The insured participated in personal accident insurance and did not participate in medical insurance. I fell off my horse because of hunting during the insurance period, because it was wet and cold.

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Compensation for accidental injuries in tourism shall be implemented in accordance with the personal accident insurance Clause on Tourism Safety:

Article 1 Composition of an insurance contract

This insurance contract (hereinafter referred to as "this contract") consists of insurance policy and other insurance documents, additional clauses, compensation standard, insurance application, insurance documents related to this contract, statements, comments, additional approval forms and other written agreements.

Article 2 Insurance conditions

All tourists who are healthy and can travel normally and travel agency employees who provide services with the group can become the insured of this insurance.

Article 3 Insurance liability

I. Accident protection

(1) During the insurance period, if the insured dies suddenly of acute illness or suffers accidental injury, resulting in death, disability or burns, the insurer shall pay the insurance money according to the following provisions:

1. If the death of the insured due to acute illness or accidental injury is the direct cause, or the insured is declared dead by the people's court due to accidental injury or natural disaster within 180 days from the date of the accident, the insurer shall pay the death insurance money according to the accidental injury insurance amount specified in the insurance policy.

2. If the insured is disabled due to accidental injury from the date of the accident 180, the insurer shall pay the disability insurance money according to the amount of accidental injury insurance specified in the insurance policy and the proportion of compensation corresponding to physical disability. If the treatment has not ended within 180 days from the date of the accidental injury, it shall be identified according to the physical condition of 180 days, and the disability insurance shall be paid accordingly.

When the insured causes multiple physical disabilities due to the same accidental injury, the insurer shall pay the sum of the corresponding disability insurance benefits. However, when different disability items belong to the same hand or foot, the insurer only pays one of them. If the proportion of disability items is different, the insurer will pay a higher proportion of disability insurance money.

3. If the insured is burned due to accidental injury, the insurer shall pay the burn insurance money according to the amount of accidental injury insurance contained in the insurance policy and the proportion corresponding to the burn in the Table of Payment Proportion of Accident Insurance Payment attached to this contract. When the insured causes multiple burns due to the same accidental injury, the insurer shall pay the sum of the corresponding burn insurance benefits.

4. The payment of accidental disability and burn insurance benefits in this insurance shall not offset each other.

(2) The insurer's liability for paying the above-mentioned insurance money to the insured is limited to the accidental injury insurance amount specified in the insurance policy. When the one-time or accumulated insurance premium reaches the accidental injury insurance amount, the insurer's above insurance liability to the insured is terminated.

(3) During the insurance period, if the insured dies of sudden acute illness or as a direct result of accidental injury within 180 days from the date of the accident, the insurer shall compensate the actual death treatment expenses within the limit of not exceeding 5% of the accidental injury insurance amount according to the compensation treatment standard attached to this contract.

Second, medical security.

(1) During the insurance period, the insured is treated in a medical institution designated or recognized by the insurer due to sudden acute illness or accidental injury, and the insurer shall bear the following insurance responsibilities:

1. The insurer shall compensate the insured for the reasonable and necessary expenses directly used for treatment within the amount of accidental injury medical insurance according to the compensation standard attached to this contract and the basic medical insurance management regulations of the government where this insurance policy is issued.

2. If the insured is hospitalized for accidental injury during the insurance period, and the treatment has not been completed after the expiration of the insurance period, the insurer will continue to bear the responsibility of paying medical insurance benefits, up to 180 days from the date of the accidental injury. For the medical expenses incurred in emergency rescue, the insurer shall be responsible for paying the medical insurance premium for no more than 2 weeks from the date of rescue.

(2) The insurer's liability for payment of medical insurance benefits to each insured is limited to the amount of medical insurance for accidental injury specified in the insurance policy. The insurer's insurance liability to the insured is terminated when the one-time or accumulated insurance premium reaches the amount of accidental injury medical insurance.

Third, supplementary medical security.

(1) During the insurance period, the insured is treated in a medical institution designated or recognized by the insurer due to sudden acute illness or accidental injury, and the insurer shall bear the following insurance responsibilities:

Reasonable and necessary transportation and lost time expenses incurred by the insured due to treatment, transportation and accommodation expenses for visiting close relatives, repatriation expenses for accompanying minors or the elderly, transportation and accommodation expenses for travel agency personnel and medical staff, and expenses incurred by trip delay shall be compensated by the insurer within the amount of supplementary medical insurance for accidental injury according to the compensation treatment standard attached to this contract.

