CIGNA CARECHOICEGROUP PLAN

CIGNA SME SERIES

General InsuranceLife Insurance

Remarks:1.

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Our missionAt Cigna, we are dedicated to improve the health, well-being, and peace of mind of those we serve.

ABOUT CIGNA CORPORATION

Sales capability inover 30 countriesand jurisdiction1

US$160 billion inrevenue1

More than 180 millioncustomer and patient

relationships1

70,000 employeesaround the world1

More than 1.5 millionrelationships with

healthcare providers,clinics and facilities1

Ranked 13th on the2020 Fortune

500 List

Named a ‘Caring Company’ for the18th consecutive year by the

Hong Kong Council of Social Service

The above data is for informational purposes only and may not relate to a particular subsidiary of Cigna Corporation. Data is based on Cigna internal reporting as of December 31, 2020 and is subject to change.

No further health declaration for employees

enrolling in Employee Health Value+ plans3

Simple 3-step application process and no health

declaration2

Customize benefits and dependent cover by employment level4

Cashless Hospitalization and Care Manager Service to bring you both physical and emotional support for

a speedy recovery

Benefit from access to more than 2,500 Network Clinics and Cigna Prestige

Hospital Cash

Employee Assistance Program (EAP) to provide

24-hour counselling support for your

employees

Take care of your employees wherever they go with our Worldwide Emergency Assistance

Service

Select optional benefits for more comprehensive cover

for your employees

Innovative solutions include "MyCigna" app,

Cigna Telehealth Service and "Chloe" to bring you a

brand new healthcare experience

Care

Why should you o�er group plan to your employees?

Why should you choose Cigna CareChoice Group Plan?

Cigna CareChoice Group Plan (“CareChoice”) is here to partner with you so that you can focus on taking care of your business while we take care of your employee’s health and wellness needs with Ease, Choice and Care.

A vital tool to help retain talentWith growing competition in the market, talent is key to your business’ growth and success. An attractive group plan can help you to retain your talents, and level up your business.

Stand out from your competitionFrom our Cigna 360o Well-being Survey, 54% of respondents agree that a comprehensive group plan is important when choosing between two potential employers1.

Ease Choice

Cigna ‘360o Well-being Score’ Survey, results for 2019.Health declaration is required for 3 or 4 employees. If Optional Life and Accidental Death and Disablement Benefit is selected, then health declaration is required for 3 to 9 employees.Available to members of a Cigna Group Medical Insurance Plan with at least 10 full time employees enrolled, and this is for selected plans only.Same employment level should receive the same level of benefits.

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3. 4.

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Under this discount, if the employee does not fulfil the Pre-Authorization Saving requirements, the reimbursement percentage of eligible treatment costs will be reduced from 100% to 80%, subject to the plan's maximum benefit limit. Exception applies to emergency treatment.

What’s more?

Di�erent benefit levels can be selected for di�erent employment levels.

Remarks:1.

Not only you can enjoy premium discounts for your Cigna CareChoice Group Plan, your employees will also have access to exclusive discounts on selected Cigna products.

First Year Premium Discount

Pre-Authorization Saving1

5% o� on total premium

5% o� on total premium

5% o� on basic benefits premium

How to customize your group insurance plan?

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Privilege discount for company with a minimum of 10 full time employees

Step 1: Choose the level of basic coverage for di�erent employment level.・Hospital and Surgical Benefits

Step 2: Choose the optional benefits among the various options and the benefit levels. ・Outpatient Benefits・Dental Benefits・Vision Benefits・Life and Accidental Death and Disablement Benefit

INNOVATIVE HEALTHCARE SOLUTIONS

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Making it easy for you and your employees

Cigna embraces innovation and is dedicated to improving the health and well-being of our members. The following services o�er a brand new experience for CareChoice plan members.

Cigna’s Online Portal

Live ChatMessage Cigna through Live Chat

My PolicyView benefit information

My Claim

As an employer, you can manage policies conveniently via Cigna’s online portal. With Cigna’s online portal, you can review the policy details, premium settlement and member list. Other than that, you can submit claim inquiries and chat with our customer service representatives.

