AIA International Limited...AIA International Limited Cancer Guardian 2 / Cancer Guardian Pearl 2 06192018 DBGG P0317 “In-Patient” means the Confinement of the Insured for a Covered

AIA International Limited

Cancer Guardian 2 / Cancer Guardian Pearl 2 06192018 DBGG P0117

BASIC DEFINITIONS DEFINITIONS

In this Policy:

“Active Treatment” means any therapeutic intervention with the aim of prolonging the Insured’s life, including but not

limited to radiotherapy, chemotherapy, targeted therapy, hormonal therapy, immunotherapy, proton therapy and surgery for a

Covered Cancer, including any complications thereof (if applicable). It does not include any treatment given solely as

Palliative Treatment.

“Anaesthetist” means an Independent Person (other than the Registered Medical Practitioner operating on the Insured)

legally authorized by the government of the geographical area of his practice to perform anesthesiology services.

“Basic Policy” means this Policy (as may be amended by endorsement from time to time) excluding coverage issued under

any Supplementary Contract.

“Beneficiary” means the person or persons designated in the application form as the beneficiary under this Policy (as may be

amended from time to time in accordance with this Policy).

“Cancer” means:

Any cancer positively Diagnosed with histological confirmation or preparations from the haemic system (including but not

limited to, peripheral blood smears and bone marrow examination), and characterized by the uncontrolled growth of

malignant cells and invasion of tissue.

For the purpose of this contract, the term Cancer will include:

(1) all stages of malignant cancer, and

(2) Carcinoma-in-situ,

but will specifically exclude the following:

(a) any tumour which is histologically classified as pre-malignant;

(b) abnormal lesions of cervix uteri classified as cervical intra-epithelial neoplasia grade I (CIN I) and grade II (CIN II); and

(c) any cancer where HIV Infection is also present.

“Carcinoma-in-situ”, which means a histologically proven, localized pre-invasion lesion where cancer cells have not yet

penetrated the basement membrane or invaded (in the sense of infiltrating and / or actively destroying) the surrounding tissues

or stroma.

“Commencement Date” (a) in relation to an amendment of the Policy or a Supplementary Contract issued after the Basic

Policy, means the date shown on the relevant endorsement as the Commencement Date; and (b) in relation to a reinstatement

of the Policy, means the date on which the Policy is reinstated in accordance with the terms of this Policy.

“Company”, “we”, “us” or “our” refers to AIA International Limited.

“Confinement” or “Confined” means admission of the Insured to a Hospital as an In-Patient following the later of the Issue

Date and the latest Commencement Date upon the recommendation of a Registered Medical Practitioner for a Continuous

Physical Stay for Medically Necessary treatment in the Hospital prior to the Insured’s discharge, provided that the duration of

such Stay is six (6) hours or more. For the avoidance of doubt, and notwithstanding any other provisions of this Policy, an

admission to Hospital will not be, or will cease to be, regarded by the Company as a Confinement for purposes of this Policy

where the ensuing stay on Hospital is not a Continuous Physical Stay as defined.

“Contingent Owner” means the person named by the Owner as “Contingent Owner” in the Company’s prescribed form,

who may become the Owner pursuant to the “Change of Ownership” provisions under the OWNERSHIP PROVISIONS of

the Policy. It is only applicable for Policy with Insured under 18 years old when the Policy is issued.

“Continuous Physical Stay” or “Stay” means the continuous physical presence of the Insured as an In-Patient on the

Hospital premises, without any physical absence or interruption throughout the period commencing from the Insured’s

admission to a Hospital until his full and formal Discharge therefrom.

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“Covered Cancer” means Cancer occurring more than 90 days after the later of the Issue Date and the latest Commencement

Date of this Policy. For this purpose, a Cancer is regarded as having occurred when it has been investigated, diagnosed or

treated or when its signs or symptoms have manifested which will cause an ordinary prudent person to seek diagnosis, care or

treatment. In the event of any conflict or discrepancy of opinions relating to the signs or symptoms of a Cancer and their

manifestation between a Registered Medical Practitioner or Surgeon and the Insured, we will adopt and follow the Registered

Medical Practitioner or Surgeon’s professional opinion.

“Covered Cancer Limit” as shown on the Schedule of Benefits, means the maximum aggregate amount paid or payable in

respect of the benefits under Parts I-IV of the BENEFIT PROVISIONS for any and all Covered Cancer suffered by the

Insured for every three (3) consecutive years during the Term, provided that Covered Cancer Limit shall be deemed to be zero

upon the total aggregate amount paid under Parts I-IV of the BENEFIT PROVISIONS during the lifetime of the Insured

reaching the Lifetime Cancer Limit.

“Designated Plans” means the following insurance policies covering the Insured and issued by us:

(a) Plus Plan of Cancer Guardian 2 series;

(b) Mega Plan of Cancer Guardian 2 series;

(c) Plus Plan of Cancer Guardian Pearl 2 series; and

(d) Mega Plan of Cancer Guardian Pearl 2 series.

“Diagnosis” or “Diagnosed” means the definitive diagnosis made by a Registered Medical Practitioner as defined below,

based upon specific condition(s) referred to in the definition of the condition, illness or disease concerned or, in the

absence of such specific condition(s), based upon radiological, clinical, histological or laboratory evidence of the relevant

condition, illness or disease acceptable to the Company. Such Diagnosis must be supported by the Company’s Medical

Director who may base his opinion on the medical evidence submitted by the Insured and / or Owner and / or any

additional evidence he may require.

In the event of any dispute or disagreement regarding the appropriateness or correctness of the Diagnosis, the Company

shall have the right to call for an examination, of either the Insured or the evidence used in arriving at such Diagnosis, by

an independent Registered Medical Practitioner with expertise in the field of medicine concerned selected by the Company

and the opinion of such expert as to such Diagnosis shall be binding on both the Insured and the Company.

“Diagnostic Test” shall mean any test or investigation modality which is Medically Necessary to positively Diagnose a

Covered Cancer, including but not limited to laboratory tests, X-rays, computerized tomography (CT), magnetic resonance

imaging (MRI), positron emission tomography (PET), fine needle aspiration for cytology or histopathology, or excisional

biopsy for histopathology. Genetic testing to aid the identification of appropriate chemotherapy drugs is also included.

“Discharge” means the departure of the Insured from the Hospital (whether to return home or for transfer to another

Hospital or facility), following finalization of all formal procedures within the Hospital to end the Confinement and billing

of outstanding charges for full settlement, with no room or bed retained for the Insured at the Hospital.

“Grace Period” has the meaning ascribed to such term under the PREMIUM PROVISIONS.

“HIV Infection” shall be deemed to have occurred where blood or other relevant test(s) indicate, in the opinion of the

Company, either the presence of any Human Immunodeficiency Virus, antigens or antibodies to such a virus.

“Hospital” means a lawfully operated institution licensed as a hospital for the care and treatment of injured or ill persons

which provides facilities for diagnosis, major surgery and 24-hour nursing service and is not primarily a rest or convalescent

home, or similar establishment or, other than incidentally, a place for alcoholics or drug addicts.

“Immediate Family Member” means the legally married spouse or a child or parent of the Insured or the Owner (as the

case may be).

“Independent Person” means a person other than (a) you or the Insured; (b) an Immediate Family Member of yours or the

Insured; (c) a business partner of yours or the Insured; (d) the employer or employee of either yourself or the Insured; (e) an

insurance agent of the Company; or (f) an insurance representative of yours or the Insured.

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“In-Patient” means the Confinement of the Insured for a Covered Cancer as a registered resident bed patient where the

Insured uses and is charged for room and board facilities of the Hospital.

“Insured” means the person as shown on the Policy Information Page as the “Insured”.

“Intensive Care Unit” (ICU) means a section within a Hospital which is designated as an intensive care unit by the

Hospital providing one to one nursing care, in which patients undergo specialized resuscitation, monitoring and treatment

procedures. The unit must be staffed 24 hours a day with highly trained nurses, technicians and doctors, and be equipped

with resuscitative equipment and monitoring devices that allow continuous assessment of vital body functions such as heart

rate, blood pressure and blood chemistry.

“Issue Date” means the date shown on the Policy Information Page as the “Issue Date” and the date on which the Policy

came into force.

“Issuing Office” means: 1) where this Policy is issued in Hong Kong, AIA International Limited in Hong Kong at the address

shown on the Policy Information Page; 2) where this Policy is issued in Macau, AIA International Limited in Macau at the

address shown on the Policy Information Page; or 3) such other address (if any) as we may notify you in writing from time to

time.

“Licensed or Graduate Nurse” means an Independent Person who, upon successful completion of a course at a recognized

college or school of nursing, is legally authorized by the government of the geographical area of his practice to render nursing

services.

“Lifetime Cancer Limit” as shown on the Schedule of Benefits, means the maximum aggregate amount paid or payable

during the lifetime of the Insured in respect of the benefits under Parts I-IV of the BENEFIT PROVISIONS.

For the avoidance of doubt, only benefits paid or payable under Parts I-IV of the BENEFIT PROVISIONS up to the Covered

Cancer Limit are included in the Lifetime Cancer Limit, and any amounts paid or payable under Parts I-IV of the BENEFIT

PROVISIONS in excess of the Covered Cancer Limit up to the limit of Target Protection Benefit pursuant to Part V of the

BENEFIT PROVISIONS are excluded from the Lifetime Cancer Limit.

