sf v2 health4kids cigna premium refundable plan brochure en · 2019-09-30 · hong kong, an...

18
CIGNA HEALTH4KIDS PREMIUM REFUNDABLE PLAN CIGNA HEALTH AND WEALTH PLAN SERIES HEALTH / WEALTH Life Insurance

Upload: others

Post on 10-Jul-2020

1 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

CIGNA HEALTH4KIDSPREMIUM REFUNDABLE PLAN

CIGNA HEALTH AND WEALTH PLAN SERIES

HEALTH / WEALTHLife Insurance

Page 2: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

1

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

ABOUT CIGNA CORPORATION

Remarks:1 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, 2018 and is subject to change.

2 Per policy holder.

Sales capability in over 30 countries and jurisdiction1

US$49 billion total revenue1

More than 160 million customer relationships1,2

74,000 employees around the world1

More than 1 million relationships with

healthcare providers, clinics and facilities1

Ranked 65th on the 2019 Fortune

500 list

Named a ‘Caring Company’ for the 16th consecutive year by the Hong

Kong Council of Social Service

1

Page 3: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

2

HAVE YOU NOTICED?

Sources:The above information is extracted from Cigna’s Research of Children Health Development Concern and Saving by GfK Hong Kong, an independent market research company (data collected in December 2017)

Being a parent in Hong Kong, we understand your children’s health is of foremost importance to you; at the same time, providing a secure future for them is also a top priority. Cigna Health4Kids Premium Refundable Plan is a brand new solution that o�ers your children with comprehensive healthcare protection and wealth accumulation with guaranteed returns.

As parents or parents-to-be, there are lots of things you need to take into consideration to take care of your children. According to the recent survey about the concern of children health development and saving from parents’ perspective, some findings are as follow:

Parent’s Concern towards the kids

Financial Preparation for Children

Children’s health is theirtop concern

55% of parents start saving for their children before they turn 1

Take e�ective precautions or have financial support to meet children’s

health risks is important

Never too early to start saving for children’s future needs

Reasons for Saving Required Period for Reaching Target Return

Education expenses is the main reason why

nearly 50% of parents save for their children

Nearly a third of parentsbelieve it’ll take them 10 - 14 years

to reach their target return

Children’s education fees can be both rewarding and costly

Safeguarding your financial future takes time

Page 4: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

3

HOW CAN YOU BENEFIT FROM HEALTH4KIDS REFUNDABLE PLANWe o�er a tailored solution to help you protect your child’s health and well-being, while adding value to prepare their future needs.

Hospitalization SupportUnexpected hospital stays for your children can bring upon costly out-of-pocket expenses. This plan provides up to HKD $1,500 daily hospital cash for your children’s hospital confinement.

Premium Waiver BenefitIf you purchase this plan before the age of 51 but unfortunately pass away due to a covered critical illness or an accident, or become totally disabled for 6 months consecutively, your children will continue to enjoy protection without having to pay future premiums until the policy matures.

Preventive Care for KidsWe invest in prevention, rather than just reacting to symptoms. That’s why we provide annual coverage on preventive care expenses, including vision and oral health, vaccinations and health check-up.

Major Disease CoverageThe plan covers up to 16 children critical illnesses including cancer and coronary diseases.

3

Page 5: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

4

15yearsof premiumpayments1

Protection up to

19years old1Cash value up to

118%of your total Basic Premium

paid upon maturity1 even claims made on hospital cash

and wellness child benefit

Guaranteed Refund of Premium

Remark:1. The years of premium payment, protection period and cash value illustrated above are based on the person insured

applies the plan at aged 15 days and Plan 3 is purchased.

