AXA Personal Accident Travel Insurance

 

Chapter I ：Basic Clauses

 

Insurance Period

 

The date of effectiveness of this Contract shall be the effectiveness date specified in the insurance confirmation letter, which is the basis for calculating the expiry date of both the insurance confirmation letter and the insurance premium.

 

Sum Insured

 

Sum insured as mentioned in this Contract shall mean the sum insured corresponding to the insurance liability as specified in the insurance confirmation letter. If the sum is changed according to other clauses or notes of this Contract, the sum after such change shall be the sum insured.

 

The Policy Holder

 

Shall mean the insured person himself who has full capacity of civil conducts, or other persons having insurable interest in the insured person.

 

Beneficiaries

 

The beneficiaries under this Insurance Contract shall include:

 

1. beneficiaries of benefits for death

 

When concluding this Insurance Contract, the insured person or the policy holder may designate one or more persons as beneficiaries of benefits for death. When there are several beneficiaries of benefits for death, the insured person shall determine the sequence and shares of their respective proceeds; if the shares of benefits are not determined, each beneficiary of benefits for death shall enjoy the beneficiary right at equal shares. If a beneficiary intentionally causes the death, disability or disease of the insured person, or intentionally kills the insured person but fails, such beneficiary shall lose the beneficiary right.

 

Modification of Contractual Contents

 

The insurer reserves the right to modify the benefits or insurance liability under this Insurance Contract and that to amend the clauses.

 

The policy holder may, within the validity period of this Contract, apply for modification of the contractual contents pursuant to this Contract, and the modifications shall become effective after being consented to and recorded by the insurer and commented in the insurance contract. No broker or agent shall have the right to amend or waive any clause of this Insurance Contract.

 

If a certain insured person dies, the insurer shall not accept any application for the modification of any content in this Contract related to such insured person.

 

Obligation of Representation and Effectiveness of the Contract

 

The policy holder or the insured person shall truthfully make the representations on matters inquired by the insurer.

 

1. If the intentional non-performance of the obligation of representation is enough to directly affect the insurer's decision on whether to insure this Contract or to raise the insurance premium rate, the insurer shall have the right to, irrespective of whether an insurance accident has occurred by that time, terminate this Contract according to relevant legal provisions, and will not refund the insurance premium. The insurer shall not be liable for indemnifying or paying benefits for the insurance accidents occurring before this Contract is terminated. If the aforesaid intentional failure to perform the obligation of representation only directly affects the insurer's decision on whether to insure a certain person, such person shall be disqualified as an insured person; the insurer shall not bear any insurance liability for the insurance accidents occurring before the insured person is disqualified as an insured person.

2. If the failure to perform the obligation of representation due to gross negligence is enough to directly affect the insurer's decision on whether to insure this Contract or to raise the insurance premium rate, the insurer shall have the right to, irrespective of whether an insurance accident has occurred by that time, terminate this Contract according to relevant legal provisions, and will refund the insurance premium without interest.If the aforesaid failure to perform the obligation of representation due to gross negligence only directly affects the insurer's decision on whether to insure a certain person, such insured person will be disqualified as an insured person, and the insurer will refund the corresponding portion of insurance premium to the insured person without interest. If the intentional failure to perform the obligation of representation seriously affects the insurance accident occurring prior to the termination of this Contract or the disqualification of the insured person, the insurer shall not bear any insurance liability for such insurance accident.

3. If the failure to perform the obligation of true representation is enough to directly affect the insurer's decision on whether to raise the insurance premium rate, and the insurer agrees to continue underwriting the insurance, the policy holder shall make up to the insurer the insurance premiums accumulatively increased as of the effectiveness date of this Contract, and the interest thereof.

 

[Note] The interest shall be calculated at the rate agreed upon in this Contract.

 

Cancellation of the Contract

 

For a short-term coverage insurance whose insurance period is less than one year, the policy holder may only apply to the insurer in writing for revocation of this Contract prior to the effectiveness date of the insurance liability. If the policy holder cancels the insurance prior to the effectiveness date due to a force majeure, and has no intention to raise any claim regarding this Insurance Contract, the insurer will fully refund the paid insurance premium. If thepolicy holder cancels the insurance prior to the effectiveness date due to a cause other than force majeure, the insurer will, after deducting the management expenses (15% of the premium), refund the insurance premium paid by the insured person. If the insurance is cancelled on or after the effectiveness date, the insurance premium will not be refunded.

 

The policy holder shall, when terminating this Insurance Contract, provide the following certificates and documentations:

 

1) the application for termination of the insurance contract;

2) original copy of the insurance contract;

3) proof of the payment of insurance premium;

4) identity certificates of the policy holder and the insured person;

5) proof on the force majeure event.

