Personal Accident Plan 個人意外計劃

Transcription

1 Personal Accident Plan 個人意外計劃

2 Accidents can happen to anyone, at anytime, anywhere. One minute you can be making travel plans, trying to start a family or working hard to further your careers, the next all your plans could be put on hold due to an accident. While no one can predict when an accident will happen, it s always important to be prepared against the sudden financial hardship caused by huge medical costs or loss of earnings because of an accident. That s why we introduce to you the Personal Accident Plan. A wide range of financial protection against accidents Double benefits for extra peace of mind Premium waiver benefit Renewal bonus automatically increases the benefits Optional Medical Indemnity Benefit Personal Accident Plan A wide range of financial protection against accidents Double benefits for extra peace of mind Personal Accident Plan provides financial protection our daily lives. We will double the benefits we pay against accidental loss of use or dismemberment for accidental death, loss of use or dismemberment, and accidental death. In the unfortunate event of or total disablement if the accident happens under loss of use, dismemberment or death as a result of the following circumstances. Elevator and traffic accidents happen all too often in an accident, we will pay you or your loved ones a lump-sum payment up to 100% of the notional i. If the life insured is a fare-paying passenger on amount (see the Important Information section any public transport at the time of the accident below) in line with the percentage shown in the causing the injury. benefit table. (See notes 1 and 2) ii. If the life insured is a pedestrian and injured in a traffic accident. If the total disablement resulting from an accident iii. If the life insured is in an elevator or on an continues for 12 months, we will pay a monthly total escalator (but not in mines and construction sites) disablement benefit, which is 1% of the notional at the time of the accident causing the injury. amount, starting from the 13th month. (See notes 2 iv. If the life insured is in a public building when a and 3) fire starts and at the time of the accident causing the injury. We also offer trauma counselling benefit (see note 4), international medical assistance (see note 5) and Mainland China hospital admission guarantee benefit (see note 5). 2 v. If there are landslides or flooding caused by a natural disaster in Hong Kong or Macau.

3 Renewal bonus automatically increases the benefits Optional Medical Indemnity Benefit If you continue to renew your policy, we will automatically Benefit to protect against the huge medical expenses increase the benefits we pay for accidental death, loss caused by an accident. This benefit covers expenses of use or dismemberment and total disablement by for medical, hospital and surgical treatment, bone- 5% every year, up to 25%. You do not need to pay any setting, acupuncture, chiropractor and physiotherapy extra premium for this extra benefit. treatments that are medically necessary. It also provides You can add on an optional Medical Indemnity protection by offering home nursing after a stay in hospital and cover on auxiliary equipment, including wheelchair, crutches, folding walkers and knee braces, needed for recovery. (See notes 6, 7, 8, 9, 10 and 11) Premium waiver benefit Compassionate Death Benefit Once we are paying the total disablement benefit under A compassionate death benefit will be payable in the the plan, you do not need to pay further premiums for unfortunate event of non-accidental death. the plan and Medical Indemnity Benefit. 3

4 Example At age 30, Mr Tong bought the Personal Accident Plan with Medical Indemnity Benefit, with a notional amount of HK$1,000,000, and medical indemnity amount of HK$50,000 per incident, for an annual premium of HK$3,650. Five years later, Mr Tong suffered severe injuries to his left hand in a traffic accident while riding as a passenger on a minibus. The injury resulted in him having his thumb and all four fingers on his left hand amputated. The plan provides him with financial support and lessens his worry. As well as a lump sum payment of HK$1,125,000, he received reimbursement of the treatment expenses, including surgical and confinement expenses, physiotherapy expenses and so on, up to HK$50,000. Since he was not able to return to his original job as a piano teacher due to his disablement, starting from the 13th month he will receive a monthly benefit of HK$22,500 up to 50 months (until benefit paid, excluding double indemnity and renewal bonus, reaches 100% of notional amount) to compensate for losing his ability to work (assuming there is no other claims from Mr Tong under the plan after this accident). The premium of plan and the Medical Indemnity Benefit will be waived when he starts receiving the total disablement benefit. Notional Amount: HK$1,000,000; Medical Indemnity Benefit: HK$50,000 per incident Immediate cash support Starting from the 13th month Loss of use/ dismemberment benefit 50% of the notional amount, equal to HK$500,000 Total disablement benefit 1% of the notional amount, equal to HK$10,000 a month (up to 50 months) Double indemnity for injuries suffered on public transport Benefit was doubled to HK$1,000,000 Double indemnity for injuries suffered on public transport Benefit was doubled to HK$20,000 a month Renewal bonus The benefit we will pay (not including double indemnity) will be increased by 25%, which is HK$125,000 Renewal bonus The benefit we will pay (not including double indemnity), will be increased by 25%, which is HK$2,500 a month Total A lump-sum payment of $1,125,000 Total A monthly payment of $22,500 Expense reimbursement Medical Indemnity Benefit Up to HK$50,000 4

