保险指南

Insurance Guide

按照中国教育部规定，学校实行国际学生全员保险制度。国际学生必须按照国家有关规定和学校要求投保。对未按照规定购买保险的，应限期投保，逾期不投保的，学校不予录取；对于已在学校学习的，应予退学或不予注册。

Our university implements a system of insurance for all international students. All international students must insure themselves in accordance with the relevant regulations of China and the requirements of our university. For those who fail to purchase insurance in accordance with the relevant provisions, they should purchase insurance within a time limit. Those failing to do so within the time limit will not be admitted by our university; and those who have begun to study in our university shall drop out or not be enrolled by our university.

第一部分 保障项目

第二部分 服务指南 / Service Guide

为更好地保障来留学生在遭受意外或疾病困扰时的经济利益，您参加了在平安养老保险股份有限公司江苏分公司承保的人身保险和意外医疗保险，以下是关于保险内容的介绍及服务指南。

For guaranteeing the economic benefits for the international students who came to China when suffering from disease, you join in the insurance plan of life insurance and accidental medical insurance covered by Jiangsu Branch of Ping An Annuity Insurance Co. The insurance contents and service guide shall be shown as follows:

1、保险期间Insurance Duration

具体以您参保后，签发的保险单上载明的时间为准

Please refer to the time listed in the policy issued by our company after your application.

2、参保资格Qualification

所有身体健康、能正常工作和生活的18-60 周岁来华人士。(18~60 周岁收费标准为100%，61~70 周岁收费标准为150％，71~75 周岁收费标准为200%)

The insured is the visitor from abroad aging from 18 to 60 who is healthy and capable of normal work and normal living (charged by the rate of 100% for the insured who is aging from 18 to 60 years old, by the rate of 150% upon the basic premiums for those who are aging from 61 to 70, and by the rate of 200% upon the basic premiums for those who are aging from 71 to 75 years old).

3、参保手续Application Procedures

由各单位统一办理参保手续。

The institutions shall handle with application procedures.

4、受益人Beneficiary

医疗保险金的受益人为参保人本人，身故保险金的受益人为参保人员的法定继承人。

The beneficiary of medical benefits shall be the applicant, and the beneficiary of death benefits shall be the legal heir to the applicant.

5、服务热线Service Hotline

平安养老保险股份有限公司江苏分公司服务专员（王碧云）热线：025—84677217；13382070456

Service commissioner of Ping An Annuity Insurance Company, LTD, Jiangsu Branch Service. Tel: 025—84677217；13382070456

6、就诊指定医院Designated Hospital

（1）指定医院为当地社会基本医疗保险部门定点的区县级以上公立医院。意外急诊首诊可以到非指定的区县级以上的公立医院就诊治疗；

The designated hospitals are those public hospitals over the district or county levels designated by the local medical insurance department. If an accidental and emergency treatment is needed, the non-designated public hospital can be chosen.

（2）所指定医院的分院、外宾病区、特诊病区、特诊病房和高干病房等同类病区或病房不在指定的范围内；

The branch of designated hospitals, foreigner hospitalization ward, special treatment ward, special treatment room and high-level cadres ward or those of the same kind are not in the regulated scope.

7、用药范围 Medicine

为了切实保证来华人员获得最充足的保障，本方案医疗药品报销范围按以下相关规定执行：《南京市基本医疗保险药品目录》

For the complete guarantee, the medical scope of the insurance plan shall refer to the regulation of Medicine List of Basic Medical Insurance in Nanjing.

8、意外门急诊范围包括：The scope of accidental out-patient and emergency treatment shall include:

（1）因意外原因造成的休克、昏迷。

Shock, coma caused by accident;

（2）因意外原因所致急性出血。

Emergency bleeding caused by accident;

（3）脑外伤、骨折、脱位、撕裂、烧伤、烫伤或其他急性外伤。

Brain trauma, fracture, dislocation, avulsion, burn or other acute trauma

9、索赔Claims

（1）索赔手续：被保险人申请医疗费赔偿时，先填写《保险理赔申请书》一份并加盖公章，然后将资料交至保险公司服务人员。

Claims procedures: when the applicant lodges a claim foe medical treatment, he/she shall fill in Insurance Claims Application with the seal and then give the relative materials to the service commissioner of insurance company.

（2）理赔时限：保险公司收取理赔资料后，在15个工作日内完成理赔，并将理赔款项直接打入被保险人个人帐户，或被保险人直接到柜面领取

Claims effectiveness: After taking the claims application, insurance company should finish claims within 15 working days and transfer the indemnity into the individual account of the insurer, or the insured can draw the benefits from the counter directly.

（3）索赔时须提供的单据：Forms Required in Claims

住院或意外门诊保险金的申请

the out-patient or in-patient insurance application

由被保险人作为申请人，填写保险金给付申请书，并凭下列资料向保险人申请给付保险金：

The insured fills in the benefits claims application as the applicant and applies to the insurer for insurance with the following materials:

① 保险单或其他保险凭证及保险金申请书；

Insurance policy or the other insurance documents;

② 被保险人身份证明；

ID certificate of beneficiary;

③ 本补充约定指定或者认可的医疗机构出具的医疗费用原始收据、电脑打印的费用明细清单、意外门急诊病历复印件、出院小结；

Duplicated documentation of the case history, diagnosis certificate, brief summary of leaving hospital, prescription and the original certificate of medical expenses issued by the hospital;

④ 被保险人所能提供的与确认保险事故的性质、原因、伤害程度等有关的其他证明和资料；

Any other certificates and documents can be provided to prove the nature and cause of the insurance accident;

注：不受理外配药发票及到药房自行购买的药费发票；

Remarks: the medicine invoice bought in drug store or in the other hospital shall not be included.

10、索赔时效: Validity of claims

被保险人申请住院或意外门急诊医疗赔偿时，应在三个月内提出索赔，否则，可能会带来的不利法律后果由被保险人自行承担。

The insured should apply for in-patient or out-patient and emergency medical benefits within 3 months. Any legal consequences otherwise are borne by the insured.

11、索赔时须注意事项：Notes in Claims

（1）病历上注明病情、检查、治疗、用药及剂量；病历上的记录与收据上的收费的项目相符；病历上的诊病日期须与收据上的日期一致。

The information about case condition, inspection, treatment, medicine and dosage should be identified in the case history; the charged project in the receipt should be the same as the record in the case history; the date receiving treatment in the case history should be the same as that in the receipt.

附件一：残疾给付比例表Appendix I: Disability Benefit Percentage Table

自费学习留学生医疗保险报报销注意事项

Notice for Medical Insurance Claim Procedure for Self-sponsored Int’l Students

就诊医院：区县级以上公立医院（普通病床）

Hospital: public hospitals of district and country level or above (ordinary beds)

用药范围：南京市（或当地）医保范围内用药

Medication scope: medication within the scope of Nanjing （ Or local ） medical insurance (or referring to local medical insurance)

就诊姓名：建议使用护照名

Name used during treatment: Suggested use Passport Name or part of Passport Name