Terms & Conditions

IMPORTANT INFORMATION

The product information provided on this website is for general reference only and does not constitute the full terms and conditions of the policy. For detailed definitions of specified terms, specific coverage conditions, exclusions, and complete terms, please refer to the policy document.

1. Cooling Off Right

   You may exercise the right to cancel the policy and obtain a refund of the standard premium and premium loading (if any) and insurance levy paid within the cooling-off period.

   The cooling-off period is the period of 30 days immediately following the day of the delivery of the policy or the cooling-off notice (whichever is the earlier), to you or your nominated representative. The cooling off notice is a notice that will be sent to you or your nominated representative by Cigna Worldwide General Insurance Company Limited to notify you of the cooling-off period around the time the policy is delivered.

   To exercise this right, a written notice of cancellation must be signed by you or the request to cancel must be made by you in a form prescribed by the Company and received directly by the Company at 16/F, 348 Kwun Tong Road, Kwun Tong, Kowloon, Hong Kong. In such event, the policy shall be deemed to have been void from the policy effective date and the Company shall not be liable to pay any benefit.

   No refund can be made if a benefit payment has been made, is to be made or pending.

2. Policy Cancellation

   After the cooling-off period, you may cancel the policy by giving not less than 30 days notice to us using a form prescribed by the Company.

   Termination of the policy caused by such cancellation shall become effective on the date specified in such form or the date approved by the Company, whichever is the later.

   There shall be no refund of the standard premium, the premium loading (if any) and insurance levy paid. The Company reserves the right to charge the standard premium and the premium loading (if any) calculated until the end of such policy year during which the termination of the policy becomes effective.

3. Mis-statement of non-health related information

   If any non-health related information (E.g. age, sex or smoking Habit) of the Insured Person has been mis-stated in the Application or in any subsequent information or document submitted to the Company for the purpose of the application, the Company may adjust the premium payable on the basis of the correct information or declare the Policy void as from the Policy Effective Date if the application of the Insured Person should have been rejected based on the correct information.

4. Misrepresentation or fraud

   If any material fact relating to the health related information of the Insured Person has been incorrectly stated in, or omitted from the application or any statement or declaration made for or by the Insured Person in the application or in any subsequent information or document submitted to the Company for the purpose of the application; or any application or claim submitted is fraudulent or where a fraudulent representation is made, the Company may declare the policy void as from the policy effective date.

5. Premium

   1. Premium payable

      For the basic policy, you are required to pay the standard premium and the premium loading (if any) regularly on the premium due date.

   2. Non-payment of premium

      If you fail to pay the initial premium in full for the policy on or before the policy issuance date or the policy effective date (whichever is the earlier), the policy shall be deemed to be void as from the Policy Effective Date for all purposes. Accordingly, we shall not be liable to pay any benefit under the policy.

      Except for the initial premium payment, a grace period after any premium due date will be allowed for payment of premium or any part thereof. The coverage of the policy will remain in force during this grace period, but the Company shall have the right to deduct at its discretion any due premium payment from the benefit payable under the policy if there is any benefit payable during the grace period.

      If the standard premium and premium loading (if any) of the Basic Policy or any part thereof remains unpaid at the end of the grace period, the policy shall terminate on the premium due date on which the unpaid standard premium and premium loading (if any) was first due.

   3. Premium Adjustment

      The Company reserves the right to revise the standard premium of the Policy on each anniversary date at its sole discretion by taking into account such factors as the Company determines to be relevant for the purpose of revising the standard premium. If the premium loading is set as a percentage of the standard premium, the amount of premium loading will be adjusted automatically according to the change in the standard premium.

6. Claims Procedure

   To make a claim, please download and register for the MyCigna HK app. For details of procedures by claims type, please visit the Company website https://www.cigna.com.hk/en/customer-service/insurance-claim-procedure.

   A fully completed claim form prescribed by the Company must be given to the Company during the lifetime of the insured person and within 60 days (a) after the date of the event giving rise to the claim or (b) after the first diagnosis of critical illness or early stage critical illness (whichever is the earlier). Such form shall include information sufficient to identify the insured person and the nature of the claim.

