PUBLIC TRANSPORTATION ACCIDENT INSURANCE POLICY
公共交通意外保險單
PUBLIC TRANSPORTATION ACCIDENT INSURANCE POLICY
中國太平保險( 澳門) 股份有限公司，經與被保險人約定， 根據其 所簽 具的 投 保書 所述內 容， 出立 x保險單 承保被 保險 人作 為乘客 在乘坐 公共 交通 工具期間 的人身 意外 險 ， 被保險 人繳付 保費 後， 本保險單即予生效。
茲證明 x保單 或批 單上 所列之 承保條 件及 條款 為依歸下 ， 本公 司將 賠償 被保險 人任何 或所 有以 下所列在保險期間內所發生的承保事項。
Whereas the Insured by a proposal which shall be the basis of the contract and be held as incorporated herein has applied to the Company for the Insurance hereinafter contained and has paid the Premium as consideration for such Insurance.
Now this policy witnesses that subject to the Terms and Conditions contained herein or endorsed hereon, the Company will pay to the Insured while riding as a passenger in or on Public Transportation in respect of any or all the contingencies hereinafter mentioned happening during the period of insurance.
保 障 範 圍
DESCRIPTION OF COVERAGE
A. 意外死亡及永久完全或部分傷殘:
Accidental Death or Permanent Disablement:
如 被 保 險 人 發 生 確 屬 x 保 險 單 應 負 責 的 外 來 明 顯 意 外事故所致 之體殘 或身故，本 公司將根 據下表 所列之 比例賠償給被 保險人 或其指 定的 受益人。
If at any time during the period of Insurance stated in this Policy hereto the Insured sustains any bodily injury caused directly and solely by accidental, external and visible means, then the Company agrees to pay the Insured, or in the event of the death of the Insured to his/her appointed legal Beneficiary, the benefits specified in the Schedule of Benefits.
賠償金額表(保障A 所列之最高賠償額的百分比)
THE SCHEDULE OF BENEFITS
(Percentage of the maximum benefits specified in Coverage A)
項目 Item | 傷害程度 Injury | 賠償利益 Benefits |
1. | 身故 (失蹤不能作為意外事故，但因乘坐飛機或船隻失事而致完全滅失的不在此限) Death (Accidental death shall not in any way be presumed by reason of disappearance of the insured except in the event of the total loss by wreck of the ship or aeroplane on which the insured was travelling) | 100% |
2. | 全身癱殘 (必須終身臥床或永久喪失工作能力) Total paralysis (Resulting in being permanently bedridden or permanent disablement from engaging in or giving attention to Profession or occupation) | 100% |
3. | 喪失兩肢 (指自手腕或足踝關節以上之分離喪失) Loss of two limbs (Actual physical severance through or above wrist or ankle joints) | 100% |
4. | 雙目失明 Loss of sight of both eyes | 100% |
5. | 喪失一肢及一目失明 Loss of one limb and sight of one eye | 100% |
6. | 喪失一肢或一目失明 Loss of either one limb or either sight of one eye | 50% |
7. | 喪失手指，足趾：(每手、腳的) Loss of Fingers or Toes (on each hand or foot): a. 喪 失 四 指 Loss of four fingers………………………. b. 喪失拇指全部 Loss of thumb (both phalanges)…... c. 喪失拇指一節或食指全部 Loss of thumb (1 phalanx) or index finger (3 phalanges)……...…. d. 喪失食指一節或二節或中指全部 Loss of index finger (1 or 2 phalanges), or middle finger (3 phalanges)……………………….…...…… e. 喪失中指一節或二節, 或無名指、小指全部 Loss of middle finger (1 or 2 phalanges), or ring finger(3 phalanges), or little finger (3 phalanges)... f. 喪失無名指、小指一節或二節 Loss of ring finger (1 or 2 phalanges), or little finger (1 or 2 phalanges)…………………………… g. 喪失腳趾全部 Loss of toes – all……………………. h. 喪失大趾全部 Loss of toes – great (both phalanges)……………………………….…… i. 喪失大趾一節或其他任何一趾的全部 Loss of toes – great (1 phalanx) or any other toes (all)…... j. 喪失大趾以外任何一趾的一節 Loss of toes – any other than great (1 phalanx)……………………….. | |
40% | ||
25% | ||
10% | ||
6% | ||
3% | ||
1% | ||
15% | ||
5% | ||
2% | ||
1% | ||
8. | 其他傷殘如耳聾、斷骨等Other Injuries as deafness, fracture of bones and etc. | (照註冊醫生鑑定的百分率) (Such proportion to be assessed by qualified and registered physician) |
規約：本表內賠款按下列規約辦理：
Provisos:
1. 在保險有效期內，不論每次意外或整個保險有效期內發生一次或多次賠償，保險公司最高賠償責任，以不超過承保表所示之保險金額為限。
The total liability of the Company in respect of any claim or claims accumulated for any one accident and in aggregate for any one period of insurance shall not exceed the total amount insured as stated in the Schedule of this Policy.
