CathayLife Corp., Hsinchu Office Name : Bill Tsung Cell : : 改變,從這一刻開始 誠信、當責、創新 Foreign Student Insurance
Briefings for CathayLife Corp., Why pay 3000 NTD for insurance Insurance Content Exclusion for this Insurance Application for Benefit
Briefings for CathayLife Corp., 1.The Largest insurance company in Taiwan 2.Only insurance company for TOP 100 branch conducted MOEA of Taiwan 3.No.1 for financial enterprises in Taiwan from TOP 1000 enterprises conducted by CommonWealth Magazine 4.Only one candidate in Taiwan of TOP 500 globalization in US Fortune 5.No.1 of financial enterprise in Taiwan from global TOP 2000 conducted Forbes Free customer service: MUST Contact: Mr. Tsai, International Student Service Section, ext.2317 CathayLife: Bill Tsung, , Hsinchu Office Add: 2F., No.9, Sec. 3, Zhonghua Rd., North Dist., Hsinchu City 300, Taiwan
Why pay 3000 NTD for insurance 根據全民健康保險法第九條,在臺灣地區領有居留證明文件,並符合下 列各款資格之 一者,亦應參加本保險為保險對象: 一、在臺居留滿六個 月。 二、有一定雇主之受僱者。 According to Article 9 of National Health Insurance Act, any national of the Republic of China must meet one of the following requirements in order to become the beneficiaries of this Insurance: 1.Those who have established a registered domicile for at least six consecutive months; 2.Those with a regular employer. 故外籍學生在本國居住前六個月,因無資格參加健保。學校為彌補該保 險空窗期,特委託本公司承作該六個月之保險事宜,以保障學生在台灣健 康及意外保障。 For covering six months without national health insurance, MUST trusts insurance to CathayLife with 500NTD per month for one.
第十四條 門 ( 急 ) 診醫療保險金之給付被保險人於本契約有效期間內(如於 本契約生效後加保之被保險人,則係指加保之翌日起)因疾病或傷 害,而於醫院或診所接受門 ( 急 ) 診診療者,本公司按醫院或診所 實際收取之門 ( 急 ) 診醫療費用(包含診察、處方、醫藥、檢驗或 X光檢查等之全部費用),給付「門 ( 急 ) 診醫療保險金」,但每 次最高給付金額以 1000 元為限。 Article 14 Regarding to payment for outpatient services or emergency service due to disease or accident, CathayLife pays 「 benefit for outpatient/emergency services ( 門 ( 急 ) 診醫療保險金 ) 」 based on real payment to hospital, including examination, prescription, medicine, test or X-ray, without exceed of 1,000 NTD per service Insurance Content Outpatient/emergency service Payment for daily ward hospital allowance of be in hospital
第十五條 每日病房費用保險金的給付被保險人於本契約有效期間內(如於本 契約生效後加保之被保險人,則係指加保之翌日起)因疾病或傷害 而住院診療時,本公司按該被保險人住院期間內所發生之下列各項 費用核付「每日病房費用保險金」,但每日最高給付金額以 1000 元為限: 1. 超等住院之病房費差額。 2. 管灌飲食以外之膳食費。 3. 特別護士以外之護理費。 Article 15 Regarding to daily ward payment due to disease or accident, CathayLife pays 「 benefit for daily ward ( 每日病房費用保險金 ) 」 as followings and without exceed of 1,000 NTD daily 1.Fee difference of ward upgraded 2.Food except for tube feeding 3.nursing except special nursing Insurance Content Outpatient/emergency service Payment for daily ward hospital allowance of be in hospital