“Medically Necessary” is a medical service, procedure or supply, which in the Company's opinion:

(a) is consistent with generally accepted professional standards of medical practice;

(b) is required to establish a Diagnosis and/or to provide treatment; and

(c) cannot be safely delivered at a lower level of medical care.

Experimental, screening and preventive services or supplies are not considered Medically Necessary.

“Out-Patient” means an Insured who receives services and supplies in connection with treatment for Covered Cancer

given in the clinic of a Registered Medical Practitioner, a Registered Chinese Medicine Practitioner, a day surgery centre,

or in the out-patient department, emergency treatment room or day surgery centre of a Hospital.

“Owner”, “you” or “your” is the person who owns this Policy and shown on the Policy Information Page as the “Owner”,

subject to the “Change of Ownership” provisions under the OWNERSHIP PROVISIONS of this Policy, if applicable.

“Palliative Treatment” means treatment intended only to improve the quality of the Insured’s life in the case of a life

threatening Covered Cancer by relieving pain or alleviating other symptoms of the Covered Cancer and/or complication(s)

thereof, or the side effects of its/their treatment, without any attempt at its/their cure.

“Policy” consists of:

(a) Basic Policy (including schedules);

(b) Policy Information Page;

(c) application for the Basic Policy and for Supplementary Contracts (if any), including the application forms (if any), any

subsequent amendments, declarations and statement duly made by the Owner and/or the Insured;

(d) endorsements to this Policy (if any); and

(e) Supplementary Contacts (if any).

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“Policy Anniversary” refers to the same date in each subsequent year as the Policy Date. If the Policy Date is 29 February of

a leap year, then the Policy Anniversary will be 28 February in a non-leap year.

“Policy Date” means the date shown on the Policy Information Page as “Policy Date” and the date from which Policy Years,

policy months, Policy Anniversaries and Premium Due Dates are determined.

“Policy Debt” means the aggregate amounts that you owe us under this Policy, including any accrued interest.

“Policy Information Page” means the schedule to the Basic Policy headed “Policy Information Page”.

“Policy Year” means each twelve-month period starting on the Policy Date.

“Pre-existing Condition” means (1) any physical, medical or mental condition or (2) any illness or disease:

(a) that existed;

(b) that was investigated, Diagnosed, or treated by a Registered Medical Practitioner;

(c) for which a Registered Medical Practitioner was consulted; or

(d) the signs or symptoms of which commenced,

before the later of the Issue Date and the latest Commencement Date.

“Premium Due Date” refers to the date when the premium payment is due and payable under this Policy and as described on

the Policy Information Page or as stated on our written notification as may be amended from time to time.

“Psychological Counselling” means counselling or consultation with a Registered Psychiatrist / Registered Clinical

Psychologist for the psychiatric management of a mental, behavioural, psychiatric or psychological disorder but not limited to

anxiety, anorexia, depression, stress, fatigue, or psychiatric complications of physical disorders, cognitive impairment and

sleep disorders.

“Reasonable and Customary” in relation to a fee, a charge or an expense, means any fee or expense which (a) is charged

for treatment, supplies (inclusive of medication) or medical services that are Medically Necessary and in accordance with

standards of good medical practice for the care or treatment of an ill person under the care, supervision or order of a

Registered Medical Practitioner; (b) does not exceed the usual level of charges for similar treatment, supplies (inclusive of

medication) or medical services in the locality where the expense is incurred, which for the avoidance of doubt, shall not

exceed the level of such charges applicable to a Semi-Private Room for treatment, supplies (inclusive of medication) or

medical services provided during a covered Confinement; and (c) does not include charges that would not have been made

if no insurance existed. The Company reserves the right to determine whether any particular Hospital/medical charge is a

Reasonable and Customary charge with reference but not limited to any relevant publication or information made available,

such as schedule of fees, by the government, relevant authorities and recognized medical association in the locality. The

Company reserves the right to adjust any and all benefits payable in relation to any Hospital/medical charges which in the

opinion of the Company’s Medical Director is not a Reasonable and Customary charge.

“Reasonable and Customary Hospital Confinement” in relation to a Confinement, means a Confinement in Hospital for

a Covered Cancer which is Medically Necessary, where the admission of the Insured, length of Confinement, and medical

services and treatment received during Confinement: (a) are all in accordance with standards of good medical practice; and

(b) do not exceed the usual standard for the treatment of such Covered Cancer at the location where such Confinement

takes place. For the avoidance of doubt, a Confinement is not a Reasonable and Customary Hospital Confinement if it is in

respect of a medical procedure or treatment which, having regard to standards of good medical practice: i) is routinely

performed on other patients on an Out-Patient basis; and ii) could reasonably have been performed on the Insured as an

Out-Patient.

“Reconstructive Surgery” means the actual undergoing of plastic or reconstructive surgery on the head or on the breast

which is deemed to be Medically Necessary to restore function or appearance following previous surgery on the head or breast

done for treatment of a Covered Cancer. Surgery solely for isolated dental restorations is excluded.

“Registered Chinese Medicine Practitioner” means an Independent Person who is an herbalist or an acupuncturist

registered with the Chinese Medicine Council of Hong Kong according to the Chinese Medicine Ordinance or with the

local medical authorities at the place of treatment if such treatment is received outside Hong Kong.

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“Registered Dietician” means an Independent Person who is legally authorized in the geographical area of his practice to

render dietician consultation services.

“Registered Medical Practitioner” or “Surgeon” means an Independent Person qualified by degree in western medicine

who is licensed to practice western medicine and legally authorized in the geographical area of his practice to render medical

or surgical services.

“Registered Physiotherapist” means an Independent Person who is qualified and legally authorized in the geographical area

of his practice to render assessment and treatment service on physical disability by means of cryotherapy, heat therapy,

electrotherapy, manual therapy, traction, exercise therapy, hydrotherapy and acupuncture.

“Registered Psychiatrist” or “Registered Clinical Psychologist” means an Independent Person who is qualified by degree

in psychiatry or psychology (respectively) and is legally authorized in the geographical area of his practice to render

psychiatric or psychological services, respectively.

“Schedule of Benefits” means the Schedule of Benefits appended to this Policy.

“Semi-Private Room” means a single or double occupancy room, with a shared bath/shower room, in a Hospital.

“Special Terms” means the special terms you have agreed for your Policy, if any, (including, but not limited to, special terms

to reflect increased risks in relation to residence, nationality or health).

“Supplementary Contract” means the terms and conditions set out in any supplementary contract or rider to the Basic

Policy in relation to benefits supplemental to your Basic Policy benefits.

“Term” means a period starting on the date of first Diagnosis of the first Covered Cancer suffered by the Insured and ending

on the date when the total aggregate amount paid under Parts I-IV of the BENEFIT PROVISIONS during the lifetime of the

Insured reaches the Lifetime Cancer Limit.

GENERAL INTERPRETATION AND APPLICATION

Where the context requires, words importing one gender shall include the other gender, and singular terms shall include the

plural and vice versa.

Headings are for convenience only and shall not affect the interpretation of this Policy. References to sections, clauses,

provisions and schedules are to sections, clauses, provisions and schedules to this Policy.

Schedules to this Policy form part of this Policy.

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BENEFIT PROVISIONS

While this Policy is in force and during the Insured’s lifetime, following Diagnosis of a Covered Cancer or any complication

of Covered Cancer suffered by the Insured, we will reimburse the Reasonable and Customary charges for actual charges

incurred pursuant to Parts I-VI herein (except Part VI.1, VI.2, VI.3 and VI.4), or pay the benefit(s) under Part VI.1, VI.2, VI.3,

VI.4 and/or Part VII, subject to the following:

i) the terms and conditions of the Policy (including but not limited to the “Limitations of Benefits” and “Limitations of

Confinement Benefits” sections);

ii) the Covered Cancer Limit for the benefits under Parts I-IV herein;

iii) the Lifetime Cancer Limit for the benefits under Parts I-IV herein;

iv) the maximum limits shown in the Schedule of Benefits for the benefits under Part V (Target Protection Benefit) and

Part VI (Additional Caring Benefits ) herein; and

v) the benefits under Part II.1(f), Part V (Target Protection Benefit) and Part VI.4 herein are only available for

Designated Plans.

For purposes of applying the Covered Cancer Limit, there shall only be one and the same Covered Cancer Limit for all

Covered Cancers suffered by the Insured for every three (3) consecutive years during the Term.

Once the aggregate amount paid or payable in respect of benefits under Parts I-IV herein reaches the Lifetime Cancer

Limit as shown on the Schedule of Benefits, coverage under the BENEFIT PROVISIONS will automatically cease and this

Policy shall terminate.

PART I DIAGNOSTIC BENEFIT

(a) Subject to the Covered Cancer Limit and Lifetime Cancer Limit, we shall reimburse the Reasonable and Customary

charges actually incurred for any Medically Necessary Diagnostic Test(s) which directly confirms the positive

Diagnosis of Covered Cancer undergone by the Insured in a Hospital or a clinic under the supervision of a

Registered Medical Practitioner.

For the avoidance of doubt, any charges incurred in respect of routine health screenings which are not for the

specific purpose of identifying the existence, nature or extent of a Covered Cancer shall not be covered, regardless

of the results of the related tests/procedures.

