1.来华留学生保险服务微信服务平台(微信扫码)
International Students Insurance Service Wechat Platform(Scan the QR Code and log in by your passport number)
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2.来华留学生保险服务平台(网址)
International Students Insurance Service Platform(Website)
http://www.lhgj.net/insurance/gwcx/gwcx_list.jsp
3.留学生保险24小时热线: 400-810-5119 转 1
Service Hotline For 24 Hours: 400-810-5119 transit 1
4.登陆www.lxbx.net获取更多信息
You can register to the www.lxbx.net and check more information.
5.
常见问题
FAQ(Frequently Asked Question)
留学生问:我要看病时该怎么办?
保险公司答:记住你的保险服务电话:如果因生病要看医生,务必拨打400-810-5119转1,可随时咨询,取得正确的就医、理赔指导 。
留学生问:当需要住院垫付的时候,我应该如何处理?
保险公司答:在就诊前必须拨打服务电话400-810-5119再按1键,提供投保时的护照号及服务卡号,经服务公司确认需要住院的,会协助被保险人到就近的网络医院(或按照被保险人要求的网络医院)进行住院救治并垫付相关合理的住院费用。
留学生问:疾病门诊包括哪些类型?
保险公司答:普通门诊、急诊、门诊手术、急诊留观、急诊抢救所产生的相关费用,由公立医院或卫生防疫部门提供证明的传染病因隔离期间所产生的相关费用、及因与住院同一病因产生的院前、院后门所产生的费用等均归属于门急诊医疗责任范围内。
留学生问:我如果生病了去医院门诊治疗的,保险公司会理赔吗?(非意外类型的)
保险公司答:必须通过4008105119再按1键电话进行报案及询诊,如果确实需治疗的,留学生自己先垫付,然后将资料快递到如下地址申请理赔。构成保险责任才能赔付,如果未构成保险的则不能赔付。
就诊时须注意:1)就诊医院必须为中国大陆境内的公立医院;
2)公费医疗标准范围内的费用,自费项目不能报销;
3)每个保险期间内,就诊费用日限额为600元,累计超过起付线2000元以上的部分保险人按照85%的比例赔付。
4)资料必须齐全:发票原件、每次就诊的门诊病历复印件、费用明细、护照复印件、银行存折复印件、理赔申请垫付委托书(网页上下载样版)。
留学生问:“起付线”是什么意思?
保险公司答:也称免赔额,是保险公司对被保人门诊医疗责任理赔费用的计算起点,起付线以下的门诊费用由被保险人自己支付。
留学生问:如果我在公立医院住院,想住包房、外宾部、高干病房、特需病房,也可以进行理赔吗?
保险公司答:不可以。
留学生问:如果我在保险期限内多次住院,保险公司也理赔吗?
保险公司答:被保险人不论一次或多次住院治疗,本公司均在规定限额内给付保险金,分项累计给付金额达到其保险金额时(40万元人民币),该项保险责任终止。
留学生问:怎样领取理赔款?
保险公司答:在资料提交时提交收款人帐户。
1)帐户需为本人在中国大陆境内的帐户。
2)如果是银行卡,需要在银行柜面打印账单明细或对账单,目的是获取正确的户名和开户分支行信息,保证转账准确性。
保险使用流程
从不舒服开始 --> 致电4008105119转1键 --> 服务公司医生询诊、给出治疗建议
门诊治疗: 先学生支付,后期材料快递救援公司进行垫付报销
住院治疗: 病情确实需住院治疗(提交委托书及护照复印件,启用救援公司垫付)
门诊费用理算例
以起付线650元为例:小A在保险期间内因病在当地的公立医院就诊,2014年2月1日花费900元,5月3日花费400元,7月15日花费700元(就诊费用均为合理费用)。
理赔计算公式:{(600元+400元+600元)-650元}*85%=807.50元
S: What should I do when seeing the doctor?
A: Remember your insurance service phone number: in case of a sickness, you can call 400-810-5119 ext. 1, then you may get consulting at any time, and get right treatment and claims guide too.
S: when I must pay in advance for hospital expenses, what should I do?
A: Before seeing a doctor, dial 4008105119 and then transfer 1, provide the passport number and service card number when buying the insurance. If confirmed for in-patient by the company, the insured will be helped to the nearest hospital (or the Internet hospital required by the insured) , treat in hospital and pay the relevant in-patient expenses in advance.
S: What kind of diseases does the service cover?
A: It covers the costs associated with general outpatient, emergency, outpatient operation, emergency observation, and emergency treatment arising; the expenses resulting from quarantine because of infectious diseases provided by public hospitals or health and epidemic prevention departments and the expenses before and after in hospital.
S: If I get sick and go to see the doctor for the out-patient treatment, will the insurance company pay for it? (not accidental insurance)
A: It is necessary to dial 4008105119 and then transfer 1 for the report and inquiring diagnosis. If really in need of treatment, the students can pay in advance, and then deliver the materials to the following address for claim. A compensation can only be available upon such case as constituting the insurance liability, or no compensation shall be applied.
Pay attention while in treatment period:
1) the hospital must be the mainland public hospital.
2) the medical standard costs within the scope of the project, not including the excursion costs.
3) in each period of insurance, the daily limit to the medical expenses is 600 yuan. If the accumulated amount comes at more than 2000 yuan, the insurer will pay 85% of the total.
4) the materials must be complete: the original invoice, a copy of each outpatient medical record, expense details, the copy of passport, copy of bank account, the claim for the power of attorney (download the sample in the Internet).
S: What does “the pay line” mean?
A: It is also known as deductible amount, the starting point for the insurance company to pay the outpatient medical liability claim. The expenses below the pay line shall be paid by the insured.
S: If I stay in the public hospital, and I want to live in a chartered ward, foreign ward, senior cadre ward, and special ward, can I still get claim?
A: No, you can’t.
S: If I am in-patient for many times in the duration of insurance, shall the company compensate?
A: The insurance company will pay the claims in the given limit whether the insured be in hospital for one time or several times. When the accumulative payments are beyond the insurance amount (400,000 yuan), then the insurance liability ends.
S: How to receive indemnity?
A: Submit the account of payee in the data submission.
1) Account must be the mainland's account in China.
2) If using a bank card, print statement or statements in the bank counter, to obtain the correct name and account opening branch information, so as to ensure the accuracy of transfer.
Insurance Policy Guideline
Insurance Policy Guideline Begin from the comfortable feeling --> dial 4008105119 and transfer 1 --> diagnosis and treatment recommendations by the doctor
Outpatient treatment: prepayment by the students, courier case information to the rescue company for repayment
In-patient: really in need of hospitalization (submit a power of attorney and a copy of the passport, enabling the company payment in advance)
The cases of outpatient expenses calculation
Take the pay line 650 yuan as an example: A got treatment in a local public hospital in the insurance period. On February 1, 2014, he spent 900 yuan; on May 3, 400 yuan; on July 15, 700 yuan (medical expenses are reasonable expenses).
The calculation formula of claims: {(600 yuan +400 yuan +600 yuan -650 yuan}*85%=807.50 yuan)