MyCigna

Your employees can login to "MyCigna" mobile app or website to review policy details and submit claims easily anytime, anywhere.

Submit claim, upload receipt and check claim status online, no paper form submission is required

Scan here to watchMyCigna User Guide

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Cigna Telehealth Service

The virtual consultation service o�ers fast and reliable medical advice. Members can obtain professional medical advice from doctors anytime, anywhere by simply downloading the DoctorNow app.

Highlight of Benefits

Free to select among panel doctor list

Make appointment via mobile app

Skip the long queues at clinics

Get medication delivered to you at your convenience#

Medical certificate can be issued where applicable

Specialist referral available if you need advanced care

DoctorNow app is available in both English and Traditional Chinese, and supports both iOS and Android smartphone or tablet.

The medical consultation fee can be deducted from your Optional Outpatient Benefits limit(if Optional Outpatient Benefits are purchased)

# Terms and conditions apply

Cigna Customer Service Chatbot

Find a Doctor

Specialist DoctorBooking

Google MapsIntegration

Chloe - The Cigna Customer Service Chatbot is here to help members find a doctor, book an appointment and get directions to your doctor's appointment in a more convenient way. Simply add the WhatsApp number 59983779 today to access the service.

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All services will be applicable within Hong Kong only. These services are for CareChoice Group Plan members only. Our in-house Care Managers who are registered nurses in Hong Kong will work closely with the member and physician before, during and after the treatment to ensure each member receives proper treatment and care. Service hours: 9am–5:30pm, Monday to Friday except public holidays manned by Cigna Health, Wellness and Clinical services.

Remarks:1. The list of Network Clinics is subject to change from time to time at Cigna’s discretion without prior notice.

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Care Manager Service

Our in-house Care Managers who are registered nurses in Hong Kong will work closely with the member and physician before, during and after the treatment to ensure each member receives proper treatment and care.

PRIOR TO TREATMENT

› Medical Classification Service - when encountering questions about insurance coverage or medical treatment, our Customer Service team and Care Managers are here to support you.› Cashless Hospitalization Service – Cigna can settle payment directly with all private hospitals in Hong Kong. Simply arrange Guarantee of Payment before hospitalization so we can arrange a credit facility upon admission and you won’t have to make a claim upon discharge. › Our Care Managers will provide answers and bring professional advice to give you a full picture of your upcoming surgery or treatment.› Our dedicated Care Manager will provide steering service when necessary for members who have planned treatment, and we will provide doctor referral service to match your treatment specialty after reviewing your medical information.

› Our Care Managers will provide 1:1 assistance to ensure you have a suitable treatment plan and care. › Not only provide professional information, but also provide emotional support to you and your family.

› More than 2,500 Network Clinics1.› Cover niche specialties such as Traditional Chinese Medicine, Acupuncture and Bonesetting.› Includes all private hospitals in Hong Kong.

DURING TREATMENT

› Our Care Managers can help to arrange home care services if necessary.› Provide continued emotional support to ensure stress free recovery.› Accompany you on admission and discharge upon request to make sure things go as planned and discuss with the physician for any post operation care plan if necessary.

RECOVERY

Members can access Cigna’s carefully selected network of experienced medical service providers across various disciplines.

Quality medical network

PLAN AT A GLANCE

› Outpatient Benefits› Dental Benefits› Vision Benefits › Life and Accidental Death & Disablement Benefit2

Optional Benefits1

Optional Service

Enrollment Age Employee / Spouse Unmarried Children3

Age 16-64From 15 days to age 18; or

age 19 to 25 for full-time students

Maximum Cover Age

Minimum Number of Employees

Age 69 Age 18; or age 25 for full-time students

Medical Underwriting

Pre-Authorization Saving(applicable to hospitalization and hospital day case treatment only)

