Group Medical Insurance Plan
Underwritten by: Hong Kong Life Insurance Limited
Appointed Licensed Insurance Agency: Shanghai Commercial Bank Limited

To increase competitiveness, to retain professional talents

Medical protection is a key component of employee benefits. Comprehensive medical protection can help to retain staff, maintain manpower stability and enhance productivity. Hong Kong Life fully understands the needs of small and medium enterprises and thus tailored the Group Medical Insurance Plan, providing their employees with a cost effective and flexible medical plan. At a modest premium, employers can offer their staff an all-round medical coverage, allowing employees to focus on their work worry-free, thereby fostering the further development of the enterprises.

Application procedure is simple and no underwriting is required for 6 employees or above
Customize the benefits for different grades of employees
Cover can be extended to employees' spouse and children
Optional Out-Patient Benefit and Supplementary Major Medical Benefit
Provide self-selected doctor for Insured Member's selection
No minimum hours of confinement in the hospital
With hospital income benefit (for confinement in general ward of hospitals under Hong Kong Hospital Authority)
Waiver of doctor referral letter in Dermatology, Gynaecology, Otorhinolaryngology, Ophthalmology, Orthopaedics and Traumatology for Optional Out-Patient Benefit
Basic Hospital & Surgical Benefit
Optional Supplementary Major Medical Benefit
Optional Out-Patient Benefit
Issue Age of Employee Age 18 to 69*
Issue Age of Employee's Spouse Age 18 to 69*
Issue Age of Employee's Child Age 15 days to Age 18 or Age 19 to 23 and is a full-time student^
* Underwriting is required for Age 65 or above
^ Full-time student identification must be provided
 
Policy Currency HKD
Covered Area Worldwide
Benefit Class 3 Classes#
Benefit Term 1 Year
Premium Payment Term 1 Year
Premium Payment Mode Annual
Minimum Number of Employees 3 Persons
# Employer is allowed to provide different classes of benefits to employees according to classes. Employees under the same ranking must enjoy the same benefits
(Age) means the age at last birthday
  1. (Age) means the age at last birthday
  2. The premium rate may change on each policy year taking into consideration factors such as the medical trend, medical cost and inflation as well as the overall claims history of Cherish Group Medical Insurance Plan
  3. Cherish Group Medical Insurance Plan is a yearly renewable policy and there is no guarantee of renewal
  4. For Age 65 - 69, underwriting will be applied at each policy anniversary and their insurance cover shall be provided subject to satisfactory underwriting result
  5. Second Medical Opinion from Overseas Expert Service is provided by third party service provider. Such service is not part of the product features. The availability of the service is not guaranteed. The details of the service will be provided along with the policy document or please refer to the company website of Hong Kong Life. Hong Kong Life reserves the right to cancel or amend the said service at its sole discretion. In addition, Hong Kong Life will not be responsible for any services or opinions provided by the third party service provider. Hong Kong Life reserves the right of final decision in case of any dispute
Grace Period and Policy Termination

A grace period of thirty-one (31) days following each premium due date shall be allowed to the policyholder for the payment of any premium after the first payment of premium. If any premium is not paid before the expiration of the grace period, this policy shall automatically terminate. The policyholder shall be liable to the Hong Kong Life for the premium for the time this policy is in force during the grace period.

Medically Necessary

Means in respect of Hospital Confinement, treatment, procedure, supplies or other medical services, such Hospital Confinement, treatment, procedure, supplies or other medical services which are, in the Company's opinion:

      1. required for, appropriate and consistent with the symptoms and findings or diagnosis and treatment of the Disability;
      2. in accordance with generally accepted medical practice and not of an experimental or investigative nature;
      3. not for the convenience of the Insured Member (or the Covered Dependent, where applicable), Registered Medical Practitioner or any other person; and
      4. not able to be omitted without adversely affecting the medical condition of the Insured Member (or the Covered Dependent, where applicable).
Inflation Risk

When reviewing the benefit amount of this insurance plan, please note that future medical costs/ cost of living in the future is likely to be higher than it is today due to inflation.

Credit Risk of Issuer

The life insurance product is issued and underwritten by Hong Kong Life. The premium to be paid by you would become part of the assets of Hong Kong Life and that you and your policy are subject to the credit risk of Hong Kong Life. In the worst case, you may lose all the premium paid and benefit amount.

Reasonable and Customary

Means any fee, charge, or expense which:

      1. 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 Registered Medical Practitioner;
      2. 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
      3. does not include charges that would have only been made if insurance existed.

The Company reserves the right to determine whether any particular Hospital or medical charge is Reasonable and Customary with reference including but not limited to any relevant publication or information made available, such as schedule of fees by the government, relevant authorities, recognized medical association in the locality where the expense is incurred.

The Company also reserves the right to adjust any and all benefits payable in relation to any Hospital or medical charges which in the opinion of the Company's medical examiner is not Reasonable and Customary.

Levy

With effect from 1 January 2018, the Insurance Authority has started collecting levy on insurance premiums pursuant to the Insurance (Levy) Regulation ("Levy Regulation") and Insurance (Levy) Order ("Levy Order") from policyholder through insurance companies each time when a premium is paid.

