核保指引——医学核保指引（8页）.pdf
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核保指引使用指南
1 - An impairment can be found either by ’alphabetical
order’ or by ’human system’.
病患资料可根据疾病名称的首个英文字母或按人体功能系统查阅。
2 -
阁下可从目录(按人体功能系统分类），按英文字母顺序排列之各项病患资料，寻找有关之医疗核保规定。
3 An Attending Physician Statement (APS) ordering guideline
If APS is needed after check with the following 3 APS classes,
please get the followings:
i) for insured = adult with age 18 or above, please submit
Original consent form + patient card copy + ID copy;
索取应诊医生声明书(APS)所需指引
基於以下三类之应诊医生声明书(APS)指引，若需索取APS，请一同递交以下文件：
i) 18岁或以上之成年受保人，请递交客户之授权书＋覆诊卡副本＋身分证副本；
ii) 18岁以下之受保人，请递交客户之授权书连同监护声明书＋覆诊卡副本＋父母身分证副本＋出生证明文件／受保人身分证副本。
APS CLASS 类别 类别类别 类别A
Usually do not request, unless, this health
history leads to chronic health problem
不需要，除非此病歷引至慢性健康问题。
BRequest if sum insured is > USD500,000 per life in
our Company and the last consultation/ treatment
received date is within 1 year.
若保障额在本公可> $500,000 美元及於过去一年曾求诊，则需要；
可考虑豁免，若客人能递交最近身体检查报告证明健康状况。C
Request in all situation
If information obtained in APS is not sufficient for
assessing the risk, will need further underwriting requirements.
任何情况下均需要
若应诊医生声明书未能提供充足资料作风险评估，将需要更进一步的核保要求；
可考虑豁免，若客人能递交最近身体检查报告证明健康状况。
e.g. 例子 If client suffers from pneumonia 2 years ago and
is now applying for USD 300,000 insurance cover, no APS is required
(APS class is classified as class A)
若客人两年前曾患肺炎, 现投保 $300,000 美元保额, 便不需要提交应诊医生声明书。 (列入 APS 类别 A)
( APS class is classified as class B)
客户患有糖尿病及需要定期覆诊。若现投保额為 $350,000
美元的保单, 不需提交应诊医生声明书。（列入 APS 类别 B）
(Nov 2014) 1
宏利人寿保险 国际 有限公司 於百慕达註册成立之有限责任公司
ii) for insured below age 18, please submit Original Consent
& Declaration of custody form, patient card copy, Parent’s ID copy,
birth certificate / ID of insured ;
If client can submit an updated check up report which is
sufficient to prove the health condition, we can consider
to waive the APS
requirement.
Subject to the underwriter’s discretion, APS may be
requested due to special circumstances, such as multiple
impairments, uncertain diagnosis
or unclear medical declaration. 於特殊情况下, 核保员有权行使酌情权, 要求客户提交应诊医生声明书, 这些情况包括客户有多种病患, 诊断不明确
或健康状况声明资料欠详尽等。
If client can submit an updated check up report which
is sufficient to prove the health condition,we can consider to waive
APS requirement.
Client suffers from diabetes mellitus and has regular
follow up. If he is now applying for USD 350,000 insurance cover, no APS is
1 - An impairment can be found either by ’alphabetical
order’ or by ’human system’.
病患资料可根据疾病名称的首个英文字母或按人体功能系统查阅。
2 -
阁下可从目录(按人体功能系统分类），按英文字母顺序排列之各项病患资料，寻找有关之医疗核保规定。
3 An Attending Physician Statement (APS) ordering guideline
If APS is needed after check with the following 3 APS classes,
please get the followings:
i) for insured = adult with age 18 or above, please submit
Original consent form + patient card copy + ID copy;
索取应诊医生声明书(APS)所需指引
基於以下三类之应诊医生声明书(APS)指引，若需索取APS，请一同递交以下文件：
i) 18岁或以上之成年受保人，请递交客户之授权书＋覆诊卡副本＋身分证副本；
ii) 18岁以下之受保人，请递交客户之授权书连同监护声明书＋覆诊卡副本＋父母身分证副本＋出生证明文件／受保人身分证副本。
APS CLASS 类别 类别类别 类别A
Usually do not request, unless, this health
history leads to chronic health problem
不需要，除非此病歷引至慢性健康问题。
BRequest if sum insured is > USD500,000 per life in
our Company and the last consultation/ treatment
received date is within 1 year.
若保障额在本公可> $500,000 美元及於过去一年曾求诊，则需要；
可考虑豁免，若客人能递交最近身体检查报告证明健康状况。C
Request in all situation
If information obtained in APS is not sufficient for
assessing the risk, will need further underwriting requirements.
任何情况下均需要
若应诊医生声明书未能提供充足资料作风险评估，将需要更进一步的核保要求；
可考虑豁免，若客人能递交最近身体检查报告证明健康状况。
e.g. 例子 If client suffers from pneumonia 2 years ago and
is now applying for USD 300,000 insurance cover, no APS is required
(APS class is classified as class A)
若客人两年前曾患肺炎, 现投保 $300,000 美元保额, 便不需要提交应诊医生声明书。 (列入 APS 类别 A)
( APS class is classified as class B)
客户患有糖尿病及需要定期覆诊。若现投保额為 $350,000
美元的保单, 不需提交应诊医生声明书。（列入 APS 类别 B）
(Nov 2014) 1
宏利人寿保险 国际 有限公司 於百慕达註册成立之有限责任公司
ii) for insured below age 18, please submit Original Consent
& Declaration of custody form, patient card copy, Parent’s ID copy,
birth certificate / ID of insured ;
If client can submit an updated check up report which is
sufficient to prove the health condition, we can consider
to waive the APS
requirement.
Subject to the underwriter’s discretion, APS may be
requested due to special circumstances, such as multiple
impairments, uncertain diagnosis
or unclear medical declaration. 於特殊情况下, 核保员有权行使酌情权, 要求客户提交应诊医生声明书, 这些情况包括客户有多种病患, 诊断不明确
或健康状况声明资料欠详尽等。
If client can submit an updated check up report which
is sufficient to prove the health condition,we can consider to waive
APS requirement.
Client suffers from diabetes mellitus and has regular
follow up. If he is now applying for USD 350,000 insurance cover, no APS is
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