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Domestic Helper Insurance Policy

Please read this Policy carefully upon receipt and promptly request the Company for necessary amendments.

This policy and the Schedule shall be read together as one contract and any word or expression to which a specific meaning has been attached in any part of this Policy or of the Schedule shall bear such meaning wherever it may appear.

The proposal and declaration made by the Insured shall form the basis of this contract and are deemed to be incorporated herein. In consideration of the Insured has applied to Tugu Insurance Company Limited (hereinafter called the "Company") for the insurance hereinafter contained and has paid or agreed to pay the Premium as specified for such insurance, the Company will pay the Benefits to the Insured or in the case of death of the Insured to the Insured's legal personal representative.

Definiton

The Insured

As named in the Schedule

Insured Person

The domestic helper(s) named in the Schedule who is legally employed by the Insured and who is eligible for and covered by the insurance provided in this Policy.

The Ordinance

Employees' Compensation Ordinance (Chapter 282 of the laws of Hong Kong SAR)

Period of Insurance

The period specified in the Schedule and any subsequent period for which the Insured shall have paid and the Company shall have accepted a renewal premium.

Hospital

An establishment duly constituted and registered as a hospital for the care and treatment of sick and injured persons and which:

  1. has organised facilities for diagnosis, treatment and major surgery;
  2. provides twenty-four (24) hours a day nursing services by registered graduate nurses;
  3. is under the supervision of a physician; and
  4. is not primarily a clinic, a place for custodial care, alcoholics or drug addicts, a nursing, rest or convalescent home or home for the aged or similar establishment.

General Exclusions Applicable To All Sections

This Policy does not apply to any event which is caused directly or indirectly by or which results from:-

  1. war invasion act of foreign enemy hostilities or warlike operations(whether war be declared or not) civil war mutiny rebellion revolution insurrection or military or usurped power;
  2. intentional self-inflicted injury or suicide (whether felonious or not) or any attempt thereat while sane or insane;
  3. childbirth, pregnancy, miscarriage, abortion and all complications in connection therewith notwithstanding that such event may have been accelerated or induced by accident;
  4. intoxication by alcohol, narcotics or drugs not prescribed by a legally qualified and registered medical practitioner and treatment in connection with drugs or alcohol;
  5. acquired Immune Deficiency Syndrome (AIDS) or AIDS Related Complex (ARC), howsoever this syndrome has been acquired or may be named;
  6. pre-existing condition for which the Insured Person had received medical treatment, diagnosis, consultation or prescribed drugs prior to this Period of Insurance.    For the purpose of Section 2, 3, 4, 5 and 8 of the Schedule of Benefits, no benefits shall be payable for injury sickness or disease sustained prior to inception of the Insured Person's insurance and resulting in medical treatment received within three (3) consecutive months immediately before inception of the Insured Person's insurance, it being understood that if no medical treatment is incurred on such injury, sickness or disease within three (3) consecutive months immediately after inception of the Insured Person's insurance, benefits under these sections shall subsequently become effective;
  7. nuclear weapons material or ionising radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel and for the purpose of this exception combustion shall include any self-sustaining process of nuclear fission;
  8. unless otherwise specified in the Schedule, no coverage shall be provided for any Insured Persons who are not aged between 18 and 60 during the Period of Insurance.
  9. any injury, sickness, accident or event occurring and/or medical treatment or surgery received outside the territorial limits of Hong Kong SAR.

Section 1 - Employees' Compensation

If any Insured Person in the Insured's immediate employ shall sustain bodily injury or death by Accident occurring or Disease contracted during the Period of Insurance within the Geographical Area and arising out of and in the course of his/her employment by the Insured.

The Company will subject to Policy Limit of Indemnity and to the terms exclusions and conditions contained in or endorsed on the Policy (all of which are hereinafter collectively referred to as "the Terms of this Policy") indemnify the Insured against his legal liability in respect of such bodily injury or death under the Ordinance and independently of the Ordinance to pay compensation and damages and claimant's costs and expenses and also indemnify the Insured against costs and expenses incurred by or on behalf of the Insured with the Company's written consent in connection therewith.

Provided that in the event of any change to the Ordinance during or subsequent to the Period of Insurance altering the legal liability of the Insured under the Ordinance the liability of the Company under this Policy shall be limited to such sums as the Company would have been liable to pay if the Ordinance had remained unaltered.