5 Benefits table Types of benefit Percentage of notional amount 1. Accidental death benefit (see notes 1 and 2) 100% 2. Loss of use or dismemberment benefit (see notes 1, 2 and 12) Total loss of two limbs 100% Total loss of one limb 100% Total loss of sight of both eyes 100% Total loss of sight of one eye 100% Total loss of lens of one eye 50% Permanent and incurable insanity 100% Total loss of speech and hearing 100% Total loss of hearing: both ears 75% one ear 25% Total loss of speech 50% Total loss of four fingers and thumb: right hand 70% left hand 50% Total loss of four fingers: right hand 40% left hand 30% Total loss of one thumb: both right joints 30% one right joint 15% both left joints 20% one left joint 10% Total loss of one finger: three right joints 10% two right joints 7.5% one right joint 5% three left joints 7.5% two left joints 5% one left joint 2% Total loss of toe: all one foot 15% both great joints 5% one great joint 3% Fractured leg or patella with established non-union 10% Shortening of leg by at least 5 cm 7.5% Major burns: Area Third-degree burns as percentage of total body surface area Head equal to or greater than 8% 100% equal to or greater than 5% but less than 8% 75% equal to or greater than 2% but less than 5% 50% Body equal to or greater than 20% 100% equal to or greater than 15% but less than 20% 75% equal to or greater than 10% but less than 15% 50% 3. Total disablement benefit (see notes 2 and 3) 1% per month 4. Compassionate death benefit 1% 5. Trauma counselling benefit (see note 4) Reimbursement limit per accident: HK$5, Medical indemnity benefit (see note 6 and 11) The most we will pay per accident is 100% of the medical indemnity amount (i) Medical or surgical treatment benefit (ii) Hospitalization benefit (iii) Post-hospitalization home nursing (see note 7) (iv) Auxiliary equipment (see note 8) (v) Bonesetter and/or acupuncture expenses (see note 9) (vi) Chiropractor and/or physiotherapy expenses (see notes 9 and 10) Reimbursement sub-limits No sub limit No sub limit Up to 15 visits per accident, one visit per day (Per policy year) Crutches HK$400 Folding walkers HK$400 Knee braces HK$400 Wheelchairs HK$2,000 HK$600 per accident HK$300 per visit per day 5

