PartⅠ Summary of the Benefits
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1 Terms and Conditions Summary of Sign and Fly Group Travel Accident Insurance for MasterCard World Elite Credit Cards China Note: This Summary is for reference only and does not form part of the Policy. Please refer to the Policy for the details of the coverage, exclusions and claims etc. Should there be any inconsistencies between this Summary and the Policy, the Policy shall prevail. PartⅠ Summary of the Benefits Cover (Offered By MasterCard Asia/Pacific Pte. Ltd. Policy SFSH000025) Maximum Limit per Insured Person Benefits Cardholder (RMB: Yuan) Accompanying Spouse Accompanying Children Sign and Fly Accidental Death & Dismemberment (Aircraft Only) 6,000,000 3,000, ,000 Sign and Fly Accidental Death & Dismemberment (Train and Ship Only) Sign and Fly Accidental Death & Dismemberment (Common Carriers Other Than Aircraft/Train/Ship) 2,000,000 1,000, ,000 1,000, , ,000 Sign and Fly Accidental Medical Reimbursement /Per Accident 150,000 No Cover No Cover Sign and Fly Travel Delay (RMB 300 for every 5 hours of delay) 3,000 No Cover No Cover Sign and Fly Baggage Delay (RMB 500 for every 8 hours of delay) 3,000 No Cover No Cover Sign and Fly Personal Effect 30,000 No Cover No Cover Sign and Fly Trip Cancellation 30,000 No Cover No Cover PartⅡ General Conditions Eligible Card: World Elite Credit Cards Eligibility of Insured Person:For all named cardholders of the World Elite Credit Cards declared by MasterCard Asia/Pacific Pte. Ltd. and the foresaid cardholders accompanying spouses and children, excluding any terrorist or member of a terrorist organization, narcotics trafficker, or illegal purveyor of nuclear, chemical or biological weapons defined by any country or international organization. How to get the coverage: The cardholder eligible for this insurance pays all the traveling expenses of the travel with the Bankcard provided for under the Policy and takes the relevant Common Carrier accordingly.
2 All the traveling expenses referred to in the Policy shall mean the Insured Person successfully uses the Bankcard to pay the following expenses: 1) All the travel group fee; or 2) All the expenses for the Common Carrier, or 3) Traveling expenses agreed upon by the Policyholder and the Insurer in advance; Age Limit: 1. Cardholders and the accompanying spouses: years of age 2. Accompanying children of the Cardholders: 60 days after birth to 18 years of age Generic Sanction Exclusion: The Insurer shall not be deemed to cover nor shall be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose the Insurer to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the People s Republic of China or United States of America. Definition of Common Carrier: Common Carrier shall mean any steamer, train, any fixed-wing aircraft provided and operated by an airline or an air charter company and any helicopter provided and operated by an airline and operating only between established commercial airports or licensed commercial heliports provided and operated by a carrier duly licensed for the regular transportation of fare-paying passengers, and any regularly scheduled airport limousine operating on fixed routes and schedules provided and operated by a carrier duly licensed for the regular transportation of fare-paying passengers. Any of the aforesaid common carrier will not be defined as Common Carrier under the Policy in case that it is used for non Common Carrier intention or purpose. Part Ⅲ Coverage Scope Sign and Fly Accidental Death and Dismemberment Benefit In respect of any Accident, the total benefits payable by the insurer for all the Insured Persons shall be limited to the aggregate limit for each Accident as stated in the Schedule. In case such aggregate limit is insufficient to pay the sum insured for each Insured Person in any Accident, then benefit will be payable to each Insured Person in such the proportion as the sum insured of each Insured Person bears to the aggregate limit. In case that during the Policy Period, any Insured Person suffers from an Accident while riding as a fare paying passenger in the means of Common Carrier to its departure from such means of Common Carrier during a travel, which results in death or the dismemberment covered hereunder within one hundred and eighty (180) days from the date of the Accident, the Insurer will pay to the beneficiary the death benefit in the amount of the sum insured applicable to the such Insured Person as stated in the Schedule, or pay accidental dismemberment benefit to such Insured Person after confirming its dismemberment.