The Company will also in the event of the death of the Insured indemnify the insured's legal personal representatives in the terms of this Policy in respect of liability incurred by the Insured provided that such legal personal representatives shall as though they were the Insured observe fulfill and be subject to the terms of this Policy in so far as they can apply.

Policy Limit of Indemnity

  1. In respect of any Accident or Disease giving rise to a claim or claims against the Insured for which indemnity is provided under this Section, the Company's indemnity to the Insured including costs and expenses incurred by on behalf of the Insured with the Company's written consent shall in the aggregate be limited to HK$100,000,000 irrespective of the number of Insured Person who may sustain bodily injury or death consequent on or attributable to the same occurrence of Accident or Disease.
  2. In relation to any liability of the Insured in respect of a Disease contracted by an Insured Person due to the nature of his employment with the Insured which nature of employment applies during a period that extends over more than one Policy Period of Insurance:
    i. the aggregate of the Company's indemnity to the Insured under all insurance policies including costs and expenses such Disease was due first affected the Insured Person; and
    ii.subject to the limitation of paragraph (b)(i) hereof, the Company's indemnity to the Insured under this Policy including costs and expenses incurred by or on behalf of the Insured shall be limited to such proportion of the Insured's liability in respect of such Disease as that part of the Insured Person's period of employment falling within the Period of Insurance of this Policy bears to the total period of his/her employment to the nature of which such Disease was due.
  3. If the occurrence of any Accident or Disease results in indemnity hereunder to more than one Insured, the limitations of the Company's liability specified in paragraphs (a) and (b) hereof shall apply to the aggregate of indemnity to all Insureds.
  4. At any time after the occurrence of any Accident or Disease giving rise to a claim against the Insured for which indemnity is provided under this Policy, the Company may pay to the Insured the full amount of the Company's liability specified in paragraph (a) or (b) hereof (after the deduction of any sums already paid) or any lesser amount for which such claim or claims can be settled and shall relinquish the conduct of any defence settlement or proceedings relating to such claim or claims and shall not thereafter be responsible for any compensation damages or costs in respect thereof or for any costs or expenses whatsoever incurred by the Insured after the Company shall have relinquished such conduct or for any loss damage or expenses caused to the Insured in consequence of any act or omission of the Company in connection therewith or of the Company relinquishing such conduct.

Geographical Area

Hong Kong Special Administrative Region

Exclusions applicable to Section 1

The Company shall not be liable in respect of:

  1. any liability of the Insured which attaches by virtue of an agreement but which would not have attached in the absence of such agreement;
  2. any sum which the Insured would have been entitled to recover from, any party but for an agreement between the Insured and such party;
  3. any liability arising from Pneumoconiosis or Noise-Induced Deafness ("Noise-Induced Deafness" has the same meaning as assigned to that expression in the Occupational Deafness (Compensation) Ordinance (Chapter 469 of the laws of Hong Kong SAR).    "Pneumoconiosis" has the same meaning as assigned to that expression in the Pneumoconiosis (Compensation) Ordinance (Chapter 360 of the laws of Hong Kong SAR).);
  4. the Insured's liability to any person who is not an employee of the Insured within the meaning of the Ordinance;
  5. any late payment surcharge fines penalties or punitive aggravated or exemplary damages for which the Insured may become liable under the Ordinance or independently of the Ordinance;
  6. any injury by Accident or Disease where the Company has not been given sufficient notice of the institution of proceedings in a court of tribunal to enable the Company to be added as a party to the proceedings.

Section 2 - Clinical Expenses

In the event the Insured Person required medical treatment from a clinic for bodily injury caused solely and directly by violent accidental external and visible means or sickness, the Company will pay the actual, necessary and reasonable expenses incurred (after deduction of any sums recovered or recoverable from all other sources):

  1. upto HK$200 per visit per day for each Insured Person where treatment is received from a legally qualified and registered medical practitioner; or
  2. upto HK$100 per visit per day and upto a maximum of HK$500 for each Insured Person for the Period of Insurance where treatment is received from a licensed or registered Bonesetter or Physiotherapist.

The maximum amount payable for each Insured Person under this Section during the Period of Insurance is HK$3,000.

