TotalProtect Refundable Accident and Disability Protection Plan
TotalProtect Refundable Accident and Disability Protection Plan1 (the “Plan”) provides all-inclusive accident insurance coverage to ease your financial burden and support you through difficult times should misfortune happens. By paying 10 years of premiums, you can enjoy 15 years of coverage. Moreover, you will receive up to 100% premium refund at policy maturity, regardless of your claim record under the Plan.
4 benefit levels to suit your needs
You can choose from 4 different benefit levels2 to cater to your personal needs.
Accidental death and dismemberment benefit3,4,5
If the insured becomes injured in an accident, and such injury results in death or any of the injuries as stated in the “accidental death and dismemberment benefit schedule” within 180 days from the date of the accident, the Plan will pay a lump sum benefit according to the “accidental death and dismemberment benefit schedule”, giving you and your family financial support at a time of need. The total benefit amount of this benefit will be subject to the benefit limit of “accidental death and dismemberment benefit” as shown on the “benefit schedule”.
Accidental total and permanent disability benefit4,5,7
If the insured is injured in an accident on or after the policy anniversary when the insured reaches age 18, and suffers from total and permanent disability6 within 180 days after the date of the accident and such disability will persist and is proved by a registered medical practitioner that it has continued for 180 days from the date of diagnosis, the Plan will provide on a monthly basis the benefit amount of “accidental total and permanent disability benefit” as shown on the “benefit schedule” starting from the first policy monthiversary after the date of diagnosis of such disability of the insured, up to a maximum of 100 months. This can help cover the living costs and medical expenses.
Double indemnity benefit
For extra peace of mind, if the insured passes away or suffers from an injury caused by an accident as a fare-paying passenger of public conveyance, and the “accidental death and dismemberment benefit” and/or “accidental total and permanent disability benefit” (as the case may be) has been paid under the Plan for such death or injury within 180 days from the date of the accident, the Plan will pay an extra “double indemnity benefit” which is equal to the amount paid for “accidental death and dismemberment benefit” and/or “accidental total and permanent disability benefit” (as the case may be).
Accidental medical expenses benefit8
The medical costs arising from an accident can be significant. As such, the Plan will reimburse the reasonable and customary actual medical expenses incurred for specified medical services that are medically necessary for the injury within 365 days after the date of the accident of the insured, up to a maximum of HKD24,000 per accident (depending on the benefit level).
The specified medical services cover outpatient, hospitalization to rehabilitation:
● medical or surgical treatment
● hospital confinement
● home nursing within 31 days after discharge from hospital
● bone-setting or acupuncture treatment
● chiropractic treatment, physiotherapy, occupational therapy or speech therapy
● purchase or rental of specified medical equipment
Compassionate death benefit
If the insured dies while the policy is in force, and “accidental death and dismemberment benefit” is not payable for such death, the Company will pay to the beneficiary the “compassionate death benefit” as shown on the “benefit schedule”. The Plan shall then terminate.
For the details of the benefits, please refer to the “benefit schedule” and “accidental death and dismemberment benefit schedule” of the product brochure of the Plan.
Up to 100% premium refund
Regardless of your claim record under the Plan1, you will receive a maturity benefit9 of 100% of the accumulated premium due and paid, less all indebtedness (if any) upon policy maturity. The Plan shall then terminate.
Surrender value and policy termination benefit9
If you choose to surrender the policy before the policy maturity date, we will pay a surrender value; while in the event the policy is terminated upon the occurrence of any of the following events (whichever is earlier), we will pay a policy termination benefit: (i) the total amount of claims paid by the Company for the “accidental death and dismemberment benefit” and/or “accidental total and permanent disability benefit” has reached 100% of the basic amount of the basic plan; or (ii) the due premium has not been paid within 31 days after the premium due date.
