7) 被保险人因妊娠(含宫外孕)、流产、分娩(含剖宫产)导致的伤害;
The insured’s injuries caused by gravidity (including ectopic pregnancy), abortion, confinement
(including cesarean birth);
8) 被保险人因医疗事故、药物过敏或精神和行为障碍(依照世界卫生组织《疾病和有关健康问题的国际统计分类
(ICD-10)》确定)导致的伤害;
The insured’s injuries caused by medical accident, drug allergy, spiritual or behavioural disturbance
(confirmed by ICD-10);
9) 被保险人未遵医嘱,私自使用药物,但按使用说明的规定使用非处方药不在此限;
The insured takes medicines without doctor’s permission, excluding the usage of the OTC drugs in
accord with the instruction book;
10) 细菌或病毒感染(因意外伤害导致的伤口发生感染者除外);
Bacteria or virus infection (excluding wound infection caused by accidental injuries);
11) 被保险人从事潜水、跳伞、攀岩、蹦极、驾驶滑翔机或滑翔伞、探险、摔跤、武术比赛、特技表演、赛马、赛车
等高风险运动。
The insured engages in sports or activities with high risks such as diving, parachuting, climbing, bungee
jumping, glider driving, paraglider, expedition, martial arts, wrestling competitions, acrobatics, horse
riding, racing, etc.
发生上述第一项情形导致被保险人身故的,本公司对该被保险人保险责任终止,并向受益人退还该被保险人的未满期
净保险费。
If the insured dies because of the policy holder’s intentionally behaviors toward the insured, the insurer
ceases to be liable for the insured and refund the unearned premium to the beneficiary after deducting
termination fees.
发生上述其它情形导致被保险人身故的,本公司对该被保险人保险责任终止,并向投保人退还该被保险人的未满期净
保险费。
If the insured dies because of the other reasons, the insurer ceases to be liable for the insured and refund the
unearned premium to the policy holder after deducting termination fees.
二、因下列情形之一或方案中未涵盖的责任的,造成被保险人医疗费用支出的,本公司不承担给付保险金或不承担紧
急救援费用的责任
We will NOT bear any liability to reimburse benefits in the following situations and conditions not
covered in this plan:
1)非疾病治疗类
Non-disease Treatments
各种美容整形项目:如皮肤色素沉着、对皮肤表面无囊肿形成或无脓肿的痤疮治疗、红斑痤疮治疗;对未表现出可
疑细胞行为(如近期大小、形状、颜色发生改变)的良性皮肤损害(雀斑、老年斑、痣、疣等)的治疗和去除;对浅表
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平安健康保险股份有限公司 Ping An Health Insurance Co., Ltd.