(b) If the Insured is Confined in Hospital for performance of a Diagnostic Test and such Confinement is Medically

Necessary for performing the Diagnostic Test, we shall also reimburse the Reasonable and Customary charges

actually incurred for such Confinement (based on the level of such charges applicable to Confinement in a Semi-

Private Room) pursuant to Part II.1 (Hospitalisation And Treatment Benefits).

PART II CANCER TREATMENT BENEFITS

Subject to the Covered Cancer Limit and Lifetime Cancer Limit, we shall reimburse the Reasonable and Customary charges

actually incurred for consultation and/or treatment for the Insured, either on an In-patient or Out-patient basis, for Active

Treatment or Palliative Treatment of a Covered Cancer and/or any complication(s) thereof, including the following:

1. Hospitalisation And Treatment Benefits

If the Insured is Confined in Hospital for Active Treatment or Palliative Treatment of a Covered Cancer, we shall

reimburse the Reasonable and Customary charges actually incurred (based on the level of such charges applicable

to Confinement in a Semi-Private Room) for:

a. hospital daily room and board during the Insured’s Confinement;

b. any visits made by the Insured’s attending Registered Medical Practitioner to the Insured at his Hospital bed

during his Confinement;

c. Intensive Care Unit (ICU) charges made by the Hospital;

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d. Surgical expenses, including:

the Surgeon’s fees;

the Anaesthetist’s fees; and

charges for use of the operating theatre (including the items and equipment used in the operating theatre);

e. Miscellaneous hospital expenses, including:

Drugs and medicines prescribed by the Insured’s attending Registered Medical Practitioner and consumed

in the Hospital;

Dressing, ordinary splints and plaster casts but excluding special braces, artificial limbs, appliances and

equipment;

Laboratory examinations;

Electrocardiograms;

Basal Metabolism Tests;

Physiotherapy;

X-ray examinations;

Intravenous injections and solutions;

Administration of blood and blood plasma but excluding costs of blood or blood plasma; and

Ambulance service to or from the Hospital of Confinement; and

f. Hospital Companion Bed, including one (1) extra bed for one (1) person who accompanies the Insured in the

Hospital. This benefit is only available for Designated Plans.

2. Day Treatment and Surgery

a. We shall reimburse the Reasonable and Customary charges for consultation and treatment actually incurred

for Active Treatment or Palliative Treatment of the Insured by a Registered Medical Practitioner on an Out-

patient basis, including but not limited to radiotherapy, chemotherapy, targeted therapy, hormonal therapy,

immunotherapy, proton therapy and day surgery. For the avoidance of doubt, the covered Reasonable and

Customary charges actually incurred for radiotherapy include the consultation fee for the planning session

and consumables specified for the purpose of radiotherapy.

b. We shall also reimburse the Reasonable and Customary charges actually incurred for medication prescribed

by the Insured’s attending Registered Medical Practitioner for Active Treatment or Palliative Treatment of

the Insured, including anti-nausea drugs, anti-rejection drugs, anti-vertigo drugs and anti-anodyne. Long-term

medication for Active Treatment or Palliative Treatment of the Insured, including but not limited to hormonal

therapy prescribed by the Insured’s attending Registered Medical Practitioner subsequent to surgery for

Active Treatment or Palliative Treatment of the Insured, is also covered.

PART III RECONSTRUCTIVE SURGERY BENEFIT

Subject to the Covered Cancer Limit and Lifetime Cancer Limit, we shall reimburse the Reasonable and Customary charges

actually incurred for Reconstructive Surgery performed on the Insured which is recommended in writing by the Insured’s

attending Registered Medical Practitioner, including the Reasonable and Customary charges actually incurred for:

a. the Surgeon’s fees;

b. the Anaesthetist’s fees;

c. charges for use of the operating theatre (including the items and equipment used in the operating theatre); and

d. the cost of any implants.

If the Insured’s Confinement in the Hospital is Medically Necessary for such Reconstructive Surgery, subject to the

Covered Cancer Limit and Lifetime Cancer Limit, we shall also reimburse the Reasonable and Customary charges actually

incurred for such Confinement (based on the level of such charges applicable to Confinement in a Semi-Private Room)

pursuant to Part II.1 (Hospitalisation And Treatment Benefit).

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PART IV MONITORING BENEFIT

Subject to the Covered Cancer Limit and Lifetime Cancer Limit, in addition to any Diagnostic Tests to directly confirm a

positive Diagnosis of Covered Cancer covered under Part I.(a) herein, for up to five (5) years from the date of completion of

Active Treatment on the Insured, we shall reimburse the Reasonable and Customary charges actually incurred in respect of the

consultation fee as well as laboratory tests, imaging procedures or screening tests undertaken to monitor the Insured’s

response to treatment and progress of the Insured’s recovery after completion of treatment and/or consultation(s) covered

under Part II herein.

If the Insured’s Confinement in Hospital is Medically Necessary for such monitoring, subject to the Covered Cancer Limit

and Lifetime Cancer Limit, we shall also reimburse the Reasonable and Customary charges actually incurred for such

Confinement (based on the level of such charges applicable to Confinement in a Semi-Private Room) pursuant to Part II.1

(Hospitalisation and Treatment Benefits).

Any routine health screening carried out which is not directly due to the Covered Cancer shall not be covered.

For the avoidance of doubt, this Benefit only covers eligible charges incurred following completion of Confinement, Active

Treatment or Palliative Treatment of the Insured covered under Part II herein. Any charges incurred for Confinement,

treatment, consultation and/or medication for a Covered Cancer or any complication(s) thereof are not covered hereunder but

shall be covered only in accordance with the provisions of Part II herein.

PART V TARGET PROTECTION BENEFIT

This benefit is only available for Designated Plans.

Subject to the “Termination” provisions under the GENERAL PROVISIONS and other applicable terms and conditions of the

Policy, if the Insured is diagnosed with any of the following Covered Cancers:

(a) any Covered Cancer which has been classified as Stage IV malignant tumour pursuant to the American Joint

Committee on Cancer (AJCC) staging system;

(b) Liver Cancer;

(c) Brain Cancer;

(d) Blood Cancer; and

(e) Lymphoma,

there shall be an additional benefit amount equals to 50% of the Covered Cancer Limit for (1) total benefits which may be

claimed under Parts I-IV herein and (2) such Covered Cancers specifically mentioned in this Part V, provided that this benefit

shall only be utilised one time only while this Policy is in force.

PART VI ADDITIONAL CARING BENEFITS 1. 1-Year Waiver of Premium

Upon the first Diagnosis of first Covered Cancer (excluding Carcinoma-in-situ for the purpose of this section)

suffered by the Insured, we shall waive the premiums payable under this Policy for one (1) year. The first premium

to be waived shall be the one falling due immediately after the date following the first Diagnosis of first Covered

Cancer (excluding Carcinoma-in-situ for the purpose of this section) suffered by the Insured, except any premium

falling due shall continue to be paid pending our approval of a claim hereunder. Following such approval, we shall

refund any premiums (without interest) paid which are later waived hereunder.

Regardless of the mode of payment of premiums selected under the Policy, any waiver of premiums hereunder shall

be effected as if the Policy were on a monthly premium mode. However, there shall be no waiver of any premium

the due date of which is more than one (1) year before the day of receipt by us of written notice of claim for waiver

of premiums hereunder.

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2. Daily Hospital Cash Benefit for ICU

For any Confinement which is covered under Part II.1 (Hospitalisation and Treatment Benefit), we shall pay a

daily Hospital Cash benefit in the amount shown on the Schedule of Benefits for each day of Confinement of the

Insured in the Intensive Care Unit (ICU). This benefit is restricted to one payment of Hospital Cash benefit for

each day of Confinement in the ICU, and is subject to the maximum number of days per Policy specified in the

Schedule of Benefits.

3. Daily Hospital Cash Benefit for Long Term Hospitalisation

We shall pay a Daily Hospital Cash Benefit in the amount shown on the Schedule of Benefits for each day of

Confinement of the Insured for a Covered Cancer commencing from the thirty-first (31st) day of a covered

Confinement after a Continuous Physical Stay of thirty (30) days. This benefit is restricted to one payment of

Hospital Cash Benefit per day and is subject to the maximum number of days per Policy specified in the Schedule

of Benefits.

4. Transportation Fee Subsidy

This benefit is only available for Designated Plans.

We shall pay the Transportation Fee Subsidy in the amount shown on the Schedule of Benefits for each day on

which the Insured receives medical treatment or undergoes surgery, tests, procedures or Confinement covered

under Parts I-VI herein. This benefit is restricted to one payment of Transportation Fee Subsidy per day,

regardless of the number of eligible procedures or treatments received or consultation visits made by the Insured,

and is subject to the maximum number of days per Policy specified in the Schedule of Benefits.

5. Registered Chinese Medicine Practitioner Consultation and Chinese Medicines

We shall reimburse the Reasonable and Customary charges actually incurred for the Insured’s Out-patient

consultation visit(s) with, and Chinese medicines prescribed by, a Registered Chinese Medicine Practitioner for a

Covered Cancer. This benefit is restricted to one (1) visit per day and is subject to the maximum limit per visit

and the maximum number of visits per Policy specified in the Schedule of Benefits.

