Countdown To The 2019 C&D Xiamen Marathon

(January 6, 2019)

0 DAYS
0 HRS
0 MINS
0 SEC

Introduction of the Life Insurance of 2019 C&D Xiamen International Marathon

Ⅰ. Insured period:

The days when the races take place in  2019.


Ⅱ. The scope of the insurance coverage:

Accidental injuries and acute diseases that occur to insured attendants ( according to the census provided by the Committee of 2019 C&D Xiamen International Marathon ) during the race.


Ⅲ. Insured Benefits:

During the effective period of the insurance, when accidental injuries and acute diseases occur, the insurer is liable for the following payouts:

(1) Accidental death and disability benefits

1) Accidental death benefit:

If an accidental injury occurs during the competition and causes the insured’s death within180 days following the date of the accident, the insurer shall pay the insured sum in accordance with the insurance contract. Then this insurance contract is terminated after the payout.

2) Accidental disability benefit:

If an accidental injury occurs during the competition, and directly causes one of the disability items listed in the Disability Assessment Standards and Codes of Life Insurance attached to the contract within 180 days following the accident, the insurer shall multiply the insured sum written in the contract by the proportion of payment listed in the table according to the severity of the insured’s disability, and pay out the amount. If the treatment is still not finished after 180 days following the date of the accident, an assessment of the 180th day’s condition shall be made, and the insured amount for accidental disability will be paid according to the severity of that day.

 

If the insured has pre-existing disability caused before this accident( including the condition before the conclusion of the contract), the insurer shall pay a sum according to the total severity of the present disability condition after the accident. However, it is regarded that the insurer had paid a sum for the pre-existing disability according to its severity, and thus this sum should be deducted from the total amount.

 

If the accident directly causes the disability and death within 30 days following the date of the accident, the insurer should not pay for the accidental disability insurance.

The maximum payout that the insurer is liable to for the insured’s accidental disability is limited by the insured sum.

意外伤害是指遭受外来的、突发的、非本意的、非疾病的客观事件直接致使身体受到的伤害。

 

Accidental Injury refers to direct injury to the body caused by external, unexpected, unintentional and non-diseased objective events.

 

(2) Benefit for death due to acute disease

急性病身故给付: 被保险人在参加比赛过程中猝死或突发急性病并在该病发作之日起七日内导致身故,本公司按本合同保险凭证上所载的急性病身故保险金额给付急性病身故保险金,本合同对该被保险人的保险责任终止。

Payout for death due to acute disease: If in the course of the competition, sudden death occur to the insured, or an acute disease occur and causes the insured’ death within 7 days following the day of the occurrence, the insurer shall pay the insured sum for the death in accordance with the contract, and then the insurance liability to the insured shall be terminated.

 

Acute Disease refers to the condition for which the insured has not received any treatment or diagnosis before the effective date of this policy, and for which the insured must receive treatment immediately in the hospital to avoid damage to health.

  

突发急性病是指被保险人在本合同生效日之前未曾接受治疗及诊断且在比赛中突然发病必须立即在医院接受治疗方能避免损害身体健康的情况。

猝死是指貌似健康的人因潜在疾病、机能障碍或其他原因在出现症状后24小时内发生的非暴力性突然死亡。猝死的认定,如有司法机关的法律文件、医疗机构的诊断书等,则以上述法律文件、诊断书等为准。

Sudden Death is a death that suddenly happens to a seemingly healthy person within 24 hours following symptoms that appear due to potential disease, dysfunction or other causes. The authentication of a sudden death should be based on legal documents issued by judicial authorities and on the diagnoses from the medical institutions if these documents are available.

 

(3). Reimbursement of the medical expenses due to accidents and acute diseases

 

In the course of the competition, if accidental injury or acute disease that occurs to the insured causes the latter to take treatments in the hospital for the accidental injury or acute disease within 5 days following the date of the occurrence, the insurer shall be liable to the medical expenses as stipulated below:

  

1)被保险人在中华人民共和国境内二级以上(含二级)医院接受治疗所支出的、符合当地社会医疗保险主管部门规定可报销范围的医疗费用,在医疗保险金额范围内,按100%给付医疗保险金。

1) The medical expenses incurred by the insured in the public hospital of second level (or higher leveled public hospital) in People's Republic of China, which are in accordance with the provisions of the local social medical insurance administration, shall be reimbursable 100% within the limit of the insured sum of the medical insurance.

  

2)保险期间届满被保险人治疗仍未结束的,本公司所负给付保险金的期限可按下列情况延长:门诊治疗者,自保险期间届满次日起计算,最多延长15日;住院治疗者,在保险期间届满次日起计算至出院之日止,最多延长90日。

2) If the treatments are not finished before the expiration of the insured period, the insurer will extend the insured period according to the following conditions: For out-patient treatments, an extension of maximum 15 days can apply, calculated from the next day of the expiration; for in-patient treatments, an extension of maximum 90 days can apply, calculated from the next day of the expiration.

  

3)若被保险人的医疗费用已从任何其他途径(包括社会医疗保险机构、工作单位、本公司在内的任何商业保险机构等)取得补偿,本公司给付的保险金仅以约定范围内费用未取得补偿的剩余部分为限。

3) If the insured's medical expenses have been compensated by any other means (including social medical insurance institutions, work place, any commercial insurance company including the insurer itself, etc.), the insurer's reimbursement is limited to the remaining part that hasn’t been reimbursed, within the scope of the insurance policy.