Page 6: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

5

PLAN AT A GLANCE

Remarks:1. Subsequent to the successful application of Basic Benefits, policyholder can also apply the Optional Benefits at least

30 days prior to the policy anniversary date within the policy term.2.

the right to revise the terms of the Optional Benefits upon each policy anniversary date.3. Refer to total premium paid for Basic Benefits only.4. Each Person Insured can enroll in one Cigna Health4Kids Premium Refundable Plan only.5. Each policyholder can purchase Cigna Health4Kids Premium Refundable Plan for at maximum four children.

Outstanding Series Nurturing Series

Plan 3 Plan 2 Plan 1

Basic BenefitsKids Critical Illness Benefit; Hospital Cash;

Wellness Child Benefit; Cash Value upon Maturity;Premium Waiver Benefit

Optional Benefits Outpatient Benefits (yearly renewable)

Issue age of Person Insured1

(at last birthday)15 days to age 9 15 days to age 5

Policy Term2 Until age 19 Until age 15

Premium Structure Basic Benefits : Level and guaranteed premium Optional Benefits: Yearly renewable

Premium Payment Frequancy Annual/ Monthly

Policy Currency HKD

Payment Term – Basic Benefits

Issue age Years of Premium Payment Issue age Years of Premium

Payment

15 days 15 years 15 days 11 years

1 14 years 1 10 years

2 13 years 2 9 years

3 12 years 3 8 years

4 11 years 4 7 years

5 10 years 5 6 years

6 9 years

7 8 years

8 7 years

9 6 years

Premium payment up to age 15 Premium payment up to age 11

– Optional Benefits Payable every year, until the end of policy term

Maximum Cash Value upon maturity

Up to 118% of total Basic Premium

paid3

Up to 115% of total Basic Premium

paid3

Up to 113% of total Basic Premium paid3

Page 7: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

6

BENEFIT SCHEDULE

Basic Benefits Plan 3 Plan 2

Benefit Items Maximum Limit (HK$)

Kids Critical Illness Benefit1

Diseases listed below after the Waiting Period and has survived for 30 days.

$500,000 plus 100% refund of the total Basic Premium paid

$300,000 plus 100% refund of the total Basic Premium paid

Hospital CashProvide cash benefit during the hospital confinement of person insured

$1,500 / day(Up to 45 days per policy year)

$1,000 / day(Up to 45 days per policy year)

Wellness Child BenefitCover the actual charges incurred if the person insured carries out the following services during the policy year:- Eye test or hearing test- Dental care and treatment- Vaccinations for preventive care- Check up test (including general physical check up / spinal screening /

allergy test /nutrition consultation)

Reimbursement percentage:

80% of actual expenses; (Up to $1,000 per policy year)

Reimbursement percentage:

80% of actual expenses; (Up to $800 per policy

year)

Compassionate Death Benefit1

Provide the compassionate death benefit if the person insured passes away

100% refund of total Basic Premium paid

Cash Value1 Cash value will be payable upon policy termination by the policyholder or policy maturity according to the percentage of total Basic Premium paid indicated in the Cash Value Table.

Up to 118% of total Basic Premium paid

Up to 115% of total Basic

Premium paid

Remarks:1. The policy will be terminated after Kids Critical Illness Benefit, Compassionate Death Benefit or Cash Value is paid.

Major Diseases:

1. Cancer2. Coma3. Coronary Artery Bypass

Surgery4. Hand, foot and mouth diseases

with severe (life threatening) complications

5. Insulin-Dependent Diabetes Mellitus

6. Kawasaki Disease with Heart Complications

7. Kidney Failure8. Liver Failure9. Major Burns10. Major Organ Transplantation11. Myocardial infarction 12. Poliomyelitis13. Rheumatic Fever with Valvular

Impairment14. Severe Asthma15. Severe Epilepsy16. Stroke

The Outstanding SeriesThe Outstanding Series o�ers long-term care protection: you’re only required to make contributions for your children until they turn 15, and they can continue to enjoy the benefits below until they reach the age of 19. You’re also entitled up to 118% cash value of your Basic Premium paid upon maturity - even if you’ve made claims on your children’s wellness and hospital cash. The Outstanding Series provides the best healthcare protection and a prosperous foundation for your children to reach their fullest potential and realise their dreams.

