I want all-round protection against critical illnesses

Transcription

1 critical illness protection I want all-round protection against critical illnesses healthelite critical illness insurance

2 Getting sick isn t something we like to think about, but unfortunately it happens. In Hong Kong, 1 in every 4 men or 5 women is at risk of developing Cancer before age 75. Beyond Cancer, there are other life-threatening illnesses we may have to face. Risk of developing cancer before age 75 in Hong Kong 1 in every 4 men will develop cancer 1 in every 5 women will develop cancer Source: Hong Kong Cancer Registry, Overview of 2012 Hong Kong Cancer Statistics 1

3 Thanks to advancement in medical technology, many critical illnesses can now be detected earlier through medical check-ups. With timely and proper treatment, people today can have a higher chance of surviving a critical illness than before. Whilst this progress is encouraging, there are still many worries people may have when coping with critical illnesses Difficulty in getting other insurance coverage in future Termination of existing insurance coverage after making claim Risk of suffering from complications or other related illnesses Loss of income Unexpected huge medical bills Risk of suffering from other critical illnesses in future Risk of recurrence 2

4 All-round critical illness coverage brings you peace of mind AXA s HealthElite Critical Illness Insurance ( Basic Plan ), which is issued with its supplement HealthElite Enhanced Benefit Supplement ( Supplement ) 1 (collectively HealthElite ), offers you an all-round protection against the unfortunate events of critical illnesses. Provides financial support against 120 illnesses of different severity levels, from minor to early stage and major illnesses Allows multiple claims among the covered illnesses, ensuring continued coverage even after any claim of illness made under the policy Enhances protection for 3 common serious illnesses in Hong Kong Cancer, Heart Attack and Stroke You can refer to the case below: (This illustrative example is for reference only) Mr. Leung faces a series of cardiovascular diseases 15 years after taking out a HealthElite policy. Age of diagnosis Diagnosed illness Is it covered by HealthElite? Age 50 Angina and angioplasty is required 3 Age 50 (6 months later) Age 51 (1 year after the 1 st heart attack) Age 53 (2 years after the 2 nd heart attack) Heart attack 3 Another heart attack 3 Coronary arteries stenosis and bypass surgery is performed 3 For more details of how Mr. Leung is protected, please refer to the illustrative example 2 on page 9 of this product brochure. Note: Claims for the above illnesses are subject to relevant terms, conditions and exclusions of the policy contracts. The relevant illnesses have to fulfill and subject to the relevant eligibility requirements, conditions and exclusions as set out in the definitions of the illnesses concerned in the policy contracts. 3

5 Critical illness protection Comprehensive protection against critical illness HealthElite provides protection against 56 sets of sicknesses. Each set of sickness covers up to 3 severity levels of illnesses, namely major illness, early stage major illness and minor illness (as set out in Table 1: List of sicknesses), protecting you against the unforeseen event. Sickness Major Illness Early Stage Major Illness Minor Illness 56 sets of sicknesses 1 Cancer 2 Chronic Adrenal Insufficiency (Addison s Disease) Carcinoma-in-situ of Specific Organs Treated with Surgery (Specific Organs refer to Breast, Prostate, Corpus Uteri, Ovary, Fallopian Tube, Colon and Rectum, Stomach, Bladder, Thyroid, Liver, Testicle, Lung or Pancreas) Adrenalectomy for Adrenal Adenoma i) Carcinoma-in-situ / Carcinomain-situ (CIS) at Breast, Cervix Uteri, Uterus, Ovary, Fallopian Tube, Vagina, Testicles, Lung, Urinary Tract, Stomach, Esophagus, Nasopharynx, Penis, Colon, Rectum or Liver ii) Early Stage Cancer of Prostate. 56 Terminal Illness 56 major illnesses 52 early stage major illnesses 12 minor illnesses 120 illnesses Besides, there are 8 additional minor illnesses which are specially for insured aged under 22 (as set out in Table 2: Juvenile minor illnesses). Flexibility of multiple claims In the event where the insured is diagnosed with any one of the covered illnesses, a lump sum amount will be paid to provide financial support for medical treatments or other expenses. Benefits Benefit amount for each claim (% of the sum insured) Major Illness Benefit 100% Early Stage Major Illness Benefit 50% Minor Illness Benefit 2 20% There is a chance that a person may suffer from critical illness more than once during his lifetime. HealthElite allows multiple claims among the covered major illnesses, early stage major illnesses and minor illnesses. You can enjoy peace of mind knowing your protection will continue even after any claim of illness made under the policy. 4

6 Enhanced protection for common critical illnesses Under HealthElite, the aggregate amount of eligible benefits paid under the Major Illness Benefit, Early Stage Major Illness Benefit and Minor Illness Benefit 2 ( aggregate amount of benefits paid ) for each set of sickness is up to 100% of the sum insured, except for the sets of sicknesses related to Cancer, Heart Attack or Stroke. Cancer, Heart Attack and Stroke are 3 common critical illnesses in Hong Kong, which often require lengthy treatment and special care. Also, these illnesses may occur more than once. To ease you from the worry of inadequate financial support, an enhanced protection is offered to these 3 sets of sicknesses. Set of sickness related to (Set of sickness as shown in Table 1: List of sicknesses) Maximum aggregate amount of benefits paid (% of the sum insured) Cancer (Sickness no. 1) Up to 300% Heart Attack (Sickness no. 14) Up to 200% Stroke (Sickness no. 34) Up to 200% Other sets of sicknesses Up to 100% Total coverage of up to 300% of the sum insured HealthElite offers you a total coverage of up to 300% of the sum insured, which is comprised of the following: Total coverage of the policy 5 up to 300% of the sum insured Supplement (maximum coverage) 200% of the sum insured (up to age 85 4 ) Basic Plan (maximum coverage) 100% of the sum insured (up to age ) Claims shall be paid under the Basic Plan first. Once the 100% of the sum insured of the Basic Plan is exhausted, the Supplement s coverage will kick in. The approved but unpaid portion of claim under the Basic Plan and the subsequent claims will then be made under the Supplement (except for Moderately Loss of Independent Existence, Loss of Independent Existence and Terminal Illness). Note: Claims for the Major Illness Benefit, Early Stage Major Illness Benefit and Minor Illness Benefit are subject to relevant terms, conditions and exclusions, please refer to the section To know more about HealthElite on page 15 of this product brochure for details. 5