2. 就項目 1 而言，身故必須在意外事故發生之日起 180 天內造成。 Under item 1, Death must occur within 180 days from the date of accident.
3. 被保險人不得因遭受一次意外，而獲得表列一項以上的賠償金額。只表列第七項內的可同時兼得，但該項最高賠款不得超過保險金額的百分之五十 (損失必須在意外事故發生之日起 180天內造成)。
The Insured shall not be entitled to compensation under more than one of the items in the Schedule of Benefit in respect of any one accident. With the exception of item 7, but the maximum payment of compensation under item 7 shall not exceed 50% of the amount insured (Loss must occur within 180 days from the date of accident).
B. 燒傷保障:
Burns Benefit:
若被保險人因意外身體損傷而經具合資格之註冊醫生診斷受到下表損害, 本公司將根據下表所列之比例作出賠償:
If as a result of an Accident the Insured sustains an injury and is diagnosed by a duly qualified and registered Physician to have suffered any of the Events listed hereunder, the Company will pay the Insured in respect of the following Events according to the percentage bearing hereunder:
損害事項 Events (二級燒傷或三級燒傷) (Xxxxx, Second Degree or Third Degree) | 賠償之百分比 Percentage of Compensation |
燒傷面積達 45%或以上 On 45% or more of body surface | 100% |
燒傷面積達 27%或以上 On 27% or more of body surface | 60% |
燒傷面積達 18%或以上 On 18% or more of body surface | 50% |
燒傷面積達 9%或以上 On 9% or more of body surface | 30% |
燒傷面積達 4.5%或以上 On 4.5% or more of body surface | 20% |
同一宗意外身體損傷只會賠償以上保障項目的其中一項。如在同一宗意外身體損傷遭受到多於一項保障項目，則按其中最高賠償額的一項作出賠償。
Compensation shall not be payable for more than one of the above Events in respect of the same injury. Should more than one of the Events occur in the same injury, the Company shall only be liable for the greatest Compensation.
如本公司在同一宗意外身體損傷在「保障範圍 B-燒傷保障」中已作出賠償，則在「保障範圍 A-意外死亡及永久完全或部分傷殘」中的賠償將被扣減。
The Compensation payable for loss of life under Coverage A (Accidental Death or Permanent Disablement), if any shall be reduced by any Compensation payable under this Coverage B (Burns Benefit) in respect of the same injury.
C. 骨折保障:
Broken Bones Benefit:
若被保險人因意外而受下表所列之傷害，本公司將根據下表所列之比例作出賠償:
If as a result of an Accident the Insured sustains an injury listed hereunder, the Company will pay the Insured in respect of the
following injuries according to the percentage bearing hereunder:
傷害程度 Injury | 賠償之百分比 Percentage of Compensation |
髖關節和/或骨盆之骨折 Broken Hip and/or Pelvis | 100% |
大腿和/或腳跟之骨折 Broken Thigh and/or Heel | 50% |
頭骨，鎖骨，小腿，踝關節，手臂，肘部和/或手腕之骨折Broken Skull, Collarbone, Lower Leg, Ankle, Arm, Elbow and/or Wrist | 40% |
下顎之骨折 Broken Lower Jaw | 30% |
椎，肩胛骨，髕骨，胸骨，手和/或腳之骨折 Broken Vertebrae, Shoulder Blade, Knee Cap, Sternum, Hand and/or Foot | 20% |
上頜骨，顴骨，鼻子，肋骨，尾骨，腳趾和/或手指之骨折Broken Upper Jaw, Cheek Bone, Nose, Ribs, Coccyx, Toes and/or Fingers | 15% |
同一宗意外身體損傷只會賠償以上保障項目的其中一項。如在同一宗意外身體損傷遭受到多於一項保障項目，則按其中最高賠償額的一項作出賠償。
Compensation shall not be payable for more than one of the above injuries arising from the same Accident. Should more than one of the injuries occur from the same Accident, the Company shall only be liable for the greatest compensation.
