GENERAL INFORMATION
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A
completed Oral Examination Report must be submitted with the first
dental claim. All conditions requiring treatment as of the first dental
visit are deemed to be pre-existing conditions. |
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Medical
plans do not cover care, treatment, services or supplies for:
- Pre-existing conditions not declared to and accepted
by the Company
- Which the Insured Person is entitled to indemnity
from a third party or other benefit plan
- Birth
control; treatment of impotence or infertility (including artificial
insemination, in-vitro fertilization, embryo transfer); sterilization
reversal or elective abortion
- Congenital conditions and genetic deformities or
diseases;
- Weight treatment and management;
- Custodial
Care, routine medical check-ups, or any treatments considered
unnecessary by the Company, vaccinations, counselling, hearing tests,
refractive defects of the eye, corrective eye surgery for refractive
error, corrective devices, or dental treatment unless covered under the
optional benefits cover of this policy for vision, dental, or medical
check-up;
- Disability resulting from war or any act thereof,
service in the military, naval or air force, riot, civil commotion;
- Hazardous or professional sports unless declared to
and accepted by the Company;
- Intentionally self-inflicted injury, suicide, abuse
of alcohol, drug addiction or venereal diseases;
- Cosmetic or reconstructive surgery;
- Prosthesis, orthotic devices, corrective devices and
medical appliances not required for a surgical operation;
- AIDS,
AIDS Related Complex, or Human Immunodeficiency Virus (HIV) and related
illnesses which manifest at any time within five years from the Insured
Person's effecitve date; and
- Expenses incurred for provision of medical
documentation required by the Company.
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You may
return your policy within fourteen days after receipt for a full refund
of the premiums paid. |
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A
child of a female Insured Person is eligible for the same medical plan
as the Insured Person 15 days after the later of the date of birth or
the date of discharge on submission of application to the Company until
the Insured Person's next renewal for free.
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Applies
to the Medical Plan (& options) premium for residents to cover
the
high cost of medical care in that particular area. |
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Personal
Accident cover is based on the hazard class associated with an
occupation and its duties.
Class 1: very light hazards;
Class 2: light hazards;
Class 3: non-hazardous manual labor; and,
Class 4: hazardous occupations.
Class 3's are quoted on request and Class 4's have no cover. |
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Any
Disability which existed before the policy effective date in respect of
an Insured Person, which presented signs and symptoms of which the
Insured Person was aware or should reasonably have been aware |
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Are
based on the Insured Person's age on the first day of the policy year;
the rate table in effect on the premium due date; and, residence,
family status, payment mode and other factors which affect the cost of
insurance. Premiums may be revised based on claims experience or other
criteria which the Company, at its sole discretion, may determine.
Policies renew automatically upon payment of renewal premium. |
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Does
not apply to inpatient expenses incurred for emergency treatment of
injury or acute illness which occurs wholly after the start of travel
for up to 30 days of travel to the affected areas in any one policy
year. |
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Benefits
are not paid for sickness during the first 30 days of coverage.
Benefits for injuries due to covered accidents occurring wholly after
the effective date are covered immediately. |