第十六條 住院醫療費用保險金之給付被保險人於本契約有效期間內(如於 本契約生效後加保之被保險人,則係指加保之翌日起)因疾病或 傷害而住院診療時,本公司按該被保險人住院期間內所發生之下 列各項費用核付「住院醫療費用保險金」,但被保險人同一次住 院最高給付金額以 12 萬元為限: Article 16 Payment for stay in hospital due to disease or accident, CathayLife pays 「 hospital allowance of be in hospital ( 住院醫 療費用保險金 ) 」 as followings and without exceed of 120,000 NTD 一、醫師指示用藥。 1. Medicine by Doctor’s instruction 二、血液 ( 非緊急傷病必要之輸血 ) 。 2. Blood for non urgency 三、掛號費及其證明文件。 3. registration fee and documents 四、來往醫院的救護車費。 4. for ambulance around trip 五、手術費用。 5. For operation 六、手術室、手術後恢復室或急救室及其設備之應用。 6. equipment/device applied for recovery after operation 七、材料費。 7. materials Insurance Content Outpatient/emergency service Payment for daily ward hospital allowance of be in hospital
Insurance Content 八、化驗室檢驗、心電圖、基礎代謝率檢查。 8. chem-test, electrocardiogram, check for basal metabolic rate 九、復健治療。 9. Physical recovery treatment 十、麻醉劑、氧氣及其應用。 10. Apply anesthetic and oxygen 十一、放射線診療費。 11. Radiation treatment 十二、血液透析費。 12. Blood dialysis 十三、注射技術費及其藥液。 13. Introduction technique and medicine 十四、檢驗費。 14. Test fee 十五、治療費。 15. Treatment fee Outpatient/emergency service Payment for daily ward hospital allowance of be in hospital
第十九條 除外責任被保險人因下列原因所致之疾病或傷害而住院診療或接 受門 ( 急 ) 診診療者,本公司不負給付各項保險金的責任。 一、被保險人之故意行為(包括自殺及自殺未遂)。 二、被保險人之犯罪行為。 三、被保險人非法施用防制毒品相關法令所稱之毒品。 Article 19 The CathayLife does not take responsibility due to disease or accident caused by following circumstances: A. the activities on purposed by the insured, including suicide or attend suicide B. Criminal by the insured C. The insured takes illegal drugs according Taiwan regulation Exclusion
被保險人因下列事故而住院診療或接受門 ( 急 ) 診診療者,本公司不 負給付各項保險金的責任。 一、美容手術、外科整型。但為重建其基本功能所作之必要整型,不 在此限。 二、外觀可見之天生畸形。 三、非因當次住院事故治療之目的所進行之牙科手術。 四、裝設義齒、義肢、義眼、眼鏡、助聽器或其它附屬品。 但因遭受意外傷害事故所致者,不在此限,且其裝設以一次為限。 The CathayLife is not responsible for staying hospital or outpatient service due to following circumstances A. Operation for beauty 、 surgery, but excluding necessary orthopedics for basic function B. Birth defect, C. Dental treatment not caused by happened case D. Artificial teeth, limb, eyes, classes, hearing aid or accessories However, above conditions are effective caused by injury accidences and one time is restricted. Exclusion
五、健康檢查、療養、靜養、戒毒、戒酒、護理或養老之非以直接診治病人為 目的者。 E. Healthy check, rest, drug quitting, alcohol quitting, nursing, elderly care or indirect medical treatments 六、懷孕、流產或分娩及其併發症。但下列情形不在此限: F.Pregnant, miscarriage, parturition and complication. The following are excluded : ( 一)懷孕相關疾病: 1. 子宮外孕。 2. 葡萄胎。 3. 前置胎盤。 4. 胎盤早 期剝離。 5. 產後大出血。 6. 子癲前症。 7. 子癇症。 8. 萎縮性胚胎。 9. 胎兒染色體異常之手術。 (A). related pregnant disease : a. extrauterine pregnancy, b. vesicular mole, c. placenta previa, d. premature separation of placenta, 5. postpartumhemorrhage. 6. pre-eclampsia, 7. eclampsia, 8.atrophic embryo, 9. operation for abnormal embryo chromosome. Exclusion