(2) The insurer's liability to pay the supplementary medical insurance money to each insured is limited to the amount of supplementary medical insurance for accidental injury as stated in the insurance policy. The insurer's insurance liability to the insured is terminated when the amount of insurance money paid once or cumulatively reaches the amount of supplementary medical insurance for accidental injury.

Article 4 Exemption from liability

If the insured suffers losses under any of the following circumstances, the insurer shall not be liable for paying the insurance money:

1. The applicant or beneficiary intentionally kills or hurts the insured;

2. The insured violates the law, intentionally commits a crime or resists arrest;

3. The insured fights, gets drunk, commits suicide, intentionally injures himself, takes drugs or injects drugs;

4. The insured is influenced by alcohol, drugs and controlled drugs;

Five, the insured drunk driving, driving without a license and driving a motor vehicle or motor vehicle without a valid driver's license;

Six, the insured is pregnant, abortion, childbirth;

7. The insured is insane or insane;

Eight, the insured medical accidents caused by examination, anesthesia, surgical treatment, drug treatment;

Nine, the insured did not follow the doctor's advice, taking, smearing or injecting drugs without authorization;

10. Without the consent of the insurer, the insured engages in high-risk sports and activities such as diving, skydiving, skiing, water skiing, gliding, hunting, rock climbing, adventure, martial arts, wrestling, stunt, horse racing, racing and bungee jumping;

Xi. During the period when the insured suffers from AIDS or is infected with HIV (HIV positive);

12. The insured is declared dead by the court for reasons other than accidental injury or natural disaster;

Thirteen, war, military action, terrorist acts, riots or armed rebellion;

14. Nuclear explosion, nuclear radiation or nuclear pollution.

Fifteen, for orthopedics, cosmetic surgery, beauty, psychological counseling, organ transplantation, or repair, installation and purchase of disabled appliances (such as wheelchairs, prosthetics, hearing AIDS, glasses, artificial eyes, dentures, etc.). );

Sixteen, the insured physical examination, recuperation, rehabilitation treatment;

Seventeen, the insured's medical expenses, medical expenses that should be compensated by a third party according to law, but the perpetrator escaped or was unable to compensate.

If the insured dies due to the above circumstances, the insurer's insurance liability to the insured is terminated and the insurance premium will not be refunded.

Article 5 Special tourism projects

If the insured participates in high-risk sports and activities referred to in Paragraph 10 of Article 4 of this contract during the insurance period, he shall inform the insurer in writing when applying for insurance; After the insurer has approved and collected the corresponding insurance premium, it shall bear the insurance liability for the accidental injuries that occur during the insured's participation in high-risk sports and activities in accordance with the relevant provisions in Article 3 of this contract.

Article 6 Period of insurance

The insurance period of this contract shall be agreed by both parties. After the insurer receives the insurance premium and issues the insurance policy, the insurance period starts at 0: 00 on the agreed start date and ends at 24: 00 on the agreed end date.

Article 7 Insurance amount and insurance premium

1. The amounts of accidental injury insurance, accidental injury medical insurance and accidental injury supplementary medical insurance in this contract shall be agreed by both parties. Once the insured amount is determined, it shall not be changed halfway.

Two, the insured shall pay all the insurance premiums at the time of insurance.

Article 8 tell the truth

When concluding this contract, the insurer shall clearly state the contents of the insurance clauses, especially the exemption clauses, and have the right to inquire about the applicant and the insured in writing, and the applicant and the insured shall truthfully inform them.

If the applicant and the insured intentionally fail to perform the obligation of telling the truth, the insurer has the right to terminate this contract, and will not be responsible for paying or returning the insurance premium for the insurance accident that occurred before the termination of this contract.

If the applicant and the insured fail to fulfill the obligation of truthful disclosure due to negligence, which is enough to affect the insurer's decision on whether to agree to underwrite or increase the insurance premium rate, the insurer has the right to terminate this contract; If it has a serious impact on the occurrence of the insured accident, the insurer shall not be responsible for paying the insurance premium or returning the insurance premium for the insured accident that occurred before the termination of this contract.

Article 9 designation and change of beneficiaries

1. The insured or the insured may designate one or more persons as beneficiaries of death insurance benefits. When there are several beneficiaries, the order or share of benefits shall be determined. If the beneficiary is not specified, the insurance money shall be regarded as the insured's legacy, and the insurer shall fulfill the obligation to pay the insurance money to the insured's successor in accordance with the contract.

