温馨提示：为了保证被保险人知悉理赔规则，可以顺利申请理赔，就医前，请拨打4008105119进行咨询。

Notice：Please call 4008105119 before you go to hospital to make sure that you can get claim rules.

A：（1）需要去中国大陆境内的公立医院普通科室进行就诊；

             Seeing doctors in China mainland’s public hospital and normal department.

（2）在挂号时使用护照姓名；

             Using passport name to register.

（3）被保险人每次就诊时都需要叮嘱医生出具就诊病历；

             Having medical records from doctors.

（4）如果在自助缴费机缴费须前往门诊收费窗口换取发票原件。

             Changing original invoices from charging if you spend money on charging machine.

A：请您本人持护照及该次看病医院给您出具的发票原件及其他相关医疗文件，到您当时看病的这家医院科室，找医生给您补该次看病的门急诊病历，注意此门急诊病历所记载的就诊日期一定要与发票的日期一致；如果到医院后遇到困难，也可以到导医台寻求帮助。

     Please bring your passport as well as the original invoice and other related medical documents issued to you by the hospital you go to for that time to the department for the outpatient service or emergency treatment we received in that hospital and find the doctor to write up the records for you. Please be noted that the date for receiving medical service recorded in this case history for outpatient service or emergency treatment must be identical to the one on the corresponding invoice; and you could also go to the Guiding Desk to ask for help whenever you have difficulties after having arrived a hospital.

A：根据被保险人的出险情况不同，申请所需材料不同。

     Different situation will prepare different application documents.

A：建议被保险人在治疗结束后，且符合保险规则的情况下，及时申请理赔，以防材料丢失。

     We suggest that after treatment finished and in accordance with claim rules, please apply the claim in time, in case that you loss some crucial documents.

A：被保险人准备好理赔材料后，将材料先发送到：lp@lxbx.net进行预审，若审核无误，请将材料邮寄至：

     The insured prepared documents and send to lp@lxbx.net at first, then company can do proofreading. After proofreading, you can send all documents to address as below:

收件人：来华项目组

电话：400 810 5119

地址：北京市西城区金融街23号平安大厦9层

A：理赔材料齐全且无误，提交理赔后，预计一周左右会有理赔结果。如果花费金额较高，预计会在一个月内会有理赔结果。

     It will be in a week, if all of your documents are settled and not much money. However, it will take in a month.

材料不齐全，我们会联系补充，时效以补充齐全的时间开始计算。

If we need more documents we will contact with you as soon as possilble.

A：疾病门诊的理赔不是百分之百赔付的。根据方案的不同，赔付标准也不同。

According to different package will have different reimbursement rules.

以留学生800元方案为例：

Examples for 800yuan package are shown as below:

2021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）。

You have paid RMB 900 on February 1st, 2021, paid RMB 400 on May 3rd, and RMB 700 on July 15th (all the fees for clinical service are rational) due to being treated in a local public hospital within the insurance period.

理赔计算公式：{（600元+400元+600元）-650元}*85%=807.50元

The formula for claim settlement: {（600 +400 +600）-650}*85%=807.50 (Unit: RMB Yuan)

赔付标准：(每天在日限额600元以内的费用相加-650元（免赔额）)*85%=可报销费用（合理费用合计不含当地社会基本医疗保险规定的自费及部分自费费用）。

Reimbursement equation: (the expense of each day within the daily limit RMB600 yuan add up-650 yuan) * 85%=reimbursable amount (the total amount of reasonable expenditures shall exclude the self-paid or partly self-paid items and expenses stipulated by the local regulations of the basic medical insurance)

其余方案请以保险责任内容为准。

Other package please refer to the insurance liability.

释义：

Definitions:

日限额：每日就诊的最高合理费用限额；

Daily limit: The top claim limit of available medical cost.

免赔额：即保险公司不给赔的额度，该部分由被保险人自行承担损失。

Deductible: Below the deductible, there is no compensation.

材料的正确样例如下所示：

Correct Document Samples:

病历（必须提供）

Medical record (mandatory)

住院病历（必须提供）

Medical record of inpatient department

(mandatory)

费用明细清单

（住院材料必须提供）

Detailed expenditure list (mandatory for the inpatient claim)

银行账户信息（必须提供）

Bank account information (mandatory)

当意外发生事故时，

请同时准备意外事故说明

（必须提供）

In case of an accident, please prepare an accident report (mandatory)