Reimbursement for Lifelong Medical Protection

The Plan is a medical plan of reimbursement for incurred medical expenses. In case that the Life Insured is hospitalized due to Injury or Sickness during the Benefit Term, the Plan can help you to relieve the sudden financial burden.

In addition, the Plan is yearly renewable¹ up to age 100 of the Life Insured.

Flexible Choices of Different Benefit Classes

The Plan offers 3 different choices of benefit classes: Standard, Superior and Deluxe.

Major Medical Benefit to Uplift the Maximum Coverage

Whole Life Medical Protector (Golden Pack) further offers "Major Medical Benefit" which uplifts the maximum medical coverage for you to cope with the costly hospitalization expenses.

The following coverage items are reimbursed on Medically Necessary² and Reasonable and Customary³ basis.

Hospitalization Benefit Schedule

 

Major Medical Benefit ^@

1. The renewal premium is not guaranteed and will be calculated according to the Life Insured's attained age and the premium rates upon renewal.
2. "Medically Necessary" means a medical service or supply, when in Hong Kong Life's opinion it is consistent with generally accepted professional standard of medical practice and required to establish a diagnosis and provide treatment, which cannot be safely delivered in a lower level of medical care. Screening, experimental and preventive services or supplies are not considered Medically Necessary.
3. "Reasonable and Customary" means any fee or expense which: (1) is charged for treatment, supplies or medical services that are Medically Necessary and in accordance with standards of good medical practice for the care of a sick or injured person under the care, supervision or order of a Registered Medical Practitioner; and (2) does not exceed the usual level of charges for similar treatment, supplies or medical services at the location where the expense is incurred; and (3) does not include charges that would have only been made if insurance existed. Hong Kong Life reserves the right to determine whether any particular Hospital/medical charge is Reasonable and Customary with reference but not limited to any relevant publication or information made available, such as schedule of fees, by the government, relevant authorities and recognized medical association at the location where the expense is incurred. Hong Kong Life reserves the right to adjust any or all benefits payable in relation to any Hospital/medical charges which in the opinion of Hong Kong Life's appointed medical officer is not Reasonable and Customary.

* Age means age of the Life Insured at the last birthday

The Plan shall not cover any claims caused directly or indirectly, wholly or partly, by any one of the following occurrences:

1. any hospitalization or charges incurred as a result of any Pre-existing Condition or illness the symptoms of which first occurred prior to or within 30 days following the Issue Date, date of endorsement or date of any reinstatement of the Plan, whichever is later;
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; (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 Life Insured is under the influence of alcohol or drugs and treatment in connection with addiction to drugs or alcohol;
7. routine physical examinations, health check-ups or tests, rest cure, sanatorium care, vaccinations, immunization injections, preventive medication or any treatment which is not Medically Necessary;
8. dental treatment or 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 Life Insured;
9. 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 Acquired Immune Deficiency Syndrome (AIDS) and/or any mutations, derivations or variations thereof; venereal diseases, sexually transmitted diseases, infertility, sterilization or psychiatric treatment; mental or nervous diseases or disorder including but not restricted to anorexia nervosa, anxiety, depression, mania, neurosis, paranoid, psychosis and schizophrenia; congenital deformities and anomalies that gives rise to signs or symptoms, or is diagnosed before the Life Insured reaches age 14;
10. childbirth, pregnancy, miscarriage or abortion;
11. treatment or surgery for tonsils, adenoids or hernia until the Life Insured has been continuously covered under the Plan for a period of 120 days immediately preceding such treatment or surgery;
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.

• Basic Plan

Risk

Exchange Rate Risk

You are subject to exchange rate risks for the Policy denominated in currencies other than the local currency. Exchange rates fluctuate from time to time. You may suffer a loss of your benefit values and the subsequent premium payments (if any) may be higher than your initial premium payment as a result of exchange rate fluctuations.

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.

Inflation Risk

When reviewing the values shown in the Insurance Proposal, please note that future medical costs/ cost of living in the future is likely to be higher than it is today due to inflation.

Important Policy Provisions

Renewability

The Plan may be renewed on each Policy Anniversary for a further twelve (12) months' period by continuing payment of premium, at such premium rates and terms as may be determined by Hong Kong Life at the time of renewal when due. Hong Kong Life reserves the right to cancel the Plan at any time by giving thirty (30) days' notice in writing to the Policyowner. Whenever the Plan is so cancelled, Hong Kong Life shall return the unearned portion of premium paid without interest. Cancellation shall be without prejudice to any claim arising prior to the date of cancellation.

Automatic Revision of Benefit

Hong Kong Life reserves the right to revise the benefits payable under the Plan from time to time in order to keep the level of benefits in line with the changing medical costs. Hong Kong Life shall notify the Policyowner in writing at least thirty (30) days before the Policy Anniversary effecting such revision specifying, among others, the revised Schedule of Benefits, the effective date, the new premium and its due date. The new premium shall be determined by Hong Kong Life in accordance with its rate basis then applicable and the revised Schedule of Benefits and shall take effect on the date specified unless the Policyowner declined in writing in which case the Plan shall terminate automatically on the next premium due date following the date of such notification.

Automatic Termination

The Plan shall terminate automatically:

1. upon the death of the Life Insured; or
2. if and when the Plan expires; or
3. if and when a premium remains unpaid at the end of the Grace Period as specified in the General Provisions; or
4. on the Policy Anniversary on or immediately following the Life Insured's one hundredth (100^th) birthday; or
5. upon receipt of the written notification from the Policyowner declining any revised Schedule of Benefits under the Automatic Revision of Benefit.

Others

Premium Adjustment

Hong Kong Life has the right to review and adjust the Plan's premium rates for particular risk classes upon renewal, but not for any individual customer. Hong Kong Life may adjust premium rates because of several factors, such as Hong Kong Life's claims and persistency experience, expenses directly related to and indirect expenses allocated to the Plan, medical price inflation, projected future medical costs and any applicable changes in benefit.

Insurance Costs

Part of the premium pays for the insurance and related costs (if any).

Cooling-off Period

If you are not satisfied with your Policy, you have a right to cancel it within the cooling-off period and obtain a refund of any premium(s) and levy(ies) paid (in the original payment currency) to Hong Kong Life without any interest. A written notice signed by you should be received directly by Hong Kong Life Insurance Limited at 15/F Cosco Tower, 183 Queen's Road Central, Hong Kong within the cooling-off period (that is, the period of 21 calendar days immediately following either the day of delivery of the Policy or the Cooling-off Notice to you or your nominated representative (whichever is the earlier)). After the expiration of the cooling-off period, if you cancel the Policy before the end of the term, the projected Total Surrender Value (if applicable) may be less than the Total Premiums Paid.

Cancellation

After the cooling-off period, the Policyowner can request cancellation of the Policy by giving thirty (30) days prior written notice to Hong Kong Life, provided that there has been no benefit payment under the Policy during the relevant Policy Year.

Dispute on Selling Process and Product

Chong Hing Bank Limited, CMB Wing Lung Bank Limited, OCBC Wing Hang Bank Limited and Shanghai Commercial Bank Limited (collectively "Appointed Licensed Insurance Agencies" and each individually "Appointed Licensed Insurance Agency") are the Appointed Licensed Insurance Agencies of Hong Kong Life, and the life insurance product is a product of Hong Kong Life but not the Appointed Licensed Insurance Agencies. 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 life insurance product should be resolved between Hong Kong Life and the customer directly.

• Product Leaflet
• Premium Schedule
• Forms Download and Claims Procedures