/ CHINA MERCHANTS INSURANCE COMPANY LIMITED
/ 保 險 有 限 公 司
18th Floor, China Merchants Tower, Shun Tak Centre
168-200 Connaught Road Central, Hong Kong
Tel: 2890 5940 ∙ Fax: 2576 2292 / 香 港 干 諾 道 中 168 – 200 號
信 德中 心∙招商 局 大廈18 樓
電話： 2890 5940 傳真： 2576 2292

GROUP PERSONAL ACCIDENT POLICY

Please read this Policy carefully upon receipt and promptly request for any necessary amendments

WHEREASthe Insured by a proposal and declaration which shall be the basis of this contract and is deemed to be incorporated herein has applied to CHINA MERCHANTS INSURANCE COMPANY LIMITED (hereinafter called “the Company”) for the insurance hereinafter contained.

NOW THIS POLICY WITNESSETHthat in consideration of the payment of Premium, and subject to all the exclusions, conditions and other terms of this Policy, the Company hereby insures the person named in the Schedule against loss resulting directly and independently of any other cause from bodily injuries (hereafter called “Such Injuries”) caused by violent, accidental, external and visible means occurring during the term of this Policy.

COVERAGE

A –ACCIDENTAL DEATH

If within one year from the date of accident Such Injuries shall result in death of the Insured Person, the Company will pay the Principal Sum stated in the Schedule.

B –PERMANENT DISABLEMENT

If within one year from the date of accident Such Injuries shall result in permanent disablement but not in death of the Insured Person, the Company will pay for

Percentage of thePrincipal Sum stated in the Schedule

Loss of two limbs / / Loss of thumb - one phalanx …………………………………..… / 10%
Loss of both hands, or of all fingers and both thumbs / Loss of index finger - / three phalanges ..……….…………..… / 10%
Total loss of sight of both eyes / two phalanges …………….………..…. / 8%
Total paralysis / one phalanx………………….…..…..... / 4%
Injuries resulting in being permanently bedridden / Loss of middle finger - / three phalanges…………....…..…… / 7.5%
Any other injury causing permanent total disablement / two phalanges………..….……..…... / 4%
Loss of arm - / at shoulder / / one phalanx……………..…………... / 2%
between shoulder and elbow / Loss of ring finger - / three phalanges………………….....…… / 7.5%
at elbow / two phalanges…………………..…..….... / 4%
between elbow and wrist / one phalanx……………………..….…..... / 2%
Loss of hand at wrist / Loss of little finger - / three phalanges………………...…..…… / 7.5%
Loss of leg - / at hip / two phalanges………….………..…..…... / 3%
between knee and hip / one phalanx…………….………..…..…... / 2%
below knee / Loss of metacarpals - / first or second (additional) …….…...…. / 3%
Loss of eye - / whole eye / third, fourth or fifth (additional)….……. / 2%
sight of / Loss of toes - / all………………………………….…….…...…… / 15%
Loss of sight of eye except perception of light ……………..… / 50% / great, both phalanges…………………..…..….. / 5%
Loss of lens of eyes - / both eyes …………………………..… / 75% / great, one phalanx …………………….………… / 2%
one eye ……………………...…..…... / 50% / other than great, if more than one toe lost,
Loss of four fingers and thumb of one hand ………………..... / 50% / each……….………………………………..……. / 1%
Loss of four fingers ……………………………………………… / 40% / Loss of hearing - / both ears ………………………….….…… / 75%
Loss of thumb - both phalanges ……………………...……..… / 30% / one ear ………………………………..…... / 15%

Permanent total loss of use of member shall be treated as loss of member.

Where the injury is not specified the Company will adopt a percentage of disablement which in its opinion is consistent with the above scale.

The aggregate of all percentages payable in respect of any one accident shall not exceed 100%.

