Under this plan, we will not cover any of the following events or conditions:

• any treatment, investigation, service or supplies which is not medically necessary
• any pre-existing condition or congenital defect that appears or is diagnosed before the person protected under the policy reaches the age of 17
• self-destruction, intentional self-inflicted injury or drug abuse
• war or warlike operations, and civil commotion, any violation or attempted violation of the law or resisting arrest, acts of terrorism for the insured is a terrorist, the use of atomic, biological or chemical weapons as well as radioactive, biological or chemical contamination due to any act of terrorism (except where the insured is injured during a Trip outside the insured’s permanent residence country or place); or when the insured travels to a country at war, or where there is warlike operation, mutiny, riot, civil commotion, martial law or state of siege, or a war zone as recognised by the United Nations
• pregnancy, miscarriage, child birth, abortion, or related complications, AIDS or any complications associated with HIV infection, except for the “HIV / AIDS treatment benefit” (see benefits schedule, item 21 for details), mental or nervous disorder, except for the “mental or nervous disorder benefit” (see benefits schedule, item 22 for details)
• cosmetic or plastic surgery, dental care or surgery, corrective aids and treatments of refractive errors unless necessitated by injury caused by an accident, body check- up, gradual recovery of health or rest care
• consumption of any of the following traditional Chinese medicines, except for the “post-hospitalisation / outpatient surgery ancillary benefit” and "stroke ancillary benefit" (see benefits schedule, items 17b and 24biii for details):
  • cordyceps 冬蟲夏草 / ganoderma 靈芝 / antler 鹿茸 / cubilose 燕窩 / donkey-hide gelatin 阿膠 / hippocampus海馬 / ginseng 人參 / red ginseng 紅參 / american ginseng花旗參 / radix ginseng silvestris 野山參 / antelope horn powder 羚羊角尖粉 / placenta hominis 紫河車 / agaricus blazei murill 姫松茸 / musk 麝香 / pearl powder 珍珠粉

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. Premium Adjustment
   In order to provide you with continuous protection, we will annually review and adjust the premium of your plan accordingly at the end of policy year if necessary. During the review, we may consider factors including but not limited to the following:
   1. claim costs incurred from all policies under this plan and the expected claim outgo in the coming year which reflects the impact of medical trend, medical cost inflation and product feature revisions
      
   2. historical investment returns and the future outlook of the product's backing asset
      
   3. policy surrenders and lapses
      
   4. expenses directly related to the policy and indirect expenses allocated to this product
      


2. Product Features Revision
   We reserve the right to revise the benefit structure, terms and conditions and / or product features, so as to keep pace with the times for medical advancement and to provide you with continuous protection.

We will give you a written notice of any revision 31 days before the end of policy year or upon renewal.

1. Cover for specific items will be effective on the following dates (after the policy commences):
   1. Accidental injury: Immediately
   2. Illness: 30 days
   3. Investigation / treatment / surgery for tonsils, adenoids, hernias or a disease particular to female generative organs: 120 days
   4. Specialist network service: 180 days
      
   5. HIV / AIDS treatment: 5 years


2. We only cover the charges and / or expenses of the person protected under the policy 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.
       
   
3. The person protected under the policy will be covered for any room type in which he stays at hospital, but there will be a reduction in his benefit pay-out amount in case the person protected under the policy stays in a room type higher than the plan covered. In such a case, the benefit pay-out amount will be adjusted by multiplying the following factor:
   
   = Daily room charge of the covered room type in the hospital admitted by the person protected under the policy (depends on which country or place the person protected under the policy stays) / Daily room charge of the room the person protected under the policy stays


4. “Asia” means Afghanistan, Australia, Bangladesh, Bhutan, Brunei, Cambodia, China, Hong Kong, India, Indonesia, Japan, Kazakhstan, Kyrgyzstan, Laos, Macau, Malaysia, Maldives, Mongolia, Myanmar, Nepal, New Zealand, North Korea, Pakistan, the Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Tajikistan, Thailand, Timor-Leste, Turkmenistan, Uzbekistan, and Vietnam.


5. If the person protected under the policy continuously stays for 365 days in one of following regions, the medical services and / or treatments provided to the person protected under the policy in such region will be permanently reduced to 60% of his benefit pay-out amount. Such reduction applies to all items in the benefits schedule except items 27 and 28:
   1. Australia: Australia
   2. New Zealand: New Zealand
   3. North America (For emergency treatment only): United States and Canada
   4. Western Europe (For emergency treatment only): Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Monaco, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom and Vatican City


6. If the eligible expenses have been reimbursed under any law, or medical program or other insurance policy provided by any government, company, other third party or us, such expenses will not be reimbursable by us under this policy.
   
   
7. Worldwide emergency assistance services are covered during the trip only (except for 24-hour worldwide telephone enquiring services), which are additional benefits. The services are provided by third party service provider(s). AIA shall not be responsible for any act, negligence or omission of medical advice, opinion, service or treatment on the part of them. AIA reserves the right to amend, suspend or terminate the service without further notice.
   
   
8. Medical network services, Credit Facility Service for Hospitalisation, and Medical Expense Pre-approval Service are additional benefits and do not form part of the contractual service. Medical network services are provided by network doctor. AIA shall not be responsible for any act or omission of network doctor in the provision of medical network services. Credit Facility Service for Hospitalisation is provided by third party service provider(s). AIA reserves the right to amend, suspend or terminate these services without further notice.

If you wish to make a claim, you must notify us in writing within 20 days of the date the covered event happened, and send us the appropriate forms and relevant proof within 90 days of the same date. You can get the appropriate claim forms from your financial planner, 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. 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.