The amount of levy payable for each premium payment under an insurance policy will be the amount of premium multiplied by a levy rate and a cap will apply on the levy. The levy rates and maximum levy prescribed under the Levy Order are reproduced as follows:

Policy Date or Policy Anniversary Levy Rate % Maximum per Policy (HKD)
From 1 Apr 2021 onwards (inclusive of that date) 0.1% 5,000

It is important to note that policyholder who failed to pay the prescribed levy within the timeframe as required by law shall commit an offence under section 3(4) of Levy Regulation and be liable to a pecuniary penalty not exceeding HKD5,000.

Levy is calculated based on the premiums payable stipulated in the contract. Any discounts, commissions or other deductions/ payments not stipulated in the contract will not be taken into account for levy calculation.

Policy Termination

This policy may be terminated by either the policyholder or the Company providing thirty one (31) days' prior written notice of termination to the other party before the date on which such termination shall become effective. In the event of such termination, the insurance cover of an Insured Member (or the Covered Dependent, where applicable) shall continue until the date of expiration of the period for which premium payment is made on account of his insurance. Termination shall not affect any claim originating prior to the effective date of such termination.

Dispute Resolution

If any dispute, controversy or disagreement arises out of the policy, including matters relating to the validity, invalidity, breach of clause or termination of the policy, Hong Kong Life and policyholder shall use their endeavours to resolve it amicably, failing which, the matter may (but is not obliged to) be referred to any form alternative dispute resolution, including but not limited to mediation or arbitration, as may be agreed between Hong Kong Life and the policyholder, before it is referred to a Hong Kong court.

Each party shall bear its own costs of using services under alternative dispute resolution.

Dispute on Selling Process and Product

Shanghai Commercial Bank Limited ("Appointed Licensed Insurance Agency") is the Appointed Licensed Insurance Agency of Hong Kong Life, and the group insurance product is a product of Hong Kong Life but not the Appointed Licensed Insurance Agency. In respect of an eligible dispute (as defined in the Terms of Reference for the Financial Dispute Resolution Centre in relation to the Financial Dispute Resolution Scheme) arising between the Appointed Licensed Insurance Agency and the customer out of the selling process or processing of the related transaction, Appointed Licensed Insurance Agency is required to enter into a Financial Dispute Resolution Scheme process with the customer; however any dispute over the contractual terms of the group insurance product should be resolved between Hong Kong Life and the customer directly.

Exclusions (applicable for medical benefit)
  1. Pre-existing conditions for which the Insured Member (or the Covered Dependent, where applicable) received medical treatment, diagnosis, consultation or prescribed drugs in respect of Injuries or Sickness sustained during the ninety (90) days preceding the effective date of his coverage, unless during any consecutive six months' period after such effective date or the date of his last consultation, whichever is the later, the Insured Member (or the Covered Dependent, where applicable) does not undergo any medical treatment or surgical care in respect of such Injuries or Sickness;
  2. Suicide or self-inflicted injuries while sane or insane;
  3. War whether declared or undeclared or any act thereof, invasion, civil commotion, riots or any warlike operations;
  4. Service in the armed forces in time of declared or undeclared war or while under orders for warlike operations or restoration of public order; or violation or attempted violation of the law or resisting arrest or participation in any brawl or affray;
  5. Engaging in or taking part in (a) driving or riding in any kind of race; (b) professional sports; or (c) underwater activities involving the use of breathing apparatus; (d) flying or other aerial activity except as a fare paying passenger in a commercial aircraft;
  6. Injury or Sickness sustained whilst the Insured Member (or the Covered Dependent, where applicable) is under the influence of alcohol or drugs and treatment in connection with addiction to drugs or alcohol;
  7. Poison, gas or fumes whether voluntarily or involuntarily taken;
  8. Routine physical examinations, health check-ups or tests, rest cure, sanatorium care, vaccinations, immunizations injections, preventive medication, physiotherapy and chiropractic treatment (unless covered in Physiotherapy / Chiropractic Treatment as specified in medical benefit), any treatment which is not Medically Necessary;
  9. Dental treatment, eye examinations, dentures, glasses or hearing aids or the fitting of any thereof, cosmetic surgery or plastic surgery, except and to the extent that any of such treatment is necessary for the cure or alleviation of Injury to the Insured Member (or the Covered Dependent, where applicable);
  10. Human Immunodeficiency Virus (HIV) infection (except and to the extent that such infection occurs through an accidental cut or wound) and/or any HIV related illness including AIDS and/or any mutations, derivations or variations thereof; venereal diseases, sexually transmitted diseases, infertility, sterilization, psychiatric treatment, mental or nervous diseases or disorder, congenital deformities and anomalies;
  11. Pregnancy, childbirth, miscarriage, abortion, birth control, sterilization or any complications arising therefrom;
  12. Any Injury or Sickness for which compensation is payable under any government law or for which benefits are payable under any other insurance policy or the like except to the extent that such charges are not reimbursed by such laws or policies.

The above information is for reference and is applicable within Hong Kong only. For terms and conditions, please refer to the policy document. If there is any conflict between the above information and the policy document, the latter shall prevail. The copy of the policy document is available upon request. Before applying for the insurance plan, you may refer to the contents and terms of the policy document. You may also seek independent and professional advice before making any decision.