2. When the insured or the applicant changes the beneficiary of death insurance money, it shall notify the insurer in writing, and the insurer shall endorse the insurance policy. The applicant shall obtain the written consent of the insured when designating and changing the beneficiary of the death insurance.

3. The beneficiary dies before the insured, or the beneficiary waives (loses) the beneficial right according to law:

(1) If no other beneficiary is specified in the insurance contract, it shall be handled as if no beneficiary is specified;

(2) If other beneficiaries are listed in the insurance contract, the insurance premium shall be paid in the following ways:

1. order, the insurer shall pay the insurance money to the beneficiary whose benefit order is the first among other beneficiaries;

2. If equal or proportional benefits are adopted, the insurer shall pay insurance benefits to other beneficiaries according to the share of benefits agreed in the insurance contract; The insurance benefits under the name of the deceased beneficiary or the beneficiary who gave up (lost) the beneficial right according to law shall be regarded as the insured's heritage, and the insurer shall perform the obligation of paying the insurance benefits to the insured's heirs in accordance with the provisions of this contract.

Four, the insured and the beneficiary died in the same accident, it is impossible to determine the order of their deaths, it is presumed that the beneficiary died before the insured.

Five, in addition to the death insurance, the beneficiary of other insurance benefits is the insured himself, and the insurer does not accept other designations or changes.

Article 10 Notice of Insurance Accident

The applicant, the insured or the beneficiary shall notify the insurer within 5 days from the date when he knows or should know the occurrence of the insured accident. Otherwise, the applicant, the insured or the beneficiary shall bear the increased exploration and inspection expenses due to the delay in notification. Except for the delay caused by force majeure.

Article 11 Application for insurance money

1. In the event of an insurance accident, the beneficiary of the insurance premium shall fill in the application for payment of the insurance premium as the insured, and apply to the insurer for payment of the insurance premium with the following documents and materials:

(1) Insurance policies or other insurance certificates;

(two) the beneficiary's household registration certificate or identity certificate;

(3) Certificate of accidental injury issued by the public security department;

(4) If the insured dies due to accidental injury, it shall provide the death certificate of the insured and the cancellation certificate of the insured's household registration issued by the public security department or the medical institution designated or recognized by the insurer;

(5) If the insured is declared dead due to accidents or natural disasters, a death judgment issued by the people's court shall be provided;

(6) If the insured is disabled due to accidental injury, an appraisal of the degree of disability of the insured issued by a medical institution or doctor designated or recognized by the insurer shall be provided;

(7) If the insured is treated in a medical institution designated or recognized by the insurer due to sudden acute disease or accidental injury, he shall provide the diagnosis certificate, medical record, hospitalization certificate, discharge summary and original invoice of medical expenses issued by the medical institution.

(8) Other certificates and materials that can be provided by the insured and the beneficiary to confirm the nature, cause and degree of injury of the insured accident.

2. If the beneficiary entrusts others to apply for insurance benefits, it must also provide information such as the power of attorney and the identity certificate of the trustee.

3. After receiving the applicant's application for payment of insurance benefits and the certificates and materials listed in the first and second paragraphs of this article, the insurer shall fulfill its obligation to pay insurance benefits within 10 days after reaching an agreement with the applicant on the amount of insurance benefits; For those who do not belong to the insurance liability, a notice of refusal to pay the insurance premium shall be issued to the applicant.

4. If the insurer cannot determine the amount of the insurance premium belonging to the insurance liability within 60 days from the date of receiving the application for payment of the insurance premium from the applicant and the documents and materials listed in the first and second paragraphs of this article, the insurer shall pay the corresponding difference according to the existing documents and materials and the minimum amount that can be determined.

5. If the insured returns after his death, the beneficiary shall return the insurance money paid by the insurer within 30 days after he knows or should know that the insured is alive.

Six, the beneficiary of the insurer's right to request payment of insurance benefits, since he knew or should have known that the insured accident occurred within two years.

Article 12 Receipts for medical expenses

After the insured pays the medical expenses and makes a claim, he shall submit the relevant medical records and the original receipt of medical expenses to the insurer. When the amount of compensation is less than the full amount of actual medical expenses, the claimant may apply to the insurer in writing to return the original receipt. The insurer shall stamp the original receipt and indicate the paid amount before returning it.