6 Annual premium table (HK$) Notional amount HK$400,000 to HK$800,000 HK$1,000,000 to HK$1,700,000 Personal Accident Plan Premium rate per HK$1,000 Medical Indemnity Benefit Premium rate per HK$1,000 Occupation Medical indemnity Occupation Class 1 Class 4 amount Class 1 Class HK$2,000,000 or above HK$20,000 to HK$23,000 HK$30,000 to HK$40,000 HK$50,000 to HK$100,000 Note: We will add HK$100 to the premium for the Personal Accident Plan as a policy fee every year The premium rates and policy fee for Personal Accident Plan and Medical Indemnity Benefit are for reference only and are not guaranteed. We have the right to change the premium rate and policy fee from time to time. Notes: 1. We will pay the benefits if the bodily injury results in the life insured s death or loss of use or dismemberment within 180 days from the date of the accident. 2. In any event, the total amount we pay for accidental death benefit, loss of use or dismemberment benefit and total disablement benefit, not including double indemnity and renewal bonus, will not be higher than 100% of the notional amount. 3. We will pay the total disablement benefit if the bodily injury results in total disablement of the life insured within 180 days from the date of the accident and the benefit will start after the disablement has continued for 12 months in a row. We will not pay this benefit if the life insured is aged 15 or under on the date of the accident. 4. We will pay the trauma counselling benefit if we are also paying benefit for loss of use or dismemberment or total disablement for the same accident. 5. The international medical assistance and Mainland China hospital admission guarantee benefit are provided by a third party service provider which is an independent contractor and is not our agent. We shall make no representation, warranty or undertaking as to the availability of any medical opinions given by the medical service provider or any services given by the service providers. The services may change from time to time. Please visit our company website ( for the latest Emergency Assistance Benefits Provisions and Mainland China Hospital Admission Guarantee Benefit Provisions for the terms and conditions of the services. 6. We will pay the medical indemnity benefit for charges and expenses which are incurred within 365 days from the date of the accident. We will pay the benefit on reimbursement basis up to medical indemnity amount per accident and subject to the sub-limits of some benefit items as shown in the Benefits table. Please see the policy provisions for the terms and conditions. 7. We will pay post-hospitalization home nursing benefit if the service is provided to the life insured within 30 days immediately after the life insured leaves hospital and such hospital confinement is resulted from an injury. 8. We will only pay benefit for auxiliary equipment the life insured needs within 90 days after the accident as long as they have been in hospital because of the accident. We will pay for only one, one pair or one set of auxiliary equipment for each accident. 9. We will pay for expenses of bone-setting, acupuncture, chiropractic or physiotherapy treatments, in a policy year, up to 10% of the medical indemnity amount. 10. We will pay for expenses for chiropractic treatment if a doctor certifies the injury of the life insured before the life insured receives such treatment, and the treatment is consistent with diagnosis of the injury and is performed by a registered chiropractor. We will pay for expenses for physiotherapy treatment received by life insured due to an injury if the life insured s attending doctor recommends such treatment in writing and the treatment is performed by a registered physiotherapist. 11. Claims of Medical Indemnity Benefit will only be paid for medical necessary services based on reasonable and customary charges, please refer to the policy provision for the definitions. 12. If the life insured is left-handed, we will swap round the percentage for the various disabilities of the right hand and left hand. Learn more: 立即關注 WeChat ID: Manulife_HongKong Smart say - by Manulife Manulife Hong Kong 6

7 Important Information Your policy will have a notional amount, which is an amount we use to work out the premium and benefits of the plan. Any change in this notional amount will lead to a corresponding change in the premiums and benefits of the plan. Other product disclosures 1. Nature of the product The product is an insurance plan without a savings element. There is no cash value for the product. The product is aimed at customers who want an insurance product of the nature as described in this product leaflet and can pay the premium as long as they want the protection as described in this product leaflet. As a result, you are advised to save enough money to cover the premiums in the future. The premium pays for the insurance and related costs. 2. Cooling-off period If you are not happy with your policy, you have a right to cancel it within the cooling-off period and get a refund of any premiums paid. To do this, you must give us, within the cooling-off period, your written notice signed by you at Individual Financial Products, Manulife (International) Limited, 22/F, Tower A, Manulife Financial Centre, Wai Yip Street, Kwun Tong, Kowloon, Hong Kong (if the policy is issued in Hong Kong) or at Avenida De Almeida Ribeiro number 61, Circle Square, 14 andar A, Macau (if the policy is issued in Macau). In other words, your written notice to cancel your policy must reach us at the relevant address within 21 days after we have delivered the policy or sent you or your representative a notice telling you about the availability of the policy and the expiry date of the cooling-off period, whichever is the earlier. 3. Premium adjustment The premium rates are not guaranteed. We will regularly review our products, including the premium rates to make sure we can continue to provide cover. When reviewing the premium rates, we will consider our claims experience and other factors. 4. Premium term and result of not paying the premium You should continue to pay the premium (or premiums) on time throughout the benefit term. If you do not pay a premium on time, you have 31 days from the due date to pay it, during which the policy will continue in force. If we do not receive the premium after the 31-day period ends, the policy will end without further notice and the life insured will not be covered. 5. Credit risk Any premiums you paid would become part of our assets and so you will be exposed to our credit risk. Our financial strength may affect our ability to meet the ongoing obligations under the insurance policy. 6. Inflation risk The cost of living in the future is likely to be higher than it is today due to inflation. As a result, your current planned benefits may not be enough to meet your future needs. 7. Condition for ending the policy This policy will end if: i. the life insured dies; ii. you fail to pay the premium within 31 days from the due date; iii. the policy reaches the anniversary closest to the life insured s 75th birthday; iv. we approve your written request to end the policy; or v. we have paid 100% of the notional amount for accidental death benefit, loss of use or dismemberment benefit and/or total disablement benefit; whichever happens first. 8. Renewal You can renew this plan by paying the premium on the renewal date at our premium rate in force at the time. We can refuse to renew this plan on any anniversary date of the policy if we give you 30 days written notice mailed or delivered to you at your last-known address. 9. Exclusions and limitations We will not pay any benefit, except compassionate death benefit, if the injury results directly or indirectly from any of the following. i. Any injury intentionally self-inflicted or suicide, whether sane or insane. ii. Any drug, poison, intoxicating liquor, gas or fumes, voluntarily or otherwise taken, administered, absorbed or inhaled, other than as a result of an accident arising from a hazard incidental to the life insured s occupation. iii. War or any act incidental to war, or service in the armed forces of any country at war or in a civilian force auxiliary thereto. War means any war whether declared or not, or any conflict between the armed forces of countries, international organizations or combinations thereof. The armed forces of any country at war means the military, naval and air forces and will be deemed to include the armed forces of any international organization engaged in war. iv. Travelling or flight in any vehicle or device for aerial navigation, except as a passenger on an aircraft operated by a regular airline. v. Engaging in or taking part in: a. driving or riding in any kind of race; or b. underwater activities which take place at seadepth greater than 130 feet; or 7