Section 3 - Surgical and Hospitalization Expenses

In the event the Insured Person while as a patient is confined in a hospital for surgery or treatment of bodily injury caused solely and directly by violent accidental external and visible means or sickness, the Company will pay the actual, necessary and reasonable expenses incurred up to:

  1. HK$300 per day for room and board and other hospital miscellaneous services
  2. HK$10,000 per surgical operation
  3. 25% of the amount payable under b) above for anesthesia and its administration
  4. 12.5% of the amount payable under b) above for use of the operating theatre.

The maximum amount payable for each Insured Person under this Section during the Period of Insurance is HK$30,000.

Section 4 - Service Interruption Cash Subsidy

If the Insured Person is confined in a hospital as an in-patient for surgery or treatment of bodily injury caused solely and directly by violent accidental external and visible means or sickness causing loss or interruption of service to the Insured, the Company will pay the Insured HK$200 for each day of confinement commencing from the 4th day of hospital confinement of the Insured Person.

If the Insured Person is confined in a hospital as an in-patient for surgery or treatment of bodily injury caused solely and directly by violent accidental external and visible means or sickness causing loss or interruption of service to the Insured, the Company will pay the Insured HK$200 for each day of confinement commencing from the 4th day of hospital confinement of the Insured Person.

The maximum amount payable for each Insured Person under this Section during the Period of Insurance is HK$6,000.

Exclusions applicable to Section 2, Section 3 and Section 4

Section 2, Section 3 and Section 4 under this Policy do not apply to any event which is caused directly or indirectly by or which results from:

  1. nervous or mental disease or disorder, venereal disease, congenital anomalies and deformities, infertility, sterilization, heart disease or cancer;
  2. rest cure or physical check-ups;
  3. cosmetic or plastic surgery unless to correct an injury for which this Policy covers;
  4. vaccinations, immunization, injections or preventive medication.

Section 5 - Dental Expenses

In the event of the Insured Person requires oral surgery, treatment of abscesses, X-rays, extractions or fillings as a result of dental disease, the Company will pay two-thirds of the actual, necessary and reasonable expenses incurred for such treatments received from a legally qualified and registered dentist.

The maximum amount payable for each Insured Person under this Section during the Period of Insurance is HK$1,500.

Exclusions applicable to Section 5

Section 5 under this Policy does not apply to any event which is caused directly or indirectly by or which results from:

  1. any routine examination, scaling, polishing or cleaning and crowning;
  2. cost of any bridges, braces and dentures.

Section 6 - Personal Accident Benefits

In the event the Insured Person sustains bodily injury caused solely and directly by violent accidental external and visible means during his or her rest days and such bodily injury is not arising out of and in the course of his/her employment resulting in accidental death or permanent disablement occurring within twelve (12) months from the date of such accident, the following compensation shall be payable:


Accidental death HK$100,000
Loss of or permanent total loss of use of two or more limbs HK$100,000
Loss of sight of both eyes HK$100,000
Loss of or permanent total loss of use of one limb and loss of sight of one eye HK$100,000
Loss of or permanent total loss of use of one limb HK$50,000
Loss of sight of one eye HK$50,000

Loss of limb shall mean physical severance of a hand or foot at or above the wrist or ankle or an arm or leg or above elbow or knee.

Loss of sight shall mean entire and irrecoverable loss of all sight.

The maximum amount payable for each Insured Person under this Section during the Period of Insurance is HK$100,000.

Exclusions applicable to Section 6

Section 6 under this Policy does not apply to any event which is caused directly or indirectly by or which results from:

  1. injury occurring outside the rest days of the Insured Person;
  2. the Insured Person engaging in or taking part in:

    a. hunting, steeplechase, motorcycling as driver or passenger, racing of any kind or any practice therefor (other than on foot), mountaineering, gliding including hang gliding, parachuting, diving, winter sports, skiing, water skiing, water ski-jumping, ice-hockey, rugby, polo, pot-holing, or using power-driven woodworking machinery or any abnormally hazardous adventure which expression shall include but in no way be limited to skin diving, deep sea fishing, yachting other than inshore sailing, tobogganing, bobsleighing, under water pastimes, mountain or rock climbing necessitating the use of ropes or guides, expeditions, boxing, wrestling, judo, karate, unarmed combat, skating, show jumping.
    b.flying except as a passenger in a fully licensed passenger aircraft not as a member of the crew nor for the purpose of undertaking any trade or technical operation therein.

Section 7 - Repatriation Expenses

In the event the Insured Person suffers bodily injury caused solely and directly by violent accidental external and visible means or serious sickness and has been certified to be medically unfit to continue employment with the Insured, the Company will pay the actual, necessary and reasonable expenses incurred in repatriating the Insured Person to his/her home country.