Premium Payment Frequency Annual

Policy Currency HK$

3 full-time employees4

Basic Benefits and Optional Outpatient, Dental and Vision

Benefits

Optional Life and Accidental Death & Disablement Benefit

Waived for company with 5 or more employees5

Waived for company with 10 or more employees6

Pre-Authorization Service Cashless Hospitalization

All hospitalization treatment(except emergency treatment)7

PRE-AUTHORIZATION SAVINGBy choosing to enjoy Pre-Authorization Saving, members of your group plan will commit to use our Pre-Authorization and Cashless Hospitalization Service prior to undergoing treatment in specific treatment settings. Not only will you receive an extra 5% o� on your annual basic benefit premiums, you can ensure your members will benefit from direct access to our team of registered nurses who can o�er a Medical Classification Service, arrange a Second Medical Opinion (where appropriate) and Cashless Hospitalization Service.

The following table summarizes the treatment settings that require Pre-Authorization and Cashless Hospitalization Service. If the following Pre-Authorization Saving requirements are not met, the reimbursement percentage will be reduced from 100% to 80%, subject to the plan's maximum benefit limit. Exception applies to emergency treatment.

All hospital Day Case Treatment

Pre-Authorization Saving Requirements for 100% Reimbursement

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Remarks:1.

2.3.4.5.6.7.

All benefits are underwritten by Cigna Worldwide General Insurance Company Limited except Life and Accidental Death & Disablement Benefit which is issued as a separate policy underwritten by Cigna Worldwide Life Insurance Company Limited. Applicable to employees only.For optional Vision Benefits, minimum enrollment age is 4. For optional Dental Benefits, minimum enrollment age is 8.Cigna reserves the right to terminate the policy when the number of insured individuals is less than 3.Health declaration is required for companies with 3 to 4 employees at enrollment and / or renewal.Health declaration is required for companies with 3 to 9 employees at enrollment and / or renewal.For emergency treatment, Cigna must be notified within 48 hours after the emergency treatment occurs.

Basic Benefits1 Hospital & Surgical Benefits

This product is a standalone group policy. The Basic Benefits provide hospitalization benefits which can be added with optional benefits of

outpatient coverage, permanent total disability and other medical protection. The policy provides both indemnity and non-indemnity

benefits. It does not contain any cash value.

1 year and Annually Renewable

The plan provides a protection period of 1 year to cover insured employee and spouse of age under age 69, unmarried children of

employee of age under 18 (age 24 for full time student). Payment period until the end of protection period. Premium rate will increase with age,

and yearly adjustable.

Plan Type

Policy Term and PremiumStructure of Basic Benefits

SUMMARY OF BENEFITS

BASIC BENEFITS – Hospital & Surgical Benefits

The following is for reference only. The benefits are payable on “Reasonable and Customary” basis. Please refer to the policy provision for details.

Area of Cover Worldwide

Accommodation Room Type

Plan Level Level 1 Level 2 Level 3 Level 4 Level 5

Reimbursement percentage 100%1

Benefit Items Maximum Amount per Person Insured (HK$) (per disability)

120,000

400/day 600/day 800/day 900/day 1,000/day

185,000 250,000 350,000 450,000

200/day 300/day 400/day

US$1,000,000 per medical evacuation / repatriation

450/day 500/day

Annual Health Check Up

Hotline service

Ward Semi-Private Standard Private

› Room & Board (up to 120 days)

› Intensive Care Unit

› Miscellaneous Hospital Expenses

› Inpatient Doctor Visit (up to 120 days)

› Surgical Benefits(Covers the surgeon fee, anaesthetistsfee and operating theatre fee oninpatient and outpatient basis)

› Post-Hospitalization Outpatient Visit (Covers post-hospitalization follow-up clinic visits within 90 days after discharge from hospital or after the performanceof surgery in the Registered MedicalPractitioner’s clinic)

Hospital Cash for Hong Kong Government Ward Bed (up to 120 days)

One fully covered annual health check by Cigna’s designated medical services provider which includes a physical

examination, lipid profile and a doctor report consultation3

Cigna Prestige Hospital Cash (up to 120 days)2

Worldwide Emergency Assistance Service

Employee Assistance Program (EAP)– employees only

Entitled Level of Accommodation Actual Level of Accommodation Adjustment Factor

Ward

Ward

Semi-Private

Semi-Private

Standard Private

Standard Private

50%

25%

50%

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The following adjustment factor will be applied to reimbursement only if the actual level of accommodation is higher than the entitled level of accommodation:

No benefit will be payable for hospital confinement in VIP suite or deluxe suite, and no hospital cash will be payable if the actual level of accommodation is higher than the entitled level of accommodation.Applicable to the hospital network designated by Cigna from time to time. You may refer to http://bit.ly/3a1BmHM for the latest Network Hospitals.Applicable to member aged 12 or above only.