The following is for reference only, please refer to the policy provisions for details.

Page 8: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

7

CASH VALUE TABLE

Plan 3 and Plan 2

Maturity Value (% of cash value of total Basic Premium paid)

Issue Age of Person Insured Plan 3 Plan 2

0 118% 115%

1 116% 114%

2 115% 113%

3 114% 112%

4 113% 111%

5 112% 110%

6 111% 109%

7 110% 109%

8 109% 108%

9 108% 108%

Cash value, which is a percentage of total Basic Premium paid, will be payable according to the following table upon maturity. (i.e. Person Insured reaches aged 19) :

Page 9: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

8

BENEFIT SCHEDULE

Basic Benefits Plan 1

Benefit Items Benefit Amount (HK$)

Kids Critical Illness Benefit1

Diseases listed below after the Waiting Period and has survived for 30 days.

$200,000 plus 100% refund of the total Basic Premium paid

Hospital CashProvide cash benefit during the hospital confinement of person insured

$800 / day(Up to 45 days per policy year)

Wellness Child BenefitCover the actual charges incurred if the person insured carries out the following services during the policy year:- Eye test or hearing test- Dental care and treatment- Vaccinations for preventive care- Check up test (including general physical check up / spinal screening /

allergy test /nutrition consultation)

Reimbursement percentage: 80% of actual expenses; (Up to $500 per

policy year)

Compassionate Death Benefit1

Provide the compassionate death benefit if the person insured passes away100% refund of total Basic Premium paid

Cash Value1 Cash value will be payable upon policy termination by the policyholder or policy maturity according to the percentage of total Basic Premium paid indicated in the Cash Value Table.

Up to 113% of total Basic Premium paid

Remarks1. The policy will be terminated after Kids Critical Illness Benefit , Compassionate Death Benefit or Cash Value is paid.

Major Diseases:

1. Cancer2. Coma3. Coronary Artery Bypass

Surgery4. Hand, foot and mouth diseases

with severe (life threatening) complications 5. Insulin-Dependent Diabetes

Mellitus6. Kawasaki Disease with Heart

Complications

7. Kidney Failure8. Liver Failure9. Major Burns10. Major Organ Transplantation11. Myocardial infarction 12. Poliomyelitis13. Rheumatic Fever with Valvular

Impairment14. Severe Asthma15. Severe Epilepsy16. Stroke

The Nurturing SeriesCigna Health4Kids Premium Refundable Plan is also available in the Nurturing Series, with a shorter premium payment term, giving you greater flexibility to meet other financial commitments, e.g. paying for your children’s tuition fees. You’re only required to make contributions for your children until they turn 11 in order for them to enjoy below benefits until they reach the age of 15. You’re also entitled to a cash value up to 113% of your Basic Premium paid upon maturity - even if you’ve made claims on your children’s wellness and hospital cash. The Nurturing Series provides a comprehensive healthcare protection and a solid foundation to help prepare your children’s future needs.

The following is for reference only, please refer to the policy provisions for details.

Page 10: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

9

Issue Age of Person Insured Maturity Value (% of cash value of total Basic Premium paid)

0 113%

1 112%

2 111%

3 110%

4 109%

5 108%

Cash value, which is a percentage of total Basic Premium paid, will be payable according to the following table upon maturity. ( i.e. Person Insured reaches age of 15) :

CASH VALUE TABLE

Plan 1

9

Page 11: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

10

Premium Waiver Benefit1

(only applicable to policyholder who aged 50 or below when the policy is firstly issued)

If the policyholder dies due to accident or from covered Major Diseases below2 or becomes totally and permanently disabled for at least 6 months during his/her lifetime, the company will waive the payment of subsequent premium for the basic benefits until the basic benefit matures. 2 year waiting period applies.

