I want all-round protection against critical illnesses

Transcription

1 critical illness protection I want all-round protection against critical illnesses healthelite critical illness insurance

2 Getting sick isn t something we like to think about, but unfortunately it happens. In Hong Kong, 1 in every 4 men or 5 women is at risk of developing cancer before age 75. Beyond cancer, there are other life-threatening illnesses we may have to face. Risk of developing cancer before age 75 in Hong Kong 1 in every 4 men will develop cancer 1 in every 5 women will develop cancer Source: Hong Kong Cancer Registry, Overview of 2012 Hong Kong Cancer Statistics 1

3 Thanks to advancement in medical technology, many critical illnesses can now be detected earlier through medical check-ups. With timely and proper treatment, people today can have a higher chance of surviving a critical illness than before. Whilst this progress is encouraging, there are still many worries people may have when coping with critical illnesses Difficulty in getting other insurance coverage in future Termination of existing insurance coverage after making claim Risk of suffering from complications or other related illnesses Loss of income Unexpected huge medical bills Risk of suffering from other critical illnesses in future Risk of recurrence 2

4 All-round critical illness coverage brings you peace of mind AXA s HealthElite Critical Illness Insurance ( Basic Plan ), a participating life insurance plan issued with its supplement HealthElite Enhanced Benefit Supplement ( Supplement ) 1 (collectively HealthElite ), is designed for offering you an all-round protection against the unfortunate events of critical illnesses. Highlights Provides financial support against 120 illnesses of different severity levels, from minor to early stage and major illnesses Allows multiple claims among the covered illnesses, ensuring continued coverage even after any claim of illness made under the policy Enhances protection for 3 common serious illnesses in Hong Kong Cancer, Heart Attack and Stroke You can refer to the case below: (This illustrative example is for reference only) Mr. Leung faces a series of cardiovascular diseases 15 years after taking out a HealthElite policy. Age of diagnosis Diagnosed illness Is it covered by HealthElite? Age 50 Angina and angioplasty is required Age 50 (6 months later) Age 51 (1 year after the 1 st heart attack) Age 53 (2 years after the 2 nd heart attack) Heart attack Another heart attack Coronary arteries stenosis and bypass surgery is required For more details of how Mr. Leung is protected, please refer to the illustrative example 2 on page 9 of this product brochure. Note: Claims for the above illnesses are subject to relevant terms, conditions and exclusions of the policy contracts. The relevant illnesses have to fulfil and be subject to the relevant eligibility requirements, conditions and exclusions as set out in the definitions of the illnesses concerned in the policy contracts. 3

5 Critical illness protection Comprehensive protection against critical illness HealthElite provides protection against 56 sets of sicknesses. Each set of sickness covers up to 3 severity levels of illnesses, namely major illness, early stage major illness and minor illness (as set out in Table 1: List of sicknesses), protecting you against the unforeseen event. Sickness Major Illness Early Stage Major Illness Minor Illness 56 sets of sicknesses 1 Cancer 2 Chronic Adrenal Insufficiency (Addison s Disease) Carcinoma-in-situ of Specific Organs Treated with Surgery (Specific Organs refer to Breast, Prostate, Corpus Uteri, Ovary, Fallopian Tube, Colon and Rectum, Stomach, Bladder, Thyroid, Liver, Testicle, Lung or Pancreas) Adrenalectomy for Adrenal Adenoma i) Carcinoma-in-situ / Carcinomain-situ (CIS) at Breast, Cervix Uteri, Uterus, Ovary, Fallopian Tube, Vagina, Testicles, Lung, Urinary Tract, Stomach, Esophagus, Nasopharynx, Penis, Colon, Rectum or Liver ii) Early Stage Cancer of Prostate N/A. 56 Terminal Illness N/A N/A 56 major illnesses 52 early stage major illnesses 12 minor illnesses 120 illnesses Besides, there are 8 additional minor illnesses which are specially designed for insured aged under 22 (as set out in Table 2: Juvenile minor illnesses). Flexibility of multiple claims In the event where the insured is diagnosed with any one of the covered illnesses, a lump sum amount will be paid to provide financial support for medical treatments or other expenses. Benefits Benefit amount for each claim (% of the sum insured) Major Illness Benefit 100% Early Stage Major Illness Benefit 50% Minor Illness Benefit 2 20% There is a chance that a person may suffer from critical illness more than once during his lifetime. HealthElite allows multiple claims among the covered major illnesses, early stage major illnesses and minor illnesses. You can enjoy peace of mind knowing your protection will continue even after any claim of illness made under the policy. 4

6 Enhanced protection for common critical illnesses Under HealthElite, the aggregate amount of eligible benefits paid under the Major Illness Benefit, Early Stage Major Illness Benefit and Minor Illness Benefit 2 ( aggregate amount of benefits paid ) for each set of sickness is up to 100% of the sum insured, except for the sets of sicknesses related to Cancer, Heart Attack or Stroke. Cancer, Heart Attack and Stroke are 3 common critical illnesses in Hong Kong, which often require lengthy treatment and special care. Also, these illnesses may occur more than once. To ease you from the worry of inadequate financial support, an enhanced protection is offered to these 3 sets of sicknesses. Set of sickness related to (Set of sickness as shown in Table 1: List of sicknesses) Maximum aggregate amount of benefits paid (% of the sum insured) Cancer (Sickness no. 1) Up to 300% Heart Attack (Sickness no. 14) Up to 200% Stroke (Sickness no. 34) Up to 200% Other sets of sicknesses Up to 100% Total coverage of up to 300% of the sum insured HealthElite offers you a total coverage of up to 300% of the sum insured, which is comprised of the following: Total coverage of the policy up to 300% of the sum insured Supplement (maximum coverage) 200% of the sum insured (up to age 85) Basic Plan (maximum coverage) 100% of the sum insured (up to age 100) Claims shall be paid under the Basic Plan first. Once the 100% of the sum insured of the Basic Plan is exhausted, the Supplement s coverage will kick in. The approved but unpaid portion of claim under the Basic Plan and the subsequent claims will then be made under the Supplement (except for Moderately Loss of Independent Existence, Loss of Independent Existence and Terminal Illness). Note: Claims for the Major Illness Benefit, Early Stage Major Illness Benefit and Minor Illness Benefit are subject to relevant terms, conditions and exclusions, please refer to the section To know more about the conditions required for critical illness claims on page 15 of this product brochure for details. 5