7 Overview of critical illness protection under HealthElite Sickness Major Illness Early Stage Major Illness Minor Illness 56 sets of sicknesses 1 Cancer. Carcinoma-in-situ of Specific Organs Treated with Surgery (Specific Organs refer to Breast, Prostate, Corpus Uteri, Ovary, Fallopian Tube, Colon and Rectum, Stomach, Bladder, Thyroid, Liver, Testicle, Lung or Pancreas) 14 Heart Attack Pericardectomy. 34 Stroke Carotid Artery Surgery. 55 Loss of Speech Loss of Speech due to Vocal Cord Paralysis i) Carcinoma-in-situ / Carcinoma-in-situ (CIS) at Breast, Cervix Uteri, Uterus, Ovary, Fallopian Tube, Vagina, Testicles, Lung, Urinary Tract, Stomach, Esophagus, Nasopharynx, Penis, Colon, Rectum or Liver ii) Early Stage Cancer of Prostate Insertion of Pacemaker or Defibrillator Maximum aggregate amount of benefits paid for each set of sickness 300% of the sum insured 200% of the sum insured 200% of the sum insured 100% of the sum insured Total coverage of the policy 5 Up to 300% of the sum insured i.e. 100% of the sum insured under the Basic Plan (up to age ) + 200% of the sum insured under the Supplement (up to age 85 4 ) 56 Terminal Illness Benefit amount for each claim 100% of the sum insured 100% of the sum insured per major illness claim 50% of the sum insured per early stage major illness claim 20% of the sum insured per minor illness claim 2 Extra 35% Coverage Benefit 6 Before the 10 th policy anniversary and while the coverage of the Basic Plan is in effect, if the insured is diagnosed with any one of the covered major illnesses or passes away, an additional amount equivalent to 35% of the sum insured of the Basic Plan will be paid. Index-linked Increase Endorsement 7 Our Index-linked Increase Endorsement can help you keep pace with inflation. While this endorsement is in effect, the sum insured will be automatically increased every year with extra premium. No additional medical check-up is required. 6

8 Policy value accumulation and life protection under the Basic Plan Guaranteed Cash Value 8 From the 3 rd policy anniversary onwards, we will provide a Guaranteed Cash Value upon policy surrender, regardless of the financial market performance. Special Bonus 9 When your policy has been in force for 5 years or more, we will pay you a non-guaranteed Special Bonus on top of the Guaranteed Cash Value. This non-guaranteed Special Bonus (if any) is payable when (i) the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured; (ii) the policy is surrendered; (iii) the policy matures; or (iv) the insured passes away, whichever is the earliest. Death Benefit 10 The designated beneficiary will receive 100% of the sum insured of the Basic Plan plus any non-guaranteed Special Bonus 9 (minus any amount claimed for the Early Stage Major Illness Benefit and Minor Illness Benefit 2 under the Basic Plan and any indebtedness) in the unfortunate event that the insured passes away. Extra financial flexibility 4 choices of premium payment term You can choose a premium payment term of 10 years, 15 years, 20 years or 25 years that best suits your financial planning. Waiver of Premium Once the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured, the coverage of the Basic Plan will terminate while all future premiums of the Supplement will be waived from the next premium due date. All the insured needs to do is to focus on treatment and rehabilitation. Extended Grace Period Benefit 11 Starting from the 2 nd policy year, if you become a parent, get married or become divorced, or become involuntarily unemployed during the premium payment period of the Basic Plan, you can choose to apply for the Extended Grace Period Benefit to stay protected by HealthElite while enjoying an extended grace period for premium payment up to 365 days. Total care with supplementary protection You may extend your coverage with a wide range of other optional supplementary benefits such as accident and medical protection to meet your insurance needs. 7

9 Illustrative example 1 multiple claims for Cancer This illustrative example is for reference only (Special Bonus and Index-linked Increase Endorsement are not illustrated in this example). Ms. Wong takes out a HealthElite policy at age 30. Sum insured of the policy : HKD300,000 Premium payment term : 15 years In the 11 th policy year, she is diagnosed with carcinoma-in-situ in bladder which later progresses to bladder cancer. Age 41 (11 th policy year) Waiver of Premium kicks in # 1 st claim 2 weeks 6 months 2 nd claim 3 rd claim Protection continues until the remaining 130% coverage under the Supplement is exhausted or Ms. Wong attains age 85 Ms. Wong is diagnosed with carcinoma-in-situ in bladder (minor illness under sickness no. 1) HKD60,000 Minor Illness Benefit (20% of the sum insured under the Basic Plan) After a surgery to remove the tumour in bladder, Ms. Wong receives chemotherapy (early stage major illness under sickness no. 1) HKD150,000 Early Stage Major Illness Benefit (50% of the sum insured under the Basic Plan) Ms. Wong goes for a health check-up and unfortunately finds that her condition has progressed to bladder cancer (major illness under sickness no. 1) HKD300,000 Major Illness Benefit (100% of the sum insured i.e. 30% of the sum insured under the Basic Plan + 70% of the sum insured under the Supplement*) Total benefits paid: HKD510,000 Accumulated claims: 170% of the sum insured * As the aggregate amount of benefits paid under the Basic Plan has reached 70% of the sum insured after the 2 nd claim, 30% of the Major Illness Benefit of the 3 rd claim will be covered by the Basic Plan while the remaining 70% will be covered by the Supplement. # Once the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured, the coverage of the Basic Plan will terminate. The Supplement s coverage will kick in and all future premiums of the Supplement will be waived from the next premium due date. Note: Assuming (i) the relevant illnesses are not excluded from the coverage of the Basic Plan and the Supplement and have fulfilled the relevant eligibility requirements and conditions as set out in the definitions of the illnesses concerned; (ii) no other claim has been paid and / or becomes payable under the policy; (iii) there is no indebtedness under the policy; (iv) the sum insured of the policy remains unchanged throughout the policy term; (v) all premiums are paid in full when due and as planned; (vi) no optional supplementary benefit is attached to the policy; and (vii) Ms. Wong is not covered by other policy(ies) covering minor illnesses issued by AXA and any authorised insurers in Hong Kong and / or Macau which are affiliated with AXA. 8