3 Such Insured Person shall not be entitled to the benefits above unless it pays all the traveling expenses of the travel with the Bankcard as provided for herein, and takes on the relevant Common Carrier thereby. In case that any Insured Person pays the traveling expenses for the same travel with several Bankcards as provided for in the Policy, the liability of the Insurer for any one Accident shall be limited to the highest sum insured applicable to the Bankcard as used by such Insured Person. The Insurer shall not pay under this Policy for any injury arising as a result of: (1) any wars, military actions, riots, strikes or armed insurrection; (2) any explosions, burning or radiation caused by biological, chemical or atomic weapons, or atomic or nuclear equipment; (3) any intentional actions by Policyholder; self-inflicted injuries or suicide by the Insured Person whether sane or insane; (4) fighting, being attacked or being murdered resulting from the provocative or intentional actions of the Insured Person; (5) the Insured Person engaging in or serving in military missions or the armed forces; (6) illegal or criminal activities or resistance to arrest by the Insured Person or during the period of detention or imprisonment; (7) alcohol abuse of the Insured Person or the Insured Person under the influence of alcohol, drugs, or controlled drugs; (8) mental or nervous disorder of the Insured Person, including but not limited to insanity; (9) ingestion, application, or injection of medicine by the Insured Person without compliance with the prescription of Qualified Medical Practitioners; (10) Acquired Immune Deficiency Syndrome (AIDS) or infection of the Human Immune Deficiency Virus (HIV) (as defined by the World Health Organization (WHO); the confirmation of infection by such virus requires the existence of the above mentioned disease or its antibodies found in the blood); (11) on board of any airplanes or air transportation vehicles or conveyances except as a passenger in any properly licensed private and/or commercial aircrafts; (12) any Pre-existing Injury or complications thereof; (13) pregnancy, miscarriage, childbirth and any injuries caused thereby; injury caused by venereal diseases; (14) any bacterial or virus infection (except for infections caused by an Accident), food poisoning; (15) Payment of any claim or provision of any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose the Insurer to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the People s Republic of China or United States of America. Sign and Fly Group Travel Accidental Medical Reimbursement While the Rider is in force, if any Insured Person sustains an Accident covered while riding as a fare paying passenger in the Common Carrier till departing from the Common Carrier during a travel and receives necessary treatment within one hundred eighty (180) days from the date of the Accident, the Insurer shall reimburse the Insured Person for the Necessary and Reasonable Medical Expenses actually incurred by the Insured Person up to the limit applicable to the said Insured Person under the Rider as stated in the Schedule. However, such Insured Person shall not entitled to such benefits unless it pays all the traveling expenses of the travel with the Bankcard provided for under the Policy, and takes relevant Common Carrier thereby.
4 The actual medical expenses shall not exceed the usual level of charges as approved by the government of the locality where the expenses are incurred. Items covered include such charges for medical consultation, prescription, operation, ambulance service, room and board, medicine, x-ray examination, nursing and medical supplies as incurred in a Hospital. If the Insured Person obtains reimbursement from any social welfare institutions or any other third parties or any medical insurance policies, the Insurer will only be liable for the balance. The deductible stated in the Schedule (if any) shall apply to any aforesaid reimbursement by the Insurer. The Insurer will not be liable for any loss not exceeding the deductible. In case that any Insured Person pays the traveling expenses for the same travel with several Bankcards, the liability of the Insurer for any one Accident shall be limited to the highest sum insured applicable to the Bankcard as used by such Insured Person. The Exclusions in the Basic Policy are applicable to the Rider. In the event of any conflicts between the exclusions under this Rider and those under the Basic Policy, this Rider shall prevail. The Insurer shall not be liable for any medical expenses incurred during the following period or as a result of the following event: (1) Dental treatments or surgeries unless necessitated by an Accident, or denture fault, dental restoration or planting; (2) Correction of defect of vision or optometry test for correction of defect of vision which is not necessitated by an Accident; refraction error; (3) Cosmetic or plastic surgeries or any elective surgeries; (4) Congenital anomalies or congenital diseases; (5) Infertility, contraceptive or operations related to sterilization; (6) General health check-ups, convalescence, custodial, rest care, rehabilitation, or psychological treatment; (7) Message or acupuncture treatment received due to any reasons; (8) Any injuries caused by drug allergy or other treatments; (9) Failure to obtain a written report from the Hospital or Qualified Medical Practitioners. Sign and Fly Group Travel Delay The Insurer shall pay indemnity to the Insured Person who has paid all the traveling expenses of the travel with the Bankcard p up to the limit applicable to such Insured Person under the Rider as stated in the Schedule in the event that the Common Carrier by which the Insured Person has arranged to travel is delayed up to a length of time stated in the Schedule due to inclement weather, natural disaster, mechanic breakdown, strike, hijack or slowing down, temporary protest by the employees of other air and sea carriers, Terrorist Action, air traffic control, or Over-selling of Tickets by the airline during the insured travel while this Rider is in force. The period of delay will be the longer of: 1) time between the original scheduled departure time of the Common Carrier and the revised departure time of the first available Alternative Transportation; or 2) time between the original arrival time and the time of the actual arrival of the Insured Person at the planned destination by the Alternative Transportation.