7 Overview of critical illness protection under HealthElite Sickness Major Illness Early Stage Major Illness Minor Illness 56 sets of sicknesses 1 Cancer. Carcinoma-in-situ of Specific Organs Treated with Surgery (Specific Organs refer to Breast, Prostate, Corpus Uteri, Ovary, Fallopian Tube, Colon and Rectum, Stomach, Bladder, Thyroid, Liver, Testicle, Lung or Pancreas) 14 Heart Attack Pericardectomy. 34 Stroke Carotid Artery Surgery N/A. 55 Loss of Speech Loss of Speech due to Vocal Cord Paralysis i) Carcinoma-in-situ / Carcinoma-in-situ (CIS) at Breast, Cervix Uteri, Uterus, Ovary, Fallopian Tube, Vagina, Testicles, Lung, Urinary Tract, Stomach, Esophagus, Nasopharynx, Penis, Colon, Rectum or Liver ii) Early Stage Cancer of Prostate Insertion of Pacemaker or Defibrillator N/A Maximum aggregate amount of benefits paid for each set of sickness 300% of the sum insured 200% of the sum insured 200% of the sum insured 100% of the sum insured Total coverage of the policy Up to 300% of the sum insured i.e. 100% of the sum insured under the Basic Plan (up to age 100) + 200% of the sum insured under the Supplement (up to age 85) 56 Terminal Illness N/A N/A Benefit amount for each claim 100% of the sum insured 100% of the sum insured per major illness claim 50% of the sum insured per early stage major illness claim 20% of the sum insured per minor illness claim 2 Extra 35% Coverage Benefit 3 Before the 10 th policy anniversary and while the coverage of the Basic Plan is in effect, if the Major Illness Benefit or Death Benefit is payable, an additional amount equivalent to 35% of the sum insured of the Basic Plan will be paid. Index-linked Increase Endorsement 4,5 To guard against the pressure of inflation, an Index-linked Increase Endorsement may be attached to your policy. While this endorsement is in effect, the sum insured will be automatically increased every year with extra premiums. The rate of increase will be determined with reference to rises in the consumer price index, subject to a minimum determined by the Company from time to time. 6

8 Policy value accumulation and life protection under the Basic Plan Guaranteed Cash Value 6 From the 3 rd policy anniversary onwards, we will provide a Guaranteed Cash Value upon the surrender of the policy. Terminal Dividend 7 After your policy has been in force for 5 years, we may pay you a non-guaranteed Terminal Dividend. This non-guaranteed Terminal Dividend (if any) is payable when (i) the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured; (ii) the policy is surrendered; (iii) the policy matures; or (iv) the insured passes away, whichever is the earliest. Terminal dividend may be reduced or increased by the Company from time to time. Its actual amount will only be determined when payable. Death Benefit 8 The designated beneficiary will receive 100% of the sum insured of the Basic Plan plus any non-guaranteed Terminal Dividend 7 (minus any amount claimed for the Early Stage Major Illness Benefit and Minor Illness Benefit 2 under the Basic Plan and any indebtedness) in the unfortunate event that the insured passes away. Extra financial flexibility 4 choices of premium payment term You can choose a premium payment term of 10 years, 15 years, 20 years or 25 years that best suits your financial planning. Waiver of Premium Once the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured, the coverage of the Basic Plan will terminate while all future premiums of the Supplement will be waived from the next premium due date. All the insured needs to do is to focus on treatment and rehabilitation. Extended Grace Period Benefit 9 Starting from the 2 nd policy year, if you become a parent, get married, become divorced or become involuntarily unemployed during the premium payment term of the Basic Plan, you can choose to apply for the Extended Grace Period Benefit to stay protected by HealthElite while enjoying an extended grace period for premium payment up to 365 days. Total care with supplementary protection You can combine HealthElite with a wide range of optional supplements such as medical, accident and disability protection to meet your insurance needs. 7