10 Illustrative example 2 multiple claims for cardiovascular diseases This illustrative example is for reference only (Special Bonus and Index-linked Increase Endorsement are not illustrated in this example). Mr. Leung takes out a HealthElite policy at age 35. Sum insured of the policy : HKD500,000 Premium payment term : 20 years Starting from the 15 th policy year, he faces a series of heart-related health issues. Age 50 (15 th policy year) Waiver of Premium kicks in # Age 51 (16 th policy year) Age 53 (18 th policy year) 6 months 1 year 2 years The policy terminates as the aggregate amount of benefits paid has reached 300% of the sum insured 1 st claim 2 nd claim 3 rd claim 4 th claim Mr. Leung suffers from angina and is sent to hospital. It is found that one of his coronary arteries has 80% stenosis. He then receives angioplasty to correct the narrowing (minor illness under sickness no. 11) HKD100,000 Minor Illness Benefit (20% of the sum insured under the Basic Plan) Suffers from a heart attack (major illness under sickness no. 14) HKD500,000 Major Illness Benefit (100% of the sum insured i.e. 80% of the sum insured under the Basic Plan + 20% of the sum insured under the Supplement*) Suffers from another heart attack (major illness under sickness no. 14) HKD500,000 Major Illness Benefit (100% of the sum insured under the Supplement) Mr. Leung goes for health check-up and finds that 3 of his coronary arteries have 60% stenosis. He then receives a bypass surgery to improve blood flow (major illness under sickness no. 11) HKD400,000 Major Illness Benefit (80% of the sum insured under the Supplement^) Total benefits paid: HKD1,500,000 Accumulated claims: 300% of the sum insured * As the aggregate amount of benefits paid under the Basic Plan has reached 20% of the sum insured after the 1 st claim, 80% of the Major Illness Benefit of the 2 nd claim will be covered by the Basic Plan while the remaining 20% will be covered by the Supplement. # Once the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured, the coverage of the Basic Plan will terminate. The Supplement s coverage will kick in and all future premiums of the Supplement will be waived from the next premium due date. ^ The aggregate amount of benefits paid for sickness no. 11 is capped at 100% of the sum insured. As Mr. Leung has already received 20% of the sum insured for this set of sickness in his 1 st claim, the actual amount of benefits paid for the 4 th claim will be 80% of the sum insured. Note: Assuming (i) the relevant illnesses are not excluded from the coverage of the Basic Plan and the Supplement and have fulfilled the relevant eligibility requirements and conditions as set out in the definitions of the illnesses concerned; (ii) no other claim has been paid and / or becomes payable under the policy; (iii) there is no indebtedness under the policy; (iv) the sum insured of the policy remains unchanged throughout the policy term; (v) all premiums are paid in full when due and as planned; (vi) no optional supplementary benefit is attached to the policy; and (vii) Mr. Leung is not covered by other policy(ies) covering minor illnesses issued by AXA and any authorised insurers in Hong Kong and / or Macau which are affiliated with AXA. 9

11 Illustrative example 3 multiple claims arising from one single accident This illustrative example is for reference only (Special Bonus and Index-linked Increase Endorsement are not illustrated in this example). Mr. Choi takes out a HealthElite policy at age 32. Sum insured of the policy : HKD400,000 Premium payment term : 15 years In the 8 th policy year, he is involved in a traffic accident which results in a number of injuries and illnesses. Age 40 (8 th policy year) Waiver of Premium kicks in # Age 42 (10 th policy year) 2 months 1 month 2 years The policy terminates as the aggregate amount of benefits paid has reached 300% of the sum insured 1 st claim 2 nd claim 3 rd claim 4 th claim Mr. Choi has a car crash and needs to undergo a surgery for subdural haematoma (early stage major illness under sickness no. 20) HKD200,000 Early Stage Major Illness Benefit (50% of the sum insured under the Basic Plan) Mr. Choi is diagnosed with moderately severe brain damage (early stage major illness under sickness no. 24) HKD200,000 Early Stage Major Illness Benefit (50% of the sum insured under the Basic Plan) His condition worsens and he becomes blind (major illness under sickness no. 23) HKD400,000 Major Illness Benefit (100% of the sum insured under the Supplement) Mr. Choi is paralysed (major illness under sickness no. 29) HKD400,000 Major Illness Benefit (100% of the sum insured under the Supplement) Total benefits paid: HKD1,200,000 Accumulated claims: 300% of the sum insured # Once the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured, the coverage of the Basic Plan will terminate. The Supplement s coverage will kick in and all future premiums of the Supplement will be waived from the next premium due date. Note: Assuming (i) the relevant illnesses are not excluded from the coverage of the Basic Plan and the Supplement and have fulfilled the relevant eligibility requirements and conditions as set out in the definitions of the illnesses concerned; (ii) no other claim has been paid and / or becomes payable under the policy; (iii) there is no indebtedness under the policy; (iv) the sum insured of the policy remains unchanged throughout the policy term; (v) all premiums are paid in full when due and as planned; (vi) no optional supplementary benefit is attached to the policy; and (vii) Mr. Choi is not covered by other policy(ies) covering minor illnesses issued by AXA and any authorised insurers in Hong Kong and / or Macau which are affiliated with AXA. 10