D. 殮葬費用:
Funeral Expense Benefit:
若保險期內被保險人因意外身體損傷而死亡，本公司將按承保表所列之保險金額賠償被保險人之殮葬費用及其相關費用。
If the Insured suffer loss of life during the Period of Insurance as a result of Accidental Bodily Injury, the Company will pay the costs of the Insured’s funeral and related expenses up to the Amount of Benefit stated in the Schedule.
上述保障之規約：
Provisions for Coverage A to D:
被保險人之年齡需為 18 歲至 70 歲。
The age limit for the Insured Person is between 18 and 70.
釋 義
1. 意外 指不可預見及預料之突發事件。
2. 骨折 指必須經註冊醫生診斷且有 X 光片支持之骨胳折斷或破裂，但不包括青枝骨折，病理性骨折，撕脱骨折，絲狀骨折及應力骨折。
3. 燒傷 指皮膚組織因極端高溫，火焰或接觸加熱物件而遭到破壞。
4. 傷害 指被保險人於承保表所示之保險有效期內，在別無其他原因下由意外事故引致的體殘或身故。
5. 醫生 指其有醫學資格，獲認可及合法授權從事疾病或意外受傷診療的人士，惟被保險人之直系親屬除外。
6. 公共交通工具 指任何由正式持牌運輸機構提供和營運的公共巴士、長途巴士、計程車、渡輪、氣墊船、水翼船、輪船、火車、電車或地下火車，以及任何由正式持牌航空或包機公司提供和經營的飛機，作為定期運載購票乘客之用，以及任何定期行走的機場計程車或任何定期行走固定路線和班次的機場接送車輛。
7. 2 級燒傷 指表皮及在下面的真皮因燃燒而遭到破壞。
8. 3 級燒傷 指全部皮膚因燃燒而遭完全破壞。
D E F I N I T I O N S
1. Accident or Accidental means a sudden, unforeseen and unexpected event happening by chance.
2. Broken Bones means a complete break across a bone and must be diagnosed by a Registered Medical Practitioner and supported by X-xxx, but excludes greenstick, pathological, avulsion, hairline and stress fractures.
3. Burn or Burns means tissue damage caused by extreme heat, flame, or contact with a heated object.
4. Injury means bodily injury which sustained by an Insured during the Period of Insurance stated in the Schedule and is caused by an Accident, solely and independently of any other cause.
5. Physician means a person who is recognised by the laws of the jurisdiction in which treatment is received as qualified to treat the sickness or accidental bodily injury, and who is not an immediate family member of the Insured.
6. Public Transportation means any bus, coach, taxi, ferry, hovercraft, hydrofoil, ship, train, tram or underground train provided and operated by a carrier duly licensed for the regular transportation of fare-paying passengers, and any aircraft provided and operated by an airline or an air charter company which is duly licensed for the regular transportation of fare-paying passengers, and any regularly scheduled airport taxi or any regularly scheduled airport limousine operating on fixed routes and schedules.
7. Second Degree Burn means a Burn in which both the epidermis and the underlying dermis are damaged.
8. Third Degree Burn means a Burn resulting in the damage or
destruction of the skin to its full depth and damage to the tissues beneath.
除 外 責 任
凡直接或間接由於下列任何原因所致的身故或傷殘皆不在本保險單承保範圍以內，本公司概不負責：
(1). 戰爭、類似戰爭的行動、內戰、叛變、罷工、暴動、或由於核子武器、核子游離輻射、核子燃料或其燃燒後產生的廢料所致輻射能的沾染。上述核子燃燒包括自發的核子分裂在內。
(2). 疾病、傳染病或非因意外事故而進行內外科治療手術而致的體殘、身故。
(3). 自加傷害、自殺、或因觸犯刑章的不法行為。
(4). 遭遇謀害。
(5). 參加各種競賽、毆鬥、或因酒醉、服用药物、神經錯亂。
(6). 從事軍警當執行職務時所致的，或空中飛航當不是作為旅客搭乘航空公司班機的航程內所致的。
(7). 若被保險人為女性，由於懷孕、分娩、難產或因而引起的。
E X C E P T I O N S
This Policy does not cover death or injury directly or indirectly:
(1). Consequent upon war, hostilities or warlike operations, civil war, rebellion, strikes, riots or caused by or contributed to by or arising from ionising radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. For the purpose of this exception combustion shall include any self-sustaining process of nuclear fission.
(2). Caused or contributed to by illness, infectious disease or by medical or surgical treatment (other than treatment required on account of an accident covered by this Policy).
(3). Caused or contributed to by intentional self-injury, suicide, or criminal or disorderly conduct.