8 c. engaging in a sport in a professional capacity or where the life insured would or could earn income or remuneration from engaging in such sport; or d. other hazardous pursuits such as mountaineering; pot holing; parachuting or bungee-jumping. vi. Any injury sustained during the course of or resulting from the commission or attempt to commit a criminal offence, or resisting or avoiding arrest. vii. Childbirth, pregnancy, miscarriage or abortion, whether or not this event may have been accelerated or induced by an accident. viii. For insured working as or engaging in any of the types of work or occupation listed below (whether on temporary or permanent basis), any injury results directly or indirectly from riot and civil commotion whilst carrying out such work or occupation: a. bar, lounge, night club, sauna bath, masseur, billiards room, game centre, gambling establishment (except Hong Kong Jockey Club), bowling alley, disco or karaoke club staff; or b. disciplinary services (such as disciplined officers under Police Force, Auxiliary Police Force, Fire Services Department, Immigration Department, Custom and Excise Department, Correctional Services Department or Military Force), hawker control, traffic warden or security guard; or c. reporter, air crew, ship crew or tourist guide, who works overseas. In addition to the above exclusions, we will not pay any benefit under Medical Indemnity Benefit if the injury results directly or indirectly from any of the following. ix. A cosmetic treatment performed on the life insured unless necessitated by injury caused by an Accident and the life insured receives the cosmetic treatment within 90 days of the accident. x. Corrective aids and treatment of refractive errors performed on the life insured unless necessitated by injury caused by an Accident and the life insured receives the corrective aides treatment within 90 days of the accident. xi. Dental treatment or surgery performed on the life insured except for emergency treatment due to Accident and such treatment is performed within 24 hours of the Accident during confinement and cannot be done on an outpatient basis. What we have said above is an outline of the circumstances under which we will not pay the policy benefits. You should see the policy provision for the exact terms and conditions and pay particular attention to those terms where we will not pay the policy benefits, including but not limited to the clauses on suicide, change of occupation and limitation of claim, and the definition of accident, injury, medically necessary and reasonable and customary. In this product leaflet, you and your refer to the policyowner. Manulife, we, us and our refer to Manulife (International) Limited. Personal Accident Plan is an insurance product provided and underwritten by Manulife (International) Limited (incorporated in Bermuda with limited liability). This product leaflet provides only general information on this product. You should read the policy provision for the exact terms and conditions that apply to this product. You can ask us for a copy. You should not buy this product unless you fully understand the product features and risks. For more information, please contact your Manulife insurance advisor or call our customer service hotline on (852) (if you are in Hong Kong) or (853) (if you are in Macau). If you have any doubts, please get professional advice from independent advisors. To view our Privacy Policy, you can go to our website at You may also ask us not to use your personal information for direct marketing purposes by writing to us. You can find our address on our website. We will not charge you a fee for this. This product leaflet is for distribution in Hong Kong and Macau only, but not in mainland China. MKTPP82E (04/2017) 8