In case of death, the Company will pay for the repatriation of mortal remains.

The maximum amount payable for each Insured Person under this Section during the Period of Insurance is HK$20,000.

Exclusion applicable to Section 7

  1. the Company shall not be liable in respect of any repatriation or transportation of mortal remains originating outside Hong Kong SAR.
  2. the Company shall not pay any expenses in excess of
    1. the repatriation of the Insured Person to his/her country of residence by scheduled flight (economy class) including any transportation for ambulance transfer to and from the airport;
      or
    2. the treatment of the Insured Person's post-mortem and transportation of the mortal remains to the airport nearest to the place of burial in his/her country of residence.

Section 8 - Replacement Helper Expenses

In addition to the expenses incurred for the repatriation of the Insured Persons as described in Section 7 above, the Company will pay the expenses reasonably and necessarily incurred by the Insured for employing a replacement helper.

The maximum amount payable for each Insured Person under this Section during the Period of Insurance is HK$5,000.

Section 9 - Fidelity Guarantee

The Company will indemnify the Insured against any financial loss arising directly from any proven act of fraud or dishonesty committed by the Insured Person.

Provided that:

  1. the act of fraud or dishonesty must be committed during the Period of Insurance;
  2. the act of fraud or dishonesty must be discovered during the Period of Insurance or within thirty (30) days after the Policy expiry or within thirty (30) days after death, dismissal or expiry of employment contract of the Insured Person, whichever is the sooner;
  3. moneys due by the Insured to the Insured Person shall be deducted from any amount otherwise payable under this Benefit;
  4. discovery of any act of fraud or dishonesty must be reported to the Police within twenty four (24) hours;
  5. it is the duty of the Insured to prove that his financial loss is a direct result of the act of fraud or dishonesty committed by the Insured Person;
  6. the maximum amount payable for each Insured Person under this Section is
    1. HK$1,000 for proven unauthorized telephone calls
    2. HK$3,000 during the Period of Insurance inclusive of a. above.

Waiting Period

A 14-Days waiting period from effective date of the insurance shall be applicable under Section 2 - Clinical Expenses, Section 3 - Surgical & Hospitalization Expenses, Section 4 - Service Interruption Cash Subsidy, Section 5 - Dental Expenses and Section 8 - Replacement Helper Expenses for each Insured Person during which no benefit shall be payable.

General Conditions

  1. Conditions Precedent of Liability
    The due observance and fulfilment of the Terms of this Policy in so far as they relate to anything to be done or not to be done or to be complied with by the Insured; and the truth of the statements and answers in the Proposal and Declaration shall be conditions precedent to any liability of the Company to make payment or to provide indemnity under this Policy.
  2. Notices
    Every notice or communication to be given or made under this Policy shall be delivered in writing to the Company and in the case of notice or communication to the Insured to his address specified in the Schedule.
  3. Jurisdiction Clause
    The Company shall not be liable under this Policy in respect of judgments against the Insured which are not in the first instance delivered by or obtained from a court of competent jurisdiction of Hong Kong SAR.
  4. Avoidance of certain terms and right or recovery
    If the Company is obliged by the Ordinance to pay an amount for which the Company would not otherwise be liable under this Policy the Insured shall repay the amount to the Company.
  5. Claim Prevention
    The Insured and the Insured Person shall take all reasonable precautions to prevent accidents and disease and shall comply with all statutory obligations.
  6. Fraud
    If any claim under this Policy shall be in any respect fraudulent or if any fraudulent means or devices shall be used to obtain the Benefits under this Policy, the Company shall have no liability in respect of such a claim.
  7. Assignment
    No assignment of interest under this Policy shall bind the Company unless the written consent of the Company is first obtained and endorsed hereon.
  8. Change In Risk
    The Insured shall give immediate written notice to the Company of any material fact affection this insurance which has come to the Insured's notice during the Period of Insurance including notice of any disease physical or mental defect or infirmity affection the Insured Person.
  9. Change In Insured Person
    The Insured shall give immediate written notice to the Company in relating to the replacement of an existing Insured Person named in the Schedule during the Period of Insurance and the new Insured Person shall then be entitled to the same Benefits less any amount already paid in respect of loss or damage sustained by the existing Insured Person.
  10. Claims Settlement
    1. Claims Notification

      Immediate notice shall be given to the Company of any occurrence likely to give to rise to a claim under this Policy. Within thirty (30) days of any occurrence likely to give rise a claim under this Policy, a detailed statement in writing describing the occurrence shall be delivered to the Company.