OPTIONAL BENEFITS

OPTIONAL BENEFITS – Outpatient Benefits

Area of Cover Worldwide WorldwideHong Kong Only

Plan Level Level 1 Level 2 Level 3

Choice of provider Network &Non-Network

Network &Non-Network

Network only

Network

Non-NetworkReimbursement %

100%

100%

80%0%

Benefit Items1 Maximum Amount per Person Insured (HK$)

1. Outpatient Doctor’s Visit (per visit) 30 250 330

2. Outpatient Specialist (per visit)2

Coveredwithin Network

10

10

10

Not applicable

500 660

3. Physiotherapist or Chiropractor (per visit)3,4 350 400

800 2,000 3,000

40 30 30

250 350

OPTIONAL BENEFITS – Dental Benefits

Medical Service Provider

› Scaling and polishing

Network Only

Once a year

Unlimited

Maximum Visitsper Policy Year

4. Chinese Herbalist / Chinese Bonesetter / Acupuncture (per visit)

5. Diagnostic Laboratory Test & X-ray4

› Oral hygiene instruction and Oral examination› Intra-oral small film radiograph (if necessary) › Amalgam filling due to decay (molars and premolars) › Composite filling due to decay (canine and incisors only) › Simple extraction (excluding wisdom teeth & surgical extraction) › Drainage of Abscesses (without surgery) › Emergency consultations & dressings for pain relief › Medications (pain killers)

Benefit items 1-4 applies only to consultation / treatment fee and only one consultation / treatment will be paid for any one day.Network: Referral letter from Registered Medical Practitioner is not required.Non-Network: Referral letter is required, except Dermatologist, Ophthalmologist, Gynaecologist, Orthopaedist, Traumatologist, Paediatrician and Otorhinolaryngologist.Chiropractor not available for Level 1.Referral letter from Registered Medical Practitioner is required.

Remarks:1.2.

3.4.

Remarks:1.2.

Dental treatment must be performed by a medical service provider as designated by Cigna from time to time.Member must be aged 8 or above.

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Total No. of Visits per policy year for item 1-4

Accidental Death & Disablement Benefit› In the event of death or disablement caused by accidents such as accidental loss of life, permanent total disablement

Death Benefit› Includes Extension of Death Benefit, Dismemberment Benefit, Simplified Critical Illness Benefit, Terminal Illness Benefit

OPTIONAL BENEFITS – Life and Accidental Death & Disablement Benefit (Employee only)1

Level 1 Level 2 Level 3

Sum Insured (HK$)

500,000 1,000,000250,000

500,000 1,000,000250,000

OPTIONAL BENEFITS – Vision Benefits

Medical Service Provider Network Only

Once a year

› Comprehensive eye exam focuses on eyes and overall wellness (includes a full written report)

OR

› Refraction eye exam focuses on visual acuity and refraction test

Eye examination must be performed by a medical service provider as designated by Cigna from time to time.Member must be aged 4 or above.

Remarks:1.2.

This optional benefit will be issued as a separate policy underwritten by Cigna Worldwide Life Insurance Company Limited.Remarks:1.

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Act now and give your valuable employees a well-protected group plan.