5 In case that any Insured Person pays the traveling expenses for the same travel with several Bankcards, the liability of the Insurer for any one insured incident shall be limited to the highest sum insured applicable to the Bankcard as used by such Insured Person. All the exclusions in the Basic Policy (if applicable) shall be applicable to the Rider. In the event of any conflicts between the exclusions under the Rider and those under Basic Policy i, the Rider shall prevail. The Insurer shall not be liable for any travel delay arising directly or indirectly as a result of: (1) the failure of the Insured Person to complete check-in procedures according to the itinerary, or to obtain written confirmation from the Common Carrier on the number of hours and the reason for such delay; (2) the failure of Insured Person to get on-board after completing the check-in procedures (unless prevented from doing so due to covered incident); (3) the failure of Insured Person to get on-board the first available Alternative Transportation offered by the Common Carrier; (4) circumstances or conditions which have existed and been known to the Insured Person when he or she books the Common Carrier for the insured travel and which may lead to the travel delay, including but not limited to any announced or occurred strike, other kind of labor protest or any kind of inclement weather or natural disaster at that time. Sign and Fly Group Travel Baggage Delay The Insurer shall pay indemnity to the Insured Person who has paid all the traveling expenses of the travel with the Bankcard up to the limit applicable to such Insured Person under the Rider as stated in the Schedule in the event that the arrival of checked baggage is delayed up to a length of time stated in the Schedule after the Insured Person arrives at the planned destination by the Common Carrier during the insured travel while this Rider is in force. If the Insured Person is indemnified by the Insurer under the Sign and Fly Group Travel Personal Effects Rider for the same reason, the Insurer shall not be liable for any payment under this Rider. In case that any Insured Person pays the traveling expenses for the same travel with several Bankcards, the liability of the Insurer for any one Accident shall be limited to the highest sum insured applicable to the Bankcard as used by such Insured Person. All the exclusions in the Basic Policy (if applicable) shall be applicable to the Rider. In the event of any conflicts between the exclusions under this Rider and those under the Basic Policy, this Rider shall prevail. The Insurer shall not be liable for any baggage delay arising directly or indirectly as a result of: (1) confiscation, detention, insulation, inspection or destruction of the checked baggage by the Customs or other administrative authorities; (2) failure of the Insured Person to notify the Common Carrier or its agent of the baggage delay and get the written confirmation on the number of hours for such delay when he/she arrives at the planned destination. (3) baggage or articles not checked when taking the insured journey; (4) baggage left attended by the Common Carrier or its agent.
6 Sign and Fly Group Travel Personal Effects Whilst this Rider is in force, if an Insured Person who has paid all the traveling expenses of a travel with the Bankcard, and takes relevant Common Carrier till departing from the Common Carrier. In case of loss of or accidental damage to his/her Personal Effects including baggage, personal belongings in the baggage and articles legally owned by the Insured Person as a result of theft, robbery, attempted theft by any third party or caused by carriers of the Common Carrier or any third parties, occurring during this travel, the Insurer shall pay, after deduction of any deductible (if any), the costs for the replacement or repair thereof up to the lesser of the following: 1. the cost of repair at the time of loss or damage; 2. the cost of replacement at the time of loss or damage; 3. the limit applicable to the Insured Person under the Rider as stated in the Schedule. In the event of damage to Personal Effects of the Insured Person due to any causes above-mentioned which is proven to be beyond reasonable and economical repair, such Personal Effects shall be deemed as have been lost and the Insurer shall pay the Insured Person for the Replacement Costs for the said Personal Effects, up to the limit applicable to the Insured Person under the Rider as stated in the Schedule. In case of the above event, the title to the damaged Personal Effects shall be vested in the Insurer upon such payment by the Insurer. In respect of Personal Effects purchased for more than