12 Table 1: List of sicknesses Each set of sickness is presented in a row and classified into 3 severity levels of illnesses, namely major illness, early stage major illness and minor illness. The word will be indicated if that particular illness does not exist in that set of sickness. Sickness Major Illness Early Stage Major Illness Minor Illness Cancer 1 Cancer Illnesses related to Organ Failure 2 Chronic Adrenal Insufficiency (Addison s Disease) Carcinoma-in-situ of Specific Organs Treated with Surgery (Specific Organs refer to Breast, Prostate, Corpus Uteri, Ovary, Fallopian Tube, Colon and Rectum, Stomach, Bladder, Thyroid, Liver, Testicle, Lung or Pancreas) Adrenalectomy for Adrenal Adenoma 3 Chronic and Irreversible Kidney Failure Early Renal Failure i) Carcinoma-in-situ / Carcinoma-in-situ (CIS) at Breast, Cervix Uteri, Uterus, Ovary, Fallopian Tube, Vagina, Testicles, Lung, Urinary Tract, Stomach, Esophagus, Nasopharynx, Penis, Colon, Rectum or Liver ii) Early Stage Cancer of Prostate 4 Chronic Liver Disease Liver Surgery Chronic Auto-immune Hepatitis 5 Coma Coma for 48 Hours 6 End Stage Lung Disease Surgical Removal of One Lung 7 Loss of Independent Existence* # Moderately Loss of Independent Existence* # 8 Major Organ Transplantation Major Organ Transplantation (On Waitlist) 9 Medullary Cystic Disease Surgical Removal of One Kidney Illnesses related to Heart and Blood Vessels 10 Cardiomyopathy Early Cardiomyopathy 11 Coronary Artery Disease Requiring Surgery Keyhole Coronary Bypass Surgery 12 Dissecting Aortic Aneurysm Cerebral Aneurysm or Arteriovenous Malformation Requiring Surgery 13 Eisenmenger s Syndrome Insertion of a Veno-cava Filter Angioplasty and other Invasive Treatments for Coronary Artery 14 Heart Attack Pericardectomy Insertion of Pacemaker or Defibrillator 15 Heart Valve Surgery Percutaneous Valve Surgery 16 Primary Pulmonary Arterial Hypertension Secondary Pulmonary Hypertension 17 Severe Infective Endocarditis Moderately Severe Infective Endocarditis 18 Surgery to Aorta Minimally Invasive Surgery to Aorta Aortic Aneurysm Illnesses related to the Nervous System 19 Amyotrophic Lateral Sclerosis Early Amyotrophic Lateral Sclerosis 20 Apallic Syndrome Surgery for Subdural Haematoma 21 Bacterial Meningitis Moderately Severe Bacterial Meningitis 22 Benign Brain Tumour Surgical Removal of Pituitary Tumour 23 Blindness Optic Nerve Atrophy with Low Vision Glaucoma Surgical Treatment 24 Brain Damage^ Moderately Severe Brain Damage^ 25 Encephalitis Moderately Severe Encephalitis 26 Motor Neurone Disease Early Motor Neurone Disease 27 Multiple Sclerosis Early Multiple Sclerosis 28 Muscular Dystrophy^ Moderately Severe Muscular Dystrophy^ 29 Paralysis Moderately Severe Paralysis 30 Poliomyelitis Moderately Severe Poliomyelitis 31 Progressive Bulbar Palsy Early Progressive Bulbar Palsy 32 Progressive Supranuclear Palsy^ Early Progressive Supranuclear Palsy^ 33 Spinal Muscular Atrophy^ Early Spinal Muscular Atrophy^ 34 Stroke Carotid Artery Surgery 35 Tuberculosis Meningitis Tuberculous Myelitis Facial Reconstructive Surgery for Injury due to Accident 11

13 Table 1: List of sicknesses (cont'd) Sickness Major Illness Early Stage Major Illness Minor Illness Illnesses related to Blood 36 AIDS / HIV due to Blood Transfusion 37 Aplastic Anaemia Acute Aplastic Anaemia 38 Occupationally Acquired AIDS / HIV Illnesses related to the Digestive System 39 Chronic Relapsing Pancreatitis Acute Necrohemorrhagic Pancreatitis 40 Fulminant Hepatitis Biliary Tract Reconstruction Surgery Hepatitis with Cirrhosis 41 Severe Crohn s Disease Moderately Severe Crohn s Disease 42 Severe Ulcerative Colitis Moderately Severe Ulcerative Colitis Illnesses related to Immunology and Rheumatology 43 Severe Rheumatoid Arthritis Moderately Severe Rheumatoid Arthritis 44 Systemic Lupus Erythematosus (S.L.E.) with Lupus Nephritis Moderately Severe Systemic Lupus Erythematosus (S.L.E.) with Lupus Nephritis 45 Systemic Scleroderma Early Systemic Scleroderma Illnesses related to Neurological degeneration 46 Alzheimer s Disease Moderately Severe Alzheimer's Disease 47 Parkinson s Disease Moderately Severe Parkinson's Disease 48 Severe Creutzfeld-Jacob Disease (CJD) Illnesses related to the Musculoskeletal System 49 Amputation of Feet due to Complication from Diabetes Moderately Severe Creutzfeld-Jacob Disease (CJD) Amputation of One Foot due to Complication from Diabetes 50 Major Burns Moderately Severe Burns 51 Necrotising Fasciitis 52 Severance of Limbs Severance of One Limb Other Illnesses 53 Deafness (Loss of Hearing) Cochlear Implant Surgery 54 Elephantiasis Early Elephantiasis 55 Loss of Speech Loss of Speech due to Vocal Cord Paralysis 56 Terminal Illness* Systemic Lupus Erythematosus (S.L.E.) Retinopathy and Nephropathy due to Complication from Diabetes Skin Transplantation due to Accidental Burning * Moderately Loss of Independent Existence, Loss of Independent Existence and Terminal Illness are not covered under the Supplement. # Only an insured aged between 15 and 75 on the first diagnosis of this major illness / early stage major illness (as the case may be) is eligible to claim for the relevant benefit. ^ Only an insured aged above 5 on the first diagnosis of this major illness / early stage major illness (as the case may be) is eligible to claim for the relevant benefit. Table 2: Juvenile minor illnesses** Dengue Haemorrhagic Fever Hemophilia A and Hemophilia B Insulin Dependent Diabetes Mellitus Kawasaki Disease Osteogenesis Imperfecta Rheumatic Fever with Valvular Impairment Still s Disease Wilson s Disease ** Only an insured aged under 22 on the first diagnosis of this minor illness is eligible to claim for the relevant benefit. Each of the above 8 minor illnesses is treated as a separate set of sickness. Note: Benefits relating to major illness / early stage major illness / minor illness are payable according to the definitions of the relevant major illness / early stage major illness / minor illness (which specify the eligibility requirements, exclusions and other necessary conditions) as set out in the policy contracts of the Basic Plan and the Supplement. 12