7. Benefits

   Coverage is subject to compliance with sanctions rules under policy provisions.

   Critical Illness Benefit

   Subject to the terms and conditions of the policy, while the policy is in force and after the Waiting Period, if the insured person is first diagnosed to be suffering from a critical illness, the Company shall pay the Critical Illness Benefit to the policy holder in 1 lump sum calculated in accordance with the formula as follows:

   Critical Illness Benefit payable

   100% of the Sum Insured LESS ( - ) Any Early Stage Critical Illness Benefit paid or payable LESS ( - ) Indebtedness (if any)

   For the avoidance of doubt, the policy shall terminate and cease to provide any coverage upon payment of the Critical Illness Benefit.

   Early Stage Critical Illness Benefit

   Subject to the terms and conditions of the policy, while the policy is in force and after the Waiting Period, if the insured person is first diagnosed to be suffering from an early stage critical illness, the Company shall pay the Early Stage Critical Illness Benefit to the Policy Holder calculated in accordance with the formula as follows:

   Early Stage Critical Illness Benefit payable (for each Early Stage Critical Illness)

   The lesser of: (a) 20% of the Sum Insured; or (b) HK$400,000 less the total amount of benefits paid and/or payable in respect of the same Early Stage Critical Illness under all other policies of Cigna Healthcare VitalGuard Critical Illness PlanTM for the same Insured Person issued by the Company LESS ( - ) Indebtedness (if any)

   The Early Stage Critical Illness Benefit can be claimed for each early stage critical illness once only under the Policy. Notwithstanding the aforementioned, the Early Stage Critical Illness Benefit can be claimed in respect of “Carcinoma-in-situ” for up to 2 times, provided that the 2 claims must be in respect of “Carcinoma-in-situ” occurring in 2 different organ(s). In this regard, once “Carcinoma-in-situ” is diagnosed in 1 covered organ, that organ is excluded for purposes of a second claim for “Carcinoma-in-situ” under the Early Stage Critical Illness Benefit. If the relevant organ has both a left and a right component (such as, but not limited to, the lungs or breasts), the left side and right side of the organ shall be considered as 1 and the same organ.If the Insured Person is insured under more than 1 policy of “Cigna Healthcare VitalGuard Critical Illness Plan^TM” issued by the Company, the total amount of benefits paid and/or payable in respect of each and the same early stage critical illness under all such policies shall not exceed HK$400,000. Notwithstanding the aforementioned, if the Insured Person is insured under more than 1 policy of Cigna Healthcare VitalGuard Critical Illness Plan^TM issued by the Company: (a) the total amount of benefits paid and/or payable in respect of each claim for “Carcinoma-in-situ” under all such policies shall not exceed HK$400,000; and (b) the total amount of benefits paid and/or payable in respect of the 2 claims for “Carcinoma-in-situ” under all such policies shall not exceed HK$800,000.

   The Early Stage Critical Illness Benefit can be claimed multiple times and the aggregate amount of the Early Stage Critical Illness Benefit paid and/or payable under the Policy shall not exceed 100% of the Sum Insured.

   For the avoidance of doubt, the policy shall terminate and cease to provide any coverage when the aggregate amount of the Early Stage Critical Illness Benefit paid reaches 100% of the Sum Insured.

8. Renewal

   The basic policy shall be effective for the period of cover and thereafter guaranteed to be automatically renewable for each subsequent period of cover, provided that the standard premium and premium loading (if any) is paid on or before each premium due date and that we continue to issue new policy(ies) under the basic policy.

   The Company reserves the right to revise the standard premium on each Anniversary Date at its sole discretion by taking into account such factors as the Company determines to be relevant for the purpose of revising the standard premium.

   The Company reserves the right to revise the terms and conditions and/or the Benefit Schedule of the policy upon each renewal.

   If the basic policy is not renewed by the Company, we will send a written notice to you, at least before 30 days prior to the next renewal date, to notify you that the policy will not be renewed.

