安盟Health Insurance II--Underwriting guide(14页).doc
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Health Insurance II
Underwriting guide
internal use only
Table of contents
1. Product description
1.1. Purpose of the contract
1.2. Which kind of clients we are targeting?
1.3. Geographical scope
1.4. Summary of Covers
1.5. Level of reimbursement limitation
1.6. Detailed covers
2. Underwriting rules
2.1. Whish person could be insured?
2.2. Contract effective date
2.3. Insured period
2.4. 7 days milestone and Waiting period
2.5. Basic requests
3. Rating
3.1. Cover A
3.2. Cover B
4. Clause/Special agreement
5. List of documents
6. Payment conditions
7. Endorsement/renewal process
8. Claim process
8.1. Claim procedure
8.2. Claim requirement
8.3. Claim payment
9. Technical Department notes
1. Product description
1.1. Purpose of the contract
HEALTH contract provides reimbursement of hospitalization expenses (Bed
expense ;Pharmacy expense.; Nurse expense; Diagnosis expense;Treatment expense; Examination and assay expense;Surgical expense) due to accident or illness (in respect of waiting period).
1.2. Which kind of clients we are targeting?
This contract applies to healthy individuals aging from 5 to 59 years:
- With Social Security: cover A
- Without Social Security: cover B
1.3. Geographical scope
All over the Sichuan province.
1.4. Summary of Covers
Cover* Client Social Security status Compulsory
or Optional
Cover A WITH social security C’
Cover B Without social security C’
* Cover depends on the client social security status
1.5. Level of reimbursement limitation
Hospitalization after accident* Basic Medium High
Sum insured(RMB)
Cover A 20,000 20,000 50,000 100,000
Sum insured(RMB)
Cover B 20,000 20,000 50,000 100,000
*This option covers only the hospitalization following an accident.