 

4)在本合同有效期内,被保险人比赛期间不论一次或多次发生本合同约定的医疗费用,本公司均按本条规定分别给付医疗保险金,但对同一被保险人累计给付的医疗保险金总额以保险凭证上所载医疗保险金额为限。

4) During the effective period of this contract, the insurer shall pay out the medical expenses in accordance with the provisions of this article, regardless of how many times that the medical expenses are incurred in the course of the competition, but the total amount to be paid to the same insured is limited by the insured sum of the medical insurance written in the insurance contract.

 

Ⅳ. Exclusions

The death, disability, acute disease and medical expenses caused or contributed to by the following conditions are excluded from this policy and the insurer shall not be liable for:

(1)Murder or intentional injury to the insured committed by the policy holder;

(2)Insured’s intentionally self-inflicted injury, intentional criminal behavior, fight or being attacked caused by the insured’s intentional behavior, resistance against penal mandatory action based on legal terms, or any attempt of suicide( except for the insured being a person without capacity for civil conduct);

(3)Insured’s drinking of alcohol, and initiatively using or injecting drug;

(4)Insured’s drunk-driving, driving without effective driving license, or driving any vehicle that doesn’t have any effective road-worthiness certificate;

(5)Injury caused by insurer’s pregnancy (including extrauterine pregnancy), abortion, deliver( including cesarean section) or allergy to medication;

(6)Insured’s mental disease, schizophrenia, and plastic surgery;

(7)Medical accidents occur during insured’s dentist treatment and plastic surgery, and other internal medicine or surgical medicine;

(8)Insured’s misusing of medicine without following doctor’s advice( except for taking OTC following the instruction) ;

(9)Infections caused by bacteria, viruses and other pathogenic microorganisms, while wounds caused by accidental injury being exemptions;

(10)Insured’s hazardous activities such as diving, skydiving, rock climbing, gliding or paragliding, adventure, wrestling, martial arts competitions, stunts, horse racing and car racing without the permission of the insurer;

(11)Insured’s participation or practice in the organization and activities of terrorism or cult.

(12)War, military conflict, riot, or armed rebellion;

(13)Nuclear explosion, nuclear radiation or nuclear pollution;

(14)Pre-existing disease suffered by the insured before the effective date;

(15)When the insured is sent out of People's Republic of China as labor force;

(16)Medical expenses of the insured due to lumbar disease, cervical spondylosis and other vertebral diseases.


Ⅴ. The insured sum

For each of the runners of the race, the insured sums are as the following:

RMB 500,000 for accidental death( RMB 100,000 for juveniles);

Maximum RMB 500,000 for accidental disability( RMB 100,000 for juveniles);

RMB 500,000 for death due to acute disease;

Maximum RMB 100,000 for reimbursing medical expenses due to accident or acute disease.

 

Insurance Clauses for reference: Sunshine Life Hetai Accidental Injury Insurance for Running

Note:

Juveniles refers to persons under eighteen when the insurance is effective.


Ⅵ. The premium

The policy holder of all the captioned insurances is the Committee of 2019 Xiamen International Marathon, and Sunshine Life Insurance Co., Ltd. is the unique insurer appointed by the Committee. The runners of the race who are admitted by the policy holder to be the insured don’t need to pay the insurance premium by themselves.


Ⅶ. Claim

Documents to prepare for a claim:

Item to claim

Document to prepare

1. Original copy of the insurance contract

2. Claim form

3. Medical note of the out-patient   or emergency treatment

4. Hospital medical records and   Discharge Summary

5. Diagnosis certificate

6. Original invoice ( Fapiao) and   machine-printed sheet of medical expenses breakdown

7. Accident certificate issued by   the police or medical institution

8. Accreditation report

9. Certificates of death

10. Certificate of funeral

11. Certificates of cancellation   of household registration

12. Declaration of presumptive   death

13. Identification certificates of   the insured (when the insured is a person without capacity for civil conduct,   the guardian’s identification certificates and the guardianship certificates   are necessary. )

14. Identification certificates of   the deseased beneficiary, and certifications proving the relation between the   insured and the beneficiary.

15. Photocopy of bank card or of   the cover page of bankbook

16. Deseased beneficiary’s   confirmation form

Note: Document   (7) is necessary for claims due to accidental events.

Reimbursement of Medical expenses   due to accidental injury or acute disease ( Out-patient treatments)

1、2、3、5、6、7、13、15

Reimbursement of Medical expenses   due to accidental injury or acute disease ( In-patient treatments)

1、2、3、4、5、6、7、13、15

Death due to Accidental Injury or   Acute disease

1、2、7、9、10、11、14、15、16

Disability due to Accidental   Injury

1、2、3、4、5、7、8、13、15

 

Note: In order to protect the insured’s rights and benefits, the insurer reserves the right to require the insured to provide extra supportive documents when the above documents are not sufficient to present the situation. When the beneficiary entrusts another person to claim, an Authorization of Claim signed by the beneficiary is necessary, enclosed with beneficiary and the trustee’s identification certificates.

 

Ⅷ. Contact of the insurer:

Emergency hot-line: 95510

Official website: www.sinosig.com

The Insurer: Fujian Branch of Sunshine Life Insurance Corporation Limited