六、懷孕、流產或分娩及其併發症。但下列情形不在此限: F.Pregnant, miscarriage, parturition and complication. The following are excluded : ( 二)因醫療行為所必要之流產,包含: 1. 因本人或其配偶患有礙 優生之遺傳性、傳染性疾病或精神疾病。 2. 因本人或其配偶之四 親等以內之血親患有礙優生之遺傳性疾病。 3. 有醫學上理由,足 以認定懷孕或分娩有招致生命危險或危害身體或精神健康。 4. 有 醫學上理由,足以認定胎兒有畸型發育之虞。 5. 因被強制性交、 誘姦或與依法不得結婚者相姦而受孕者。 (B) Necessary miscarriage based on medical treatment, including 1. himself/herself and his/her couple gets genetic, epidemic or physiology disease, 2. four-level relatives to himself/herself and his/her couple get genetic disease, 3. according medical reason, it is considered lethal death, danger of body or physiology, 4.according to medical reason, it is considered abnormality possibility, 5. Pregnant by rape and enticement into unlawful sexual intercourse and restricted marriage according to regulation. Exclusion
六、懷孕、流產或分娩及其併發症。但下列情形不在此限: F.Pregnant, miscarriage, parturition and complication. The following are excluded ( 三)醫療行為必要之剖腹產,並符合下列情況者: (C) Necessary cesarean section and compliance with following: 1. 產程遲滯 Dysfunctional Labor. 2. 胎兒窘迫 Fetal distress 3. 胎頭骨盆不對稱 CPD 4. 胎位不正 abnormal fetal position 。 5. 多胞胎。 Multiple Birth 6. 子宮頸未全開而有臍帶脫落時。 cervixneck of the uterus non- fully open and umbilical cord abscisic 7. Twice (include) of IUFD intrauterine fetal demise ( pregnant for more 24 weeks, more weight 560 grams )。 Exclusion
六、懷孕、流產或分娩及其併發症。但下列情形不在此限: F.Pregnant, miscarriage, parturition and complication. The following are excluded ( 三)醫療行為必要之剖腹產,並符合下列情況者: (C) Necessary cesarean section and compliance with following: 8. 分娩相關疾病: a. 前置胎盤。 b. 子癲前症及子癇症。 c. 胎盤早 期剝離。 d. 早期破水超過 24 小時合併感染現象。 e. 母體心肺疾病: ( a )嚴重心律不整,並附心臟科專科醫師診斷證明或心電圖檢查 認定須剖腹產者。( b )經心臟科採用之心肺功能分級認定為第三 或第四級心臟病,並附診斷證明。( c )嚴重肺氣腫,並附胸腔科 專科醫師診斷證明。 relative disease : a. placenta previa, b. pre-eclampsia and eclampsia, c. premature separation of placenta, d. Premature Rupture for more more than 24 hours, e. cardiopulmonary : (a) serious cardiac arrhythmias with diagnosis, (b) heart attack level 3 or 4 with diagnosis, (c) plumonary emphysema with diagnosis. 七、不孕症、人工受孕或非以治療為目的之避孕及絕育手術。 contraception operation for Infertility, artificial insemination or non-cure orientation Exclusion
Application for Benefit 第二十條 保險金的申領受益人申領本契約各項保險金時,應檢具下列文件:一、 保險金申請書。 二、醫療診斷書或住院證明。(但要保人或被保險人為醫師時,不得 為被保險人出具診斷書或住院證明。) 三、「醫院」或「診所」所開立之醫療費用收據及醫療費用明細表。 四、受益人之身分證明文件。受益人申領保險金時,本公司於必要時 得經其同意調閱被保險人之就醫相關資料,其費用由本公司負擔。 Article 20 Documents required when applying for benefit of insurance : A. Application form filled up B. Diagnosis (if the Policyholder or insured is Doctor, they is not allowed to issue diagnosis for Policyholder or insured) C. Receipt of bill list from legal hospital or clinic D. ID of Beneficiary 。 If necessary, CathayLife will review insured medical records after agree, and CathayLife pays this fee.
第十二條 被保險人資格的喪失團體成員因下列情形喪失被保險人資格: 一、喪失團體成員資格。二、身故。 Article 12 The insured is disqualified when following happen 1.Not membership 2.Death 第十三條 住院次數之計算被保險人於本契約有效期間內,因同一疾病或 傷害,或因此引起的併發症,於出院後十四日內再次住院時, 其各項保險金給付合計額及限額,均視為同一次住院辦理。 Article 13 definition of the same case : if the insured comes back within 14 days since out of hospital, due to the exact same disease or accident or its complication, it is severed as the same disease or accident. Definition