6. Registered Physiotherapist Consultation

We shall reimburse the Reasonable and Customary charges actually incurred for the Insured’s consultation visit(s)

with a Registered Physiotherapist for a Covered Cancer. This benefit must be recommended by a Registered

Medical Practitioner. This benefit is restricted to one (1) visit per day and is subject to the maximum limit per

visit and the maximum number of visits per Policy specified in the Schedule of Benefits.

7. Registered Dietician Consultation

We shall reimburse the Reasonable and Customary charges actually incurred for the Insured’s consultation visit(s)

with a Registered Dietician for a Covered Cancer. This benefit must be recommended by a Registered Medical

Practitioner. The benefit is restricted to one (1) visit per day and is subject to the maximum limit per visit and the

maximum number of visits per Policy specified in the Schedule of Benefits.

8. Psychological Counselling

We shall reimburse the Reasonable and Customary charges actually incurred for consultation visit(s) by the

Insured and/or an Immediate Family Member with a Registered Psychologist or a Psychiatrist for Psychological

Counselling in relation to the Insured’s Covered Cancer. This benefit is capped at one (1) visit for the Insured and

one (1) visit for one (1) Immediate Family Member per day, and is subject to the maximum limit per visit and the

maximum number of visits per Policy specified in the Schedule of Benefits.

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9. Preventive Check-up for Immediate Family Members

We shall reimburse the Reasonable and Customary charges actually incurred for Diagnostic Tests undertaken by

Immediate Family Members for health screening, which shall be related directly to the type of Covered Cancer

that the Insured is Diagnosed with, as recommended by a Registered Medical Practitioner within one hundred and

twenty (120) days following the first Diagnosis of any Covered Cancer that the Insured is Diagnosed with. This

benefit covers up to two (2) Immediate Family Members and is subject to the maximum limit per Policy specified

in the Schedule of Benefits.

10. Home Nursing

We shall reimburse the Reasonable and Customary charges actually incurred for Medically Necessary nursing

services provided to the Insured by a Licensed or Graduate Nurse in the Insured’s home after the Insured’s

Discharge from Hospital following Confinement or surgery covered under Part II herein. This benefit must be

prescribed by the Insured’s attending Registered Medical Practitioner and relate directly to the Confinement of the

Insured and/or surgery performed on the Insured for a Covered Cancer.

This benefit is restricted to nursing services provided by a maximum of one (1) Licensed or Graduate Nurse

during any given time slot, and is subject to the maximum limit per day and the maximum number of days (during

which nursing services are provided for all or part of the day) per Policy specified in the Schedule of Benefits.

11. Medical Appliances

Subject to the maximum limit per Policy specified in the Schedule of Benefits, we shall reimburse the Reasonable

and Customary charges actually incurred for the purchase and / or rental of medical appliances related to Covered

Cancer which are Medical Necessary and recommended by a Registered Medical Practitioner.

12. Wig and Voice Box Expenses

Subject to the maximum limit per Policy specified in the Schedule of Benefits, we shall reimburse the Reasonable

and Customary charges actually incurred for the purchase of a wig and / or voice box for the Insured provided that

the charges for chemotherapy and / or radiotherapy have been actually incurred and are payable under Part II herein.

PART VII COMPASSIONATE DEATH BENEFIT

Upon the death of the Insured, we shall pay to the Beneficiary the Compassionate Death Benefit as shown in the Schedule

of Benefits provided proof of such death is furnished to the Company. If the Insured, whether sane or insane, commits

suicide within one (1) year from the Issue Date or Commencement Date, whichever is later, our liability under the Policy

will be limited to the refund of premiums paid (without interest) less any Policy Debt.

*** End of Page ***



LIMITATIONS OF BENEFITS

We are not liable for any Confinement, surgery and/or medical treatment for which compensation or reimbursement is

payable under any law, medical program, or insurance policy provided by any government, company or other insurer except

to the extent that such charges are not reimbursed by such law, medical program or insurance policy.

If the Insured is Confined in a room of the class above Semi-Private Room, whether voluntarily or involuntarily, on any

days of a Confinement, any reimbursable charges under Parts I-V herein in relation to such days of Confinement shall be

reduced by multiplying an adjustment factor (“Adjustment Factor”). The Adjustment Factor is calculated by dividing the

daily room charge of a Semi-Private Room in the Hospital admitted by the Insured by the daily actual room charge of each

such days of Confinement.

If the relevant Reasonable and Customary charge for actual charges is incurred in the United States, the following

limitations on benefits shall apply:

(a) The maximum aggregate amount paid or payable in respect of the benefits under Parts I-IV of the BENEFIT

PROVISIONS and benefits payable under any Target Protection Benefit pursuant to Part V of the BENEFIT

PROVISIONS (if applicable) for any one Covered Cancer under all cancer protection insurance policies (including

this Policy) covering the Insured and issued by us will be capped at HK$/ MOP 2,000,000 / US$250,000. The

Company shall have absolute discretion to determine whether an insurance policy covering the Insured falls within the

definition of a cancer protection insurance policy for the purpose of this section; and

(b) The maximum aggregate amount paid or payable in respect of the benefits under Parts I-IV of the BENEFIT

PROVISIONS and benefits payable under any Target Protection Benefit pursuant to Part V of the BENEFIT

PROVISIONS (if applicable) under this Policy for any and all Covered Cancer will be capped at HK$/ MOP

2,000,000 / US$250,000.

Notwithstanding reduction of any benefits in accordance with the above, and for the avoidance of doubt, the Covered

Cancer Limit and Lifetime Cancer Limit shall otherwise remain unchanged.

LIMITATIONS OF CONFINEMENT BENEFITS

For benefits relating to Confinement, the Confinement must be evidenced by a daily room/room & board charge by the

Hospital. We will not be liable to pay any benefit:

(a) for more than one daily room/room & board charge for each day of Confinement; or

(b) for any Confinement that is not a Reasonable and Customary Hospital Confinement.

REVISION OF BENEFIT STRUCTURE AND/OR LIMITATIONS

On any Policy Anniversary or renewal, by giving a thirty-one (31) days prior notice in writing by ordinary post to the

Owner’s last known address in the Company’s records, the Company reserves the right to revise, amend or modify the

benefit structure and/or restrictions/limitations and/or the premium, including but not limited to the Schedule of Benefits,

and/or any other items of benefits or coverage as determined by the Company.

In the event that the Owner disagrees with such revision and notifies the Company in writing within thirty (30) days after

such revision takes effect, this Policy and all its Supplementary Contracts attached hereto (if any) shall automatically

terminate on the Premium Due Date following our receipt of such notice.

Any change of benefits or coverage under this Policy as requested by the Owner shall only take effect subject to the

approval by the Company and on the Policy Anniversary or renewal.

An appropriate endorsement shall be issued following each revision together with the revised Schedule of Benefits.

*** End of Page ***



EXCLUSIONS

Except for Compassionate Death Benefit under Part VII above, this Policy does not cover any Covered Cancer resulting

directly or indirectly from or in respect of any of the following or any event which arises from the following:

(a) any tumour which is histologically classified as pre-malignant;

(b) abnormal lesions of cervix uteri classified as cervical intra-epithelial neoplasia grade I (CIN I) and grade II (CIN II);

(c) any drug or alcohol abuse;

(d) any Pre-existing conditions;

(e) nuclear, biological or chemical contamination (NBC); and

(f) the Confinement, treatment, surgery and/ or charges relating to or caused directly or indirectly, wholly or partly, by any

of the following:

(1) general check-up (whether with or without any positive findings(s) on the Insured), convalescence, custodial or rest

care not related to the Covered Cancer; screening or checkups looking for the presence of Covered Cancer on a

preventative basis or where there are no symptoms or history of Covered Cancer; vaccines for the prevention of

Covered Cancer;

(2) disease or infection with any human immunodeficiency virus (HIV) and/or any HIV-related illness;

(3) any treatment, tests, service or supplies which is not Medically Necessary or any charges which exceed the

Reasonable and Customary charges;

(4) narcotics used by the Insured unless taken as prescribed by a Registered Medical Practitioner;

(5) mental disorder, psychological or psychiatric conditions, behavioural problems or personality disorder unless such

occurrence is covered by Psychological Counselling under Part VI.8;

(6) any congenital Covered Cancer gives rise to signs or symptoms, or was diagnosed, before the Insured attains

seventeen (17) years of age;

(7) any services primarily for physiotherapy or for the investigation of signs and/ or symptoms with diagnostic imaging,

laboratory investigation or other diagnostic procedures unless they are covered by Diagnostic Benefit under Part I;

(8) non-medical services, including but not limited to guest meals, radio, telephone, photocopy, taxes, personal items,

medical report charges and the like;

(9) any experimental, unproven or unconventional medical technology/ procedure/ therapy or novel drugs/ medicines/

stem cell therapy not yet approved by the government, relevant authorities and/ or recognized medical association of

the country or region where the treatment is sought;

(10) genetic testing undertaken to test for a genetic predisposition to Covered Cancer;

(11) any treatment modality undergone without a definite Diagnosis of the presence of Covered Cancer in the Insured’s

body as per the definition specified; and

(12) over-the-counter medication and nutrient supplement not prescribed by a Registered Medical Practitioner.

