POLICY WORDINGS OF ACCIDENTAL PARTIAL PERMANENT DISMEMBERMENT (BV-NR12/2011) CONTENTS

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Francine Bishop
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1 1 POLICY WORDINGS OF ACCIDENTAL PARTIAL PERMANENT DISMEMBERMENT (BV-NR12/2011) CONTENTS CHAPTER I: GENERAL PROVISIONS... 2 CHAPTER II: INSURANCE BENEFITS... 3 CHAPTER III: INSURANCE DURATION AND EFFECT... 5 CHAPTER IV: PREMIUM AND CHARGE... 6 TABLE OF PAYMENTRATE... 8

2 2 This Rider is a supplementary agreement between Bao Viet Life and the Policyholder to the main Policy (Policy). CHAPTER I: GENERAL PROVISIONS Article 1: The Insured The Insured under this rider (the Insured) isthe person who is accepted to be insured by Bao Viet Life in compliance with regulations. Limits on the Insured s age at entry and at maturity are provided by BaoViet Life s regulations and notified to the Policyholder at policy s application and renewal (if changed). The necessary information about the Insured is shown in the Application and the Policy s Appendix. Article 2: Definitions 2.1. Accident is a specific event or series of consecutive events caused by the sudden impact of an external force or a substance, without the Insured s intention and expectation, on the Insured s body resulting in death or injuries, excluding any process caused by disease, aging or deterioration. The above event or series of events must be the direct and unique cause of the death or injuries of the Insured "Sum Insured" is the amount of money used to calculate this Rider s insurance benefits. The Sum Insured is chosen by the Policyholder in accordance with Bao Viet Life s regulations and is shown in the Application Form and/or the Appendix Pre-existing condition is the state of any disease, bodily injuries, disorders, which have been diagnosed or have appearedor existed before the commencement of this Rider The other terminologies used in this Rider have the same meaning as explained in the Policy s wordings.

3 3 Article 3: Similar application The provisions concerning insurance application, duty of honest disclosure and strict compliance with the commitments in the Rider, claim settlement, dispute settlement relating to this Rider shall be similar to those stipulated in the main policy. Article 4: Priority In case there is a difference between the wordings of the Rider and the Policy, those of the Rider CHAPTER II: INSURANCE BENEFITS Article 5: Insurance benefits 5.1. In case the Insured suffers from partial permanent dismemberment resulted from accident while the Rider is still in force, Bao Viet will pay the Policyholder the benefit as regulated in the Insurance Benefit Payment rate table of this Rider. Article 6: Rules on settlement of insurance benefits 6.1. The total and unrecoverable loss of the function of a body s part shall be considered as loss of that part In the event that a series of losses shall arise out of the same accident, the total insurance benefit payment for all losses would not exceed 100% of the Sum Insured of this Rider In case the Insured fall under dismemberment more than 1 accident, the total insurance benefit payment to each Insured in each policy year will not exceed 100% of Sum Insure of this Rider. 6.4 In case the consequence of the accident is worsened by the pre-existing conditions of the Insured or the deferred injury treatment or the treatment does not conform to the instruction from the authorized medical unit, BVL shall pay the insurance benefit as per a similar case happened for a standardhealth- conditionperson receiving reasonable treatments.

4 4 6.5 The insurance benefit of this Rider will be paid independently with the Main policy. Article 7: Exclusions 7.1. BVL shall not pay the insurance benefits in cases the Insured suffers from partial permanent dismemberment not due to accident BVL shall not pay the insurance benefits that stipulated in Article 5 in case the Insured either would have become qualified the partial permanent dismemberment due to direct or indirect consequences of: Suicide of the Insured; Intentional act of the Insured, the Policyholder or the Beneficiary; deliberate failure by the Insured to perform reasonably actions which could have avoided the insured event occurring and those accidents occurring if the Insured deliberately exposed the Insured to a situation where expectation of an occurrence of insured event was inevitable or very high; HIV infection, AIDS contraction (Acquired Immune Deficiency Syndrome), or diseases relating to AIDS; The Insured participates in: aeronautical activities (except as a passenger in a civil airplane); dangerous activities: parachuting, car/motor/bicycle racing, horse racing, hunting, boxing, diving; The Insured s criminal act (as per conclusion of legal authority); The Insured uses illegally alcohol (beer included), narcotic or drug, other stimulants; Earthquake, tsunami, nuclear reaction, infection of radioactivity, chemical weapons, biological weapons; War (whether declared or not), civil war, terrorism, rebellion, riot or the like.