 

Notification of the Insured Accident

 

The policy holder, the insured person or the beneficiary of benefits shall, after knowing the occurrence of an insured accident, notify the insurer in time. If a claimant fails to timely notify the insurer due to intention or gross negligence, and thus causes the nature, cause or extent of losses, etc. of the insurance accident to be difficult to be determined, the insurer shall not be liable for indemnifying the undeterminable portion of losses, unless the insurer has known the occurrence of the insured accident in time through other channels or ought to know the occurrence in time. The above mentioned covenants shall not cover the delay caused from force majeure.

 

Proof Documents and Claims

 

If an insured accident occurs, the claimant shall, when claiming against the insurer, fill out the claim letter and provide the insurer with the original copies of the following proofs and documentations, so as to apply for the benefits under this Contract.

1. the insurance contract;

2. the identity certificate of the insured;

3. proof document on the travel of the insured person;

4. the insured person's permanent residence deregistration certificate issued by the public security department and the death certificate of the insured person which is issued by a medical institution recognized by the insurer or other relevant similar proof (if applicable);

5. if the insured person is declared as dead, the applicant for benefits shall provide the deathdeclaration certificate issued by the people's court (if applicable);

6. the claimant's identity certificate;

7. other certificates and documentations which can be provided by the claimant for benefits and are relevant to the confirmation of the nature, cause, loss extent, etc. of the insured accident;

8. if the claimant for benefits entrusts someone else to file the application, he shall provide the original copy of the power of attorney, the identity certificates of the entrusting person and the entrusted person as well as other relevant certificates in addition;

9. other documentations prescribed in the claim settlement guidelines promulgated by insurer.

 

If the claimant is unable to provide the above said proofs due to a particular cause, he shall provide other legally recognized proof documentations in order to raise the claim.

 

If the claimant for benefits fails to provide any relevant material, and causes the insurer to be unable to check the authenticity of the application, the insurer shall not be liable for paying benefits for the portion which is unable to be checked.

 

The insurer shall, after receipt of the claimant's claim and the complete claim documentations, make the verification in time. If the case is complicated, and no check can be made within the legally prescribed time limit, both parties will agree to properly extend the time limit, provided that the extended portion of time shall not exceed thirty days.

 

The insurer shall notify the claimant of the check result; if liable, the insurer shall, within ten days after reaching an agreement on indemnification of benefits with the claimant, perform the obligation of indemnifying the benefits. If this Insurance Contract stipulates the time limit for payment of the benefits, the insurer shall perform the obligation of paying the benefits as agreed. If the insurer is not liable after making the check according to the preceding paragraph, it shall, within three days as of making the check, send a notice to the claimant on refusing to pay the benefits, and state the reason.

 

The limitation of action for the claimant to claim against the insurer under this Contract for indemnification or payment of the benefits shall be two years, commencing as of the date when he knows or ought to know the occurrence of the insured accident.

 

Notice on Supplement of Claiming Certificates and Documentations

 

If the insurer does not consider the claiming proofs and documentations provided by the claimant are complete, it will timely notify the claimant once for all to make up them.

 

Obligation of Making Prior Indemnity

 

Within sixty days as of receipt of the claim for payment of the benefits as well as relevant proofs and documentations, the insurer will, if its payment amount is undeterminable, pay the determinable amount first on the basis of the existing proofs and documentations; the insurer will pay the corresponding balance after finally determining the paid amount.

 

Physical Examination and Judicial Authentication

 

Within the claiming period, the insurer shall have the right to require the insured person to make a physical examination or to provide the relevant examination report. If the insured person dies, the insurer shall have the right to request a judicial authentication institution to authenticate the insurance accident.

 

Frauds

 

If no insurance accident occurs, but the insured person or beneficiary falsely states that an insurance accident has occurred, and claims against the insurer for indemnification or payment of the benefits, the insurer shall have the right to terminate the contract, and will not refund the insurance premium.

 

If the policy holder or the insured person intentionally creates an insured accident, this Company shall have the right to terminate the contract, and will not be liable for indemnifying or paying the benefits.

 

If, after an insured accident occurs, the policy holder, the insured person or the beneficiary works out any false cause of accident or exaggerates the losses by using relevant forged or worked-out certificates, information or other evidence, the insurer shall not be liable for indemnifying or paying benefits for the falsely stated portion.

 

If the policy holder, the insured person or the beneficiary is in the event stipulated in the preceding paragraph, and causes the insurer to pay the benefits or other expenditures, he shall refund, at the interest rate agreed upon in this Contract, or indemnify such benefits or other expenditure.

 

Settlement of Disputes

 

The conclusion, effectiveness, interpretation and implementation of this Contract as well as the settlement of disputes shall all be governed by the laws of Hong Kong.

 

Governing Law

 

This Contract and its attached contracts shall all be governed by the laws of Hong Kong.