one year, the Insurer may, when make payment, make appropriate reduction of payment or repair Personal Effects with due allowance for wear and tear and depreciation taken into consideration. The deductible, if any, in respect of each article insured under the Rider shall be that stated in the Schedule. The Insurer shall not be liable for any loss not exceeding the deductible. If loss of or damage to Personal Effects of the Insured Person is reimbursed by the carrier or any third party, the Insurer shall only be liable for the balance. In case that any Insured Person pays the traveling expenses for the same travel with several Bankcards, the liability of the Insurer for any one Accident shall be limited to the highest sum insured applicable to the Bankcard as used by such Insured Person. All the Exclusions in the Basic Policy (if applicable) are applicable to the Rider. In the event of any conflicts between the exclusions under this Riderand those under the Basic Policy, this Rider shall prevail. The Insurer shall not be liable for any of the following property or loss of or damage to the Personal Effects of the Insured Person directly or indirectly arising as a result of: (1) loss resulting directly or indirectly from the Y2Kproblem; (2) gold, silver, jewelry or accessories, mobile phones, Lap-Top computer or Personal Digital Assistant (PDA); (3) loss as a consequence of delay, confiscation or detention by the Customs or other administrative authorities; (4) loss of or damage to seals or documents; (5) breakage or damage to fragile articles, such as glass or crystal;
7 (6) business goods or samples; (7) loss or damage caused by normal wear and tear, depreciation, vermin, mould, erosion, gradual deterioration, light, or undergoing any process involving the application of heat, dehumidifying, cleaning, dyeing, replacement or maintenance, or scratch, indenture, mechanical or electrical breakdowns, misuse, faulty craftsmanship or design, or use of defective materials; (8) loss of cash, bonds, instruments, stamps, coupons, title deeds, stocks, travel documents, plastic money (including credit cards); (9) loss of data recorded on tapes, cards, diskettes or otherwise; (10) loss of or damage to baggage sent or souvenirs and articles that are not mailed or shipped at the same time of traveling; (11) any loss due to unknown causes or any mysterious disappearance; (12) any animals or plants or foods; (13) motor vehicles (including accessories), motorcycles, boats, bike, other motor or non-motor conveyances; (14) the articles put in the vehicle left unattended unless with clear violent traces; (15) household furniture, antiques; (16) hired or leased equipment; (17) smuggling or illegal transportation or trade; (18) articles which operate normally or recover normal functions after repair by a carrier, hotel, or any other parties liable. Sign and Fly Group Travel Trip Cancellation The Insurer shall reimburse the Insured Person who has paid all the traveling expenses of the travel with the Bankcard provided for under the Basis Policy, up to the limit under the Rider as stated in the Schedule, for loss of any pre-paid, unused and non-refundable travel fare as a result of the cancellation of the insured travel due to the following event during the effective period of this Rider: (1) death or Serious Injury of the Insured Person or the Insured Person s Immediate Family Members; (2) unexpected outbreak of riot, strike by the employees of a Common Carrier, inclement weather, natural disaster or epidemic disease at the destination of the travel within seven (7) days before the departure date of the insured travel. In case that any Insured Person pays the traveling expenses for the same travel with several Bankcards, the liability of the Insurer for any one Accident shall be limited to the highest sum insured applicable to the Bankcard as used by such Insured Person. All the exclusions in the Basic Policy (if applicable) shall be applicable to the Rider. In the event of any conflicts between the exclusions under this Rider and those under the Basic Policy, this Rider shall prevail. The Insurer shall not be liable for any loss arising directly or indirectly as a result of: (1) any Pre-existing Sickness or complications thereof; (2) any expense that is covered by any other existing insurance plan, or which will be paid or refunded by the government, hotel, airline, travel agency or any other provider of travel and/or accommodation. (3) any loss caused by government regulations, or cancellation and/or disruption of the planned journey due to negligence, omission or bankruptcy of the provider of travel and/or accommodation and/or Common Carrier.