9 Illustrative example 1 multiple claims for Cancer This illustrative example is for reference only (Terminal Dividend and Index-linked Increase Endorsement are not illustrated in this example). Ms. Wong takes out a HealthElite policy at age 30. Sum insured of the policy : HKD300,000 Premium payment term : 15 years In the 11 th policy year, she is diagnosed with carcinoma-in-situ in bladder which later progresses to bladder cancer. Age 41 (11 th policy year) Waiver of Premium kicks in # 1 st claim 2 weeks 6 months 2 nd claim 3 rd claim Protection continues until the remaining 130% coverage under the Supplement is exhausted or Ms. Wong attains age 85 Ms. Wong is diagnosed with carcinoma-in-situ in bladder (minor illness under sickness no. 1) HKD60,000 Minor Illness Benefit (20% of the sum insured under the Basic Plan) After a surgery to remove the tumour in bladder, Ms. Wong receives chemotherapy (early stage major illness under sickness no. 1) HKD150,000 Early Stage Major Illness Benefit (50% of the sum insured under the Basic Plan) Ms. Wong goes for a health check-up and unfortunately finds that her condition has progressed to bladder cancer (major illness under sickness no. 1) HKD300,000 Major Illness Benefit (100% of the sum insured i.e. 30% of the sum insured under the Basic Plan + 70% of the sum insured under the Supplement*) Total benefits paid: HKD510,000 Accumulated claims: 170% of the sum insured * As the aggregate amount of benefits paid under the Basic Plan has reached 70% of the sum insured after the 2 nd claim, 30% of the Major Illness Benefit of the 3 rd claim will be covered by the Basic Plan while the remaining 70% will be covered by the Supplement. # Once the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured, the coverage of the Basic Plan will terminate. The Supplement s coverage will kick in and all future premiums of the Supplement will be waived from next premium due date. Note: Assuming (i) the relevant illnesses are not excluded from the coverage of the Basic Plan and the Supplement and have fulfilled the relevant eligibility requirements and conditions as set out in the definitions of the illnesses concerned; (ii) no other claim has been paid and / or becomes payable under the policy; (iii) there is no indebtedness under the policy; (iv) the owner does not make any change to the sum insured of the policy throughout the contract term of the policy; (v) all premiums are paid in full when due and as planned; (vi) no optional supplements are attached to the policy; and (vii) Ms. Wong is not covered by other policy(ies) covering minor illnesses issued by AXA and any authorised insurers in Hong Kong and / or Macau which are affiliated with AXA. 8

10 Illustrative example 2 multiple claims for cardiovascular diseases This illustrative example is for reference only (Terminal Dividend and Index-linked Increase Endorsement are not illustrated in this example). Mr. Leung takes out a HealthElite policy at age 35. Sum insured of the policy : HKD500,000 Premium payment term : 20 years Starting from the 15 th policy year, he faces a series of heart-related health issues. Age 50 (15 th policy year) Waiver of Premium kicks in # Age 51 (16 th policy year) Age 53 (18 th policy year) 6 months 1 year 2 years The policy terminates as the aggregate amount reached 300% of the sum insured 1 st claim 2 nd claim 3 rd claim 4 th claim Mr. Leung suffers from angina and is sent to hospital. It is found that one of his coronary arteries has 80% stenosis. He then receives angioplasty to correct the narrowing (minor illness under sickness no. 11) HKD100,000 Minor Illness Benefit (20% of the sum insured under the Basic Plan) Suffers from a heart attack (major illness under sickness no. 14) HKD500,000 Major Illness Benefit (100% of the sum insured i.e. 80% of the sum insured under the Basic Plan + 20% of the sum insured under the Supplement*) Suffers from another heart attack (major illness under sickness no. 14) HKD500,000 Major Illness Benefit (100% of the sum insured under the Supplement) Mr. Leung goes for health check-up and finds that 3 of his coronary arteries have 60% stenosis. He then receives a bypass surgery to improve blood flow (major illness under sickness no. 11) HKD400,000 Major Illness Benefit (80% of the sum insured under the Supplement^) Total benefits paid: HKD1,500,000 Accumulated claims: 300% of the sum insured * As the aggregate amount of benefits paid under the Basic Plan has reached 20% of the sum insured after the 1 st claim, 80% of the Major Illness Benefit of the 2 nd claim will be covered by the Basic Plan while the remaining 20% will be covered by the Supplement. # Once the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured, the coverage of the Basic Plan will terminate. The Supplement s coverage will kick in and all future premiums of the Supplement will be waived from next premium due date. ^ The aggregate amount of benefits paid for sickness no. 11 is capped at 100% of the sum insured. As Mr. Leung has already received 20% of the sum insured for this set of sickness in his 1 st claim, the actual amount of benefits paid for the 4 th claim will be 80% of the sum insured. Note: Assuming (i) the relevant illnesses are not excluded from the coverage of the Basic Plan and the Supplement and have fulfilled the relevant eligibility requirements and conditions as set out in the definitions of the illnesses concerned; (ii) no other claim has been paid and / or becomes payable under the policy; (iii) there is no indebtedness under the policy; (iv) the owner does not make any change to the sum insured of the policy throughout the contract term of the policy; (v) all premiums are paid in full when due and as planned; (vi) no optional supplements are attached to the policy; and (vii) Mr. Leung is not covered by other policy(ies) covering minor illnesses issued by AXA and any authorised insurers in Hong Kong and / or Macau which are affiliated with AXA. 9

