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平安人寿来华人员保险理赔指南
A Guide for
People Coming to China to Insurance Claim
against Ping An Life Insurance
尊敬的客户：
您如果想了解中国平安人寿保险股份有限公司来华人员综合保险理赔服务事项,请您仔细阅读如下内容。
Dear Valued Customer:
Respectful clients
of Ping An Insurance Company:
If you would like to
know services for settlement of claims of comprehensive
insurance for people coming to China, please read this guide
carefully.
1、理赔程序
⑴ 保险事故发生后，理赔的规范程序:
直接向协议约定的中国平安人寿保险股份有限公司所属分公司团险理赔部报案；
⑵ 理赔咨询电话：
协议约定的中国平安人寿保险股份有限公司所属分支机构电话或通过平安人寿北京分公司客户服务咨询及理赔报案电话010-66213388-69013直接查询被保险人所在地的平安人寿分管机构电话及详细地址；
1. Procedure of settling claims:
(1)
Claim settling procedure against the occurrence of
insured incidents:
Submit your claim to Group Insurance Division with
affiliated companies under China Ping An Life Insurance Co.,
Ltd. as stipulated in the agreement.
(2)
Claim & consulting hotlines:
Please call the local branches under China Ping An Life
Insurance Co., Ltd. or dial the service and claim consulting
number: 010-66213388-69013 of Beijing Branch to inquire the
numbers and specific address of the local branches as agreed
in the contract directly.
2、理赔应备文件：
①
团体一年定期寿险
A
被保险人护照复印件；
B
被保险人伤残时需提供伤残鉴定证明（由司法或劳动部门出具）；
C
被保险人死亡需提供死亡证明；
D
如发生交通事故，需出具公安交通部门的事故证明；
E
被保险人死亡时提供受益人身份证明复印件；
F
死亡赔付需提供受益人亲笔签字认可的保险分配方案的文件；
G
被保险人保险卡复印件；
2. Documents to be
presented for settlement of claims:
①Group term life
insurance of one year
A. Copy of passport
of the insured;
B. Disability assay
certificate in case the insured is disabled (provided by
judicial or labor department);
C. Death certificate
of the insured;
D. Proof of accident
provided by the communications department of the police in
case an traffic accident occurs;
E. Copy of the
beneficiary’s identity proof in case the insured is dead;
F. Insurance
distribution scheme signed and ratified by the beneficiary
in death compensation;
G. Copy of the
insurance card of the insured.
②团体意外伤害附加医疗
A
被保险人护照复印件；
B
意外事故经过及证明（若是交通事故则需出具公安交通部门事故证明）；
C医院诊断证明、病历本以及门诊收据、药费处方、超声波、CT、X光片、核磁等辅助检查报告单；
D
被保险人保险卡复印件；
②Annexed medical
treatment to group accidental injury
A. Copy of passport
of the insured;
B. Process of the
accident and its proof (A proof of accident provided by the
communications department of the police has to be presented
in case a traffic accident occurs);
C. Diagnoses
certificate and the medical records and medical examination
receipt, diagnoses with medical charge, assist examination
record of ultrasonic, CT, X-ray, nuclear and magnetic etc.
D. Copy of the
insurance card of the insured.
③团体住院医疗
A
被保险人护照复印件；
B
意外事故经过及证明；
C
医院诊断证明以及住院收据住院明细文件原件；
D
被保险人保险卡复印件；
③Group medical
treatment in hospital
A. Copy of passport
of the insured;
B. Process of the
accident and its proof;
C. Original copy of
diagnoses certificate and receipt and detailed documents for
hospitalization;
D. Copy of the
insurance card of the insured
④每次赔案文件中须附上被保险人或学校指定的银行帐号,并本人签字或学校盖章。
④Account number of
the insured or the school in designated bank and the
signature or school’s seal is to be annexed to each of the
claim settling documents.
注意事项：Notes:
1、若一次保险事故分别在两家（含）以上医院就诊，须出具相应医院诊断证明书、病历本等相关文件。
2、就诊医院为公立二级（含）以上医疗机构。
3、保险公司理赔完成后将加盖本公司公章的医药费分割单同赔款一同寄至申请人，以报销余下部分医药费。
4、护工费申请要求：
（1）被保险人个人申请所需材料：医院出具的护工费收据；
（2）被保险人所在单位申请所需材料：医院出具的护工费收据或单位开具的证明和护工本人的签字并加盖申请单位公章；
5、材料寄送地址：中国平安人寿当地分管机构规定的地址。
Notes:
1. Where in one
insured incident, the insured has to be treated in two or
more hospitals, diagnoses certificate from those aforesaid
hospitals and the medical records and other documents in
respect thereof shall be presented.
2. The insured shall
get treatment in hospitals which are public medical
institutions and at least in second rank.
3. After the
insurance company settles a claim, dividable medical charge
bill sealed by the insurance company and the indemnity will
be sent to the applicant so as to compensate the remaining
medical charge.
4.
Application of Nursing Fee:
(1) Materials the insured is required to submit: Receipt of
nursing fee issued by the hospital;
(2) Materials required from the applicant’s working unit:
Receipt of nursing fee issued by the hospital or letter of
identification with nurse’s signature and official seal of
the unit of applicant;
5.
Materials sent to: the appointed local branches subordinated
to China Ping An Life Insurance. |