 

Miscellaneous

 

1. Compliance with the Terms and Conditions

 

It will be the prerequisite for the insurer to bear any indemnity liability under this insurance that the insured person or any person on behalf of him/her completely abides by and performs all terms and conditions stipulated in the insurance contract, as well as accomplishes and complies with the relevant matters.

 

2. Reasonable Care

 

The insured person or insured member shall act prudentially and take reasonable care to prevent and avoid the occurrence of any insurance accident, accidental injury, disease or losses.

 

3. Post-indemnity Rights of the Insurer

 

The insurer shall have the right to, in the name of the insured person or insured member and on his behalf, refute any lawsuit and pay the indemnity, and shall also have the rights to, for maintaining its own benefits and at its own costs, make recourse against the third party for the matters covered by this insurance and independently appoint lawyers for this purpose. If the insured person or insured member dies, the insurer shall have the right to, at its own costs, request the judicial authentication institution to authenticate the insurance accident.

 

4. No Assignment

 

This Insurance Contract shall be assigned. The insurer does not accept any transaction such as trust,trusteeship, mortgage or assignment of this Insurance Contract.

 

5. Clerical Errors

 

The insurer's clerical errors shall not cause the originally effective insurance liability to be ineffective, nor shall it cause the originally ineffective insurance liability to be effective.

 

Chapter II ：Insurance Liability

 

If an insured item under this insurance liability is not specified in the insurance confirmation letter or the notes, the insurance liability for such insured item shall not be effective.

 

The accumulative amount of the benefits paid by the insurer to any insured person under Items 1, and 2 of this Clause shall be to the limit of the sum insured for the insured person as specified in the insurance confirmation letter.

 

1. Benefits for Aviation Accidental Death

 

If, within the validity period of this Contract, any insured person meets with an aviation accident during the travel, and dies directly and singly from the accident within 180 days as of the occurrence, the insurer shall, at the sum insured for the insured person as specified in the insurance confirmation letter, pay the benefits for aviation accidental death to the beneficiary of the benefits for death, and its insurance liability for the insured person shall be terminated.

 

If, within the validity period of this Contract, any insured person meets with an aviation accident within the travel period and has been missing since the occurrence of the accident, and is later declared by the people's court as dead, the insurer shall pay the benefits for death to the beneficiary the sum insured for the insured person as specified in the insurance confirmation letter. If, however, the insured person is later found to be alive after being declared as dead, the beneficiary of benefits shall, within 30 days after he knows or ought to know the insured person's being alive, refund the benefits for death paid by the insurer. This Insurance does not cover the aviation accidental death hypothesized due to the insured person's being missing.

 

Chapter III ：Exclusion of Liability

 

The insurer shall not bear any indemnity liability for any insured aviation accident occurring during the following period or arising from any of the following causes：

 

1. war, military action, riot or armed rebellion; invasion, enemy's act, hostile action (whether declared or not), civil war, rebellion, revolution, uprising, military action or usurping on power, confiscation, nationalization, requisition, damage or destruction of properties as per any government's or national authority's command, riot or commotion;

2. explosion, burns, pollution or radiation caused from any biological, medical or atomic

weapon or any atomic or nuclear device; ionizing radiation or radioactive energy pollution coming from any radioactive nuclear fuel or from any nuclear waste generated from fuel combustion, radioactive and toxic explosion, or other dangerous substance of any explosive nuclear device or its nuclear parts;

3. the policy holder's intentional acts; or the insured person injures himself or commits a suicide (irrespective of whether his minds are clear or not at that moment).

4. Fight or being attacked or murdered due to the insured person's provocation or intentional

act;

5. the insured person participates in a military or police task or implements a task in the identity of a law enforcer;

6. injury incurred from the insured person's engaging in any illegal or criminal activity or from

his resisting arrest; and the period when he is detained by the judicial authority or stays in prison after a sentence;

7. the insured person is in a period of being indulgent in excessive alcohol or affected by alcohol, drug or controlled medicine; accident occurring to the insured person due to mental disorder or abnormality.

8. the insured person is in a period of driving under influence of alcohol, unlicensed driving or driving any motor public conveyance without a valid license; the insured person takes a public conveyance illegally or takes a public conveyance not registered and permitted by the local government department;

9. the insured person does not obey the doctor's advice or prescription, and privately takes, applies or injects any drug;

10. the insured person is in the period of having a sexual disease or sexually transmitted disease, including acquired immune deficiency syndrome (AIDS) or the period of being infected by human immunodeficiency virus (HIV) (the above terms shall have the meanings Formatted: Highlight defined by the world trade organization).If the above virus or its antibody is found from the insured person's blood sample, it shall be affirmed that the patient has been infected with such virus);

11. the insured person is in a period of staying in any airplane or air public conveyance (unless he takes a civil or commercial flight in the identity of a passenger);

