聯絡的詳細資料 其他產品及服務組合資料 交易模式及行為, 財務背景及人口統計資料可被用作於直接促銷 :i) 本公司及關聯公司的保險及 / 或其他相關產品與服務 ;ii) 本公司跟聯名品牌夥伴的保險及 / 或其他相關產品與服務 ( 聯名品牌夥伴之名稱將載於相關產品及服務的申請表 建議書 宣傳小冊子及 / 或廣告單張 / 海報, 以適用者為準 ) 及 / 或本公司所選定的第三方 ;iii) 本公司, 關聯公司及聯名品牌夥伴的獎賞 忠誠及 / 或優惠項目 / 計劃 2) 就以上 (1) 段所述的用途, 個人資料亦可被提供予本公司的關聯公司, 聯名品牌夥伴及本公司所選定的第三方服務提供商, 包括但不限於, 客戶服務中心 3) 本公司須獲閣下允許 ( 包括表示不反對 ) 本公司可按照本節條文所述的用途使用個人資料 若閣下不希望本公司使用或向第三方提供個人資料作直接促銷用途, 閣下可於下方行使退出權利或於日後任何時間知會本公司 如閣下不同意個人資料用作下列直接促銷用途, 請在以下方格內加上剔號 ( ) : 本人 / 我們不允許貴公司向本文所述的第三方提供個人資料作直接促銷用途 本人 / 我們不允許貴公司使用個人資料作直接促銷用途 ( 若閣下沒有在方格內加上剔號但簽署本表格 / 文件, 閣下會被視之為不反對 ( 即閣下允許 ) 本公司使用或向第三方提供個人資料作直接促銷用途 ) 附註 : 本收集個人資料聲明的英文及中文版本之間如有任何歧義, 概以英文版本為準 聲明 : 本人 / 我們確認, 本人 / 我們已獲提供一份由忠意保險有限公司香港分行 ( 忠意保險 ) 發出的收集個人資料聲明 ( 該聲明 ) 本人 / 我們確認已經閱讀並且明白該聲明 本人 / 我們同意忠意保險可依照該聲明的條款收集 使用 儲存 披露 轉移及以其他方式處理本人 / 我們的個人資料 本人 / 我們進一步確認, 本人 / 我們已獲得受保人和任何其他有關人士 ( 如適用的話 ) 的明示同意, 可以按照該聲明所述的用途將他們的個人資料提供給忠意保險, 並允許忠意保險可依照該聲明的條款收集 使用 儲存 披露 轉移及以其他方式處理該等個人資料 Use and Provision of Personal Data in Direct Marketing (This section forms part of the Personal Information Collection Statement.) 1) The Personal Data, including but not limited to, name, contact details, other products and services portfolio information, transaction pattern and behavior, financial background and demographic information may be used for the purpose of direct marketing: i) insurance and/ or other related products and services of the Company and its Affiliated Companies; ii) insurance and/ or other related products and services of the Company s co-branding partners (the names of such co-branding partners can be found in the application form(s), proposals, brochures and/ or advertising leaflet(s)/ poster(s) for the relevant products and services, as appropriate) and/ or third parties selected by the Company; iii) reward, loyalty and/ or privileges programs/ plans of the Company, its Affiliated Companies and co-branding partners. 2) The Personal Data may also be provided to the Company s Affiliated Companies, co-branding partners and third party service providers selected by the Company for the purpose set out in paragraph (1) above, including, without limitation, call centres. 3) The Company requires your consent (which includes an indication of no objection) to the use of Personal Data for the purpose set out in this section. If you do not wish the Company to use or provide to other parties the Personal Data for the purpose of direct marketing, you may exercise the opt-out right below or by notifying the Company at any time thereafter. Please tick ( ) the boxes below if you do not agree with the following use(s) of the Personal Data in direct marketing. I/ We do not consent to the provision of the Personal Data to the third parties as described herein for the purpose of direct marketing. I/ We do not consent to the use of the Personal Data by the Company for the purpose of direct marketing. (If you do not tick the boxes but sign the Form/ document, you will be regarded as having indicated you have no objection (i.e. you consent) to the use or transfer to third parties of the Personal Data for the purpose of direct marketing by the Company.) Note: In case of discrepancies