CONDITIONS

Eligibility Employees employed and based in Hong Kong

Enrollment Age

Unmarried Children1Employee / Spouse

Age 16-64 (Age 65 to 69 eligible

for renewal only)

From 15 days to age 18;or age 19 to 25

for full-time students

Participation

Plan Level

All eligible employees within the company must participate

Employees within the same employment level must be enrolled in the same plan level (e.g. all manager grade must apply the same plan level)

Dependent CoverIf dependent cover is selected, all eligible dependents must participate, and they must join the same plan level as that of the relevant employee

Optional Life and Accidental Death & Disablement Minimum annual premium of HK$3,000 per policy

APPLICATION FORMNEW MEMBERREGISTRATIONFORM

COPY OFBUSINESS REGISTRATIONLICENSE

HOW TO APPLY You only need to submit these 3 things to apply

For optional Vision Benefits, minimum enrollment age is 4. For optional Dental Benefits, minimum enrollment age is 8.Remarks:1.

Further information or documents may be required in accordance with or in compliance with any laws or regulations, or related underwriting requirements.

*

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Have full protection to prevent the unexpectedMary, aged 32, works in an IT start up with a prosperous future. Mary is aware that medical treatment can be very expensive and is worried about increasing medical costs.

CASE ILLUSTRATIONThe following example is hypothetical and for illustrative purposes only.

Remarks:1.

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Employee Health Value+ Portable Plan is a standalone individual indemnity hospital insurance plan o�ered to existing members of Cigna’s Group Medical Insurance Plans. Members can customize their own individual medical insurance plan as a supplement to the coverage provided by the employer. For details, please refer to Cigna’s website or relevant insurance intermediaries.Subject to enrollment guidelines of Employee Health Value+ at the time of insurance application.

Cigna CareChoice Group Plan will not only help you attract and retain the right talent, but also give your employees access to a�ordable comprehensive medical

cover through Employee Health Value+ Portable Plan.

For as little as HK$367 a month, CareChoice together with Employee HealthValue+ saved Mary HK$200,000 out of pocket expenses.

CareChoice &Employee Health Value+

1st Claim - CareChoiceHK$250,000

2nd Claim – Employee Health Value+HK$200,000

HK$250,000Medical protection

Additional Benefit

Cigna Prestige Hospital Cashfor 6 days

HK$2,400 (HK$400/day)

Cigna Prestige Hospital Cashfor 6 days

HK$2,400 (HK$400/day)

Mary’s out of pocketexpenses HK$200,000 -

Mary’s estimated premiums - HK$367 per month

Only CareChoice

Insured person: Mary, age 32

Diagnosis & Treatment: Mary had an accident resulting in serious injury to her knee. She needed a total knee replacement and chose to undergo the surgery at Hong Kong Adventist Hospital (Stubbs Road).

Medical cost: HK$450,000

Group insurance plan: Cigna CareChoice Group Plan (Level 3) provided by Mary’s employer.

Individual insurance plan: Employee Health Value+ Portable Plan1 (Plan 2) purchased by Mary to top up her group insurance plan. As a CareChoice member, Mary didn’t have to go through any further underwriting2 when she purchased Employee Health Value+.

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The product information in this brochure does not represent the full terms of the policy and the full terms can be found in the policy document.

Policy Term and RenewalThe policy is issued for a term of one year and shall be automatically renewed at the end of each policy year provided that the premium due on the following policy anniversary is fully paid and received by the Company before the expiration of the grace period.

Premium LevelThe initial premium shall be calculated at the Premium Rate(s) specified in the Schedule of Rates, and each subsequent premium shall be calculated at the Premium Rate(s) on the Premium Due Date.

Premium AdjustmentPremium adjustments involving the return of unearned premiums shall be limited to the period of twelve (12) months preceding to the evidence for such adjustments being received.

The Company reserves the right to adjust the premium rates of this policy on any Premium Due Date. Factors leading to premium rates adjustment may include but not limited to our overall experience in claims and expenses incurred by and / or in relation to this product, change of eligibility of a class of individuals for insurance and change in the material factors bearing on the risk assumed. The Company may adjust any premium rate by giving advance notice in writing to you. Except for factors including the change of eligibility of a class of individuals for insurance and change in the material factors bearing on the risk assumed, any other increase in premium rate should become e�ective at least twelve (12) months after e�ective date of the policy / any previous increase in premium rates.