*** End of Page ***



CLAIM PROCEDURES (1) NOTICE OF CLAIM

All cases of death must be notified immediately to us in writing. Other claims must be submitted to us within twenty

(20) days after the date the covered event happens. Failure to give notice within such time shall not invalidate any claim

if it shall be shown not to have been reasonably possible to give such notice and that notice was given as soon as

reasonably possible. The claims against this Basic Policy and any Supplementary Contracts attached hereto are assessed

independently of each other and it may lead to different claim decisions.

(2) FILING PROOF OF CLAIM

Affirmative proof of loss and any appropriate forms as required by us must be completed and furnished to us, at the

claimant’s expenses, within ninety (90) days after the date the covered event happens, unless specified otherwise. We

reserve the right to require any additional proof and documents in support of the claim. The original copies of the

official statement of accounts and receipts showing the itemized expenses are required.

(3) MEDICAL EXAMINATION

We reserve the right to require any additional proof and request medical examination of the Insured. In case of death,

we may require, if appropriate and legally allowable, an autopsy.

(4) CANCELLATION

If you or the claimant submits a claim which is in any respect fraudulent, unfounded, incorrect, incomplete or

misleading, or if you or the claimant withhold any information or conspire with a third party to obtain a benefit from

this Policy, we shall have the right to cancel this Policy immediately. In any of these circumstances, we shall also have

the right to recover from you or the claimant any benefit we have already paid to you or the claimant in relation to any

claim which is not eligible.

(5) DEDUCTION OF PREMIUM AT DEATH

If the Insured dies, any balance of the premium due for the full Policy Year in which death occurs shall be deducted

from the proceeds payable under the Policy.

*** End of Page ***



GENERAL PROVISIONS

THE CONTRACT

Your Policy is a legally enforceable agreement between you and us. This Policy comes into force on the Issue Date provided

you have paid the full amount of the first premium and have submitted a signed and dated application.

The plan name of the Basic Policy and the product and/or code name and form number of any Supplementary Contract

attached hereto are shown under the Schedule of Benefits and Premiums of the Policy Information Page.

We rely on the information you provide in your application in deciding whether or not to accept your application. We also rely

on such information to decide at our sole and absolute discretion whether or not to apply Special Terms to your Policy. We

will treat all statements made in your application (in the absence of fraud) to be representations and not warranties.

If your application omits facts or contains materially incorrect or incomplete facts, we have the right to declare the Policy

void. Alternatively, we may impose Special Terms on your Policy that will apply from the date on which the cover

commences.

MISSTATEMENT OF AGE AND SEX

If the Insured’s age and sex was misstated in your application, the amount payable by us under your Policy will be adjusted at

the time we make any payment under the Policy.

Where a higher premium would have applied on the basis of the correct age and sex, we will adjust the benefit payable based

on what the premiums paid would have provided at the Insured’s correct age and sex.

Where a lower premium would have applied on the basis of the correct age and sex, we will refund any surplus premium paid

without interest.

Where the Insured would not have satisfied our insurability requirements on the basis of the correct age and sex, we have the

right to declare the Policy or the Supplementary Contract void (as the case may be) and our liability under the Policy or the

Supplementary Contract (as the case may be) will be limited to return the premiums paid (without interest).

We have the right to require proof of the Insured’s age to our satisfaction at the time of processing any claim or payment of

any benefit under your Policy.

INCONTESTABILITY

Except for fraud or non-payment of premiums, we will not contest the validity of this Policy after it has been in force during

the lifetime of the Insured for a continuous period of two (2) years from the Issue Date or Commencement Date, whichever is

later.

This “Incontestability” provision does not apply to any Supplementary Contract providing accident, hospitalisation or

disability benefits.

SMOKING HABIT

This Basic Policy is issued or reinstated on the basis of the Insured’s declared smoking habits. If the Insured is a smoker as at

the date of the application form for the Basic Policy or as at the date of the appropriate form for reinstatement of the Basic

Policy but you and / or the Insured do not disclose the same to us in the relevant form, this Basic Policy shall be voidable by

the Company notwithstanding any other provision of the Policy (including, but not limited to, any incontestability clause in

this Policy).

MODIFICATIONS

No variation to this Policy (or any waiver of any term or condition of the Policy) will be binding unless evidenced by an

endorsement signed by our duly authorized officer.

CURRENCY AND PLACE OF PAYMENT

All amounts payable under this Policy either to or by us shall be made in the currency shown on the Policy Information Page

provided that we shall have the absolute discretion to accept payment in another currency. All amounts due from us will be

payable by our Issuing Office.

*** End of Page ***



OWNERSHIP PROVISIONS

Owner

The Owner is the only person entitled to exercise any right or privilege provided under this Policy.

Change of Ownership

While this Policy is in force, you may, without the consent of the Beneficiary or trustee, change ownership of this Policy

by filing a written notice on the Company’s prescribed form. Any change of ownership of this Policy shall be conditional

upon the satisfaction of customer due diligence and other applicable requirements under Anti-Money Laundering and

Counter-Terrorist Financing Ordinance and other applicable guidelines, and any such change will not be effective until

such change is evidenced by an endorsement issued by us. We are not responsible for any written notice of a change of

ownership received by us pending issue of an endorsement.

If and when the Owner dies:

(a) If the Insured is 18 years old or above and no Contingent Owner is named, the Insured will become the Owner of this

Policy.

(b) If the Insured is 18 years old or above and a Contingent Owner is named, the Insured will become the Owner of this

Policy.

(c) If the Insured is less than 18 years old and a Contingent Owner is named, the Contingent Owner will become the

Owner of this Policy.

(d) If the Insured is less than 18 years old and no Contingent Owner is named, the successor to the Owner’s estate will

become the Owner of this Policy.

PAYMENT OF BENEFITS

During the lifetime of the Insured, all benefits (except death benefit) payable under the Policy will be paid to the Owner if

the Owner is alive, otherwise to the Owner’s estate.

If the Insured dies, unless otherwise provided under applicable law, any death benefit payable under the Policy will be paid

to the Beneficiary. If no Beneficiary survives the Insured, the death benefit and all other benefits, if any, will be paid to the

Owner if the Owner is alive, otherwise to the Owner’s estate.

Payment of the death benefit and all other benefits payable under this Policy (or Supplementary Contracts) to the above

person(s) in the manner pursuant to this clause shall be deemed a good and full discharge of the Company’s obligations under

this Policy (or Supplementary Contracts).

CHANGE OF BENEFICIARY

While your Policy is in force and to the extent permitted by law, you may change the designated Beneficiary by sending a

written notice to us on our Company’s prescribed form unless the previous designation specifies otherwise. A change of

Beneficiary will not be valid unless:-

(a) such change has been confirmed by our Issuing Office in writing;

(b) both you and the Insured are alive at the date of such confirmation; and

(c) such change is evidenced by an endorsement issued by us.

We are not responsible for any written notice of a change of Beneficiary received by us pending issue of an endorsement.

*** End of Page ***



GUARANTEED RENEWAL

Subject to all of the terms and conditions of this Policy, you have a guaranteed right to renew this Policy by advance

payment of the appropriate annual premium on each Policy Anniversary during the lifetime of the Insured. We reserve the

right to determine the terms and conditions for renewal. Unless otherwise specified, the premium is not fixed, and at the

time of such renewal, we reserve the right to revise or adjust it according to our applicable premium rate for the attained

age of the Insured at the time of such renewal, subject to other terms and conditions, if any, as set out in this Policy.

LIMITATIONS OF TIME FOR BRINGING SUIT

Subject to applicable law, any action at law or in equity to recover on this Policy shall only be brought within two (2) years

from the date of the Company’s final decision in respect of any claim herein.

NO THIRD PARTY RIGHTS

A person who is not a party to this Policy (including, but not limited to, the Insured or the Beneficiary) has no right to

enforce any terms of this Policy.

TERMINATION

This Policy shall automatically terminate on the occurrence of the earliest of the following:

(a) the death of the Insured;

(b) the lapse of the Policy pursuant to the “Grace Period” clause under the PREMIUM PROVISIONS; and

(c) the date the aggregate amount paid in respect of benefits under Parts I-IV of the Benefit Provisions under this Policy

reaches the Lifetime Cancer Limit.

On termination of your Policy, all benefits under all Supplementary Contracts (if any) will also terminate.

Termination of this Policy shall be without prejudice any claim arising prior to such termination unless otherwise stated.

The payment to or acceptance of any premium hereunder subsequent to termination of this Policy shall not create any

liability on the Company but the Company shall refund any such premium.

Notwithstanding the foregoing or anything else contained in this Policy, if on the date the Policy terminates pursuant to

clause (b) above the Insured is Confined in a Hospital for a Covered Cancer, the Policy shall not terminate and coverage

shall continue to be extended for an additional thirty (30) days of such Confinement without any premium payment,

subject to any Coverage/Maximum Limit(s) shown in the Schedule Of Benefits or limitation(s) applicable to the covered

benefit(s) in question.

CONFORMITY WITH LAW

Any provision of the Policy which on its Issue Date or Commencement Date, is in conflict with the laws of the country or

place in which this Policy is delivered or issued for delivery is hereby amended to conform to the minimum requirements of

such laws and shall not affect this Policy which shall remain in full force and effect.

GOVERNING LAW AND JURISDICTION

This Policy is governed by and shall be construed in accordance with the laws of such place where this Policy is issued

(being Hong Kong or Macau, as the case may be). The courts of such place shall have non-exclusive jurisdiction to

consider and determine any dispute or proceedings arising out of or in connection with this Policy.

