问:如果我要住院,应该怎么做?
Q : What should I do if I need to be hospitalized?
答:如果您要住院,请提前 2 个工作日致电平安热线 95511 转 7 获得预授权。紧急情况下,在接受治疗之日起的 48
小时内致电平安热线申请预授权。否则,只能理赔金额将是正常理赔的 60%。
A : When you are requested to be hospitalized or expected to give birth to a baby, please call Ping An hotline
4008833663*2 to apply pre-authorization. As for emergency, please do as soon as possible within 48 hours
after access to treatment.
问:我何时能收到理赔结果?
Q : When do I receive claim settlement?
答:我们在收到理赔材料后,将尽快为您处理。若材料完整,一般情况下,15 个工作日内结案,结案后 7 个工作日内
发出通知或银行转账。较复杂的案件,将在 30 个工作日内结案。理赔结果会通过电子邮件发送给您。如遇特殊情况,
我们会与您沟通。
A : If the claim materials are complete, at most time we finish claim within 15 days. Very complicated cases
will be finished within 30 days. We will send you claim settlement notification by email. If any questions,
service specialist will contact you.
责任免除 Exclusions
一、因下列情形之一导致被保险人身故、伤残的,本公司不承担给付保险金的责任:
Exclusions of the accidental death & disability benefit:
1) 投保人对被保险人的故意杀害、故意伤害;
Death or injury of the insured intentionally caused by the policy holder;
2) 被保险人故意自伤、故意犯罪、抗拒依法采取的刑事强制措施或自杀,但被保险人自杀时为无民事行为能力人的
除外;
Suicide or criminal compulsory measures in case of the self-inflicted injury or the insured commits crime
intentionally or resists the arrest, excluding the suicide of the person who has no capacity of civil
conduct;
3) 被保险人殴斗、醉酒,主动吸食或注射毒品;
The insured assaults, gets drunk, takes, sucks or injects drug;
4) 被保险人酒后驾驶、无合法有效驾驶证驾驶,或驾驶无有效行驶证的机动车;
The insured drives after drinking, or drives without driving license, or drives any motor vehicle without
vehicle license;
5) 战争、军事冲突、暴乱或武装叛乱;
War, military action, civil commotion, or armed rebellion;
6) 核爆炸、核辐射或核污染;
Nuclear explosion, nuclear radiation or nuclear pollution.
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平安健康保险股份有限公司 Ping An Health Insurance Co., Ltd.