14 Frequently asked questions What is the major advantage of HealthElite? A person may suffer from critical illness more than once during his lifetime. Under the protection of HealthElite, multiple claims for covered illnesses of different severity (including major illness, early stage major illness and minor illness) are allowed up to 300% of the sum insured, subject to relevant terms, conditions and exclusions as set out in the policy contracts. For example, the benefit amount for each claim of early stage major illness is 50% of the sum insured. With the total coverage of 300% of the sum insured available under HealthElite, up to 6 early stage major illness claims can be made. What can I do if I want to know more about the details of the illnesses covered under HealthElite? You are advised to refer to the terms and conditions of the policy and also the relevant definitions of the illnesses covered, which contain the eligibility requirements, conditions and exclusions on the coverage as set out in the policy contracts. For example, Coronary Artery Disease Requiring Surgery, a major illness under sickness no. 11, refers to the undergoing of open heart surgery with a thoracotomy and sternotomy to correct narrowing or blockage of 1 or more coronary arteries with bypass grafts in persons with limiting anginal symptoms, but excluding non-surgical techniques such as balloon angioplasty, laser relief of an obstruction, stenting and all other intra-arterial catheter based techniques. The surgery must be considered medically necessary by a specialist. For details of the definition of other covered illnesses, please refer to the policy contracts. If I am diagnosed with critical illnesses and have difficulty in making premium payment, will I still be protected? HealthElite Enhanced Benefit Supplement is designed with a waiver of premium feature to help lessen your financial burden when needed. Once the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured, the coverage of the Basic Plan will terminate while that of the Supplement will kick in. Under the Waiver of Premium of the Supplement, all future premiums for the Supplement will be waived from the next premium due date to keep you protected. How do I make a claim? Please call your financial consultant or contact us at (852) , fax (852) or [email protected]. We will help you process your claim as soon as possible. If you have other optional supplementary benefits attached to the policy, premiums of the relevant benefits still need to be paid. 13

15 HealthElite at a glance HealthElite Critical Illness Insurance HealthElite Enhanced Benefit Supplement Benefit period Up to age Up to age 85 4 Maximum coverage Major Illness Benefit Early Stage Major Illness Benefit Minor Illness Benefit 2 Extra 35% Coverage Benefit 6 Guaranteed Cash Value 8 Special Bonus 9 Surrender Value Maturity Benefit 12 Death Benefit 10 Waiver of Premium Extended Grace Period Benefit 11 Premium payment term and issue age Up to 100% of the sum insured of the Basic Plan (not including the Extra 35% Coverage Benefit 6 ) Additional 35% of the sum insured will be payable when the Major Illness Benefit or Death Benefit 10 is payable under the Basic Plan before the 10 th policy anniversary Available starting from the 3 rd policy anniversary; payable upon surrender of the policy Non-guaranteed; payable after the policy has been in force for 5 years or more on the earliest occurrence of the following (if any): when the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured; the surrender of the policy; the maturity of the policy; or the death of the insured 100% of the Guaranteed Cash Value 8 plus any Special Bonus 9 (non-guaranteed) as at the policy surrender date, minus any amount claimed for the Early Stage Major Illness Benefit and Minor Illness Benefit 2 under the Basic Plan and any indebtedness 100% of the sum insured of the Basic Plan plus any Special Bonus 9 (non-guaranteed) as at the policy maturity date, minus any amount claimed for the Early Stage Major Illness Benefit and Minor Illness Benefit 2 under the Basic Plan and any indebtedness 100% of the sum insured of the Basic Plan plus any Special Bonus 9 (non-guaranteed), minus any amount claimed for the Early Stage Major Illness Benefit and Minor Illness Benefit 2 under the Basic Plan and any indebtedness Extension of the grace period for premium payment up to 365 days; available from the 2 nd policy year 100% of the sum insured for each claim 50% of the sum insured for each claim 20% of the sum insured for each claim 10 years (age 0 65) 15 years (age 0 60) 20 years (age 0 55) 25 years (age 0 50) Up to 200% of the sum insured of the Supplement All future premiums of the Supplement will be waived from the next premium due date when the aggregate amount of benefits paid under the Basic Plan reaches 100% of the sum insured Premium structure Level but not guaranteed 13 Payment mode Minimum sum insured Maximum sum insured Monthly, semi-annual or annual Below age 45 : HKD120,000 / USD15,000 Age 45 or above : HKD80,000 / USD10,000 HKD10,000,000 / USD1,250,000 Note: The above benefits of the Basic Plan / Supplement are applicable while the coverage of the Basic Plan / Supplement is in effect. 14