11 Illustrative example 3 multiple claims arising from one single accident This illustrative example is for reference only (Terminal Dividend and Index-linked Increase Endorsement are not illustrated in this example). Mr. Choi takes out a HealthElite policy at age 32. Sum insured of the policy : HKD400,000 Premium payment term : 15 years In the 8 th policy year, he is involved in a traffic accident which results in a number of injuries and illnesses. Age 40 (8 th policy year) Waiver of Premium kicks in # Age 42 (10 th policy year) 2 months 1 month 2 years The policy terminates as the aggregate amount reached 300% of the sum insured 1 st claim 2 nd claim 3 rd claim 4 th claim Mr. Choi has a car crash and needs to undergo a surgery for subdural haematoma (early stage major illness under sickness no. 20) HKD200,000 Early Stage Major Illness Benefit (50% of the sum insured under the Basic Plan) Mr. Choi is diagnosed with moderately severe brain damage (early stage major illness under sickness no. 24) HKD200,000 Early Stage Major Illness Benefit (50% of the sum insured under the Basic Plan) His condition worsens and he becomes blind (major illness under sickness no. 23) HKD400,000 Major Illness Benefit (100% of the sum insured under the Supplement) Mr. Choi is paralysed (major illness under sickness no. 29) HKD400,000 Major Illness Benefit (100% of the sum insured under the Supplement) Total benefits paid: HKD1,200,000 Accumulated claims: 300% of the sum insured # Once the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured, the coverage of the Basic Plan will terminate. The Supplement s coverage will kick in and all future premiums of the Supplement will be waived from next premium due date. Note: Assuming (i) the relevant illnesses are not excluded from the coverage of the Basic Plan and the Supplement and have fulfilled the relevant eligibility requirements and conditions as set out in the definitions of the illnesses concerned; (ii) no other claim has been paid and / or becomes payable under the policy; (iii) there is no indebtedness under the policy; (iv) the owner does not make any change to the sum insured of the policy throughout the contract term of the policy; (v) all premiums are paid in full when due and as planned; (vi) no optional supplements are attached to the policy; and (vii) Mr. Choi is not covered by other policy(ies) covering minor illnesses issued by AXA and any authorised insurers in Hong Kong and / or Macau which are affiliated with AXA. 10

12 Table 1: List of sicknesses Each set of sickness is presented in a row and classified into 3 severity levels of illnesses, namely major illness, early stage major illness and minor illness. The word N/A will be indicated if that particular illness does not exist in that set of sickness. Sickness Major Illness Early Stage Major Illness Minor Illness Cancer 1 Cancer Illnesses related to Organ Failure Carcinoma-in-situ of Specific Organs Treated with Surgery (Specific Organs refer to Breast, Prostate, Corpus Uteri, Ovary, Fallopian Tube, Colon and Rectum, Stomach, Bladder, Thyroid, Liver, Testicle, Lung or Pancreas) i) Carcinoma-in-situ / Carcinoma-in-situ (CIS) at Breast, Cervix Uteri, Uterus, Ovary, Fallopian Tube, Vagina, Testicles, Lung, Urinary Tract, Stomach, Esophagus, Nasopharynx, Penis, Colon, Rectum or Liver ii) Early Stage Cancer of Prostate 2 Chronic Adrenal Insufficiency (Addison s Disease) Adrenalectomy for Adrenal Adenoma N/A 3 Chronic and Irreversible Kidney Failure Early Renal Failure N/A 4 Chronic Liver Disease Liver Surgery Chronic Auto-immune Hepatitis 5 Coma Coma for 48 Hours N/A 6 End Stage Lung Disease Surgical Removal of One Lung N/A 7 Loss of Independent Existence* # Moderately Loss of Independent Existence* # N/A 8 Major Organ Transplantation Major Organ Transplantation (On Waitlist) N/A 9 Medullary Cystic Disease Surgical Removal of One Kidney N/A Illnesses related to Heart and Blood Vessels 10 Cardiomyopathy Early Cardiomyopathy N/A 11 Coronary Artery Disease Requiring Surgery Keyhole Coronary Bypass Surgery Angioplasty and other Invasive Treatments for Coronary Artery 12 Dissecting Aortic Aneurysm Cerebral Aneurysm or Arteriovenous Malformation Requiring Surgery N/A 13 Eisenmenger s Syndrome Insertion of a Veno-cava Filter N/A 14 Heart Attack Pericardectomy Insertion of Pacemaker or Defibrillator 15 Heart Valve Surgery Percutaneous Valve Surgery N/A 16 Primary Pulmonary Arterial Hypertension Secondary Pulmonary Hypertension N/A 17 Severe Infective Endocarditis Moderately Severe Infective Endocarditis N/A 18 Surgery to Aorta Minimally Invasive Surgery to Aorta Aortic Aneurysm Illnesses related to the Nervous System 19 Amyotrophic Lateral Sclerosis Early Amyotrophic Lateral Sclerosis N/A 20 Apallic Syndrome Surgery for Subdural Haematoma N/A 21 Bacterial Meningitis Moderately Severe Bacterial Meningitis N/A 22 Benign Brain Tumour Surgical Removal of Pituitary Tumour N/A 23 Blindness Optic Nerve Atrophy with Low Vision Glaucoma Surgical Treatment 24 Brain Damage^ Moderately Severe Brain Damage^ Facial Reconstructive Surgery for Injury due to Accident 25 Encephalitis Moderately Severe Encephalitis N/A 26 Motor Neurone Disease Early Motor Neurone Disease N/A 27 Multiple Sclerosis Early Multiple Sclerosis N/A 28 Muscular Dystrophy^ Moderately Severe Muscular Dystrophy^ N/A 29 Paralysis Moderately Severe Paralysis N/A 30 Poliomyelitis Moderately Severe Poliomyelitis N/A 31 Progressive Bulbar Palsy Early Progressive Bulbar Palsy N/A 32 Progressive Supranuclear Palsy^ Early Progressive Supranuclear Palsy^ N/A 33 Spinal Muscular Atrophy^ Early Spinal Muscular Atrophy^ N/A 34 Stroke Carotid Artery Surgery N/A 35 Tuberculosis Meningitis Tuberculous Myelitis N/A 11