(4). Caused or contributed to by encountering murder.
(5). Consequent upon the Insured Racing of any kind or Fighting or caused whilst the Insured is by intoxication, drugs or insanity.
(6). In case of the Insured engaging service in the forces or police, caused by whilst the Insured is on duty, or aviation other than flying solely as a passenger by aircraft of a regular airline.
(7). In case of women, caused or contributed to be pregnancy, childbirth, dystocia or the result or consequence thereof.
不 保 事 項
資訊科技澄清條款
x保險單承保的財產損毀意指財產的實物之實質損毀。
財產的實物之實質損毀並不包括數據或軟件的損毀，特別是因原結構的刪除、毀壞或變形引致數據、軟件或電腦程式的有害變更。
因此，本保險單不承保以下各項：-
A. 數據或軟件的損毀，特別是因原結構的刪除、毀壞或變形引致數據、軟件或電腦程式的有害變更，及由該等損毀引起的營業中斷損失。即使因本不保條款，惟因所保財產的實物之實質損失直接引致的數據或軟件的損毀仍然受保障。
B. 因數據功能、軟件或電腦程式的可用性、使用限度或存取等功能損毀引致的損毀，包括因此損毀導致的營業中斷損失。
不保戰爭及內戰條款
x保險單不保任何由下述所造成的損失、損毀或責任 :
1. 戰爭、侵略、外敵行為、敵對或侵略行動(不論宣戰與否)、內戰；
2. 叛變、民眾暴亂所引發或形成的大規模暴動、軍事行動叛變、革命、暴動、軍事行動或武力奪權、或任何人的行為是代表或與任何組織有關連其目的是包括使用恐佈主義或暴力手段推翻或影響任何合法或實質上的政府。
不保恐怖主義批單
儘管本保險單載有任何相反的規定或任何批單，茲同意本保險單不承保因下述行為直接或間接導致、產生或與其有關連的任何性質的損失、損毀、費用和支出，無須理會其他同時或任何時間順序有份造成損失的因由及事故。
於本批單中，恐怖主義行為包括但不限於任何人或團體使用武力、暴力及暴力威嚇的行為，不論其是否單獨、代表或關連任何組織或政府；或為政治、宗教、思想、種族或類似目的或原因包括意圖影響任何政府或及令公眾或任何社會人事恐懼而干犯的行為。
本批單亦不承保因執行控制、防止、鎮壓或關連任何恐怖主義行為等行動直接或間接導致、產生或與其有關的任何性質的損失、損毀、費用和支出。
若本公司聲稱以本批單為由，對損失、損毀、費用或支出不負賠償責任，則証明本公司確有責任賠償的舉証責任在被保險人。
如本批單部份條文被裁定無效及不能強制執行，其餘部份仍然完全有效及有全面效力。
國際制裁除外條款
保險人(分保人)不可被視為會提供保險，亦無法律責任償付任何索賠或提供任何所保利益，惟僅限於該等保險提供、索賠償付、利益提供會使得保險人(分保人)遭受聯合國決議、或歐洲聯盟、英國、美國的貿易或經濟制裁、法律、或規例所規定的制裁、禁制或限制。
E X C L U S I O N S
IT Clarification Clause
Property damage covered under this Policy shall mean physical damage to the substance of property.
Physical damage to the substance of property shall not include damage to data or software, in particular any detrimental change in data, software or computer programs that is caused by a deletion, a corruption or a deformation of the original structure.
Consequently the following are excluded from this Policy:
A. Loss of or damage to data or software, in particular any detrimental change in data, software or computer programs that is caused by a deletion, a corruption or a deformation of the original structure, and any business interruption losses resulting from such loss or damage. Notwithstanding this exclusion, loss of or damage to data or software which is the direct consequence of insured physical damage to the substance of property shall be covered.
B. Loss or damage resulting from an impairment in the function, availability, range of use or accessibility of data, software or computer programs, and any business interruption losses resulting from such loss or damage.
War & Civil War Exclusion Clause
Any loss or damage or liability directly or indirectly caused by:
1. War, invasion, act of foreign enemy, hostilities or war-like operations (whether war is declared or not), civil war;
2. Mutiny, civil commotion assuming the proportions of or amounting to a
popular rising, military rising insurrection, rebellion, revolution, military or usurped power, or any act of any person or persons acting on behalf of or in connection with any organization the objects of which are to include the overthrowing or influencing of any de jure or de facto government by terrorism or by violent means.
