science or medicine.
三、因下列情形之一,造成被保险人住院治疗的,本公司不承担给付住院津贴保险金的责任:
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) 被保险人患先天性疾病、遗传性疾病、精神和行为障碍、先天性畸形、变形或染色体异常(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);
Medical expenses incurred by the Insured on account of the treatment of congenital malformation or
disease, genetic disease or chromosome abnormalities (determined in line with the International
Statistical Classification of Diseases and Related Health Problems (ICD-10) of the World Health
Organization)
3) 被保险人不孕不育治疗、人工受精、怀孕、分娩(含难产)、流产、堕胎、节育(含绝育)、产前产后检查以及
由以上原因引起的并发症,但因意外伤害事故所致的分娩(含难产)、流产及其并发症,不受此限;
The insured’s injuries caused by Infertility, gravidity (including ectopic pregnancy), abortion,
confinement (including cesarean birth); Pre-natal examinations, natural childbirth, delivery by
caesarean section out of medical necessity, miscarriage, post-natal examination, pregnancy and
pregnancy complications treatment Assisted reproduction; male and female birth control.
(Birth or abortion by accident are not excluded)
4) 被保险人接受矫形、视力矫正手术、美容、牙科保健及康复治疗、非意外伤害事故所致的整容手术;
Surgical, examination and treatment items for a variety of orthopedic and physical defects: such as flat
foot and snoring, as well as various nonfunctional plastic surgery and orthopedic surgery costs
5) 被保险人健康检查、疗养、静养或特别护理;
Environmental therapy for rest or observation, or services and treatments received at any long-term
care institution, spa resort, hydrotherapy clinic, rehabilitation center, nursing room or medical
institution not specified under this Contract.
6) 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、武术比赛、摔跤、特技表演、赛马、赛车
等高风险运动;
Treatment arising from injuries caused by the Insured’s participation or involvement in diving,
skydiving, rock climbing, bungee jumping, paragliding, adventure sports, martial art competitions,
wrestling, special effect performances (stunts), horse racing, car racing or other high-risk sports
7) 被保险人患未告知的既往症及保险单中特别约定的除外疾病;
Medical expenses for pre-existing conditions and diseases specifically excluded in this Contract
8) 被保险人故意自伤、故意犯罪或抗拒依法采取的刑事强制措施;
Medical expenses arising from the intentional self-inflicted injury, intentional crime or resistance against
the criminal coercive measures taken according to the law by the Insured.
9) 被保险人殴斗、醉酒,主动吸食或注射毒品;
Medical expenses for the treatment of medical conditions resulting from fighting, drunkenness or
deliberate use of illegal drugs by the Insured.
10) 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;
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平安健康保险股份有限公司 Ping An Health Insurance Co., Ltd.