13 Table 1: List of sicknesses (cont'd) Sickness Major Illness Early Stage Major Illness Minor Illness Illnesses related to Blood 36 AIDS / HIV due to Blood Transfusion N/A N/A 37 Aplastic Anaemia Acute Aplastic Anaemia N/A 38 Occupationally Acquired AIDS / HIV N/A N/A Illnesses related to the Digestive System 39 Chronic Relapsing Pancreatitis Acute Necrohemorrhagic Pancreatitis N/A 40 Fulminant Hepatitis Biliary Tract Reconstruction Surgery Hepatitis with Cirrhosis 41 Severe Crohn s Disease Moderately Severe Crohn s Disease N/A 42 Severe Ulcerative Colitis Moderately Severe Ulcerative Colitis N/A Illnesses related to Immunology and Rheumatology 43 Severe Rheumatoid Arthritis Moderately Severe Rheumatoid Arthritis N/A 44 Systemic Lupus Erythematosus (S.L.E.) with Lupus Nephritis Moderately Severe Systemic Lupus Erythematosus (S.L.E.) with Lupus Nephritis 45 Systemic Scleroderma Early Systemic Scleroderma N/A Illnesses related to Neurological degeneration 46 Alzheimer s Disease Moderately Severe Alzheimer's Disease N/A 47 Parkinson s Disease Moderately Severe Parkinson's Disease N/A 48 Severe Creutzfeld-Jacob Disease (CJD) Illnesses related to the Musculoskeletal System 49 Amputation of Feet due to Complication from Diabetes Moderately Severe Creutzfeld-Jacob Disease (CJD) Amputation of One Foot due to Complication from Diabetes Systemic Lupus Erythematosus (S.L.E.) N/A Retinopathy and Nephropathy due to Complication from Diabetes 50 Major Burns Moderately Severe Burns Skin Transplantation due to Accidental Burning 51 Necrotising Fasciitis N/A N/A 52 Severance of Limbs Severance of One Limb N/A Other Illnesses 53 Deafness (Loss of Hearing) Cochlear Implant Surgery N/A 54 Elephantiasis Early Elephantiasis N/A 55 Loss of Speech Loss of Speech due to Vocal Cord Paralysis N/A 56 Terminal Illness* N/A N/A * Moderately Loss of Independent Existence, Loss of Independent Existence and Terminal Illness are not covered under the Supplement. # Only an insured aged between 15 and 75 on the first diagnosis of this major illness / early stage major illness (as the case may be) is eligible to claim for the relevant benefit. ^ Only an insured aged above 5 on the first diagnosis of this major illness / early stage major illness (as the case may be) is eligible to claim for the relevant benefit. Table 2: Juvenile minor illnesses** Dengue Haemorrhagic Fever Hemophilia A and Hemophilia B Insulin Dependent Diabetes Mellitus Kawasaki Disease Osteogenesis Imperfecta Rheumatic Fever with Valvular Impairment Still s Disease Wilson s Disease ** Only an insured aged under 22 on the first diagnosis of this minor illness is eligible to claim for the relevant benefit. Each of the above 8 minor illnesses is treated as a separate set of sickness. Note: Benefits relating to major illness / early stage major illness / minor illness are payable according to the definitions of the relevant major illness / early stage major illness / minor illness (which specify the eligibility requirements, exclusions and other necessary conditions) as set out in the policy contracts of the Basic Plan and the Supplement. 12

14 Frequently asked questions What is the major advantage of HealthElite? A person may suffer from critical illness more than once during his lifetime. Under the protection of HealthElite, multiple claims for covered illnesses of different severity (including major illness, early stage major illness and minor illness) are allowed up to 300% of the sum insured, subject to relevant terms, conditions and exclusions as set out in the policy contracts. For example, the benefit amount for each claim of early stage major illness is 50% of the sum insured. With the total coverage of 300% of the sum insured available under HealthElite, up to 6 early stage major illness claims can be made. What can I do if I want to know more about the details of the illnesses covered under HealthElite? You are advised to refer to the terms and conditions of the policy and also the relevant definitions of the illnesses covered, which contain the eligibility requirements, conditions and exclusions on the coverage as set out in the policy contracts. For example, Coronary Artery Disease Requiring Surgery, a major illness under sickness no. 11, refers to the undergoing of open heart surgery with a thoracotomy and sternotomy to correct narrowing or blockage of 1 or more coronary arteries with bypass grafts in persons with limiting anginal symptoms, but excluding non-surgical techniques such as balloon angioplasty, laser relief of an obstruction, stenting and all other intra-arterial catheter based techniques. The surgery must be considered medically necessary by a specialist. For details of the definition of other covered illnesses, please refer to the policy contracts. If I am diagnosed with critical illnesses and have difficulty in making premium payment, will I still be protected? HealthElite Enhanced Benefit Supplement is designed with a waiver of premium feature to help lessen your financial burden when needed. Once the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured, the coverage of the Basic Plan will terminate while that of the Supplement will kick in. Under the Waiver of Premium of the Supplement, all future premiums for the Supplement will be waived from the next premium due date to keep you protected. If you have other optional supplements attached to the policy, premiums of the relevant supplements still need to be paid. How do I make a claim? Please call your financial consultant or contact us at (852) , fax (852) or customer.services@axa.com.hk. We will help you process your claim as soon as possible. 13