Surrender value and policy termination benefit are respectively equal to the amount stated in the below table, together with the policy deposit (if applicable), less any unpaid premium (if applicable) and all indebtedness (if applicable):
| The effective date of policy surrender or the date of the policy termination (as the case may be) is | The amount which is equivalent to the following percentage of the accumulated premium due and paid calculated while the policy is in force and until the effective date of the policy surrender or the date of the policy termination (as the case may be) |
| Prior to the 7th policy anniversary | 0% |
| From the 7th policy anniversary and prior to the 8th policy anniversary | 60% |
| From the 8th policy anniversary and prior to the 9th policy anniversary | 65% |
| From the 9th policy anniversary and prior to the 10th policy anniversary | 70% |
| From the 10th policy anniversary and prior to the 11th policy anniversary | 75% |
| From the 11th policy anniversary and prior to the 12th policy anniversary | 80% |
| From the 12th policy anniversary and prior to the 13th policy anniversary | 85% |
| From the 13th policy anniversary and prior to the 14th policy anniversary | 90% |
| From the 14th policy anniversary and prior to the policy maturity date | 95% |
| Policy maturity date | 100% |
Simplified underwriting
The application of the Plan is simple and fast as no medical examination is required.
24-hour worldwide emergency assistance service10
If the insured is diagnosed with an illness or is injured in an accident outside the country of residence, he/she will access comprehensive coverage under the free 24-hour worldwide emergency assistance service.
TotalProtect Refundable Accident and Disability Protection Plan
| Issue age | 15 days to age 55 |
| Premium payment term | 10 years |
| Benefit term | 15 years |
| Premium payment mode11 | Annual, monthly, annual and premium prepayment12 |
| Policy currency | HKD |
Notes :
- Each insured is allowed to have one TotalProtect Refundable Accident and Disability Protection Plan in force only.
- Plans 3 and 4 are not applicable to insured of occupation class 3.
- If the insured suffers from more than one injury caused by the same accident, the Company will only pay the “accidental death and dismemberment benefit” for one injury (whichever is higher), and in the event of the same benefit payment, the Company reserves the sole and final decision as to which injury shall be paid.
- If the Company has paid the “accidental death and dismemberment benefit” for an injury, the Company will not pay the “accidental total and permanent disability benefit” for the total and permanent disability due to the same injury.
- The total amount of claims paid by the Company for “accidental death and dismemberment benefit” and/or “accidental total and permanent disability benefit” is subject to 100% of the basic amount of the basic plan. If the total amount of claims paid by the Company for the “accidental death and dismemberment benefit” and/or “accidental total and permanent disability benefit” has reached 100% of the basic amount of the basic plan when the Company is paying for the “accidental total and permanent disability benefit”, the “accidental total and permanent disability benefit” will be terminated and the Company will pay the policy termination benefit at the same time. The policy shall then terminate.
- “Total and permanent disability” means the inability of the insured in his lifetime to engage in all missions of any gainful work, occupation or profession for which the insured is suited by education level, training or experience to earn or to obtain wage, compensation or profit as a result of injury between the policy anniversary when the insured reaches age 18 and the policy anniversary when the insured reaches age 64 (both dates inclusive), then the definition of “total and permanent disability” will be fulfilled; and the inability of the insured who is diagnosed after the policy anniversary when the insured reaches age 64 as a result of injury to perform, without assistance, at least 3 of the 6 activities of daily living, then the definition of “total and permanent disability” will be fulfilled. Please refer to the policy provisions for the definition of activities of daily living.
- The “accidental total and permanent disability benefit” will be paid by the Company for up to 100 months, or until the date of recovery from such disability of the insured, the policy maturity date, the date of death of the insured, or the date of termination of the policy for whatever reason, whichever is the earliest. The premiums due will still have to be paid by the policyholder during the claims payment period. The remaining claims payment for “accidental total and permanent disability benefit” will not be payable if the policy is terminated for whatever reason.
- For “accidental medical expenses benefit”, the Company is not liable for any confinement, surgery and/or medical treatment for which compensation or reimbursement has been paid under any law, medical program, or insurance policy provided by any government, company or other insurers except to the extent that such charges are not reimbursed by such law, medical program or insurance policy.
- For the avoidance of doubt, when the Company has paid any of the following benefits, the remaining two benefits will not be applicable: (a) surrender value; or (b) policy termination benefit; or (c) maturity benefit.