Non-payment of PremiumExcept for the initial premium payment, there will be a grace period of thirty-one (31) days following each Premium Due Date. This policy will remain e�ective during the grace period. If any premium for the Person Insured in any class is not paid before the expiration of the grace period, this policy will automatically discontinue for all Persons Insured in such class at the expiration of the grace period with the loss of insurance coverage.

Misstatement of Facts If any relevant facts related to the Person Insured have been found material and incorrectly reported to the Policyholder or to the Company, the validity of the insurance policy and the premium payable shall be determined based on the true facts.

Optional BenefitLife and Accidental Death & Disablement BenefitAccidental Death & Disablement (ADD) Benefits become payable if an Insured Individual su�ers any loss specified in the Schedule of Coverage from policy provisions which is directly resulted from an accident and within one year from the date of the accident. Insurance coverage of this benefit item will terminate immediately when 100% of the benefit amount has been paid.

IMPORTANT INFORMATIONTerminationTermination of member coverageAn Individual’s insurance under this Policy shall terminate on the earliest of the following dates:

1.

2.

3.

4.

5.

Termination of policy1.

2.

Inflation RiskDue to inflation, the future cost of living may be higher than they are today and the current planned benefits may not be

Conversion of policyIf you have an existing medical insurance policy and intend to switch the coverage to this plan, please be aware of the potential implications in terms of insurability, claims eligibility and financial values regarding the change to the insurance arrangement.

Some benefits under the existing policy may be changed or not be covered under this plan due to changes in policy features, Age, health conditions, occupation, lifestyle, habit or recreational activities. Also, riders or supplementary benefits under your existing insurance policy may not be available under this plan.

Benefits under the existing insurance policy will no longer be payable to you if you surrender the policy or allow it to lapse. Besides, you may need to start a new waiting period (if any) in respect of certain benefits under the terms and conditions of the new policy.able to meet future insurance needs.

the date when an Individual dies or ceases to be a member of a class of Individuals eligible for insurance;

the date of discontinuance of this Policy;

the end of the Policy Year during which the Individual attains the age of sixty-nine (69) years;

the end of the Policy Year during which the Policyholder has notified the Company in writing an Individual ceases to be employed in Hong Kong or based in Hong Kong for one hundred and eighty five (185) days or more during that Policy Year; and

the date of termination of employment as hereafter defined. Cessation of Active Work shall be deemed termination of employment, except that while an Individual is absent from work on account of Sickness or Bodily Injury, employment shall be deemed to continue until premium payments for such Individual’s insurance are discontinued. At the option of the Policyholder, the insurance of an Individual may be continued during an authorized leave of absence granted by the Policyholder for reasons other than Sickness or Bodily Injury but not beyond twenty-four (24) calendar months from the date the leave of absence commences.

The Company reserves the right to discontinue this policy on any Premium Due Date,

(a) for all classes of individuals, when there are less than 3 individuals are insured under the policy; or

(b) for any class of individuals, when there are less than 100% of individuals in such class are insured under the policy;

provided the Company gives the Policyholder at least thirty-one (31) days' notice of its intent to discontinue.

This Policy may be terminated as at any Premium Due Date by either the Policyholder or the Company by mailing written notice of termination to the other party, not less than thirty-one (31) days before the Premium Due Date on which such termination shall be e�ective. Termination shall be without prejudice to any claim originating prior to the e�ective date of termination.

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1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

KEY EXCLUSIONSThe following list is for reference only and it is not a full list of exclusions. Please refer to the policy provisions for the complete list and details of exclusions.Cigna shall not be liable to pay any claim or expenses incurred directly or indirectly resulting from or consequent upon or contributed by the following items:

Any sickness or bodily injury for which the Person Insured has received medical treatment, diagnosis, or prescribed drugs during the ninety (90) days preceding the e�ective date of his coverage (i.e. pre-existing conditions) unless the Person Insured a�ected by these conditions has been insured under this policy continuously for twelve (12) months.

Bodily injuries arising directly or indirectly from riots or war, declared or undeclared.

Routine physical examinations, or health check-ups or test not incident to treatment or diagnosis of an actual sickness or bodily injury. This is not applicable to the Network Annual Health Checkup.