15 HealthElite at a glance HealthElite Critical Illness Insurance HealthElite Enhanced Benefit Supplement Premium payment term and issue age 10 years (age 0 65) 15 years (age 0 60) 20 years (age 0 55) 25 years (age 0 50) Benefit period Up to age 100 Up to age 85 Premium Minimum sum insured Will not be adjusted based on the insured s attained age Premium rates are not guaranteed Below age 45 : HKD120, Age 45 or above : HKD80, Maximum coverage Up to 100% of the sum insured of the Basic Plan (not including the Extra 35% Coverage Benefit 3 ) Up to 200% of the sum insured of the Supplement Major Illness Benefit Early Stage Major Illness Benefit Minor Illness Benefit 2 Extra 35% Coverage Benefit 3 Guaranteed Cash Value 6 Terminal Dividend 7 Surrender Value Maturity Benefit 11 Death Benefit 8 Additional 35% of the sum insured will be payable when the Major Illness Benefit or Death Benefit 8 is payable under the Basic Plan before the 10 th policy anniversary Available starting from the 3 rd policy anniversary; payable upon surrender of the policy Non-guaranteed; payable after the policy has been in force for 5 years on the earliest occurrence of the following (if any): when the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured; or the surrender of the policy; or the maturity of the policy; or the death of the insured 100% of the Guaranteed Cash Value 6 plus any Terminal Dividend 7 (non-guaranteed) as at the policy surrender date, minus any amount claimed for the Early Stage Major Illness Benefit and Minor Illness Benefit 2 under the Basic Plan and any indebtedness 100% of the sum insured of the Basic Plan plus any Terminal Dividend 7 (non-guaranteed) as at the policy maturity date, minus any amount claimed for the Early Stage Major Illness Benefit and Minor Illness Benefit 2 under the Basic Plan and any indebtedness 100% of the sum insured of the Basic Plan plus any Terminal Dividend 7 (non-guaranteed), minus any amount claimed for the Early Stage Major Illness Benefit and Minor Illness Benefit 2 under the Basic Plan and any indebtedness 100% of the sum insured for each claim 50% of the sum insured for each claim 20% of the sum insured for each claim N/A N/A N/A N/A N/A N/A Waiver of Premium Extended Grace Period Benefit 9 N/A Extension of the grace period for premium payment up to 365 days; available from the 2 nd policy year All future premiums of the Supplement will be waived from the next premium due date when the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured N/A Please refer to Premium adjustment under the section Important information for details. Note: The above benefits of the Basic Plan / Supplement are applicable while the coverage of the Basic Plan / Supplement is in effect. 14

16 To know more about the conditions required for critical illness claims Major illness, early stage major illness and / or minor illness claim(s) from both of the Basic Plan and the Supplement are subject to all of the following conditions: Major Illness Benefit Each Major Illness Benefit claim must be for a different major illness (except for Cancer, Heart Attack and Stroke). For subsequent claim(s) on Cancer, Heart Attack and Stroke, each subsequent claim must fulfil the additional requirements below: (i) if the Cancer of the subsequent claim for Cancer is a Recurrence of the Cancer 12 of any preceding claim(s) for Cancer (for which benefit has been paid), the Cancer of the subsequent claim for Cancer shall be covered only if it is first diagnosed after a 5-year Cancer-free Period 13 ; (ii) if the Cancer of the subsequent claim for Cancer is not a Recurrence of the Cancer of any preceding claim(s) for Cancer (for which benefit has been paid), the Cancer of the subsequent claim for Cancer shall be covered only if it is first diagnosed at least 1 year after the date of first diagnosis of the Cancer of the immediate preceding claim for Cancer (for which benefit has been paid). of diagnosis of the preceding claim of Heart Attack for which benefit has been paid and the diagnosis must be supported by fresh evidence of the following: (i) a history of typical chest pain; and (ii) new electrocardiographic (ECG) changes indicating myocardial infarction; and (iii) Diagnostic elevation of cardiac biomarkers indicating myocardial damage inclusive of CKMB or Cardiac Troponin T or I above generally accepted laboratory level. preceding claim of Stroke for which benefit has been paid and the diagnosis must be supported with new imaging evidence consistent with diagnosis of a second Stroke. For each major illness claim (apart from any major illness claim of Cancer, the Cancer of which is a Recurrence of the Cancer of any preceding major illness claim(s) of Cancer, Loss of Independent Existence and Terminal Illness), the first diagnosis of the major illness of any subsequent major illness claim must be at least 1 year after the date of first diagnosis of the major illness of the immediate preceding claim. Early Stage Major Illness Benefit Each Early Stage Major Illness Benefit claim must be for a different early stage major illness except for Carcinoma-in-situ of Specific Organs Treated with Surgery provided that each claim must be for a different covered organ. Minor Illness Benefit Each Minor Illness Benefit claim must be for a different minor illness except for (i) Angioplasty and Other Invasive Treatments for Coronary Artery and (ii) Carcinoma-in-situ of covered organs, which can be claimed twice subject to the exclusions and terms and conditions of this benefit. A second claim can be made subject to the additional conditions below: (i) For Angioplasty and Other Invasive Treatments for Coronary Artery, the treatment must be performed on a location of stenosis in major coronary artery where no stenosis of greater than 60% was identified in the medical examination relating to the first claim; (ii) For Carcinoma-in-situ of covered organs, the Carcinoma-in-situ is of a different covered organ from that of the first claim. 15