*** End of Page ***



PREMIUM PROVISIONS

PAYMENT

While the Insured is living, all premiums are payable annually to us on or before their due dates. Payment shall be made to us

either at our Issuing Office or to our authorized officer or cashier. The Company shall have the right to review and adjust the

premium for this Policy from time to time. Any premium(s) paid to us but not yet due (“Prepaid Premium”) and/or any

payment in excess of premium(s) currently due and payable (“Overpayment”) shall, subject to any maximum amount as

determined by us from time to time, accumulate interest at such interest rates as we may determine from time to time. We

reserve the right to reject any Prepaid Premium and/or Overpayment paid to us in excess of such maximum amount. You may

withdraw the Prepaid Premium or Overpayment and/or any interest thereon in accordance with our procedures. The balance of

any Prepaid Premium, Overpayment and / or interest thereon that is not withdrawn shall be automatically used to offset any

premium due and payable which is not paid within the Grace Period.

DEFAULT

After payment of the first premium, failure to pay a subsequent premium on or before its due date will constitute a default in

premium payment.

GRACE PERIOD

A Grace Period of thirty-one (31) days from the Premium Due Date shall be allowed for payment of each premium after the

first premium during which this Policy shall remain in force. If a loss occurs within the Grace Period, the Company shall be

entitled to deduct at its discretion any premium due and unpaid from the proceeds payable under this Policy. If any

premium remains unpaid at the end of its Grace Period, the Policy shall be deemed to have lapsed and to have no further value

as of the Premium Due Date in default.

REINSTATEMENT

If any premium is in default beyond the Grace Period, the Policy may be reinstated with the consent of the Company

within five (5) years after (and excluding) the Premium Due Date in default subject to:

(a) a written application for reinstatement;

(b) production of evidence of insurability satisfactory to the Company; and

(c) all due and overdue levy on insurance premium (if any) as prescribed by the applicable laws are paid.

Such reinstatement shall only cover a loss or covered event which occurs after the latest Commencement Date. We will

consider reinstatement by redating subject to our rules and regulations, including but not limited to the requirement that all

claims for benefits hereunder prior to reinstatement be carried forward and included for purposes of applying the Covered

Cancer Limit, the Lifetime Cancer Limit and any maximum limits shown on the Schedule of Benefits for benefits payable

under the BENEFIT PROVISIONS to benefits payable under the reinstated Policy.

*** End of Page ***


CG2 / CGP2 – Schedule of Benefits – Standard Plan (HK$/MOP) 06192018 DCDW P0102

SCHEDULE OF BENEFITS OF CANCER GUARDIAN 2 / CANCER GUARDIAN PEARL 2 – STANDARD PLAN

Coverage/Maximum Limit

LIFETIME CANCER LIMIT

(applicable to Benefits under Parts I - IV below) HK$/MOP3,000,000

COVERED CANCER LIMIT

(applicable to Benefits under Parts I - IV below,

limit for every 3 consecutive years during the

Term)

HK$/MOP1,000,000

I. DIAGNOSTIC BENEFIT Fully covered*

II. CANCER TREATMENT BENEFITS

1. Hospitalisation and Treatment Benefits

(a) Hospital Daily Room and Board Fully covered*

(b) Attending Registered Medical

Practitioner’s Visit

Fully covered*

(c) Intensive Care Unit Fully covered*

(d) Surgical Expenses Fully covered*

(e) Miscellaneous Hospital Expenses Fully covered*

(f) Hospital Companion Bed Not applicable

2. Day Treatment and Surgery Fully covered*

III. RECONSTRUCTIVE SURGERY BENEFIT Fully covered*

IV. MONITORING BENEFIT Fully covered*

V. TARGET PROTECTION BENEFIT Not applicable

(applicable to eligible Stage IV Covered

Cancer, Liver Cancer, Brain Cancer,

Blood Cancer and Lymphoma only)

VI. ADDITIONAL CARING BENEFITS

1. 1-Year Waiver of Premium Once per Policy

2. Daily Hospital Cash Benefit for ICU HK$/MOP1,000 per day up to 15 days per Policy

3. Daily Hospital Cash Benefit for Long Term

Hospitalisation

HK$/MOP500 per day up to 60 days per Policy

4. Transportation Fee Subsidy Not applicable

5. Registered Chinese Medicine Practitioner

Consultation and Chinese Medicines

HK$/MOP600 per visit per day up to 20 visits per Policy*

6. Registered Physiotherapist Consultation HK$/MOP600 per visit per day up to 20 visits per Policy*

7. Registered Dietician Consultation HK$/MOP600 per visit per day up to 20 visits per Policy*

8. Psychological Counselling HK$/MOP1,200 per visit per day up to 20 visits per Policy*

9. Preventive Check-up for Immediate Family

Members

HK$/MOP10,000 per Policy*

10. Home Nursing HK$/MOP1,000 per day up to 60 days per Policy*

11. Medical Appliances HK$/MOP5,000 per Policy*

12. Wig and Voice Box Expenses HK$/MOP2,000 per Policy*

*** End of Page ***


CG2 / CGP2 – Schedule of Benefits – Standard Plan (HK$/MOP) 06192018 DCDW P0202

Coverage/Maximum Limit

VII. COMPASSIONATE DEATH BENEFIT

HK$/MOP20,000

THE COVERAGE/MAXIMUM LIMIT MARKED WITH “*” DENOTES THAT EACH OF THE

ITEMIZED EXPENSES AS SHOWN IN THE OFFICIAL STATEMENT OF ACCOUNTS OR RECEIPTS

SUBMITTED TO THE COMPANY FOR REIMBURSEMENT IS SUBJECT TO THE REASONABLE

AND CUSTOMARY CHARGES.

*** End of Page ***


Worldwide Emergency Assistance - HK$/MOP 06192018 THLW P0104

WORLDWIDE EMERGENCY ASSISTANCE SERVICES ENDORSEMENT

This Endorsement is attached to and forms a part of the Policy. Except as otherwise provided in this Endorsement, all

terms, conditions, provisions and definitions of the Policy shall have full force and effect.

BENEFITS

While this Policy is in force, and subject to the terms, conditions and exclusions herein contained, we will provide the

following coverages which will be organized and implemented using the means and services best adapted to the physical

condition of the Insured by a service provider (“Provider”) engaged by us.

(a) EMERGENCY MEDICAL EVACUATION

If the Insured suffers a Serious Injury or Sickness commenced during the Insured's Trip outside the country or

place of which the Insured was a permanent resident at the time the Trip commenced (being Hong Kong, Macau

or the People’s Republic of China, as the case may be), and if, in the absolute opinion of the Provider or its

authorized representative, it is judged medically appropriate with regard to relevant factors (such as the Insured’s

medical situation and the treatments that the Insured has been undertaking), the Provider will organize emergency

medical transport to the nearest medical facility that is adequately equipped to treat the Insured's medical

condition. Depending upon the medical severity of the Insured's condition, the Insured will be transported by

airplane, road or air ambulance, rail or other suitable and available means. Except as may be included under

Covered Expenses (as defined herein), medical expenses, including but not limited to the cost of medical

treatment at the nearest medical facility to which the Insured has been transported for treatment, are not covered

hereunder.

(b) REPATRIATION OF REMAINS

If the Insured dies during a Trip, the Provider will organize the repatriation of the Insured's body to the country or

place of which the Insured was a permanent resident at the time the Trip commenced (being Hong Kong, Macau

or the People’s Republic of China, as the case may be). The costs of burial, embalming, casket and ceremonies are

not covered unless this is mandatory under the local legislation.

(c) 24-HOUR WORLDWIDE TELEPHONE ENQUIRY SERVICES

While the Policy is in force, a 24-hour worldwide telephone enquiry service will be provided to the Insured for

travel matters, before or during the Insured’s Trip.

The 24-hour worldwide telephone enquiry service is limited to telephone enquiry services in relation to travel

matters. We will not be held responsible for any costs or expenses (including any medical or legal costs, and costs

for any other services) incurred by the Insured and / or you arising out of or in relation to following any advice or

referral given by or from the 24-hour worldwide telephone enquiry service.

The 24-hour worldwide telephone enquiry service is provided on a best-effort basis and may not be available due

to logistical problems, such as time, distance, location, or any other factors that are not within the control of the

Company or the Provider. Without prejudice to the provisions “GENERAL TERMS AND CONDITIONS” of this

Endorsement, the Company or the Provider shall not be held liable or responsible for any damages or losses

whatsoever suffered by the Insured for the failure, delay or omission in the delivery of this 24-hour worldwide

telephone enquiry services.

The coverage hereunder for Covered Expenses under Items (a) and (b) above is subject to a maximum aggregate limit of

HK$/MOP 5,000,000 or its equivalent of emergency assistance benefits payable under all policies insuring the same life

issued by the Company or AIA Company Limited (whether in Hong Kong or otherwise), including this Policy, which are

providing emergency assistance services coverage of the same or a similar type.

*** End of Page ***



IN CASE OF MEDICAL EMERGENCY

In case of serious medical emergency the Insured must contact the Provider immediately. There will be assistance

operators ready to respond twenty-four (24) hours a day.