Thirteenth medical expenses insurance compensation principle

The medical insurance in this contract is medical expense insurance, and the principle of compensation applies, that is, the total amount of compensation for medical expenses obtained by the insured in any way (including this insurance) is limited to the amount of medical expenses actually paid by the insured that meet the basic medical insurance management regulations of the government where this policy is issued.

Article 14 Medical preventive measures

First, the insured must receive treatment in a medical institution designated or recognized by the insurer. Acute, critical and severe patients are not subject to this restriction, but after being stabilized by first aid, they must be transferred to a medical institution designated or recognized by the insurer for treatment.

2. If the insured really needs to be transferred to hospital for treatment due to medical conditions, he must have a consultation report signed by the staff at or above the level of attending physician in the transferred hospital and a certificate of transfer, and the insured can be transferred to hospital for treatment only with the consent of the insurer.

Article 15 Changes of Contract Contents

After the establishment of this contract, the contents of the contract shall not be changed halfway.

Article 16 Handling of the termination of the contract by the applicant

After the establishment of this contract, it shall not be required to terminate the contract halfway.

Article 17 Dispute settlement

The contract dispute settlement method shall be selected by the parties from the following two ways when the contract is agreed:

1. Any dispute arising from the performance of this contract shall be settled by both parties through consultation. If negotiation fails, it shall be submitted to the arbitration commission of the place where the policy is issued or the nearest arbitration commission for arbitration, and the arbitration rules in effect at that time shall apply;

2. Disputes arising from the performance of this contract shall be settled by both parties through consultation. If negotiation fails, a lawsuit shall be brought to the people's court where the policy is issued according to law.

Article 18 Interpretation

Insurer: China Pacific Life Insurance Company Limited.

Force majeure: refers to unforeseeable, unavoidable and insurmountable objective circumstances.

Sudden acute disease: refers to an acute disease that will endanger the life of the insured if it is not treated in time during the insurance period.

Sudden death due to acute illness: refers to the insured's sudden acute illness during the insurance period, and he died of the disease or its complications within seven days from the onset or during the insurance period. If the insured dies after the end of the insurance period, the treatment after the end of the insurance period shall be carried out in a medical unit designated or recognized by the insurer, and the treatment time shall continue until the death of the insured.

Accidental injury: refers to the injury to the body caused by external, sudden, unintentional and non-disease objective events.

Payment ratio: refers to the insurance payment ratio specified in the Table of Disability Degree and Insurance Payment Ratio of Personal Insurance of China People's Bank.

Diving: refers to the underwater movement in rivers, lakes, seas, reservoirs, canals and other waters with the help of auxiliary breathing equipment.

Rock climbing: refers to climbing cliffs, building external walls, artificial cliffs, ice cliffs, icebergs and other sports.

Wushu: refers to the antagonistic competition between two or more people in judo, karate, taekwondo, Sanda, boxing and other boxing methods and various instruments.

Adventure: refers to the act of deliberately putting yourself in it knowing that there is a danger of losing your life or hurting your body under certain natural conditions. For example, river rafting, hiking through deserts or virgin forests with few people.

Special effects: refers to equestrian, acrobatics, animal training and other special skills.

Controlled drugs: refer to drugs that are classified as special management according to the Drug Administration Law of People's Republic of China (PRC) and relevant laws and regulations, including narcotic drugs, psychotropic drugs, toxic drugs and radioactive drugs.

Burn: The insured suffers from soft tissue burn due to accidental injury, and the degree of burn reaches third degree. The standard of third-degree burn is the damage of the whole skin (epidermis and subcutaneous tissue), which involves the necrosis, scabbing and final detachment of muscles, bones and soft tissues. The calculation of burn degree and burn area takes the new nine-point method as the evaluation standard.

AIDS: refers to the abbreviation of acquired immunodeficiency syndrome.

HIV: refers to the abbreviation of human immunodeficiency virus (HIV). The definition of acquired immunodeficiency syndrome should be based on the definition formulated by the World Health Organization. If the HIV antibody is positive in serological test, it can be determined as having AIDS or being infected with HIV.

Hospitalization: refers to the insured being hospitalized in the regular ward of the hospital for treatment due to accidental injury, and going through the formal admission and discharge procedures, excluding the outpatient observation room, family sickbed, other hanging beds and unreasonable hospitalization.

Insurance amount: the maximum amount that the insurer promises to pay insurance money.