between the English and Chinese versions of this Personal Information Collection Statement, the English version shall prevail. Declaration: I/ We acknowledge that I/ we have been provided with a copy of the Personal Information Collection Statement (the Statement ) issued by Assicurazioni Generali S.p.A., Hong Kong Branch ( Generali ). I/ We confirm that I/ we have read and understood the Statement. I/ We agree that Generali may collect, use, store, disclose, transfer and otherwise process my/ our personal data in accordance with the terms of the Statement. I/ We further confirm that I/ we have obtained the express consent of the life insureds and any other relevant individuals (where applicable) for providing their personal data to Generali for the purposes stated in the Statement and for allowing Generali to collect, use, store, disclose, transfer and otherwise process such personal data in accordance with the terms of the Statement.. 投保人 / 索償人 / 保單持有人 / 受保人簽署 Signature of Applicant/Claimant/Policyholder(s)/Life Insured(s) 日期 Date Civil servant scheme p.6

52 Annual Study Abroad Protector for Civil Servants and Non-Civil Servants 公務員及非公務員合約僱員全年海外留學保障全年海外留學保障計劃 忠意集團 Generali Group 有關忠意集團自 1970 年代起, 忠意集團旗下的公司在香港一直為個人及企業提供全面的保險及投資保障服務 多年以來, 我們了解到客戶不同的個別需求, 並不斷隨時代改進去迎合客戶的真正所需 忠意是世界最大的保險集團之一, 並擁有超過 180 年歷史 2015 年, 集團總保費收入超過 740 億歐羅, 成功並列 財富 世界 50 強 現有超過 7 萬 6 千員工遍佈全球超過 60 多個國家, 為 7 千 2 百萬客戶提供優質專業服務 集團在西歐市場佔有領先地位, 業務更擴展至中東歐及亞洲等地 忠意集團獲惠譽國際授予保險公司財務實力評級 A- ^ 憑著集團雄厚的財政實力, 屢獲獨立評級公司的高度評價 2015 年, 忠意集團榮登 麻省理工學院科技評論雜誌 全球最聰明公司 50 強, 而且是榜上唯一的保險公司 公司資料截至 2016 年 3 月 ^ 惠譽確認評級截至 2016 年 1 月 About Generali Our Generali entities in Hong Kong have been providing comprehensive insurance and investment protection to individuals and organizations since the 1970s. Over the years, we have come to understand the individual requirements of our clients, and are continuously adapting and innovating to meet their changing needs. The Generali Group is one of the largest global insurance providers. We pride ourselves for our history of over 180 years and we are listed amongst the Fortune Global Top 50 companies with 2015 total premium income of more than 74 billion. With above 76,000 employees worldwide serving 72 million insured persons in more than 60 countries, the Group occupies a leadership position in Western European markets and an increasingly important place in Asia and Central and Eastern Europe. Generali and its core subsidiaries have been affirmed A- ^ Insurer Financial Strength ( IFS ) Rating by Fitch Ratings. For our Group s financial strength, we have consistently received high ratings by independent agencies. Generali is also ranked among the world s 50 smartest companies in 2015 according to the MIT Technology Review and we are the only insurer on the list. Company information as at March 2016 ^Rating affirmed by Fitch as at January 2016 忠意保險有限公司 Assicurazioni Generali S.p.A. 香港皇后大道東 8 號忠意保險大廈 5 樓 5/F, Generali Tower, 8 Queen s Road East, Hong Kong 電話 Tel: (852) 傳真 Fax: (852) 香港分行電郵 : A&[email protected] Hong Kong Branch A&[email protected] 香港分行網址 : Hong Kong Branch Website: Civil servant scheme p.7