      All expenses shall, in the first instance, be paid by the Insured and original invoice and receipts submitted with the duly completed claim form to the Company for reimbursement.

      The Insured shall also give the Company notice in writing immediately the Insured becomes aware of any intention to prosecute the Insured any impending prosecution inquest or fatal inquiry in connection with any occurrence which may give rise to a claim under this Policy. Every letter claim writ summons and process shall be forwarded to the Company immediately on receipt by the Insured.

    2. Claims Control by the Company

      The Company shall be entitled upon notice to the Insured to take over and conduct in the Insured's name the defence or settlement of any claim demand or proceedings against the Insured. In that event:

      1. the Insured shall provide all such information and assistance and forward all such documents and other records to the Company for the conduct of such claim demand or proceedings as the Company in its discretion may from time to time require; and
      2. the Insured shall not without the written consent of the Company incur any expenditure in connection with any such claim demand or proceedings or make any payment admission offer or enter into any settlement whatsoever.
    3. Other Insurance (Not applicable to Section 6 -Personal Accident Benefits)
      If at the time a claim is made by the Insured under this Policy there is any other insurance covering the same liability the Company shall not be liable to pay or contribute more than its ratable proportion of any such claim and costs and expenses in connection therewith.
    4. Waiver of Claims
      The Insured shall not become a party to any agreement the effect of which is that the Insured waives any claim which the Insured would otherwise have against any person in respect of or arising out of any occurrence resulting in liability on the part of the Insured for which indemnity is provided by this Policy or whereby any such claim is limited or qualified in any way.
    5. Subrogation
      The Company shall be entitled at its sole discretion to prosecute in the name of the Insured any claim for damages costs indemnity contribution or otherwise against any person who may be liable to the Insured in respect of any liability on the part of the Insured for which indemnity is provided by this Policy and shall have full discretion in the conduct of any such proceedings and in the settlement of any such claim. The Insured shall give all such information and assistance as the Company may from time to time require and execute any necessary documents for the purpose of vesting such rights in the Company.    Any moneys recovered pursuant to the exercise of such rights shall be applied firstly for the benefit of the Company to the extent of the amount paid by the Company in respect of any claim including any costs and expenses paid or incurred by the Company and costs and expenses incurred in prosecuting such recovery action.
  11. Proof of Loss

    It is a condition precedent to any liability of the Company under this Policy that the Insured shall at his own expenses furnish to the Company such certificate information and evidence as the Company may from time to time reasonably require in the form and of the nature described by the Company.    The Company shall be allowed at its own expenses upon reasonable notice to the Insured to have a medical examination of the Insured Person from time to time or in the case of death upon reasonable notice to the Insured Person's legal personal representative to have a post-mortem examination of the body.

    The death of the Insured Person shall be established by an official death certificate.

    Any claim arising from the death of the Insured Person shall be payable to the Insured Person's legal personal representative.

  12. Cancellation

    The Company may cancel this Policy by sending seven days' notice by registered letter to the Insured at his last known address and the Company will refund to the Insured the proportionate part of any premium paid in respect of the unexpired Period of Insurance.

    The Insured may at any time cancel this Policy delivering to the Company a notice in writing whereupon the Company shall refund to the Insured all the unused part of any premium paid in respect of the unexpired Period of Insurance calculated at the customary short period rate subject to the minimum premium.

  13. Arbitration
    All differences arising out of this Policy shall be determined by arbitration in accordance with the Arbitration Ordinance as amended from time to time. If the parties fail to agree upon the choice of the arbitrator, then the choice shall be referred to the Chairman for the time being of the Hong Kong International Arbitration Centre.    It is expressly stipulated that it shall be a condition precedent to any right of action or suit upon this Policy that an arbitration award shall be first obtained.    If the Company shall disclaim liability to the Insured for any claim hereunder and such claim shall not within twelve (12) calendar months from the date of such disclaimer have been referred to arbitration under the provisions herein contained then the claim shall for all purposes be deemed to have been abandoned and shall not thereafter be recoverable hereunder.
  14. Governing Law
    This Policy is subject to the exclusive jurisdiction of Hong Kong SAR and is to be construed according to the laws of Hong Kong SAR.