16 To know more about HealthElite Conditions required for critical illness claims Major illness, early stage major illness and / or minor illness claim(s) from both of the Basic Plan and the Supplement are subject to all of the following conditions: Major Illness Benefit Each Major Illness Benefit claim must be for a different major illness (except for Cancer, Heart Attack and Stroke). For subsequent claim(s) on Cancer, Heart Attack and Stroke, each subsequent claim must fulfill the additional requirements below: For Cancer, (i) if the Cancer of the subsequent claim for Cancer is a Recurrence of the Cancer 14 of any preceding claim(s) for Cancer (for which benefit has been paid), the Cancer of the subsequent claim for Cancer shall be covered only if it is first diagnosed after a 5-year Cancer-free Period 15 ; (ii) if the Cancer of the subsequent claim for Cancer is not a Recurrence of the Cancer of any preceding claim(s) for Cancer (for which benefit has been paid), the Cancer of the subsequent claim for Cancer shall be covered only if it is first diagnosed at least 1 year after the date of first diagnosis of the Cancer of the immediate preceding claim for Cancer (for which benefit has been paid). For Heart Attack, a specialist must certify the diagnosis of a new acute Myocardial Infarction at least 1 year after the date of diagnosis of the preceding claim of Heart Attack for which benefit has been paid and the diagnosis must be supported by fresh evidence of the following: (i) a history of typical chest pain; (ii) new electrocardiographic (ECG) changes indicating myocardial infarction; and (iii) Diagnostic elevation of cardiac biomarkers indicating myocardial damage inclusive of CKMB or Cardiac Troponin T or I above generally accepted laboratory level. For Stroke, a specialist must certify the diagnosis of a new Stroke at least 1 year after the date of diagnosis of the preceding claim of Stroke for which benefit has been paid and the diagnosis must be supported with new imaging evidence consistent with diagnosis of a second Stroke. For each major illness claim (apart from any major illness claim of Cancer, the Cancer of which is a Recurrence of the Cancer of any preceding major illness claim(s) of Cancer), the first diagnosis of the major illness of any subsequent major illness claim must be at least 1 year after the first diagnosis of the major illness of the immediate preceding claim. Early Stage Major Illness Benefit Each Early Stage Major Illness Benefit claim must be for a different early stage major illness except for Carcinoma-in-situ of Specific Organs Treated with Surgery provided that each claim must be for a different covered organ. Minor Illness Benefit Each Minor Illness Benefit claim must be for a different minor illness except for (i) Angioplasty and Other Invasive Treatments for Coronary Artery and (ii) Carcinoma-in-situ of covered organs, which can be claimed twice subject to the exclusions and terms and conditions of this benefit. A second claim can be made subject to the additional conditions below: (i) For Angioplasty and Other Invasive Treatments for Coronary Artery: the treatment must be performed on a location of stenosis in major coronary artery where no stenosis of greater than 60% was identified in the medical examination relating to the first claim; (ii) For Carcinoma-in-situ of covered organs: the Carcinoma-in-situ is of a different covered organ from that of the first claim. Moderately Loss of Independent Existence, Loss of Independent Existence and Terminal Illness Moderately Loss of Independent Existence, Loss of Independent Existence and Terminal Illness are not covered under the Supplement. Any unpaid balance of claim of any of these illnesses under the Basic Plan will not be paid under the Supplement in any event. If a claim for Moderately Loss of Independent Existence, Loss of Independent Existence or Terminal Illness becomes payable, the diagnosis of any subsequent major illness, early stage major illness or minor illness must be at least 5 years after the first diagnosis of the immediate preceding Moderately Loss of Independent Existence, Loss of Independent Existence or Terminal Illness in order for the subsequent claim to be covered. Others If the definition of a major illness is met (no matter the claim is admitted or not), no benefit will be payable retrospectively for early stage major illness or minor illness of the same set of sickness (except for claims of covered illnesses under the set of sickness related to Cancer where the subsequent claim concerns an organ different from those concerned in all preceding 15

17 claims for Cancer). Similarly, if the definition of an early stage major illness is met (no matter the claim is admitted or not), no benefit will be payable retrospectively for any minor illness of the same set of sickness (except in the case of claims of covered illnesses under the set of sickness related to Cancer). In case where after a Minor Illness Benefit or an Early Stage Major Illness Benefit under the set of sickness related to Cancer ( Earlier Claim ) had been paid and it is discovered by the Company later on that a Major Illness Benefit under the same set of sickness ( Later Claim ) should be paid instead in light of further evidence, then the Company shall be entitled to deduct the monies that have been paid for the Earlier Claim from the monies that shall be payable by the Company for the Later Claim. The insured must survive for at least 14 days from the date of first diagnosis of the major illness, early stage major illness or minor illness (as the case may be) for each claim. If more than 1 illness is diagnosed on the same date as 1 event, though they may exist in different stages, conditions or forms, the Company will only pay 1 benefit for the illness for which the highest benefit amount is payable except that if a claim for Minor Illness Benefit and Early Stage Major Illness Benefit under the set of sickness related to Cancer is lodged as 1 event and the definitions and requirements for both the said Minor Illness Benefit and Early Stage Major Illness Benefit are fulfilled, then the Company will pay both the Minor Illness Benefit and Early Stage Major Illness Benefit under the set of sickness related to Cancer. For the definition of event, please refer to the policy contracts. For those organs with both left and right component (including but not limited to breast, ear, eye, fallopian tube, kidney, lung, ovary and testicle), the left component and right component of the organ ("Paired Organ") shall be considered as one and the same organ. If more than 1 illness is diagnosed in any of these Paired Organs on the same date, though they may exist in different stages, conditions or forms, the Company will only pay 1 benefit for the illness for which the highest benefit amount is payable. Key exclusions We will NOT pay any benefit under the Major Illness Benefit, Early Stage Major Illness Benefit or Minor Illness Benefit of the policy: (1) if the insured suffers symptoms of, undergoes investigation for or is diagnosed with any major illness, early stage major illness or minor illness within the Waiting Period (as defined below) of the Basic Plan / Supplement; or (2) for any major illness, early stage major illness or minor illness resulting (directly or indirectly) from, or caused or contributed by (in whole or in part), any of the following: (a) any Pre-existing Condition (as defined below); or (b) any congenital defect or disease which has manifested or was diagnosed before the insured attains age 18; or (c) Human Immunodeficiency Virus (HIV) and / or any HIV-related illness including Acquired Immune Deficiency Syndrome (AIDS) and / or any mutations, derivations or variations thereof (except AIDS / HIV due to Blood Transfusion and Occupationally Acquired AIDS / HIV as stated in the definition of major illness provision of the Basic Plan); or (d) a self-inflicted injury or attempted suicide while sane or insane; or (e) intoxication by alcohol or drugs not prescribed by a medical practitioner; or (f) any criminal act; or (g) travel in any aircraft, except as a fare paying passenger in a commercial aircraft or cabin crew working on a scheduled public air service. For the purposes of the exclusion in (1) above, Waiting Period shall mean a period of 60 days following: (i) the policy effective date; or (ii) any date of reinstatement of the policy / Supplement, whichever is later. For the purposes of the exclusion in (2)(a) above, Pre-existing Condition shall mean any pre-existing or recurring illness which the insured suffered symptoms of, underwent investigation for or was diagnosed with prior to the policy effective date or any date of reinstatement, whichever is later. The exclusion in (1) above does not apply to any major illness, early stage major illness or minor illness, which is solely and directly caused by an accident and independently of any other causes. The exclusion in (2)(b) above does not apply to Cerebral Aneurysm or Arteriovenous Malformation Requiring Surgery, Eisenmenger's Syndrome, Hemophilia A and Hemophilia B, Insulin Dependent Diabetes Mellitus and Osteogenesis Imperfecta. For the avoidance of doubt, it is without prejudice to the Pre-existing Conditions exclusion in (2)(a) above, which shall still apply to these illnesses. 16

