If the insured person sustains accidental injury during the period of insurance, the insurer shall through EAO provide medical consultation and bear the following liabilities and expenses incurred overseas, if necessary: 1, Emergency outpatient medical expenses: 1)If the EAO’s appointed doctors deem that it is medically necessary for the Insured to receive emergency medical investigation and treatment, the Insurer through its EAO, will pay for the related emergency outpatient expenses (including consultation fee, examination fee, X-ray fee and prescription fee). However, payments of such emergency outpatient expenses exclude ultrasonic examination, CT and MRI which shall be borne by the Insured. 2)The Insurer through its EAO will pay for the emergency outpatient expenses (including the first visit and follow-up consultation) up to an overall maximum of RMB 8,000 per event. The Insured person is responsible to bear RMB 800 per event when seeking emergency outpatient treatment. 2, Emergency dental outpatient medical expenses: 1)If the Insured suffers dental illness directly resulted from an accidental injury or sudden illness, the insurer through its EAO shall arrange for such emergency dental outpatient treatment. 2)The Insurer through its EAO will pay for such emergency dental outpatient treatment up to an overall maximum of RMB4,000 per incident. The Insured is responsible to bear RMB 800 per incident when seeking emergency dental outpatient treatment. 3)The Insurer shall not be liable for any dental outpatient treatment expenses arising from any dental medical record, non-emergency or pre-arranged dental treatment, bridgework and crown. 3, The amount of oversea emergency outpatient medical expenses benefits payable to any one insured person is limited to RMB 20,000.
在本合同保险期间内,被保险人在境外遭受意外伤害或突发急性病时,保险人承担以下责任及其费用: 一、紧急门诊责任 1、若被保险人因病情所需,可进行紧急医疗会诊及必要的医疗检查和治疗,保险人承担由此产生的合理且必要的医疗费用,但不包括超声波、计算机断层扫描(CT)和核磁共振(MRI)的费用。 2、保险人承担的紧急门诊费用(包括初诊和复诊)以每次事故人民币8000元为限,且每次事故人民币800元(含)以内的部分由被保险人自行承担。 二、紧急牙科门诊责任 1、被保险人因遭受意外伤害直接造成的牙病或者突发急性牙病而接受紧急治疗,保险人承担由此产生的合理且必要的医疗费用。 2、保险人承担的牙科门诊费用(包括初诊和复诊)以每次事故人民币4000元为限,且每次事故人民币800元(含)以内的部分由被保险人自行承担。 3、原有牙病的诊治、非紧急牙科诊治,以及修复、正畸、种植等的牙科门诊费用保险人不予承担。 三、保险人对每一被保险人所负给付本条保险金的责任以人民币2万元为限,一次或累计给付的本条保险金达到保险金额时,保险人对该被保险人的本条保险责任终止。
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