After this preliminary contact the Provider’s medical team, in consultation with both the attending Registered Medical

Practitioner(s) and / or the Insured's habitual Registered Medical Practitioner(s), will in their absolute discretion decide

which means of medical transport and / or medical center and / or medical care is most appropriate to the Insured's medical

situation.

In case of evacuation or repatriation due to covered Accident or Sickness the Provider will pay Covered Expenses directly

to the medical transport organization.

Any expenses for a service not approved and arranged by the Provider or an authorized representative of the Provider shall

not be covered under this Endorsement. However, the Company may at its absolute sole discretion consider reimbursing

the expenses, or any part thereof, for services not approved or arranged by the Provider or an authorized representative of

the Provider if it is proved to our satisfaction that the Insured and the Insured's traveling companions cannot, for reasons

beyond their reasonable control, contact or notify the Provider during an emergency medical situation. Any such

reimbursement will be limited to those expenses incurred for services that would have been provided by the Provider under

the same circumstances.

When the Insured's transportation or that of other people traveling with the Insured is paid for by us, we are entitled to

request any unused transportation tickets of the Insured or the Insured’s traveling companion(s), as the case may be.

GENERAL TERMS AND CONDITIONS

(a) In the event that authorization of payment and / or payment is made by the Company or the Provider or an

authorized representative of the Provider for an emergency assistance claim which is not covered under this

Endorsement, the Company or the Provider or an authorized representative of the Provider reserves the right to

recover the said sum from the Insured.

(b) The Company or the Provider cannot be held liable for any default or delay in the execution of services in the

event of strikes, riots, any act of sabotage or terrorism, civil or foreign war, release of heat or irradiation coming

from the splitting of nuclei of atoms, radioactivity, other accidents or case of natural catastrophe.

All interventions by the Provider are conducted within the context of the national and international laws and

regulations and are dependent on all necessary authorizations and permits being obtained from the relevant

authorities.

(c) The coverage under this Endorsement shall automatically terminate on the occurrence of the earliest of the

following:

i) termination of the Policy;

ii) taking up of permanent residency by the Insured in a jurisdiction other than the country or place of which

the Insured was a permanent resident at the time the Trip commenced (being Hong Kong, Macau or the

People’s Republic of China, as the case may be); or

iii) any specific loss for which any benefit of Repatriation of Remains is payable under this Endorsement.

(d) The Provider or an authorized representative of the Provider is not our agent and we shall not be held liable or

responsible for the act or omission of such provider.

*** End of Page ***



EXCLUSIONS

Exclusions of the Basic Policy and Supplementary Contracts (if any) do not apply and are replaced with the following for

purposes of this Endorsement.

Benefits under this Endorsement will not be provided for any expenses or loss resulting in whole or in part from any of the

following occurrences:

(a) War declared or undeclared, invasion, civil war, revolution, and any warlike operations;

(b) Treatment of alcoholism, or drug abuse or any other complications arising therefrom, or Accidents and / or

illnesses caused by and whilst under the influence of drugs or alcohol;

(c) The Insured commencing his Trip contrary to medical advice, or with intention to obtain medical treatment or

after a terminal prognosis has been made;

(d) Suicide, attempted suicide or intentionally self-inflicted Injury;

(e) The Insured engages or takes part in hang-gliding, parasailing, parachuting or any sports undertaken on a

professional or competitive basis;

(f) The Insured engaging in air-travel except flying as a fare-paying passenger in or on any aircraft operated by a

commercial passenger airline on a regularly scheduled passenger trip over its established passenger route;

(g) The Insured engaging in services in any of the armed forces;

(h) Violation or attempted violation of the law or resistance to arrest;

(i) Pre-existing Conditions;

(j) Childbirth, pregnancy and its Complications of Pregnancy;

(k) Mental or nervous disorders;

(l) Cosmetic or plastic surgery, or any elective surgery; or

(m) Any loss that is covered by any other existing insurance scheme, government program or which will be paid or

refunded by a hotel, airline, travel agent or organizer, or any other providers of travel and / or accommodation.

MODIFICATIONS AND CANCELLATION

We reserve the absolute right and discretion to determine, specify and amend the scope and conditions of any of the

coverage under this Endorsement or to terminate or cancel any of them at any time without notice.

*** End of Page ***



BASIC DEFINITIONS

“Accident” shall mean any bodily injury, unintentional on the part of the Insured, resulting directly from the sudden action

of an external cause and independently of all other causes, of which the Insured is a victim.

“Complications of Pregnancy” refers to those conditions requiring hospital stays (when the pregnancy is not terminated)

whose diagnoses are distinct from pregnancy but are adversely affected by pregnancy or are caused by pregnancy. These

conditions include acute nephritis, nephrosis, cardiac decompensation, missed abortion and similar medical and surgical

conditions of comparable severity. Complications of pregnancy also include non elective Caesarean section, ectopic

pregnancy which is terminated and spontaneous termination of pregnancy, which occurs during a period of gestation in

which a viable birth is not possible.

“Covered Expenses” shall mean expenses for transportation, medical services and / or medical supplies necessarily

incurred in connection with service provided and / or arranged by the Provider or an authorized representative of the

Provider for emergency medical evacuation of the Insured or repatriation of the Insured’s remains.

“Pre-existing Condition” refers to any sickness, disease, or other condition for which the Insured received medical

treatment, diagnosis, consultation or prescribed drugs, or a condition for which medical service or treatment was

recommended by a Registered Medical Practitioner, before the commencement of coverage under this Endorsement.

“Serious Injury or Sickness” is an Injury or Sickness which requires treatment by a Registered Medical Practitioner and

which results in the Insured being certified by that Registered Medical Practitioner as unfit to travel or continue with the

original Journey.

“Sickness” shall mean any noticeable change in the physical health of the Insured provided that this change occurs during

the Trip, the Insured requires the care of a Registered Medical Practitioner acting within the scope of his / her license to

treat the Sickness, and the nature of the illness is not excluded from this Endorsement.

“Trip” shall mean a journey taken by the Insured and commences upon the Insured leaving the country or place of which

the Insured was a permanent resident at the time of leaving (being Hong Kong, Macau or the People’s Republic of China,

as the case may be) or two (2) hours before the Insured’s arrival at any immigration counter for the purpose of leaving such

country or place (whichever is later), and ceases on the occurrence of the earliest of the following:

(i) the Insured’s return directly to the country or place of which the Insured was a permanent resident at the time of

leaving (being Hong Kong, Macau or the People’s Republic of China, as the case may be); or

(ii) two (2) hours following the Insured’s arrival at any immigration counter for the purpose of returning to such

country or place after the journey.

*** End of Page ***


AIA Vitality Endorsement 01012017 ACAN P0105

AIA VITALITY ENDORSEMENT

This Endorsement is attached to and forms part of the Basic Policy and/or Supplementary Contract under AIA Vitality

Series as specifically designated and referred to in the Policy Information Page or AIA Vitality Membership Confirmation

Letter (“Designated Discounted Policy”). Except as otherwise provided in this Endorsement, all terms, conditions,

provisions and definitions of the Policy shall have full force and effect. If any of the provisions of this Endorsement is

inconsistent or in conflict with any other provisions of the Policy, the provisions of this Endorsement shall prevail to the

extent of any such inconsistency or conflict.

Unless otherwise defined or redefined in this Endorsement, words and expressions defined in the Basic Policy and/or

Supplementary Contract shall have the same meanings in this Endorsement.

Notwithstanding anything contained in the Policy and Policy Information Page to the contrary, it is hereby understood and

agreed that:

1. The following provisions shall be added under the section on PREMIUM PROVISIONS as set out in the Basic

Policy

“PREMIUM ADJUSTMENT TO THE DESIGNATED DISCOUNTED POLICY AVAILABLE UNDER

AIA VITALITY”

DEFINITIONS

These additional definitions shall apply:

“AIA Vitality” means the science-backed incentivized wellness programme administered, managed and

distributed by the Company separately in Hong Kong or Macau (as the case may be) to the Insured to promote

personal wellness and healthy lifestyles, which has its independent terms and conditions to govern a person’s

eligibility, reward and participation in the programme as well as the AIA Vitality Status. The Company shall have

the sole discretion to (1) modify AIA Vitality structure, make changes, in whole or in part, with or without notice,

to any aspect of AIA Vitality, benefits, rules, regulations, polices, procedures, conditions of participation or other

features and any other terms and conditions communicated in any other materials relating to AIA Vitality, even

though changes may affect the points earned (or to be earned) and accumulated and the benefits entitlement; and

(2) terminate, suspend, cancel, deactivate, recall or revoke AIA Vitality (in whole or in part) at any time, upon

reasonable notice where it is possible and/or practical to give such notice. Any revised version of the terms and

conditions shall be effective at the date of publication on the website, and available for download at AIA Vitality

website at www.aiavitality.com.hk. We also reserve the right to change our partners and benefits structure /

incentives / discounts / cash back and eligibility conditions at any time. AIA Vitality is not an insurance product

that falls under the jurisdiction of the insurance regulation. Moreover, the coverage of insured under the policy

shall remain unchanged no matter whether customer chooses to join AIA Vitality or not.