8 (4) unwillingness to take the insured travel or the insured travel being beyond the means of the Insured Person. (5) illegal or criminal act. (6) failure to notify the trip cancellation in time to the travel agency or tour operator or provider of transport or accommodation. (7) the insured journey which is to obtain medical treatment or is against the Qualified Medical Practitioner s recommendation. (8) the Insured Person being aware of any circumstances or conditions which can lead to the trip cancellation before he or she books hotel, transportation or incurs any other expenses, including but not limited to any announced or occurred strike or other labor protest, and existing natural disasters or announced outbreak of epidemic disease. Claim Flow Chart PartⅣ Claim Process and Required Documents Claim Report Submit all supporting documents Supporting documents completed and sufficient Supporting documents not completed or not sufficient 10 working days Claim Dept verify the claim and investigation if needed Within the coverage w No Claim Declined Notice Yes Claim Payment Claim Report: Hot line for claim:(86) Opening hours:9:00-17:30(exclude Saturday, Sunday and the holidays) 24 Hr Travel Guard Service:(86) & (+60) (Information services only)
9 The claimants shall complete the Claim Form and submit it to the below address together with all supporting documents within 30 days after the claim incident: North China Regional Claims Center AIG Insurance Company China Limited 5th Floor Chamtime International Financial Center, 1589 Century Avenue, Pudong Shanghai P. R. China Fax: / Require Claim Supporting Documents Benefit Items Sign and Fly Accidental Death and Dismemberment Benefit Sign and Fly Group Travel Accidental Medical Reimbursement Supporting Documents In case of claim, the Claimant shall fill in a claim form and submit the following proofs and original documents to the Insurer so as to apply for the benefits: 1) proof of cancellation of household registration of the Insured Person or other relevant proofs or identity documents of similar nature(if applicable); 2) proof of household registration of the death beneficiary/beneficiaries or other relevant proofs or identity documents of similar nature(if applicable); 3) a death certificate or other relevant documentation of similar nature issued by Hospital or police or approved by the Insurer (if applicable); 4) report on the degree of dismemberment or burns of the Insured Person issued by such Hospital which ranks as Grade II or above or other hospitals designated by the Insurer or judicial authentication institutions as approved by the Insurer (if applicable); 5) the Accident supporting document(s) issued by the carrier; 6) bills and documents of the travelling expenses; 7) the bill with which the Insured Person pays all the travelling expenses with the covered Bankcard; 8) other proof and material that could be provided by the claimant in connection with the claim. If the Claimant can not provide any of the above supporting documents due to certain reason, he or she should provide other relevant supporting document that is acceptable under the law in filing a claim. The Claimant shall submit the following proofs and original documents together with the completed Claim Form as required by the Insurer to the Insurer within thirty (30) days as of the completion of treatment:
10 (1) complete medical report issued by the in-patient or emergency unit or the discharge summary; (2) original medical expense receipt issued by the Hospital (In the event the benefit amount payable cannot cover the full actual medical expenses, the Claimant may request the return of the original receipt in writing. The Insurer shall return the original receipt with a Insurer seal and remark of the amount indemnified.) (3) the Accident certification issued by the carrier in charge of the Common Carrier; (4) Bills and documents of the travelling expenses; (5) the bill with which the Insured Person pays all the travelling expenses with the prescribed Bankcard; (6) other proof and materials relevant to the claim the Claimant could provide. While filing a claim, the Insured Person shall submit the following documents as proof of claim together with the completed Claim Form required by the Insurer to the Insurer within thirty (30) days as of completion of the insured travel: Sign and Fly Group Travel Delay (1) written confirmation from the Common Carrier or its agent on the number of hours and the reason for such delay; (2) the counterfoil of the Common Carrier or other proof of hitching; (3) the bill with which the Insured Person pays all the travelling expenses with the prescribed Bankcard; (4) other proof and materials in relation to the claim the claimant could provide. While filing a claim, the Insured Person shall submit the following documents as proof of claim together with the completed Claim Form required by the Insurer to the Insurer within thirty (30) days as of completion of the insured travel: Sign and Fly Group Travel Baggage Delay Sign and Fly Group Travel Personal Effects (1) written confirmation from the Common Carrier or its agent on the number of hours and the reason for such delay; (2) the counterfoil of the Common Carrier or other proof of hitching; (3) the bill with which the Insured Person pays all the travelling expenses with the prescribed Bankcard; (4) other proof and materials in relation to the claim the Claimant could provide. While filing a claim, the Insured Person shall submit the
11 following documents as proof of claim together with the completed Claim Form required by the Insurer to the Insurer within thirty (30) days as of the end of the travel: (1) the list and the invoices for articles lost; (2) the counterfoil of the Common Carrier or other proof of hitching; (3) the bill with which the Insured Person pays all the travelling expenses with the prescribed Bankcard; (4) the written proof issued by relevant authorities or the police; (5) other proof and materials in relation to the claim that the claimant could provide. While filing a claim, the Insured Person shall submit the following documents as proof of claim together with the completed Claim Form required by the Insurer to the Insurer within thirty (30) days as of the cancellation of the insured travel: Sign and Fly Group Travel Trip Cancellation (1) relevant travel ticket, proof of hotel booking; (2) the bill with which the Insured Person pays all the travelling expenses with the prescribed Bankcard; (3) medical report from the Qualified Medical Practitioner or Hospital; (4) other proof and materials in relation to the claim the claimant could provide.
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