Remarks:1. Once the Premium Waiver Benefit begins, any Optional Outpatient Benefits added to the Basic Benefits will be

automatically terminated.2. Premium Waiver Benefit for death due to Major Diseases will be payable only when the policyholder survives for 15

days after first confirmed diagnosis of any Major Diseases.

Major Diseases:

Tumour1. Benign Brain Tumour 2. Cancer

Illnesses related to heart and blood vessels3. Cardiomyopathy 4. Coronary Artery Bypass Surgery 5. Heart Valve Replacement 6. Infection due to Blood Transfusion 7. Myocardial Infarction 8. Primary Pulmonary Arterial Hypertension9. Surgery to Aorta

Illnesses related to organ failure10. Aplastic Anaemia 11. End Stage Lung Disease12. Fulminant Viral Hepatitis 13. Kidney Failure 14. Liver Failure 15. Major Organ Transplantation 16. Medullary Cystic Disease 17. Occupationally acquired HIV 18. Systemic Lupus Erythematosus (S.L.E.) with Lupus

Nephritis

lllnesses related to the nervous system19. Alzheimer’s Disease/Dementia 20. Amyotrophic Lateral Sclerosis 21. Bacterial Meningitis 22. Brain Surgery 23. Coma

24. Creutzfeldt-Jakob Disease25. Encephalitis 26. Meningeal Tuberculosis 27. Multiple Sclerosis28. Muscular Dystrophy29. Paralysis 30. Parkinson’s Disease 31. Poliomyelitis 32. Primary Lateral Sclerosis 33. Progressive Bulbar Palsy 34. Progressive Muscular Atrophy 35. Progressive Supranuclear Palsy36. Severe Brain Damage 37. Spinal Muscular Atrophy 38. Stroke 39. Vegetative State

Other major illnesses40. Blindness 41. Chronic Relapsing Pancreatitis 42. Crohn’s Disease 43. Ebola 44. Elephantiasis 45. Loss of Hearing 46. Loss of Limbs 47. Loss of Speech 48. Major Burns 49. Necrotising Fasciitis / Gangrene 50. Rheumatoid Arthritis (Adult) 51. Severe Ulcerative Colitis 52. Terminal Illness

Waiting Period

Benefit Items Waiting Period

Kids Critical Illness Benefit 90 days

Hospital Cash 30 days

Premium Waiver Benefit 2 years1

Remarks:1. The waiting period will be counted afresh if there is change in policyholder upon Company’s approval.

Page 12: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

11

Optional Outpatient BenefitsCover treatments or consultations on outpatient basis.

Plan 2 Plan 1

Reimbursement Percentage / Choice of Doctor 80% / Free Choice

Benefit Items Maximum Limit (HK$)

1. General Practitioner Consultation1 3 4 $240 / visit $180 / visit

2. Specialist Consultation2 3 4 $480 / visit $350 / visit

3. Physiotherapy2 3 4 $430 / visit $330 / visit

4. Chiropractor Consultation2 3 4 $430 / visit $330 / visit

5. Chinese Medicine Practitioner Consultation1 3 4

(includes 2 packs of basic Chinese medicines)$180 / visit $150 / visit

6. Chinese Bone-setting1 3 4 $180 / visit $150 / visit

7. Acupuncture1 3 4 $180 / visit $150 / visit

8. Home Consultation (consultation fee only, per visit)3 4 $520 / visit $350 / visit

9. Prescribed Western Medicine (per policy year) $1,500 $1,000

10. Diagnostic Imaging and Laboratory Tests (per policy year) $2,000 $1,500

Remarks: For items 2, 3, 4 & 10, a written referral letter from the physician is required.1. Only one of the General Practitioner Consultation, Home Consultation, Chinese Medicine Practitioner Consultation,

Chinese Bone-setting or Acupuncture will be paid for any one day.2. Only one of the Specialist Consultation, Physiotherapy, or Chiropractor Consultation will be paid for any one day.3. Benefit items 1-8 applies only to consultation / treatment fee, and only one consultation / treatment will be paid for

any one day. 4. An overall maximum of 30 visits per policy year from items 1 to 8, with an overall maximum of 10 visits per policy

year from items 4 to 8.