Terrorism Exclusion Endorsement
Notwithstanding any provision to the contrary within this insurance or any endorsement thereto it is agreed that this insurance excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any act of terrorism regardless of any other cause or event contributing concurrently or in any other sequence to the loss.
For the purpose of this endorsement an act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisation(s) or government(s), committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear.
This endorsement also excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to any act of terrorism.
If the Insurers allege that by reason of this exclusion, any loss, damage, cost or expense is not covered by this insurance the burden of proving the contrary shall be upon the assured.
In the event any portion of this endorsement is found to be invalid or unenforceable, the remainder shall remain in full force and effect.
Sanction Exclusion Clause
No (re)insurer shall be deemed to provide cover and no (re)insurer shall be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose that (re)insurer to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.
基 本 條 款
1. 被保險人所簽署的投保書，是本公司簽發保險單的根據，也是本保險單的組成部分，因此，正確據實填報，是本公司履行賠償責任的先決條件。如有偽報虛報或提供偽證等情況，本保險單即行失效。
2. 在保險有效期內，被保險人遭受確因本保險單應負責任的意外傷殘或身故
(或確因本保險單應負責任的意外受傷後在 180 天內因傷而致身故的)，經本公司查驗屬實，根據不同傷害程度，按後開賠償金額表所訂百分率，給予賠償。
3. 被保險人如遷移地址或更改受益人，應即以書面通知本公司。
4. 被保險人在保險有效期間內，發生意外傷害，須在三十天內以書面通知本公司。被保險人如意外身故，其受益人須即以書面通知本公司。被保險人或其受益人必須履行此一規定，才有索賠權利。
5. 被保險人或其受益人索賠時，須向本公司提供足以證明意外傷殘或身故之
證據，該項提供證據之費用由被保險人(或其受益人)自己負擔。
6. 所有由於本保險單所引起的爭議，應交付公斷人決定之，該公斷人由爭議雙方以書面選定之。如雙方對該一被選之公斷人不能同意時，則每方可於對方書面請求後一個月內各選一人為公斷人決定之。如二公斷人對該項爭議不能取得一致意見時，則應於公斷未開始前，由該二公斷人以書面選定第三公斷人參與公斷程序，並任為仲裁人。在公斷人未作出公斷書之前，被保險人不得對本公司起訴。
7. 本公司拒絕被保險人(或其受益人)的賠償請求後，如被保險人(或其受益人)
在十二個月內未按照上述第六項規定要求仲裁，則作為已放棄索賠權論，此後，不能再行取得賠償。
8. 本保單生效後不會退還保險費。
C O N D I T I O N S
1. The written application which the Insured has made and declared being the basis of issuing this Policy must be true and correct. If any claim made shall be fraudulent or exaggerated or if any false declaration or statement shall be made in support thereof, then this Policy shall be void.
2. In the event of the Insured shall sustain bodily injury (or death taking
place within 180 days after the date of bodily injury) caused by accident during the period of this insurance, the Company will subject to the terms and conditions as stated in this Policy agree to pay to the Insured the benefits according to the scale set forth in the Schedule of Benefit.
3. The Insured shall give immediate written notice to the Company of any
change of address or his beneficiary.
4. Upon the happening of any accident during the Period of Insurance likely to give rise to a claim under this Policy, the Insured shall give written notice to the Company within 30 days after the happening of such accident. In the event of the death of the Insured prompt notice shall be given to the Company by his beneficiary. No claim shall be payable unless the provisions of this Article are fulfilled by the Insured or his beneficiary.
5. In the event of claim being made or arising from this Policy the Insured or his beneficiary shall furnish the Company with all certificates,
information and evidence required by the Company at the expense of the claimant.
6. All differences arising out of this Policy shall be referred to the decision
of an Arbitrator to be appointed in writing by the parties in difference or if they cannot agree upon a single Arbitrator, or the decision of two Arbitrators one to be appointed in writing by each of the parties within one calendar month after having been required in writing so to do by either of the parties or in case the Arbitrators do not agree of an Umpire appointed in writing by the Arbitrators before entering upon the reference. The Umpire shall sit with the Arbitrators and preside at their meetings and the making of an Award shall be a condition precedent to any right of action against the Company.
7. If the Company shall disclaim liability to the Insured (or his beneficiary)
for any claim hereunder and such claim shall not within twelve calendar months from the date of such disclaim have been referred to arbitration under the provision herein contained, then the claim shall for all purposes be deemed to have been abandoned and shall not thereafter be recoverable hereunder.
8. No refund of premium is allowed once the insurance has been effected.