C – ACCIDENTAL MEDICAL EXPENSES

The Company will pay the expenses incurred by or on behalf of the Insured Person for actual medical or surgical treatment, hospital services required and prescribed by legally qualified physician or surgeon as a result of Such Injuries if such treatment or services commences within 52 weeks of the date of accident, but not including the first HK$150 in respect of each and every accident and not exceeding the Maximum Amount specified in the Schedule during the term of this Policy.

AGE

The normal age limits of this Policy are 2 to 65. For Insured Person who is aged under 2 or over 65 at the time of the accident, the amounts of benefit are limited to 50% of the Principal Sums under this Policy.

AGGREGATE LIMIT

The Company’s liability to the Insured under this Policy, in respect of one claim or a series of claims resulting from or arising out of one event and irrespective of the number of Insured Persons claiming to be indemnified under this Policy, shall not in the aggregate exceed the amount specified in the Schedule.

EXCLUSIONS

This Policy does not cover loss, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any one or more of the following:

  1. Intentionally self-inflicted injuries; suicide (whether felonious or not) or any attempt thereat, while sane or insane;
  1. Any bacterial infection other than bacterial infection occurring in consequence of an accidental cut or wound; venereal disease, or any disease; hernia however caused;
  1. Human Immunodeficiency Virus (HIV) and/or any HIV related illness including Acquired Immune Deficiency Syndrome (AIDS) and/or any mutant derivatives or variations thereof however caused;
  1. Pregnancy, childbirth, miscarriage notwithstanding that such loss may have been accelerated or induced by accident;
  1. Pre-existing physical or mental defect or infirmity;
  1. Accident occurring while the Insured Person is engaging in navy, military or airforce training or in the service or duty with the police or the armed forces of any country;
  1. Motorcycling, racing of any kind other than on foot, trial of speed or reliability, polo, hunting, snow or water skiing, underwater activities necessitating the use of underwater breathing apparatus, ski jumping, ice hockey, winter sports other than ice skating, parachuting, hang gliding, mountaineering, bungee jumping;
  1. Accident occurring while the Insured Person is engaging in any sport in a professional capacity or where the Insured Person would or could earn income or remuneration from engaging in such sport;
  1. Intoxication by alcohol, narcotics or drugs not prescribed by legally qualifiedphysician, and treatment in connection with addiction to drugs or alcohol;
  1. Travel of flight in any vehicle or device for aerial navigation other than solely as a passenger, not an operator or crew member, in boarding or alighting from a certified passenger aircraft operated by a regularly established airline or any regularly scheduled, non-scheduled; special or chartered flight;
  1. Declared or undeclared war or any act thereof, invasion, act of foreign enemy, hostilities, civil war, rebellion, revolution, insurrection, military or usurped power, strike, riot, civil commotion;
  1. Ionizing radiation or contamination by radioactivity from any nuclear fuel, or from any nuclear waste from the combustion of nuclear fuel;
  1. Radioactive toxic explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof;
  1. Asbestos in whatever form or quantity;
  1. Any chemical or biological contamination;
  1. Any act of terrorism regardless of any other cause or event contributingconcurrently or in any other sequence to the loss.

For the purpose of this Policy an act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisation(s) or government(s), committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear.

This Policy also excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to any act of terrorism.