18 Remarks: 1. The policy will automatically terminate upon the cancellation of the Supplement. 2. The aggregate amount payable in respect of a covered minor illness of the insured under all policies, covering the same or similar illnesses issued by the Company and any authorised insurers in Hong Kong and / or Macau which are affiliated with the Company, shall not exceed HKD240,000 / USD30,000 (as the case may be, depending on the policy currency of the policy). 3. The coverage under the Basic Plan will terminate on the earliest occurrence of the following: when Death Benefit becomes payable under the Basic Plan; when the aggregate amount of benefits paid under the Basic Plan reaches 100% of the amount of the sum insured of the Basic Plan; or on the policy anniversary on or immediately following the insured s 100 th birthday. 4. The Supplement will terminate on the earliest occurrence of the following: when the aggregate amount of benefits paid under the Supplement reaches 200% of the amount of the sum insured of the Supplement; on the policy anniversary on or immediately following the insured s 85 th birthday; when the Supplement is cancelled; or when the policy terminates. 5. The policy will terminate on the earliest occurrence of the following: when the insured dies; on the policy anniversary on or immediately following the insured s 100 th birthday; when the amount of indebtedness equals / exceeds the cash value minus all benefits paid or payable under the Basic Plan; when the Supplement is cancelled; when there is no further coverage under the Basic Plan and all attached supplements (if any); when the last subsisting attached supplement (apart from waiver of premium type of supplement) is terminated in case where coverage under the Basic Plan has already been terminated; when the policy lapses, is cancelled or surrendered; or when the right of policy termination is exercised pursuant to the cross-border provision of the policy (for details of the cross-border provision, please refer to the policy contract). On termination of the policy, the Basic Plan and all attached supplements and endorsements, if any, will also terminate. 6. The benefit amount payable under the Extra 35% Coverage Benefit is equivalent to 35% of the sum insured of the Basic Plan (excluding any amount of the sum insured which is increased by the Index-linked Increase Endorsement) as at the date when the Major Illness Benefit or Death Benefit is payable under the Basic Plan. This benefit is payable once only under the Basic Plan and will automatically terminate if there is no Major Illness Benefit or Death Benefit payable under the Basic Plan before the 10 th policy anniversary. 7. This endorsement will terminate on the occurrence of the earliest of the following events: when the owner declines 2 consecutive increases made in accordance with the policy contract; on the day immediately preceding the 6 th / 11 th / 16 th policy anniversary for premium payment term of the Basic Plan being 15 / 20 / 25 years respectively; on the policy anniversary on or immediately following the insured s 60 th birthday; when any Major Illness Benefit, Early Stage Major Illness Benefit or Minor Illness Benefit becomes payable under the Basic Plan; or when the Basic Plan of the policy becomes fully paid-up. This endorsement is not applicable for the Basic Plan with premium payment term of 10 years. 8. Any amount claimed for the Early Stage Major Illness Benefit and Minor Illness Benefit under the Basic Plan and any indebtedness will be deducted from the aggregate amount of the Guaranteed Cash Value payable upon surrender of the policy. No Guaranteed Cash Value will be available after the coverage of the Basic Plan terminates. 9. Special Bonus is not guaranteed, and is payable only after the policy has been in force for 5 years or more (if any). It may be reviewed and changed from time to time by the Company at its absolute discretion based on a series of factors including but not limited to the past investment performance of and future investment outlook for underlying assets which support the relevant insurance policies as well as the Company's other experiences such as expenses, claims and / or policy persistency. Any amount claimed for the Early Stage Major Illness Benefit and Minor Illness Benefit under the Basic Plan and any indebtedness will be deducted from the Special Bonus when payable. No Special Bonus will be payable after the coverage of the Basic Plan terminates. 10. The policy will automatically terminate when the Death Benefit becomes payable. No Death Benefit will be payable after the coverage of the Basic Plan terminates. 11. To be eligible for the Extended Grace Period Benefit, the owner must provide the relevant evidence to the Company. Please refer to the policy contract for details. The extended grace period of premium payment can be up to 365 days from the next premium due date upon the application approval. At the end of the extended grace period, the owner has to pay all overdue premiums without interest. There is no accumulation of cash value during the extended grace period. It is not allowed to reduce the sum insured or apply for policy loan during this period. The Extended Grace Period Benefit is offered once during the whole policy term. For detailed terms and conditions of this benefit, please refer to the policy contract. 12. Maturity Benefit is payable on the policy anniversary on or immediately following the insured s 100 th birthday. No Maturity Benefit will be payable after the coverage of the Basic Plan terminates. 13. The initial premium is based on the age of the insured at the time of application and a number of factors including but not limited to gender, smoking status and sum insured. Premium is level and will not subsequently increase as a result of the insured s age. Premium rate is not guaranteed. The Company reserves the right to review and adjust the premium rate by reference to a number of factors including but not limited to change in claim experience on each policy anniversary and adjust the premium rate accordingly across a particular risk class. 14. Recurrence of the Cancer means a subsequent Cancer is caused by (i) the same malignant cells that caused the Relevant Preceding Cancer(s) (as defined below); or (ii) metastasis of the Relevant Preceding Cancer(s); where there has been more than 1 claim for Cancer. Relevant Preceding Cancer(s) means the Cancer of the immediate preceding claim for Cancer (for which benefit has been paid), which causes Recurrence of the Cancer in the subsequent claim for Cancer. 15. The 5-year Cancer-free Period must be determined by the insured s treating specialist(s) to confirm the cancer-free state in respect of the Relevant Preceding Cancer(s) (as defined above) of the insured for the whole duration of the last 5-year period after the Relevant Preceding Cancer(s) of the insured. The said cancer-free state must also be confirmed and supported by clinical, radiological, histological and laboratory evidence, and evidence of all other relevant investigative methods available at that time. The 5-year Cancer-free Period shall be deemed to start on the date of completion of all treatments in respect of Relevant Preceding Cancer(s), which treatments shall include any surgery, chemotherapy, radiation therapy, immunotherapy, monoclonal antibody therapy and other conventional cancer treatments that have been used as prescribed by the insured s treating specialist(s). Note: Unless otherwise specified, all ages mentioned in this product brochure refer to the age of the insured on his or her last birthday. 17