- 24-hour worldwide emergency assistance service is provided by a third party service provider. China Life (Overseas) will not guarantee the service quality and shall not be liable for any matter in connection with the services. China Life (Overseas) reserves the right to amend the terms and conditions thereof from time to time without prior notice.
- If the required renewal premium is paid by you within the grace period, the policy shall continue to be in force. For details, please refer to the policy provisions issued by China Life (Overseas). If the policy is lapsed or surrendered early, the policy cash value (if any) received by you may be considerably less than the total amount of the premiums paid.
- If you choose the annual and premium prepayment option, you can withdraw the unused prepaid premium (including interest, if any) at one time. China Life (Overseas) will charge 2% of the withdrawal amount, at a minimum amount of HKD100. You can withdraw the unused prepaid premium once only. The interest rate of prepaid premium is not guaranteed.
- “Basic amount” means the amount shown on the policy information page or endorsement as the “basic amount”. The “basic amount” is used to calculate premium, but it is not applicable to the calculation of the “compassionate death benefit”. If the basic amount has been amended while the policy is in force, the said premium will be adjusted accordingly.
Important Information:
This product brochure is for reference only. Please refer to the Policy documents for the complete definitions of the capitalised terms, as well as all the terms and conditions of this product. You are reminded to review all of the relevant product materials provided to you and to seek independent professional advice if necessary.
- The Policy is underwritten by China Life Insurance (Overseas) Company Limited (“China Life (Overseas)” or "us/we/our"). China Life (Overseas) is responsible for the features, underwriting and benefit payments under the Policy. You should fully understand all of the risks involved in this product and consider whether this product is affordable and suitable to you before making your application.
- China Life (Overseas) shall make the final decisions on the underwriting and claims. Weshall rely on your submitted information to assess whether to accept or decline your application, and shall refund any Premium paid without interest for declined cases.
- This is a non-participating life insurance Policy and therefore dividends are not available to the Plan.
- Exclusions – unless the contract expressly provides to the contrary, China Life (Overseas) shall not be liable to pay expenses incurred directly or indirectly in connection with and/or for, in relation to any and all of the following:: (1) Pre-existing Condition, or any Disease within 30 days prior to the Policy Effective Date or date of Reinstatement; (2)treatment or investigation which is not Medically Necessary8; (3) any injury or Disease for which compensation is payable under any laws or regulations or any other insurance policy or other source, except the expenses which could not be covered under that laws or regulations or other insurance policy; (4) any charges for accommodation, nursing and services received in health hydros, nature cure clinics, convalescent home or similar establishments; (5) any charges in respect of surgical or non-surgical cosmetic treatment, or hearing test, routine blood tests, general check-ups, vaccination or inoculations, Hair Mineral Analysis (HMA), health supplements or body weight control, eye refraction including but not limited to routine eye tests or any costs of fitting of spectacles or lens; (6) Congenital Conditions, Developmental Conditions or Hereditary Conditions; (7) treatment that commenced during the first 5 policy years and which in any way arises from, is attributable to, or is consequential upon Human Immunodeficiency Virus Infection; (8) Sexually Transmitted (Venereal) Diseases or their sequel; (9) treatment relating to pregnancy, including diagnostic tests for pregnancy or resulting childbirth, abortion or miscarriage, birth control or sterilization of either sex; infertility including in-vitro fertilization or any other artificial method of inducing pregnancy; sexual dysfunction including but not limited to impotence, erectile dysfunction, pre-mature ejaculation, regardless of cause; (10) abuse of drugs or alcohol, self-inflicted injuries or attempted suicide; (11) treatment relating to any injury or disease resulting from participation in criminal activities; (12) alternative treatment including but not limited to Chinese Medicine treatment, acupuncture, acupressure, Tui Nai, hypnotism, rolfing, massage therapy, aromatherapy; (13) any geriatric, psychological, psychogeriatric or psychiatric condition of any and all kinds, including but not limited to psychoses, neuroses, depression, anxiety, anorexia nervosa, schizophrenia, behavioural disorders, Alzheimer’s disease, delirium, dementia-senile, Parkinsonism, insomnia, neurasthenia; (14) any charges for the procurement or use of special braces and appliances including but not limited to spectacles, hearing aids and other equipments such as wheel chairs and crutches; (15) dental treatment and oral surgery (except directly caused by an Emergency as a direct result of an Accident and the treatment or oral treatment is performed during Hospital Confinement). Follow-up treatment from such Hospital Confinement shall not be covered; (16) any charges blood and blood plasma; (17) treatment arising from war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection or military or usurped power or terrorist acts; (18) non-medical services including but not limited to guest meals, radio, telephone, photocopy, taxes, medical report charges and the like; (19) experimental and/or new medical technology/procedure not yet approved by China Life (Overseas); (20) treatment or surgery for tonsils, adenoids, hernia or a disease peculiar to the female generative organs within 120 days from the Policy Issue Date or a later Effective Date as shown on the endorsement validly made to this Policy whereby this Rider becomes effective; (21) intentional self-injury or suicide (whether sane or not), intoxication by alcohol or insanity; and (22) the Insured participating in hunting, mountaineering, motor racing, horse racing, skiing; water-skiing, diving, parachuting, hand gliding or flying, boxing or other hazardous competitions or performances.
