Personal Accident Benefit 個人意外附加保障

Transcription

1 Personal Accident Benefit 個人意外附加保障

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 Benefit. A wide range of financial protection against accidents Double benefits for extra peace of mind Renewal bonus automatically increases the benefits Optional Medical Indemnity Benefit Personal Accident Benefit A wide range of financial protection against accidents Personal Accident Benefit provides financial protection against accidental loss of use or dismemberment and accidental death. In the unfortunate event of loss of use, dismemberment or death as a result of an accident, we will pay you or your loved ones a lump-sum payment up to 100% of the protection amount in line with the percentage shown in the benefit table. (See notes 1 and 2) If the total disablement resulting from an accident continues for 12 months, we will pay a monthly total disablement benefit, which is 1% of the protection amount, starting from the 13th month. (See notes 2 and 3) 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). Double benefits for extra peace of mind Elevator and traffic accidents happen all too often in our daily lives. We will double the benefits we pay for accidental death, loss of use or dismemberment, or total disablement if the accident happens under the following circumstances. i. If the life insured is a fare-paying passenger on any public transport at the time of the accident causing the injury. ii. If the life insured is a pedestrian and injured in a traffic accident. iii. If the life insured is in an elevator or on an escalator (but not in mines and construction sites) at the time of the accident causing the injury. iv. If the life insured is in a public building when a fire starts and at the time of the accident causing the injury. v. If there are landslides or flooding caused by a natural disaster in Hong Kong or Macau. 2

3 Renewal bonus automatically increases the benefits Optional Medical Indemnity Benefit If you continue to renew your Personal Accident Benefit to protect against the huge medical Benefit, we will automatically increase the benefits we expenses caused by an accident. This benefit pay for accidental death, loss of use or dismemberment covers expenses for medical, hospital and surgical and total disablement by 5% every year, up to 25%. treatment, bone-setting, acupuncture, chiropractor You do not need to pay any extra premium for this and physiotherapy treatments that are medically extra benefit. necessary. It also provides protection by offering You can add on an optional Medical Indemnity 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) 3

4 Example At age 30, Mr Tong bought the Personal Accident Benefit with Medical Indemnity Benefit, with a protection amount of HK$1,000,000, and medical indemnity amount of HK$50,000 per incident. He added this to his basic life insurance policy, for an annual premium of HK$3,450. 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. Personal Accident Benefit 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 13 th 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 protection amount) to compensate for losing his ability to work (assuming there is no other claims from Mr Tong under the plan after this accident). Protection 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 protection amount, equal to HK$500,000 Total disablement benefit 1% of the protection 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 Protection 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. Trauma counselling benefit (see note 4) Reimbursement limit per accident: HK$5,000 / US$ Medical indemnity benefit (see notes 6 and 11) Reimbursement sub-limits The most we will pay per accident is 100% of the medical indemnity amount (i) Medical or surgical treatment benefit No sub limit (ii) Hospitalization benefit No sub limit (iii) Post-hospitalization home nursing (see note 7) Up to 15 visits per accident, one visit per day (iv) Auxiliary equipment (see note 8) (Per policy year) Crutches HK$400 / US$50 Folding walkers HK$400 / US$50 Knee braces HK$400 / US$50 Wheelchairs HK$2,000 / US$250 (v) Bonesetter and/or acupuncture expenses (see note 9) HK$600 / US$75 per accident (vi) Chiropractor and/or physiotherapy expenses (see notes 9 and 10) HK$300 / US$38 per visit per day 5

6 Annual premium table (HK$/US$) Protection amount HK$400,000 to HK$800,000 / US$50,000 to US$100,000 HK$1,000,000 to HK$1,700,000 / US$125,000 to US$212,500 HK$2,000,000 or above / US$250,000 or above Personal Accident Benefit Premium rate per HK$/US$1,000 Medical Indemnity Benefit Premium rate per HK$/US$1,000 Occupation Medical indemnity Occupation Class 1 Class 4 amount Class 1 Class HK$20,000 to HK$23,000 / US$2,500 to US$2,800 HK$30,000 to HK$40,000 / US$3,800 to US$5,000 HK$50,000 to HK$100,000 / US$6,300 to US$12, The premium rates for Personal Accident Benefit and Medical Indemnity Benefit are for reference only and are not guaranteed. We have the right to change the premium rate 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 protection 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 benefit 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 benefit provisions 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: WeChat ID: Manulife_HongKong Smart say - by Manulife Manulife Hong Kong 6

7 Important Information 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. 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. 3. Premium term and result of not paying the premium You should continue to pay the premium (or premiums) on time throughout the benefit term. We will collect the premium for this supplementary benefit together with the premium for your basic plan. If you do not pay these premiums together on time, you have 31 days from the due date to pay them, during which the policy and the supplementary benefits will continue in force. If we do not receive the premium after the 31-day period ends, the policy and the supplementary benefits will end without further notice and the life insured will not be covered. 4. 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. 5. Currency risk This supplementary benefit is available in foreign currency. You should consider the potential currency risks when deciding which policy currency you should take. The foreign-currency exchange rate may fall as well as rise. Any change in the exchange rate will have a direct effect on the amount of premium you need to pay and the value of your benefits in your local currency. The risk of changes in the exchange rate may cause a financial loss to you. This potential loss from the currency conversion may wipe out the value of your benefits under the policy or even be more than the value of benefits under your 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 supplementary benefit This supplementary benefit will end if: i. the life insured dies; ii. you fail to pay the premium within 31 days from the due date and there is no cash value in the basic plan of the policy to which this supplementary benefit is attached; iii. the policy to which this supplementary benefit is attached ends or matures; iv. you cash in the policy or we apply the non-forfeiture benefit (if any) to your policy; v. the policy reaches the anniversary closest to the life insured s 75 th birthday; vi. we approve your written request to end this supplementary benefit; or vii. we have paid 100% of the protection 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 supplementary benefit 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 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 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 7

8 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 benefits. You should see the benefit provision as well as the policy provision for the exact terms and conditions and pay particular attention to those terms where we will not pay the 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 Benefit is an insurance product (supplementary benefit) 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 relevant benefit provision as well as 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. MKTPP83E (04/2017) 8