19 U.S. Foreign Account Tax Compliance Act Under the U.S. Foreign Account Tax Compliance Act ( FATCA ), a foreign financial institution ( FFI ) is required to report to the U.S. Internal Revenue Service ( IRS ) certain information on U.S. persons that hold accounts with that FFI outside the U.S. and to obtain their consent to the FFI passing that information to the IRS. An FFI which does not sign or agree to comply with the requirements of an agreement with the IRS ( FFI Agreement ) in respect of FATCA and / or who is not otherwise exempt from doing so (referred to as a nonparticipating FFI ) will face a 30% withholding tax ( FATCA Withholding Tax ) on all withholdable payments (as defined under FATCA) derived from U.S. sources (initially including dividends, interest and certain derivative payments). The U.S. and Hong Kong have signed an inter-governmental agreement ( IGA ) to facilitate compliance by FFIs in Hong Kong with FATCA and which creates a framework for Hong Kong FFIs to rely on streamlined due diligence procedures to (i) identify U.S. indicia, (ii) seek consent for disclosure from its U.S. policyholders and (iii) report relevant tax information of those policyholders to the IRS. FATCA applies to the Company and this policy. The Company is a participating FFI. The Company is committed to complying with FATCA. To do so, the Company requires you to: (i) provide to the Company certain information including, as applicable, your U.S. identification details (e.g. name, address, the US federal taxpayer identifying numbers, etc); and (ii) consent to the Company reporting this information and your account information (such as account balances, interest and dividend income and withdrawals) to the IRS. If you fail to comply with these obligations (being a Non-Compliant Accountholder ), the Company is required to report aggregate information of account balances, payment amounts and number of non-consenting US accounts to IRS. The Company could, in certain circumstances, be required to impose FATCA Withholding Tax on payments made to, or which it makes from, your policy. Currently the only circumstances in which the Company may be required to do so are: (i) if the Inland Revenue Department of Hong Kong fails to exchange information with the IRS under IGA (and the relevant tax information exchange agreement between Hong Kong and the U.S.), in which case the Company may be required to deduct and withhold FATCA Withholding Tax on withholdable payments made to your policy and remit this to the IRS; and (ii) if you are (or any other account holder is) a nonparticipating FFI, in which case the Company may be required to deduct and withhold FATCA Withholding Tax on withholdable payments made to your policy and remit this to the IRS. You should seek independent professional advice on the impact FATCA may have on you or your policy. HealthElite Critical Illness Insurance and HealthElite Enhanced Benefit Supplement are underwritten by AXA China Region Insurance Company (Bermuda) Limited (Incorporated in Bermuda with limited liability) ( AXA, the Company, or we ). The plans are subject to the terms, conditions and exclusions of the relevant policy contracts. AXA reserves the final right to approve any application. This product brochure contains general information only and does not constitute any contract between any other parties and AXA. It is not a policy. For detailed terms, conditions and exclusions of the plans, please refer to the relevant policy contracts. ABOUT AXA HONG KONG AXA Hong Kong, a member of the AXA Group, prides itself of serving over 1 million customers 1 in Hong Kong and Macau. Besides being one of the largest health protection providers in Hong Kong, it is also the number 1 General Insurance provider 2 and a market leader in motor insurance. AXA Hong Kong is committed to the on-going development and enhancement of our life & savings, health, property & casualty, wealth management and retirement solutions in order to satisfy the different needs of our individual and corporate customers. We believe it is our inherent responsibility to support the communities we operate in, hence creating a sustainable business via constant and considerable contribution in the dimensions of health, environment and the community. 1 Including customers of AXA China Region Insurance Company Limited, AXA China Region Insurance Company (Bermuda) Limited (Incorporated in Bermuda with limited liability) and AXA General Insurance Hong Kong Limited 2 Based on 2014 Office of the Commissioner of Insurance market share statistics represented by overall gross premiums LMKG AXA China Region Insurance Company (Bermuda) Limited (Incorporated in Bermuda with limited liability) Tel: (852) Fax: (852) Website: If you do not wish to receive promotional or direct marketing materials from AXA, please inform Data Privacy Officer, AXA China Region Insurance Company (Bermuda) Limited, Suite 2001, 20/F, Tower Two, Times Square, 1 Matheson Street, Causeway Bay, Hong Kong. AXA shall, without charge to you, ensure that you are not included in future direct marketing activities. (Only for use in Hong Kong Special Administrative Region) January 2016

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