In addition, the information stated herein is for reference only. Please refer to the General Provisions for the exact terms and conditions and limitations such as incontestability, suicide and fraud etc. or all exclusions. - Non-Payment of Premium - You should pay Premiums on time according to the selected Premium payment schedule. If the due Premium remains unpaid upon the expiry of the Grace Period, the Policy will be terminated in accordance to the clauses as stated on the “Grace Period and Lapse Of Policy” section of the General Provision and you will lose the coverage.
- Cooling-off Right - You have the right to cancel the Policy within the Cooling-off Period and obtain a refund of any Premiums paid by giving written notice to us provided that you have not made any claims under the Policy. Such notice must be signed by you and submitted to China Life (Overseas) at 22/F, CLI Building, 313 Hennessy Road, Wan Chai, Hong Kong within 21 days after the delivery of the Policy or issue of a Notice to you or your representative informing you that the Policy is available, whichever is earlier.
| What are the key product risks? | |
|---|---|
| Credit risk: |
This product is a life insurance Policy issued by China Life (Overseas). Any Premium paid will become part of our assets and our financial strength will affectour ability to meet our contractual obligations to you under the Policy. Therefore this product is subject to our credit risk. |
| Exchange rate and Currency risks: |
Any Policy with foreign currencies involves risks, such as potential changes in political or economic conditions that may substantially affect the price or liquidity of a currency. The fluctuations in exchange rates may also cause financial losses to you during currency conversions. You should consider the potential currency and exchange rate risks before deciding which Policy currency you should take. |
| Inflation risk: |
The cost of living in the future may be higher than expected due to the effects of inflation. Therefore, your current planned benefits and/or returns maybeinsufficient to meet your future needs even if we fulfill all of our contractual terms and obligations. |
| Policy Termination: |
The Policy will be terminated if (a) the Insured passes away, (b) you do not pay the Premium within 31 days of the due date and the Policy has no Cash Value.Option benefit(s) (if any) will be terminated at the same time. |
| Premium adjustment and renewal： |
China Life (Overseas) has the absolute right and discretion to adjust the renewal premium payable under the Policy at the end of each Coverage Period (that is every year). Factors leading to premium adjustment may include but are not limited to the experience in claims, policy surrender, investment return, and expenses incurred by and/or in relation to this product. |
This product brochure is for reference only and contains descriptions of the key features of this product. For all the terms and conditions and exclusions of this product, please refer to the policy documents of this product. In the event of any ambiguity or inconsistency between the terms of this brochure and the policy documents, the Chinese version of the policy documents shall prevail.
This product brochure is for distribution in Hong Kong only and shall not be construed as any provision of or offer to sell or solicitation to buy any insurance product outside Hong Kong. China Life Insurance (Overseas) Company Limited ("China Life (Overseas)") does not provide or offer to sell any insurance product outside Hong Kong. The above information is for reference only. The detailed terms, conditions and exclusions of the Plan are subject to the terms and conditions of the policy contract of the Plan. For a copy of the terms and conditions of the policy contract, please contact China Life (Overseas) for enquiry.