11

The following is for reference only, please refer to the policy provisions for details.

Page 13: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

12

CASE ILLUSTRATION

With Cigna Health4Kids Premium Refundable Plan, Joanna’s child is equipped with an all-round healthcare protection, combined with superior benefits and a wealth accumulation plan, ensuring the best protection throughout his/her life’s journey. At the same time, the plan also provides security for Joanna to make sure her child is covered even if she’s exposed to unforeseen accident, death or total disability that can put her child’s aspirations at risk.

Case: Comprehensive healthcare protection with wealth accumulation

Policyholder Joanna Age 30Person Insured New born babyBackground Joanna has just given birth to her new-born 2 months

ago. She foresees the enormous expenditure required for her baby’s health development. On top of hospital insurance, she wants a medical plan that provides her child with comprehensive coverage, so she enrols on the Cigna Health4Kids Premium Refundable Plan.

Joanna receives HK$648,329

(Wellness Child Benefit, Hospital Cash and 118% cash value)

Her total Basic Premium Paid HK$533,160

The following example is hypothetical and for illustrative purpose only.

Policy Purchase

Plan Level – Plan 3

Wellness andHospital Cash Protection Policy Maturity

Monthly Premium: HK$2,962(15-year premium payment term)

Age 15: Total Premium paid: HK$533,160,no further premium payment is required.

Age 16-18:Oral polishing & examinationHK$800 x 3 years

Age 19:Policy matures with 118% premium paid: HK$629,129

Age 0 – 3: Vaccination HK$1000 x 4 years

Age 4:Vision test HK$900

Age 5: Hospitalization x 3 days HK$1,500 x 3 days

Age 6:Nutrition TestHK$1,000

Age 7 – 14:Oral polishing & examinationHK$800 x 8 years

Page 14: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

13

CASH VALUE TABLEIf the policy is surrendered (i.e. terminated by the policyholder) before policy maturity, the cash value will be payable according to the percentage of total Basic Premium paid indicated in the following table:

Plan 3 and Plan 2

Issue Age of Person Insured

Upon and after the end of policy year 0 1 2 3 4 5 6 7 8 9

1-5 0%

6 0% 25%

7 0% 25% 50%

8 0% 25% 50% 75%

9 25% 25% 25% 25% 25% 25% 25% 50% 75% 85%

10 25% 25% 25% 25% 25% 25% 50% 75% 85%

11 25% 25% 25% 50% 50% 50% 75% 85%

12 50% 50% 50% 50% 50% 75% 85%

13 50% 50% 50% 75% 75% 85%

14 50% 50% 75% 75% 85%

15 75% 75% 75% 85%

16 75% 75% 85%

17 75% 85%

18 85%

Plan 1

Issue Age of Person Insured

Upon and after the end of policy year 0 1 2 3 4 5

1-5 0%

6 0% 25%

7 0% 25% 50%

8 0% 25% 50% 75%

9 25% 25% 25% 50% 75% 85%

10 25% 25% 50% 75% 85%

11 50% 50% 75% 85%

12 50% 75% 85%

13 75% 85%

14 85%

Page 15: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

14

IMPORTANT INFORMATION

Premium

1. Premium Level and Adjustment The premium level of Cigna Health4Kids Premium

Refundable Plan corresponding to the plan level you select is determined based on age of the person insured at policy commencement. The premium of basic benefits is level and guaranteed, while that of optional outpatient benefit is yearly adjustable and we have the absolute right and discretion to adjust annually. Factors leading to premium adjustment may include but are not limited to our experience in claims, surrender, investment return, and expenses incurred by and/or in relation to this benefit.