“AIA Vitality Insurance Premium Discount” means that the discount that the Owner could enjoy with respect

to the Designated Discounted Policy as a result of the Insured’s joining of and participation in the AIA Vitality,

according to the adjustment mechanism stated hereinafter on the basis of AIA Vitality Insurance Premium

Discount Percentage and Current Year Insurance Premium Adjustment Percentage.

“AIA Vitality Insurance Premium Discount Percentage” means the percentage applied at the inception of the

Policy or at each Policy Anniversary beginning from the first (1st) Policy Anniversary (as the case may be).

“AIA Vitality Status” shall refer to the status level achieved by the Insured as a member of AIA Vitality in

accordance with the number of AIA Vitality points he/she may have earned and accumulated during a

membership year in accordance with the prevailing rules of AIA Vitality. Members start on “Bronze” level at the

inception of the AIA Vitality.

“Applicable Insurance Premium” means the standard premium amount/rate payable on a proposed insured who

is classified as standard risk for the Designated Discounted Policy before any adjustment due to AIA Vitality

Insurance Premium Discount or otherwise.

*** End of page ***



“Current Year Insurance Premium Adjustment Percentage” means the percentage corresponding with the

AIA Vitality Status achieved by the Insured as at each Policy Anniversary (beginning from the first (1st) Policy

Anniversary).

“Policy Year” means each twelve-month period starting on the Policy Date.

PREMIUM ADJUSTMENT

Whilst this Endorsement is still in force, the premiums payable for the Designated Discounted Policy after AIA

Vitality Insurance Premium Discount will be equal to the Applicable Insurance Premium minus AIA Vitality

Insurance Premium Discount, plus any extra premiums or premium loading that may be payable due to extra

mortality, morbidity and/or other ratings (if any).

For the avoidance of doubt,

(a) any extra premiums or premium loading due to any extra mortality, morbidity or other ratings will not be

subject to the premium adjustment by the application of the AIA Vitality Insurance Premium Discount

Percentage due to the AIA Vitality Insurance Premium Discount; and

(b) the AIA Vitality Insurance Premium Discount does not apply to another policy, contract and rider other

than the Designated Discounted Policy.

AIA Vitality Insurance Premium Discount Percentage applied at the inception of the Policy = 10%

AIA Vitality Insurance Premium Discount Percentage applied at current Policy Anniversary = AIA

Vitality Insurance Premium Discount Percentage applied at the inception of the Policy or the Policy

Anniversary immediately before the current Policy Anniversary (whichever is later) + Current Year

Insurance Premium Adjustment Percentage

In the event that the Insured does not have an AIA Vitality Status as at the day of any Policy Anniversary for

whatsoever reason, including but not limited to termination of the Insured’s AIA Vitality membership, no AIA

Vitality Insurance Premium Discount Percentage will be applied at that Policy Anniversary.

Notwithstanding the above, the AIA Vitality Insurance Premium Discount Percentage applied at any Policy

Anniversary shall not be more than the Maximum AIA Vitality Insurance Premium Discount Percentage and shall

not be less than the Minimum AIA Vitality Insurance Premium Discount Percentage as set out below.

Minimum AIA Vitality Insurance Premium Discount Percentage = 0%

Maximum AIA Vitality Insurance Premium Discount Percentage = 15%

The Current Year Insurance Premium Adjustment Percentage applied will be based on the Insured’s AIA Vitality

Status as at the day of relevant Policy Anniversary.

AIA Vitality Status Current Year Insurance Premium Adjustment Percentage

Bronze -2%

Silver -1%

Gold 0%

Platinum +1%

TERMINATION OF THE PREMIUM ADJUSTMENT PROVISONS

The provisions on Premium Adjustment shall end and terminate concurrently if and when the Insured’s

membership of AIA Vitality is terminated for whatsoever reason(s), and no AIA Vitality Insurance Premium

Discount shall be available to the Policy Year on which such termination of membership falls.

*** End of page ***



2. The following provisions shall be added under the clause on REINSTATEMENT under the section on

PREMIUM PROVISIONS as set out in the Basic Policy:

“The AIA Vitality Insurance Premium Discount Percentage which shall be applied on each of the Policy

Anniversaries in the period between the due date on which default of premium occurred and the reinstatement

date shall be subject to the Company’s rule prevailing from time to time.”

Important Notice: Please read carefully the Policy Information Page or AIA Vitality Membership Confirmation Letter to

find out which Basic Policy or Supplementary Contract is offered under AIA Vitality Series and hence a Designated

Discounted Policy which allows you to enjoy AIA Vitality Insurance Premium Discount. The benefits offered by our

partners under AIA Vitality are available for redemption in Hong Kong and Macau. In case of doubt, please contact our

Customer Services Centre or your sales representative.

*** End of page ***



AIA VITALITY ILLUSTRATION

AIA VITALITY INSURANCE PREMIUM DISCOUNT

There are four (4) types of AIA Vitality Status, depending on the total number of points being earned and accumulated by

a member for each membership year. Once you have joined AIA Vitality and enrol in this AIA Vitality Series product, you

are entitled to an immediate upfront 10% AIA Vitality Insurance Premium Discount for the first Policy Year. For each

subsequent Policy Year, the AIA Vitality Insurance Premium Discount may increase or decrease depending on the

Insured’s AIA Vitality Status as shown in the below table.

AIA Vitality Status Current Year Insurance Premium Adjustment

Percentage

Bronze Decrease by 2%

Silver Decrease by 1%

Gold No Adjustment

Platinum Increase by 1%

HOW TO CALCULATE MY FUTURE PAYMENTS?

The below tables illustrate the annual premium required for the first seven (7) policy years based on the highest and lowest

attainment of AIA Vitality Status by the Insured. Thereafter your annual premium will continue to be calculated in

accordance with your AIA Vitality Status achieved on each subsequent Policy Anniversary. No AIA Vitality Insurance

Premium Discount will be offered if the Insured’s AIA Vitality membership is terminated for whatever reason. The annual

premium as shown in the table is “fictitious” for illustrative purposes.

BEST SCENARIO

We assume the Insured achieves “Platinum” AIA Vitality Status (i.e. highest status) at the end of each subsequent

Policy Year, starting from Policy Year one (1)

The maximum attainable AIA Vitality Insurance Premium Discount is 15% and it can be attained starting from Policy

Year six (6)

Policy

Year

AIA Vitality

Insurance

Premium Discount

for the previous

year (%)

Adjustment to the

AIA Vitality

Insurance Premium

Discount based on

AIA Vitality Status

(%)

AIA Vitality

Insurance

Premium

Discount for the

current year (%)

Annual Premium i

Discounted Annual

Premium i, ii

1 N/A N/A 10% 1,000 900

2 10% +1% 11% 1,100 979

3 11% +1% 12% 1,200 1,056

4 12% +1% 13% 1,300 1,131

5 13% +1% 14% 1,400 1,204

6 14% +1% 15% 1,500 1,275

7 15% +1% 15% 1,600 1,360

*** End of page ***



WORST SCENARIO

We assume the Insured achieves “Bronze” AIA Vitality Status (i.e. lowest status) at the end of each subsequent Policy

Year, starting from Policy Year one (1)

No AIA Vitality Insurance Premium Discount will be offered starting from Policy Year six (6)

Policy

Year

AIA Vitality

Insurance

Premium

Discount for the

previous year (%)

Adjustment to the

AIA Vitality

Insurance Premium

Discount based on

AIA Vitality Status

(%)

AIA Vitality

Insurance

Premium

Discount for the

current year (%)

Annual Premium i

Discounted Annual

Premium i, ii

1 N/A N/A 10% 1,000 900

2 10% -2% 8% 1,100 1,012

3 8% -2% 6% 1,200 1,128

4 6% -2% 4% 1,300 1,248

5 4% -2% 2% 1,400 1,372

6 2% -2% 0% 1,500 1,500

7 0% -2% 0% 1,600 1,600

Remarks:

i. All premiums (including renewal premiums) shown above are based on the standard premium rate and do not

include any extra premiums due to loading. Moreover, the above renewal premiums payable, for the sake of easy

understanding, are assumed as illustrated in above table, and in reality, the renewal premiums payable in the

subsequent Policy Years may adjust. The actual renewal premiums will be calculated according to the Insured’s

attained age and the applicable premium rate at the time of renewal. Such premium rate is non-guaranteed and

subject to revision by the Company from time to time.

ii. The AIA Vitality Insurance Premium Discount is only applicable to standard premiums and shall not apply to any

extra premiums due to loading.

Important Notes:

1) The AIA Vitality Insurance Premium Discount is only applicable to the specific Basic Policy or Supplementary

Contract. The AIA Vitality Insurance Premium Discount is not extended to any other Basic Policy or Supplementary

Contracts unless it is specifically stated otherwise. Please check the illustration of the other Basic Policy or

Supplementary Contracts, and contact us if you have any doubt.

2) The AIA Vitality Insurance Premium Discount is capped at 15% and floored at 0%.

3) The insured person has to be an AIA Vitality member in order to enjoy the AIA Vitality Insurance Premium

Discount.

4) An annual membership fee will be charged for AIA Vitality and a member has to renew the AIA Vitality

membership annually in order to enjoy AIA Vitality Insurance Premium Discount in the subsequent policy years.

5) If the AIA Vitality member is insured by more than one policy under the AIA Vitality Series, the AIA Vitality

Insurance Premium Discount applied should be calculated independently in accordance with each policy.

*** End of page ***

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