EMPLOYEE BENEFITS LIFE INSURANCE PLAN

Transcription

1 EMPLOYEE BENEFITS LIFE INSURANCE PLAN AXA China Region offers:- Security for the dependants of your employees Low cost life insurance cover Benefit payable for death from any cause Competitive rates Efficient settlement of claims Salary related benefits Minimum health evidence with generous guaranteed issue limits 31 day grace period for premium payments Life Benefits Life benefit is payable for death resulting from any causes. Life protection shall be extended subject to AXA China Region s approval for up to 12 months if the insured becomes totally and permanently disabled and is terminated from employment. Life benefit for employees is normally expressed as a multiple of the basic monthly salary which excludes any fluctuating emoluments, such as overtime, bonus etc. Flat amount can also be issued. Life Benefit for spouses can be a % of the employee s life benefit subject to a maximum of 50% and up to HKD1,000,000. In the absence of fraud, the validity of the Life contract shall not be contested, except for the non-payment of premiums, after the insurance policy has been in force for one year. EBNB

2 ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS Benefits are payable for losses in the following indemnity schedule as a result of accident bodily injury. For loss of life two limbs sight of both eyes one limb and sight of one eye one limb sight of one eye For permanent and total paralysis of all limbs three limbs two limbs one limb For permanent and total loss of hearing in both ears hearing in one ear For loss of all fingers on one hand thumb both phalanges one phalanx index finger middle finger ring or little finger all toes on one foot great toe both phalanges one phalanx any other toe Insurance Amount Payable 50% 50% 75% 50% 25% 70% 20% 45% 15% 8% 10% 6% 4% 15% 5% 2% 2% Loss of limb means actual severance at or proximal to wrist or ankle joint. Loss of thumb or finger means actual severance at or proximal to metacarpophalangeal joint. Loss of toe means actual severance at or proximal to metatarsophalangeal joint. In the event of par tial loss of a finger, the amount payable per phalanx lost shall be calculated at one third of the percentage specified above. Sickness and disease Suicide or self-inflicted injury Action not permitted by law (except traf fic or pedestrian offences) Any police action or participation in a brawl War, strike, riots, revolution, civil commotion Radioactive contamination whether direct or indirect Nuclear, chemical, biological terrorism For removal of the lower jaw by surgical operation 30% EBNB

3 TOTAL AND PERMANENT DISABILITY BENEFITS Benefit is payable if the Insured, by reason of injury or sickness, is unlikely ever to engage in or to work for any compensation or profit in any business, occupation or employment. The Insured shall also be deemed totally and permanently disabled for: 1) total and irrecoverable loss of sight in both eyes or 2) the complete and permanent paralysis of the hands or feet, or actual severance at or proximal to the wrist or ankle joints or 3) total and irrecoverable loss of sight in one eye and either i) the complete and permanent paralysis of one hand or one foot or ii) actual severance at or proximal to the wrist or ankle joint. intentionally self-inflicted injury Any act due to war, military, naval or air service for any country or war. Radioactive contamination whether direct or indirect Nuclear, chemical, biological terrorism If an Insured Person has been disabled for 6 consecutive months, benefit is payable in 60 monthly instalments retroactively from the date the disability commenced (unless specified otherwise). The Total and Permanent Disability (TPD) benefit is insured in co-ordination with the life benefit. On becoming totally and permanently disabled, the Insured s life benefit will be reduced by the amount of TPD benefit. If the Insured dies, the excess of the TPD benefit over the total of all monthly instalments already paid shall be payable in one lump sum. EBNB

4 TOTAL AND PERMANENT DISABILITY BENEFITS (Similar Occupation) Benefit is payable if the Insured, by reason of injury or sickness, is unlikely ever to engage in or to work for any compensation or profit in any business, occupation or employment for which the Insured is reasonably qualified by education, training or experience. The Insured shall also be deemed totally and permanently disabled for: 1) total and irrecoverable loss of sight in both eyes or 2) the complete and permanent paralysis of the hands or feet, or actual severance at or proximal to the wrist or ankle joints or 3) total and irrecoverable loss of sight in one eye and either i) the complete and permanent paralysis of one hand or one foot or ii) actual severance at or proximal to the wrist or ankle joint. If an Insured Person has been disabled for 6 consecutive months, benefit is payable in 60 monthly instalments retroactively from the date the disability commenced (unless specified otherwise). Suicide or self-inflicted injury Use of alcohol or drugs other than as prescribed by a qualified medical practitioner Military, naval or air service for any country at war, declared or undeclared War, invasion, riots or civil commotion Driving or riding in any form of race or participating in any hazardous sport Aviation, except as a fare-paying passenger on a recognised air route Participating in a criminal act Radioactive contamination whether direct or indirect Nuclear, chemical, biological terrorism The Total and Permanent Disability (TPD) benefit is insured in co-ordination with the life benefit. On becoming totally and permanently disabled, the Insured s life benefit will be reduced by the amount of TPD benefit. If the Insured dies or reaches the policy year end on or following the Insured s 65th birthday, the excess of the TPD benefit over the total of all monthly instalments already paid shall be payable in one lump sum. EBNB512(-20%)-0711

5 LIVING INSURANCE BENEFITS Living Insurance is a supplement to Employee Benefits Life Insurance plans. If a covered employee suffers from one of the major illnesses listed below, an immediate advance on the employees Life Insurance benefit will be paid to the employee. Major Illnesses Covered 1) Cancer (excluding skin cancer) 2) Heart Attack 3) Stroke 4) Kidney Failure 5) Paralysis 6) Major Organ Transplants 7) Coronary Artery Disease Living Insurance is subject to a maximum benefit of US$125,000/HK$1,000,000 and is the lesser of 50% of an employee s basic sum insured (ie, Life benefit) and twice the amount of his/her annual salary. The benefit is payable upon the first diagnosis of any of the above mentioned illnesses. Upon payment of the benefit, the basic sum insured (Life benefit) of the employee will be reduced by the amount of the Living Insurance benefit paid and the Living Insurance coverage is then terminated. Any major illness within the first 60 days after participating in the plan. Any Human Immunodeficiency Virus (HIV) or any H I V - r e l a t e d i l l n e s s e s i n c l u d i n g A c q u i r e d Immunodeficiency Syndrome (AIDS) and/or any mutation, derivation or variation thereof. Radioactive contamination whether direct or indirect Nuclear, chemical, biological terrorism War (whether war be declared or not), hostilities, invasion or civil war Pre-existing Conditions Benefits shall not be payable for any pre-existing or recurring major illnesses which the Insured Person was suffering before participating in the plan. Benefits shall not be payable if in the opinion of AXA China Region, the Insured Person is aware of a major illness or has received treatment or advice on or before participating in the plan. In the event of an Insured Person requiring surgery for coronary artery disease, he is deemed to be requiring surger y from the date on which the cause of the need for surgery first arose or was first diagnosed; otherwise, benefits shall not be payable. EBNB

6 PARTICIPATION REQUIREMENTS All full-time, actively at work employees are eligible for the plan. Employees must be actively at work to become insured. For the Employee Benefits Health Insurance Plan, dependants cannot join while in hospital. If the employer pays all of the cost, all eligible employees will be covered. If the employee contributes a portion of the cost, 75% of the eligible employees must enrol. The maximum insured age for employees and spouses is 65 and 19 for children (23 if full-time student). Evidence of insurability, at the employee s own expense, is required if enrolment is not made when first eligible and a medical examination may be required. EBNB