2. Non-payment of Premium If you fail to pay the initial premium, your policy will

not commence or take e�ect. Except for the initial premium payment, there will be a grace period of 1 month after any premium due date. Your policy will remain e�ective during this grace period. If any premium is not paid at the end of the grace period, your policy will lapse on the premium due date and you will lose the insurance cover.

We reserve the right to deduct any outstanding premium from any benefit(s) payable.

3. Mis-statement of Age If mis-statement of the Person Insured’s age by you or

any Person Insured means that the Person Insured is still eligible for coverage, we have the right to adjust the premiums payable based on the correct information.

If mis-statement of the Person Insured’s age by you or any Person Insured means that there is a period during which the Person Insured is ineligible for coverage, all coverage during this period will be void. Our liability shall be limited to a refund (upon written request) of any premium relating to this period, to be paid out without interest. In case of fraud on the part of the Person Insured and/or the Policyholder, no premium refunds are payable. If any claims are made during such a period, we retain the right to recover them.

4. Premium Term and Early Surrender The premium term of Cigna Health4Kids Premium

Refundable Plan will be payable up to age 11 of person insured for Plan 1 while up to age of 15 of person insured for Plan 2 and Plan 3. If you surrender the policy before the end of policy term, the amount of benefit getting back (i.e. Cash Value) will be less than the total Basic Premium paid and you may su�er a loss of money and insurance coverage.

Benefits

1. Kids Critical Illness Benefit The Kids Critical Illness Benefit will be paid if the

person insured su�ers from a first confirmed diagnosis of the major diseases and has survived for 30 days thereafter. If the person insured dies within 30 days after the first confirmed diagnosis of major diseases, only Compassionate Death Benefit will be paid.

2. Premium Waiver Benefit The Premium Waiver Benefit will be paid if the

policyholder su�ers from the following conditions:• The policyholder passes away subsequent from

the diagnosis of major diseases and has survived for 15 days thereafter ; or

• The policyholder dies due to an accident; or• The policyholder becomes permanently disabled

for continuous 6 months

To entitle the Benefit, the policyholder must be aged 50 or below when the policy is firstly issued. The Benefit is subject to a waiting period, which refers to 2 years from the issue date or the commencement date (whichever is the later), or any approval date of reinstatement of your policy.

Termination

1. This Policy shall terminate forthwith upon the occurrence of the earliest of the following events:• the anniversary date on or the first anniversary

date immediately following the person insured’s fifteenth (15th) birthday for Plan 1 shown under the policy schedule and the person insured’s nineteenth (19th) birthday for Plan 2 and 3 shown under the policy schedule (i.e. the maturity date of the policy);

• the death of the person insured; • the Kids Critical Illness Benefit is fully paid; • at the end of a grace period when the premium

payable or any part thereof remains unpaid; or• the policy is terminated by policyholder.

2. If there is any fraud, mis-statement or concealment in the application or declaration, or if you or your beneficiary makes a dishonest claim, we have the right to cancel the policy immediately. In such case, all of the premium paid will not be returned and you shall immediately return all payment including claims paid by us under the policy.

Inflation Risk

While your current planned benefits will not be adjusted during the policy term, future medical costs may be higher than they are today due to inflation.

Cooling O� Right

You may cancel your policy and obtain a refund of any premium(s) paid by you within the cooling-o� period. The cooling-o� period is 30 days after (i) the delivery of the policy, or (ii) issue of a notice (informing the availability of the policy and expiry date of the cooling o� period), whichever is the earlier. You have to tell us by giving a written notice if you decide to exercise your cooling-o� right. Such written notice must be signed by you and received directly by us at 16/F, 348 Kwun Tong Road, Kwun Tong, Kowloon, Hong Kong. No refund can be made if a claim has been made.

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.