9. Termination

   The policy shall terminate upon the occurrence of the earliest of the following events:

   (a) the death of the insured person;

   (b) the policy is canceled during the cooling-off period;

   (c) the cancellation of the policy by the Policy Holder;

   (d) the cancellation of the Policy by the Company due to mis-statement of non-health information, misrepresentation or fraud, non-payment of initial payment;

   (e) the policy is non-renewal that we discontinue to issue new policy(ies)

   (f) the lapse of the policy following the non-payment premium by the end of the grace period;

   (g) upon payment of the Critical Illness Benefit;

   (h) when the aggregate amount of the Early Stage Critical Illness Benefit paid reaches 100% of the Sum Insured; or

   (i) on the anniversary date immediately after the insured person reaches age 85.

10. Inflation Risk

    Your current planned benefit may not be sufficient to meet your future needs since the future cost of living may become higher than they are today due to inflation. Where the actual rate of inflation is higher than expected, you may receive less in real terms even if the Company meet all of our contractual obligations.

11. Medically Necessary

    "Medically Necessary" shall mean the need to have medical service for the purpose of investigating or treating the relevant disability in accordance with the generally accepted standards of medical practice and such medical service must:

    (a) require the expertise of, or be referred by, a registered medical practitioner;

    (b) be consistent with the diagnosis and necessary for the investigation and treatment of the disability;

    (c) be rendered in accordance with standards of good and prudent medical practice, and not be rendered primarily for the convenience or the comfort of the insured person, his family, caretaker or the attending registered medical practitioner;

    (d) be rendered in the setting that is most appropriate in the circumstances and in accordance with the generally accepted standards of medical practice for the medical services; and

    (e) be furnished at the most appropriate level which can be safely and effectively provided to the insured person.

12. Waiting Period

    “Waiting Period” shall mean a period of 90 days from the latest of:

    (a) the policy issuance date or the policy effective date (whichever is the later); and

    (b) the effective date of reinstatement (if the policy has been reinstated).

    In respect of any increase in benefits resulting from a higher Sum Insured under the policy, "Waiting Period" shall mean a period of 90 days from the latest of:

    (a) the issue date or the effective date of the increase in the Sum Insured (whichever is the later); and

    (b) the effective date of reinstatement (if the policy has been reinstated).

Key Exclusions

The product information provided in this website is for general reference only and does not constitute the full terms and conditions of the policy. For detailed definitions of specified terms, specific coverage conditions, exclusions, and complete terms, please refer to the policy document.

Under the policy, the Company shall not pay any benefits in relation to or arising from the following:

(a) any disability other than a diagnosis of critical illness or early stage critical illness;

(b) any disability the signs or symptoms of which, or any surgery the cause or triggering condition of which, first occurred prior to the policy issuance date or the policy effective date (whichever is the later);

(c) any disability the signs or symptoms of which, or any surgery the cause or triggering condition of which, first occurred during the Waiting Period;

(d) Fulminant Viral Hepatitis or Cancer suffered by the insured person, where in our opinion such disease was directly or indirectly due to AIDS or HIV Infection (except for AIDS/HIV due to Blood Transfusion, Occupational Acquired HIV, HIV Infection due to Organ Transplant, and Medically Acquired HIV Infection);

(e) any disability or surgery caused by suicide, attempted suicide or intentionally self-inflicted injury, whether sane or insane;

(f) any disability or surgery directly or indirectly caused by the taking of drugs (except under the direction of a doctor), the consumption of poison or alcohol;

(g) any disability resulting from a physical or mental condition which existed before the policy issuance date or the policy effective date (whichever is the later) and which was not disclosed in the application;

(h) violation or attempted violation of the law or participation in fight or affray or resistance to arrest;

(i) war, whether declared or undeclared, revolution or any warlike operations;

(j) engaging in services in armed forces in times of declared or undeclared war or while under orders for warlike operations or restoration of public order;

(k) operating, being transported, or in any way engaging in air travel except as a fare paying passenger or cabin crew in any aircraft operated by a commercial passenger airline on a regular scheduled passenger trip over its established passenger route; and

(l) any congenital conditions.

Notes: “Cigna Healthcare”, “the Company”, “We”, “our” or “us” herein refer to Cigna Worldwide General Insurance Company Limited.