CONDITIONS

  1. This Policy consists of the proposal and/or declaration signed by the Insured together with any information supplied by the Insured or on his behalf, the Schedule and any endorsements subsequently issued shall be read together as one contract and words and expressions to which specific meanings have been attached in any part of this Policy or of the Schedule shall bear such specific meanings wherever they shall appear.
  1. Written notice of injury on which claim may be based must be given to the Company within thirty (30) days after the date of the accident causing Such Injuries. In the event of accidental death, immediate notice thereof must be given to the Company.
  1. Such notice by or on behalf of the Insured Person or beneficiary as the case may be, given to the Company or to any authorized representative of the Company with the information sufficient to identify the Insured Person, shall be deemed notice to the Company.
  1. The Company upon receipt of a notice of claim, will furnish to the claimant such forms as are usually furnished by it for filing proofs of loss. If such forms are not furnished within fifteen (15) days after giving of such notice, the claimant shall be deemed to have complied with the requirements of this Policy as to proof of loss upon submitting, within the time fixed in the Policy for filing proofs of loss, written proof covering the occurrence, the character and the extent of the loss for which claim is made.
  1. Written proof of loss must be furnished to the Company at its said office in case of claim for loss for which the Policy provides any periodic payment contingent upon continuing loss within ninety (90) days after the termination of the period for which the Company is liable and in case of claim for any other loss within one hundred and eighty (180) days after the date of such loss.
  1. Periodic payment will be made of all indemnities payable under this Policy which accrue during a period of more than four (4) weeks. Indemnities payable under this Policy for any loss other than loss for which this Policy provides any periodic payment will be paid within thirty (30) days after receipt of due written proof of such loss. Subject to due written proof of loss, all accrued indemnities for loss for which this Policy provides periodic payment will be paid at the expiration of each four-week during the continuance of the period for which the Company is liable, and any balance remaining unpaid upon the termination of liability will be paid immediately upon receipt of due written proof.
  1. Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment. If no such designation or provision is then effective, such indemnity shall be payable to the estate of the Insured Person. Any other accrued indemnities unpaid at the Insured’s death may, at the option of the Company, be paid either to such beneficiary or to such estate. All other indemnities will be payable to the Insured Person.
  1. The Company at its own expense shall have the right and opportunity to examine the Insured Person when and as often as it may reasonably require during the pendency of a claim hereunder and to make an autopsy in case of death where it is not forbidden by law.
  1. No action at law or in equity shall be brought to recover on this Policy prior to the expiration of sixty (60) days after written proof of loss has been furnished in accordance with the requirements of this Policy. No such action shall be brought after the expiration of three (3) years after the time written proof of loss is required to be furnished.
  1. The right to change beneficiary is reserved to the Insured Person and the consent of the beneficiary shall not be requisite to surrender or assignment of this Policy or to any change of beneficiary or to any other changes in this Policy. No change of beneficiary or assignment of interest under this Policy shall be binding upon the Company unless the original or a duplicate thereof is received by the Company, which does not assume any responsibility for the validity thereof.
  1. This Policy shall cease to be in force if there be any alteration in the occupation, business of the Insured Person or any change in risk nature of any insured event or activities unless specified otherwise in the Schedule.
  1. This Policy may be terminated at any time at the request of the Insured, in which case the Company will retain the customary short period rate for the time the Policy has been in force. This Policy may also at any time be terminated at the option of the Company, on notice to that effect being given to the Insured, in which case the Company shall be liable to repay on demand a rateable proportion of the premium for the unexpired terms from the date of the cancellation.
  1. If the Premium for this Policy or any part thereof shall have been calculated on estimates furnished by the Insured, then the Insured shall keep an accurate record containing all particulars relative thereto and shall at all times allow the Company to inspect such record. The Insured shall before the inception of insurance cover for any insured activity furnish to the Company such particulars and information as the Company may require. The Premium for such activity shall thereupon be adjusted and any difference paid by or allowed to the Insured as the case may be, subject to receipt and retention of the customary minimum premium charged by the Company.
  1. All differences arising out of the Policy shall be referred to the decision of an Arbitrator to be appointed in writing by the parties in difference or if they cannot agree upon a single Arbitrator to the decision of two Arbitrators, one to be appointed in writing by each of the parties within one calendar month after having been required in writing so to do by either of the parties or, in the case the Arbitrators do not agree, of an Umpire appointed in writing by the Arbitrators before entering upon the reference. The Umpire shall sit with the Arbitrators and preside at their meetings. The making of an Award shall subject to any relevant Statutory provisions to the contrary, be a condition precedent to any right of action against the Company; but if such action be not commenced within one year of making of an Award, the right of action shall be deemed to be abandoned and released. After the expiration of one year after the accrual of the cause of action the Company shall not be liable in respect of any claim therefore unless such claim shall in the meantime have been referred to arbitration.
PAC-GPA-0903 (2192)