Page 16: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

15

The following list is for reference only and does not represent 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:

(a) Pre-existing medical conditions and any special exclusion(s) set out under this policy;

(b) Any accident, bodily injury or illness sustained or su�ered during the Waiting Period;

(c) Suicide, attempted suicide, suicide pact or deliberate self-inflicted injury, while sane or insane;

(d) Any congenital abnormality or disorder.

Under the Hospital Cash and Outpatient Benefits (optional benefit), we do not cover expenses directly or indirectly caused by or resulting from any one or more of the following:

(a) Pre-existing medical conditions and any special

exclusion(s) set out under this policy;(b) Any accident, bodily injury or sickness sustained or

su�ered by the person insured which has occurred or which has been diagnosed or which has exhibited symptoms or which has required medical advice and/or treatment and/or the prescription of drugs prior to and/or during the Waiting Period (applicable for Hospital Cash only);

(c) War, invasion, act of foreign enemy, hostilities (whether war is declared or not), civil commotion, rebellion, revolution, insurrection, military or usurped power or terrorism;

(d) Suicide, attempted suicide or intentionally self-inflicted injuries, whether sane or insane;

(e) Any act being contrary to the law of the country or territory in which the bodily injury or sickness occurs as a result of such act;

(f) Infection with Human Immunodeficiency Virus (HIV) or variants including Acquired Immune Deficiency Syndrome (AIDS) and AIDS-related complex (ARC);

(g) Birth defects, congenital conditions, hereditary conditions or any disabilities arising therefrom;

(h) Eye refraction error and the treatment(s) of which involve but not limited to, laser treatment, refractive keratotomy or photorefractive keratectomy, except due to Bodily Injury. The Company shall pay for treatment to correct or restore eyesight if it is medically necessary as a result of a sickness or bodily injury, such as cataracts or a detached retina;

(i) Routine eye / ear examinations, cost of spectacles, contact lenses, hearing aids and artificial lens;

(j) Vaccination and immunisation injections.(k) All dental treatment prescribed by dentist except

emergency treatments by a physician during hospital confinement due to bodily injury. No claims shall be payable for any follow up treatment from such hospital confinement;

(l) Mental, psychiatric or nervous illness, personality disorder and character disorders;

(m) Organ transplantation as a donor;(n) Footcare by a chiropodist or podiatrist;(o) Developmental conditions including but not limited to:

(i) Learning di�culties such as dyslexia;(ii) Behavioral problems such as autism or attention

deficit disorder (ADHD); and(iii) Physical development problems such as short

height. (p) Not medically necessary;(q) The person insured’s voluntarily exposing himself /

herself to any hazard or danger.(r) Convalescence accommodation or treatment or

services rendered in any sanatorium or similar establishment;

(s) Medical treatment received after termination of this policy or the expiry of the period of insurance notwithstanding that such expense may arise from bodily injury or sickness occurring during the period of insurance;

(t) Routine medical examinations or health screening checks;

(u) Any bodily injury or sickness for which compensation is payable under any laws or regulations or any other insurance plan, unless such charges are not reimbursed by such laws or regulations or other insurance plan;

(v) Alternative treatment including but not limited to Chinese Medicines treatment, acupuncture, acupressure, Tui Nai, hypnotism, rolfing, massage therapy, aromatherapy except such occurrence are covered under “Acupuncture” or “Chinese Medicine Practitioner Consultation” or “Chinese Bone-setting” of Outpatient Benefits (optional benefit);

(w) Experimental and / or new medical technology / procedure not yet approved by the Company;

(x) Non-medical services, including but not limited to guest meals, radio, telephone, photocopy, taxes, medical report charges, fax and the like;

(y) Treatment which is provided by anyone who lives at the same address as the Person Insured or who is a member of Person Insured’s family.