12. pre-existing condition or the insured person's previous health conditions not declared to the insurer and not accepted by the insurer in writing;

13. despite that licensed doctor does not consider it suitable for travel, the insured person still continues the travel;

14. the insured person takes part in any occupational sport, contest or any award-based or remuneration-based sport;

15. the insured person takes part in a horse race, any vehicle performance, vehicle contest or stunt performance;

16. the accident occurring when the insured person takes part in a speed match (except walking), motorcycle match or contest, mountain climbing (by using ropes and pitons reasonably), rock climbing, soaring, gliding, parachute jumping, bungee jumping, adventure, exploration of on-ground holes, flying (unless he takes a civil or commercial flight as a fee paying passenger) or other extreme sport;

17. the insured person is employed by a commercial vessel; is taking service in the navy or air force; implementing occupational operation or testing any type of public conveyance;

18. the insured person's pregnancy, abortion, childbirth, disease, drug allergy, food poisoning, facial operation, plastic surgery operation, bacterial or virus infection (except the infection of wound caused from an accidental injury).

 

Chapter IV ：Definitions

 

Accident as mentioned in this Contract:

shall mean the bodily injury, disability or death directly and singly caused from an external, sudden, unintentional, non-diseased and unforeseeable objective event.

 

Accidental injury as mentioned in this Contract:

shall mean the bodily injury , disability or death directly and singly caused from an external, sudden, unintentional and non-diseased objective event.

 

War as mentioned in this Contract:

shall mean any war or military action taken by a sovereign country for its economic and territorial expansion, nationalism, racial, religious or other purpose, irrespective of whether declared or not.

 

Stunts as mentioned in this Contract:

shall mean the special skills such as horsemanship, acrobatics and animal taming.

 

Adventure as mentioned in this Contract:

shall mean the act of putting oneself into a known danger of losing life or being injured in the body on some certain natural conditions such as driftage on rivers, walking through a desert or a rare virgin forest off the beaten track.

 

Force majeure as mentioned in this Contract:

shall mean the unforeseeable and unavoidable objective event which cannot be overcome.

 

Full age as mentioned in this Contract:

shall mean the full age calculated on the basis of the date of birth stated in the legal identity certificate document.

 

Insurer as mentioned in this Contract:

shall mean AXA Tianping P&C Insurance Co., Ltd., which concludes this Insurance Contract with the policy holder.

 

You as mentioned in this Contract:

shall mean the policy holder and the insured person whose names are written down in the insurance confirmation letter.

 

Policy holder as mentioned in this Contract:

shall mean the person who shall have the right to conclude an insurance contract with the insurer and is obligated to, pursuant to the insurance contract, pay the insurance premium.

 

Insured person as mentioned in this Contract:

shall mean the person who has filled out the insurance application (or his name has been contained in the insurance application form), meets the conditions for insurance application and has been confirmed by the insurer or its authorized agent in writing to be insured. Unless particularly stated, insured persons herein will include both the principal insured person and the ancillary insured persons.

 

Insurance application form as mentioned in this Contract:

shall mean the form filled out by the insured person for obtaining insurance security from the insurer, along with the information, documents and declarations submitted by the insured person when he applies for the insurance security, the correspondences, expressions and declarations between the insured person and the insurer as well as any supplementary questionnaire finished by the insured person, including the information which has been or will be used by the insurer to underwrite insurance to each insured person.

 

Endorsement as mentioned in this Contract:

shall mean the written declaration or notice issued by the insurer to confirm and record any amendments to this Insurance Contract, including any wording change or coverage change of this Insurance Contract, or the restrictive conditions when the insurance is undertaken under restrictive conditions.

 

Effectiveness date as mentioned in this Contract:

shall mean the date of commencement stated in the insurance confirmation letter or that stated in the endorsement (whichever is later) to show that the insurance security begins to apply to the specific insured person.

 

Insurance period as mentioned in this Contract:

shall mean the coverage period applicable to each insured person, which is specified in the latest insurance confirmation letter or the endorsement.

 

Limb as mentioned in this Contract:

shall mean the four limbs of a human body, i.e., the left upper limb, the right upper limb, the left lower limb and the right lower limb.

 

Claimant as mentioned in this Contract:

shall mean an insured person under this Contract, his beneficiary of the benefits for death, his legal successor or any other person prescribed in any law to have the right of claiming for benefits.

 

Beneficiary of benefits for death as mentioned in this Contract:

shall mean the beneficiary of the benefits for death under this Contract, the insured person's legal successor hereunder or any other person prescribed in any law to have the right of claiming for benefits.

 

Lineal relative as mentioned in this Contract:

shall mean the insured person's spouse, parents (-in-law), children, brothers and sisters, grand parents, grand children.