17 Moderately Loss of Independent Existence, Loss of Independent Existence and Terminal Illness Moderately Loss of Independent Existence, Loss of Independent Existence and Terminal Illness are not covered under the Supplement. Any unpaid balance of claim of any of these illnesses under the Basic Plan will not be paid under the Supplement in any event. If a claim for Moderately Loss of Independent Existence, Loss of Independent Existence or Terminal Illness becomes payable, the first diagnosis of any subsequent major illness, early stage major illness or minor illness must be at least 5 years after the first diagnosis of the immediate preceding Moderately Loss of Independent Existence, Loss of Independent Existence or Terminal Illness (as the case may be) in order for the subsequent claim to be covered. Others If the definition of a major illness is met (no matter the claim is admitted or not), no benefit will be payable retrospectively for any claim of early stage major illness or minor illness of the same set of sickness (except for claims of covered illnesses under the set of sickness related to Cancer where the subsequent claim concerns an organ different from those concerned in all preceding claims for Cancer). Similarly, if the definition of an early stage major illness is met (no matter the claim is admitted or not), no benefit will be payable retrospectively for any claim of minor illness of the same set of sickness (except in the case of claims of covered illnesses under the set of sickness related to Cancer). In case where after a Minor Illness Benefit or an Early Stage Major Illness Benefit under the set of sickness related to Cancer ( Earlier Claim ) had been paid and it is discovered by the Company later on that a Major Illness Benefit under the same set of sickness ( Later Claim ) should be paid instead in light of further evidence, then the Company shall be entitled to deduct the monies that have been paid for the Earlier Claim from the monies that shall be payable by the Company for the Later Claim. The insured must survive for at least 14 days from the date of first diagnosis (including the date of diagnosis) of the major illness, early stage major illness or minor illness (as the case may be) for each claim. If more than 1 illness is diagnosed on the same date as 1 event, though they may exist in different stages, conditions or forms, the Company will only pay 1 benefit for the illness for which the highest benefit amount is payable except that if a claim for Minor Illness Benefit and Early Stage Major Illness Benefit under the set of sickness related to Cancer is lodged as 1 event and the definitions and requirements for both the said Minor Illness Benefit and Early Stage Major Illness Benefit are fulfilled, then the Company will pay both the Minor Illness Benefit and Early Stage Major Illness Benefit under the set of sickness related to Cancer. For the definition of event, please refer to the policy contracts. For those organs with both left and right component (including but not limited to breast, ear, eye, fallopian tube, kidney, lung, ovary and testicle) ("Paired Organ"), the left component and right component of the organ shall be considered as one and the same organ. If more than 1 illness is diagnosed in any of these Paired Organs on the same date, though they may exist in different stages, conditions or forms, the Company will only pay 1 benefit for the illness for which the highest benefit amount is payable. 16

18 Important information Cooling-off period If you are not completely satisfied with the policy, you have the right to cancel it by returning the policy and giving written request. Such letter of request must be signed by you and received directly by our Customer Service at Suite 2001, 20/F, Tower Two, Times Square, 1 Matheson Street, Causeway Bay, Hong Kong within 21 days after the delivery of the policy or issue of the notice (informing about the availability of the policy and the expiry date of the cooling-off period) to you or your representative, whichever is earlier. The policy will then be cancelled and a refund of any premium(s) paid will be returned to you on the condition that no claim has been admitted. Non-guaranteed benefits Dividend philosophy The plan is designed to provide you with all-round critical illness insurance protection, and at the same time an additional return through a combination of: (a) guaranteed benefits, such as cash value and various critical illness benefits; and (b) non-guaranteed terminal dividend. How do we determine your terminal dividend? The premiums from you and the owners of other policies pooled together will form a participating fund and will be invested. We will make deductions for expenses, surrenders, claims and charges from this participating fund, while it earns investment returns. The value of this participating fund is called the asset share. It is an important reference to help us determine your terminal dividend. When we determine the amount of the terminal dividend of your policy, we will take into account the following: (a) the asset share; (b) both the current and the expected future amount of guarantees; and (c) the returns we expect the participating fund to earn in the future. In the plan, profit and loss arising from investment, claims, expenses and policy persistency will impact your terminal dividend. To align our interest with yours, we aim to share with you equally the profit and loss. Your participating policy is designed to be held for long term. When we determine your terminal dividend, we also take into account the policy duration, and it is adjusted downward in the early policy years to reflect this. What will affect your terminal dividend? We consider the past performance and future outlook of the following factors when determining your terminal dividend and they may significantly affect it. Investment return This includes changes in interest rates that will cause changes in interest earnings, as well as changes in market value of the assets in the participating fund due to changes in financial markets and economic conditions. These may result from risks or changes in factors, such as interest rates, currency risk, liquidity risk, credit / default risk, volatility risk and also general investment conditions. Claims These include the cost of providing death benefit and other insurance benefits. If the amount of benefit claims turns out to be higher, your terminal dividend will be lower. Policy persistency If policies lapse or are surrendered (whether in full or partially), profits or losses arise when the benefits paid out differ from the asset share of the terminated policies. Such profits or losses will be added to the asset share of the remaining policies. Expenses These include both expenses directly related to the policy (e.g. distribution costs and taxes) and indirect expenses allocated to the product group (e.g. office rent). If the actual expenses become higher, there will be less money available to pay you as terminal dividend. We may also apply smoothing when determining the terminal dividend. The value of the participating fund may go up and down sharply within days. Instead of sharing with you the gains or losses immediately, we may even out some short-term fluctuations. As your policy will be grouped together with other similar policies, the terminal dividend of your policy may also vary if the characteristics of policies in your group change. 17