The following exclusions are applicable to Wellness Child Benefit only: (a) Cost of spectacles, contact lenses, hearing aids and

artificial lens; and(b) For cosmetic purpose. The following exclusions are applicable to Premium Waiver Benefit only: (a) Pre-existing medical conditions and any special

exclusion(s) set out under this policy;(b) Any accident, bodily injury or illness sustained or

su�ered by the policyholder which has occurred or which has been diagnosed or which has exhibited symptoms or which has required medical advice and /or treatment and / or the prescription of drugs prior to and/or during the Premium Waiver Waiting Period;

(c) The policyholder’s suicide, attempted suicide or intentionally self-inflicted injuries, whether sane or insane;

(d) Alcohol abuse, the consumption of drugs not follow a Physician’s prescription, Acquired Immune Deficiency Syndrome (AIDS), AIDS Related Complex (ARC) or infection with the Human Immunodeficiency Virus except “Infection due to Blood Transfusion” and “Occupationally acquired HIV” as defined in this Policy;

(e) Birth defects, congenital conditions, hereditary conditions or any disabilities arising therefrom;

(f) The policyholder’s engaging in or taking part in;(i) Naval, military or air force service or operations,

armed force or service with the police of any nation;

(ii) Professional sports or hazardous activities such as but not limited to rock climbing or mountaineering, parachuting, hang-gliding (whether powered or not), para-gliding, bungi-jumping or any kind of race other than by foot;

(iii) Cave, wreck or free diving, professional diving,

KEY EXCLUSIONS

15

Page 17: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

16

diving without holding the correct diving certification such as a Professional Association of Diving Instructors (PADI) and diving at depths below 40 meters;

(iiii) Professional, semiprofessional or competitive winter sports, cross country skiing or snowboarding, ski or snowboard jumping, heli-skiing, o� piste skiing or snowboarding, Speed Skiing;

(v) Working at height (over 20 feet);(vi) Operating heavy machinery;(vii) Aviation or aerial activities except air travel as a

fare-paying passenger in or as a member of the aircrew of a properly licensed, fixed-wing multi-engined aircraft constructed to carry passengers and operated by a licensed commercial air carrier or in a helicopter owned and operated by a commercial concern which is licensed for the regular transportation of fare-paying passengers provided such helicopter is operating only between commercial airports and / or licensed commercial heliports and provided further that in either event such travel is not for the purpose of any trade or technical operation in or on the aircraft; or

(viii) Manufacture, storage, filling, breakdown, handling and transport of any explosive (including but not limited to firework or firecracker) or chemical material;

(g) Medical or surgical treatment, except where such treatment is rendered necessary by bodily injury within the scope of this policy;

(h) Pregnancy, childbirth, miscarriage, abortion or complications arising from any of them even though such loss may have been accelerated or induced by Bodily Injury;

(i) Any illegal act of the policyholder in the country where bodily injury occurs;

(j) Being in a state of insanity or psychiatric or psychological disturbance;

(k) Driving any kind of vehicle while the alcohol level in policyholder’s breath, blood or urine is higher than the legal limit in the country where bodily injury occurs;

(l) War or any act of war, invasion, act of foreign enemy, hostilities (whether war be declared or not), strike, riot and/or civil commotion, civil war, rebellion, revolution, insurrection, military or usurped power or terrorism.

Notes: “Cigna”, “the Company”, “We”, “our” or “us” herein refers to Cigna Worldwide Life Insurance Company Limited.This product brochure is also available in Chinese. You may request for the Chinese version from us.

Page 18: SF V2 Health4Kids Cigna Premium Refundable Plan Brochure En · 2019-09-30 · Hong Kong, an independent market research company (data collected in December 2017) Being a parent in

Cigna Worldwide Life Insurance Company LimitedTel: (852) 2560 1990www.cigna.com.hkIssued by Cigna

CA/Brochure/0030/1019_E

The above insurance plan is underwritten by Cigna Worldwide Life Insurance Company Limited, an authorized insurer to carry on long term 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. 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 (Right 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.