5 5 Article 8: CHAPTER III: INSURANCE DURATION AND EFFECT Commencement of the Rider 8.1. In case the Rider is applied for at the same time with the main policy s commencement, the Rider will take effect at the same time with the main policy In case being applied for while the main policy is enforce, the Rider shall take effect on date Bao Viet Life accept to insure the Insured under this Rider Article 9: Insurance duration The Rider s insurance term is 1 year from its commencement date as stipulated in Article 8 or the Rider s renewal date as stipulated in Clause 11.1, Article 11. Article 10: The Rider s termination The Rider will be terminated when: The Rider is matured without renewal as stipulated in Article 11; or The Insured dies or suffers from Total Permanent Disability; or The policyholder request to paid up the main policy or the main policy premium is waived or premium term of main policy is ceased.; or The main policy has been matured or terminated; or The Insured reaches a defined age subjected to BVL s regulation; or The total insurance benefit payment to the Insured reach the limit that stipulated in sub-clause 6.2, or 6.3, Article 6; or Rider is terminated as stipulated in Subclause 12.4, Article 12; or The Policyholder requests to lapse the Rider. Article 11: Renewal

6 Within the main policy s insurance duration, the Rider will be automatically renewed on the next day of the maturity day of the Rider, except cases where the Policyholder or BaoViet Life advise not to renew the rider in writing no later than 15 days before the end of the rider s insurance term. Such day is the Rider s renewal date The Rider that has terminated as stipulated in Article 10 shall not be renewable The first premium of the renewal Rider is due on the renewal date of Rider. Stipulations in clauses and Article 12 shall be applied as stipulated for the first premium payment of renewal Rider. Article 12 Premium CHAPTER IV: PREMIUM AND CHARGE The Rider s premium is specified in the Appendix In case the frequency of premium payment is regular basic, the frequency of premium payment for this Rider is the same as the frequency of payment of the main policy. In case BVL accept the insurance application for this Rider when the frequency of the Main policy is single premium, then the frequency of premium payment for this Rider would be annual or any other periodic subject to BVL s regulations In case the Policyholder fails to pay the due premium, the grace period of 60 days counting from the premium payment due date shall be granted After the grace period stipulated in the Clause Article 12, if the Policyholder still fails to pay the due premiums, the Rider shall be automatically terminated on the first due date or after the termination of the grace period subject to the Main policy s regulations, except for the case the Rider s premiums (will be) automatically paid under the regulations of the main policy (if any) The renewal premium shall be identified at the renewal date in accordance with the Tariff which is approved by Ministry of Finance. Where necessary and in order for Bao Viet Life to take advantage of

7 premium collection, corporate management, Bao Viet Life can retain the premium applicable before the renewal date or apply the renewal premium later. In case renewal premium is applied later, the premium applicable before the renewal date shall be applied till the date the renewal premium come into effect Bao Viet Life reserves the right to adjust premium of the renewed Rider in accordance with the Tariff approved by Ministry of Finance. Whenever the premium is adjusted upward, the adjustment will be notified in writing to the Policyholder at least 15 days before the maturity of the rider The other stipulations on premium shall be applied as stipulated in the main policy s Wordings. 7 Article 13: Charge on issuance of rider In the case the Rider is applied for while the main policy is in force and Bao Viet Life accept the application then the Policyholder shall bears any charge on issuance of rider (if any) according with Bao Viet Life s regulations. This charge is necessary to cover the expenses relating to the underwriting and issuing of the rider./.

8 8 TABLE OF INSURANCE BENEFIT PAYMENRATES No. Cases in which the insurance benefit shall be paid I Eye Percentage of Sum Insured shall be paid 1 Total and unrecoverable loss of sight of one eye 55% II Ear 2 Total and unrecoverable loss of hearing of both ears 75% 3 Total and unrecoverable loss of hearing of one ear 20% 4 Total loss of both pinnas 15% 5 Total loss of one pinna 5% III Upper Limb Total and Unrecoverable loss of use of one arm 6 Surgery to remove the wrist joints 50% 7 Amputate at the forearm 55% 8 Surgery to remove the elbow joints 60% 9 Amputate at the brachium 65% 10 Surgery to remove the glenohumeral joints 70% Finger 11 Thumb (finger I) - Loss of one phalanx 8% - Loss of the whole thumb 20% 12 Loss of the whole index finger (finger II) 9% 13 Loss of the whole middle finger (finger III) 7% 14 Loss of the whole ring finger (finger IV) 6% 15 Loss of the whole little finger (finger V) 5% 16 Loss of a phalanx of fingers II, III, IV or V (any phalanx) VI Lower Limb Total and Unrecoverable loss of use of one leg 2%

9 9 17 Surgery to remove a part of foot (anterior half of foot) 35% 18 Surgery to remove the ankle joints 45% 19 Amputate at the leg (from the ankle joint to the knee joint) 55% 20 Surgery to remove the knee joints 60% 21 Amputate at the thigh (from the knee joint to the hip 65% joint) 22 Surgery to remove the hip joints 70% Toes 23 Loss of the whole big toe (toe I) 7% 24 Loss of the whole other toe II, III, IV or V 3% V Other disability 25 Total and permanent loss of speech 50% 26 Loss of the whole lower jaw 70% 27 Loss of the whole upper jaw 80%

Family Personal Accident Insurance

Family Personal Accident Insurance July 2013 1 This is your Family Personal Accident Insurance policy document. If you have any questions about these documents, please contact your insurance adviser who