PAC Select 2

Under basic benefits, we will not cover conditions that result from any of the following events (also applicable for Accidental Medical Expenses Reimbursement Benefit and Daily Hospital Income Benefit):

• war, invasion, insurrection, revolution, use of military power or usurpation of government or military power;
• violation or attempted violation of the law or resistance to arrest;
• the insured engaging in or taking part in naval, military or air force service or operations;
• the insured engaging in air travel (except as a fare paying passenger in any properly licensed aircraft);
• suicide or attempted suicide or self-inflicted injury or deliberate exposure to exceptional danger (except in an attempt to save human life), or is sustained whilst the insured is in a state of insanity;
• pregnancy, miscarriage, childbirth or any complications concerning therewith
• any kind of disease or illness (except the covered injury or covered illness of Daily Hospital Income Benefit);
• any pre-existing condition;
• engaging in a sport in a professional capacity or the insured that could or may earn income from engaging in such sport;
• duty as a professional driver outside of Hong Kong or Macau;
• assault, murder, riot, civil commotion, strikes or making an arrest while the insured is employed as a full or part-time police officer, or cadet officer or is an officer or member of the Correctional Services Department;
• riot, civil commotion or strikes while the insured is employed as a fireman or is on duty as a fireman in the course of extinguishing fires or protecting life and property in case of fire; or
• mental, nervous or sleep disorders, treatment of alcoholism, drug abuse or any other complications arising therefrom, or accident caused by and whilst under the influence of drugs or alcohol.

Accidental Medical Expenses Reimbursement Benefit, in addition to the above key exclusions of basic benefits, will not cover the following:

• medical expenses or hospitalisation charges incurred for general check-up, convalescence, custodial or rest care, cosmetic or other elective surgery, or congenital anomalies that gives rise to signs or symptoms, or is diagnosed, before the insured attains 17 years of age
• dental care or surgery, apart from the surgery necessitated by injury caused by an accident

Daily Hospital Income Benefit, in addition to the above key exclusions of basic benefits, will not cover the following:

• treatment or surgery for tonsils, adenoids, hernia or a disease peculiar to the female generative organs unless the insured has been continuously covered under this policy for a period of 120 days immediately preceding such treatment or surgery
• cosmetic or plastic surgery, elective surgery, dental care or surgery (apart from reconstructive surgery necessitated by injury caused by an accident)
• routine health checks, screening and preventive care / checking, investigations not directly related to admission, diagnosis, illness or injury, or any treatment or investigation which is not medically necessary, or convalescence, custodian or rest care
• AIDS or any complications associated with HIV infection
• any treatment or investigation which is not medically necessary or consistent in accordance with standards of good medical practice
• any fees and medical services that are not reasonable and customary

The above list is for reference only. Please refer to the policy contract of this plan for the complete list and details of exclusions.

1. Cover for specific items will become effective on the following dates:
   
   1. Covered Injury: Immediately
   2. (for the Daily Hospital Income Benefit) Covered Illness: 30 days
   3. (for the Daily Hospital Income Benefit) Treatment of surgery for tonsils, adenoids, hernia or a disease of the female reproductive organs: 120 days
   
   
2. Accidental Death & Dismemberment Benefit and Permanent Total Disability Benefit
   
   

   These benefits are only applicable for the loss resulted from a covered injury within 180 days after an accident. The loss must be listed in the Benefits Schedule for Accidental Death & Dismemberment Benefit in product brochure or defined as a permanent total disability.

   In the event that a series of losses shall arise out of the same accident, benefit shall only be paid for one of the losses, for which the amount of benefit payable shall be the greatest amount of benefit as shown in the Benefits Schedule for Accidental Death & Dismemberment Benefit in product brochure.

   The Permanent Total Disability Benefit is not available to any insured at the age of 17 or below.

3. Accidental Medical Expenses Reimbursement Benefit

   This benefit is only applicable for the reasonable and customary charges for actual medical expenses incurred within 52 weeks from the date of an accident.

4. Daily Hospital Income Benefit
   1. If the surgical procedure is not performed within the covered areas, the Daily Hospital Income Benefit will be:
      1. reduced by 50% for each confinement;
      2. limited to a maximum of 90 days for same confinement which is caused by each covered injury or covered illness; and
      3. subject to a maximum limit of HK$/MOP480 or US$60 for each day of confinement

      The covered areas are as follows: Hong Kong, Macau, Malaysia, Thailand, Taiwan, Japan, South Korea, Singapore, United States of America, Australia, New Zealand, Canada, Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Monaco, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom and Vatican City.

   2. If the insured is confined due to the same cause including any and all complications, we will only pay the Daily Hospital Income Benefit once. We will regard multiple periods of confinement as part of the same confinement if they:
      1. relate to the same (or a related) covered injury or covered illness, or to any related complications; and
      2. are separated less than 90 days (excluding the date of admission or discharge).
          
5. Medically necessary and reasonable and customary charges

   We only cover the charges and / or expenses of the insured on medically necessary and reasonable and customary basis.

   “Medically necessary” means that the medical services, diagnosis and / or treatments are:
   
   1. delivered according to standards of good medical practice;
   2. necessary; and
   3. cannot be safely delivered in a lower level of medical care.
      
   Experimental, screening, and preventive services or supplies are not considered medically necessary.
   
   “Reasonable and customary” means:
   
   1. the medical services, diagnosis and / or treatments are medically necessary and delivered according to standards of good medical practice;
   2. the costs of your medical services and the duration of your hospital stay are not more expensive or longer than the usual level of charges or duration for similar treatment in the locality of such services delivered; and
   3. does not include charges that would not have been made if no insurance existed.
      
   We may adjust any and all benefits payable in relation to any hospital / medical charges which is not a reasonable and customary charge.
   
   

In order to provide you with continuous protection, we will annually review the premium of your plan and adjust it at the end of policy year if necessary.

• claim costs incurred from all policies under this plan and the expected claim outgo in the future, which reflect the impact of change in the incidence rates of accidental deaths and dismemberments / permanent total disabilities, medical trends and medical cost inflation (where applicable)
• historical investment returns and the future outlook of the product's backing asset
• policy surrenders and lapses
• expenses directly related to the policy and indirect expenses allocated to this product
  
  

We will give you a written notice of any revision 30 days before renewal.

Any claim for death must be notified to us in writing immediately. If you wish to make a claim, you must send us the appropriate claim forms and relevant proof. You can get the appropriate claim forms at www.aia.com.hk, by calling the AIA Customer Hotline (852) 2232 8888 in Hong Kong or (853) 8988 1822 in Macau, or by visiting any AIA Customer Service Centre. For details of claim procedures, please refer to the Claim Procedure section in the policy contract. If you wish to know more about claim related matter, you may visit “File A Claim” section under our company website www.aia.com.hk.

• You have the right to cancel and obtain a refund of any premiums and any levy paid by giving written notice to us.
• Such notice must be signed by you and submitted to the Customer Service Centre of AIA International Limited at 12/F, AIA Tower, 183 Electric Road, North Point, Hong Kong or the Customer Service Centre of AIA International Limited at Unit 1903, 19/F, AIA Tower, 251A-301 Avenida Comercial de Macau, Macau within 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.