(a) Eye refractions, fitting of glasses, contact lenses;

(b) hearing aids; and

(c) gingivitis, any dental or oral care, treatment or surgery of any nature whatsoever except procedure necessitated by damage to sound natural teeth as a result of an accidental injury occurring during the period of insurance.

Bodily injuries due to insanity, self-infliction or participation in illegal acts or terrorism; conditions related to functional disorders of the mind or psychiatric disease; rest cure or sanitaria care (e.g. neurasthenia, anxiety state, anaemia); treatment of an optional nature (e.g. anorexia, acne); drug addiction or alcoholism.

Congenital conditions.

(a) Treatment occasioned by or resulting from pregnancy, childbirth, miscarriage or abortion.

(b) Treatment relating to birth control, infertility or sterilization of either sex.

Any venereal disease or AIDS disease.

Any bodily injury or sickness for which compensation is payable under any laws or regulations or any other health insurance policy or scheme except to the extent that such charges are not reimbursed by such laws or regulations or other policy or scheme.

Not Medically Necessary.

Notes:

“Cigna”, “the Company”, “We”, “our” or “us” herein refers to Cigna Worldwide General Insurance Company Limited and Cigna Worldwide Life Insurance Company Limited.

This product brochure is also available in Chinese. You may request for the Chinese version from us.此產品小冊子同時備有中文版本，閣下可向本公司索取中文版本。

Claims Procedure To make a claim, please login to our customer portal or register at www.mycigna.com.hk or download our MyCigna app. For details of procedures by claims type, please visit the Company website https://www.cigna.com.hk/en/customer-service/insurance-claim-procedure.

Medically NecessaryWe only cover the charges and / or expenses of the Person insured on medically necessary and reasonable and customary basis.

"Medically Necessary" means the necessity to have a medical service which is:

1.

2.

3.

4.

5.

6.

Reasonable and Customary“Reasonable and Customary" in relation to a fee, a charge or an expense, means any fee or expense which

1.

2.

3.

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 are not reasonable and customary.

consistent with the diagnosis and customary medical treatment for the condition at a Reasonable and Customary charge;

in accordance with standards of good and prudent medical practice;

necessary for such a diagnosis or treatment;

not furnished primarily for the convenience of the Person Insured, Physician, Chinese Medicine Practitioner, Physiotherapist, Anaesthetist or any other medical service providers;

furnished at the most appropriate level which can be safely and e�ectively provided to the Person Insured; and

with respect to hospital confinement, not furnished primarily for diagnostic scanning purpose, imaging examination or physical therapy.

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 of an injured or ill person under the care, supervision or order of a Physician;

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; and

does not include charges that would not have been made if no insurance existed.

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CA/Brochure/0037/0321_E

Cigna Worldwide General Insurance Company LimitedCigna Worldwide Life Insurance Company LimitedTel: (852) 2560 1990www.cigna.com.hk

Issued by Cigna

The above insurance plan is underwritten by Cigna Worldwide General Insurance Company Limited and Cigna Worldwide Life Insurance Company Limited, authorized insurers to carry on general insurance and life insurance business in or from Hong Kong. This brochure is intended to be distributed in Hong Kong only and shall not be construed as an o�er to sell or a solicitation to buy or provision of any products of Cigna outside Hong Kong. It is designed to provide you with a brief summary of the named insurance plan, its terms, conditions and exclusions, and is not a contract of insurance. You are recommended to seek professional advice from your independent advisors if you find it necessary. For complete details of terms, conditions and exclusions, please refer to the policy provisions. If there is any conflict between the policy provisions and this brochure, the policy provisions shall prevail.

This policy is excluded from the application of the Contracts (Rights of Third Parties) Ordinance (the “Ordinance”). Other than the Company and the policyholder, a person who is not a party to the policy (including, but not limited to, the person insured or the beneficiary) shall have no right under the Ordinance to enforce any term of this policy.

Cigna reserves the right to change any of the details in this brochure. In case of any disputes about the content of this brochure, Cigna’s decision shall be final.