19 Based on these, we conduct a detailed analysis of the participating business and make recommendation of the terminal dividend to be declared at least annually. Investment objective and strategy Investment objective The overall objective of investing the participating fund is to ensure that the guarantees we committed to the policies are met, while seeking competitive and stable returns over a medium to long term. Investment strategy We employ a rigorous and disciplined approach in determining strategic asset allocations which defines the nature of assets and how much we invest in. We monitor market positions carefully and frequently, and update our allocations when appropriate. In addition, we may complement our investment strategies with the use of derivatives and other financial agreements to manage liquidity, achieve an efficient and effective risk management and / or capture attractive investment opportunities. From time to time we will review the investment strategies and asset allocations, and will modify them if necessary. We aim to ensure all guarantees are met while maintaining non-guaranteed return potential for the terminal dividend. We also assess factors such as risk tolerance, changes in market conditions and economic outlook in order to maintain an optimal portfolio. Selection of assets We maintain a robust asset portfolio for the participating funds by investing in a wide range of investments, primarily with exposure to the U.S. and Asia (including Hong Kong and China). Generally, we aim to match the currency of the investments and the underlying policy currency denomination to the extent appropriate investments are available and acceptable. However, taking into consideration the aforementioned market constraints, we also invest in assets that are not denominated in the same currency as the underlying policies ( currency mismatch ). In such case, we may consider using derivatives to hedge the currency risk, and more broadly to ensure a proper matching between the assets and the policies. Overall, we target to limit the extent of currency mismatch, except for some specific strategies where it may bring additional returns or be a source of diversification. We also aim at maintaining adequate liquidity with respect to the policies and an appropriate level of risk diversification. Asset allocations You can find the current target asset allocations below: Assets Allocations* Government bonds, corporate bonds and other similar instruments 90% Growth assets 10% * There may be some holdings in cash. In addition, we may accept certain degree of deviation from the above targets in order to manage the portfolio efficiently. For more details, please refer to the relevant participating policy fact sheet which can be found at our website For the fulfilment ratios and total value ratios of our participating life insurance plans, please refer to our website at Policy currency If your policy is denominated in a currency other than your local currency, you may face an exchange rate risk. Upon currency conversion, the amounts you receive and the premiums you pay may vary as a result of changes in exchange rate. Premium adjustment The premium is calculated with reference to a number of factors including but not limited to the age, gender, smoking habit and risk class of the insured at the time of policy issuance and will not increase subsequently based on the insured s attained age. However, premium rates are not guaranteed. We reserve the right to review and adjust the premium rates on each policy anniversary with reference to the past performance and future outlook of factors such as claims, investment returns, policy persistency and expenses. Non-payment of premium You should pay premiums for the whole of your premium payment term. Any premiums remaining outstanding at the end of the grace period (i.e. 31 days after premium due date) may lead to termination of your policy. You may lose the insurance protection offered by the policy and the policy value (if any) to be received may be considerably less than your premiums paid. 18

20 Early surrender The policy is designed to be held for long term. Early surrender of the policy may result in a significant loss where you may get back considerably less than your premiums paid. Inflation The cost of living in the future is likely to be higher than it is today due to inflation. In case the actual rate of inflation is higher than expected, the purchasing power of the amounts you receive under the policy may be lower than expected. Termination The coverage under the Basic Plan will automatically terminate upon the earliest occurrence of any of the following: (a) when the insured dies; or (b) when the aggregate amount of all benefits paid and / or payable for the Major Illness Benefit, Early Stage Major Illness Benefit and Minor Illness Benefit of the Basic Plan reaches 100% of the amount of the sum insured of the Basic Plan; or (c) on the policy anniversary on or immediately following the insured s 100 th birthday. The Supplement will automatically terminate upon the earliest occurrence of any of the following: (a) when the insured dies; or (b) when the aggregate amount of all benefits paid and / or payable for the Major Illness Benefit, Early Stage Major Illness Benefit and Minor Illness Benefit of the Supplement reaches 200% of the amount of the sum insured of the Supplement; or (c) on the policy anniversary on or immediately following the insured s 85 th birthday; or (d) when the Supplement is cancelled; or (e) when the policy attached with the Supplement terminates. The policy will automatically terminate upon the earliest occurrence of any of the following: (a) when the insured dies; or (b) on the policy anniversary on or immediately following the insured s 100 th birthday; or (c) when the last subsisting attached supplement (apart from any attached waiver of premium supplement / applicant s waiver of premium at death supplement / applicant s waiver of premium at death or disability supplement, if any) is terminated in case where coverage under the Basic Plan has already been terminated; or (d) when the amount of indebtedness equals / exceeds the cash value minus all benefits paid or payable under the Basic Plan; or (e) when the Supplement and / or any other attached supplement, the policy provisions of which has indicated that cancellation of the supplement will automatically terminate the policy to which it is attached to, is cancelled; or (f) when there is no further coverage under the Basic Plan and all attached supplements and endorsement (if any); or (g) when the right of policy termination is exercised pursuant to the cross-border provision of the policy; or (h) when the policy lapses, is cancelled or surrendered. 19 Key exclusions We will not pay any benefit under the Major Illness Benefit, Early Stage Major Illness Benefit or Minor Illness Benefit of the policy: (a) if the insured suffers symptoms of, undergoes investigation for or is diagnosed with any major illness, early stage major illness or minor illness within the Waiting Period (as defined below) of the Basic Plan / Supplement; or (b) for any major illness, early stage major illness or minor illness resulting (directly or indirectly) from, or caused or contributed by (in whole or in part), any of the following: (1) any Pre-existing Condition (as defined below); or (2) any congenital defect or disease which has manifested or was diagnosed before the insured attains age 18; or (3) Human Immunodeficiency Virus (HIV) and / or any HIV-related illness including Acquired Immune Deficiency Syndrome (AIDS) and / or any mutations, derivations or variations thereof (except AIDS / HIV due to Blood Transfusion and Occupationally Acquired AIDS / HIV as stated in the definition of major illness provision of the Basic Plan); or (4) a self-inflicted injury or attempted suicide while sane or insane; or (5) intoxication by alcohol or drugs not prescribed by a medical practitioner; or (6) any criminal act; or (7) travel in any aircraft, except as a fare paying passenger in a commercial aircraft or cabin crew working on a scheduled public air service.