门诊理赔Medicaltreatmentforoutpatientandemergency
PleasemailallthefollowingdocumenttotheBeijingPingAnEndowmentInsuranceCo.,Ltd
A护照及签证复印件CopyofpassportandvisapageoftheInsured
B国税发票及费用清单,发票姓名与护照完全一致Originalofreceipt(Yournameonreceiptshouldbethesamewithyourpassport)anddetailedexpendituresheet
C病例(与发票日期一致)、诊断证明、化验单、检查报告复印件等Medicalrecord(samedatewithreceipt),andcopyofexaminationreportandlaboratorytestreportofeachrespectivetreatment
D理赔申请ClaimapplicationformfromInternationalStudents‘Office(RM302)
E意外伤害证明/交警事故认定书Certificateofaccidentwithsignature/CIS’sstamp(when/where/how,ect.)incaseofanaccident,(incaseoftrafficaccident,thetrafficunitshouldissuealiabilityconfirmationoftrafficaccident)
F银行开户信息单Yourbankaccountinformationsheetwithyoursignature
大病垫付及理赔Majoraccidentinjuriesorinpatientservice
Adirectly4008105119formedicalconsultationduetodiseaseoraccidentandapplyforadvancedpaymentofmedicalexpense.
Be-mailorfaxthescanofyourpassportandvisapagetocyry@lhgj.net(fax:010-58766773)
Ce-maiorfaxpowerofattorneyofpayment(getfromCIS)tocyry@lhgj.net(fax:010-58766773)
Documenttobepresentedforsettlementofclaims
B意外伤害证明/交警事故认定书Certificateofaccident(when/where/how,ect.)withsignature/CIS’sstampincaseofanaccident,(incaseoftrafficaccident,thetrafficunitshouldissuealiabilityconfirmationoftrafficaccident)
C国税发票及费用清单,发票姓名与护照完全一致Originalofreceipt(Yournameonreceiptshouldbethesamewithyourpassport)anddetailedexpendituresheetforhospitalization
D病例、诊断证明、化验单、检查报告复印件等Medicalrecord,copyofexaminationreportandlaboratorytestreportofeachrespectivetreatment
E出院小结复印件Copyofhospitaldischargesummaryormedicalrecordofhospitalization
F理赔申请ClaimapplicationformfromInternationalStudents‘Office(RM302)
G残疾证明DisabilitycertificatewhentheInsuredisdisabled(anevaluationreportshallbeissuedbytheassignedevaluationbody)
H银行开户信息单Thebeneficiaries‘bankaccountinformationsheetwithsignature/school-assignedbankaccountwithschoolstamp(RM302)
I受益人与被保险人关系证明CertificateofrelationshipbetweentheInsuredandallthebeneficiaries,andcopyofidentificationproofofthebeneficiaries
(Specificcontentpleasedial4008105119transfer1)
Pleasemailtheabovedocumenttothefollowingaddress!
Materialsforclaimsofsettlementsentto:北京市朝阳区东三环中路55号富力双子座B座303室(邮编100022)
Addressee:来华项目理赔部
Tel:010-59104919,4008105119转1
Pleaseloginwww.lxbx.netforlatestinsuranceintroduction.
Chineseexplanationprevailsincaseofcontradictionarisingoutoftheaforementionedcontents.