This policy has certain requirements that shall be evaluated by the customer. It is very important to consider them in order to decide which insurance policy satisfies better the policyholder needs.
The aim of this policy is to provide cover for the reasonable fees of accredited treatments. This insurance is not planned to cover experimental or unproven treatments, but if such possibility occurs, we will discuss it with the policyholder specialist and decide if the cost of the suggested treatment will be covered.
For the full Policy exclusions please refer to your policy document. The following are some of the restrictions that apply to the policy, unless otherwise specified in Your Policy Schedule or Table of Benefits:
- We will not pay for pre-existing medical conditions that, however, will be covered after five years of continuous insurance with us, provided that during that period policyholder has not consulted any doctor for treatment or advice, or taken any medication (including drugs, medicines, special diets and injections) for that condition.
- We will only cover pre-existing cardiac or cancer conditions provided at the time when the condition reappears the beneficiary has been free from treatment, advice or medication for that condition during the previous ten years.
- We will not pay for fees charged for providing medical reports and prescriptions.
- We will not cover pregnancy or childbirth, other than for related complications arising at least ten months after the expectant mother contracted the policy. In the case of a caesarean section we will only pay the difference between the reasonable fee for the intervention, and the fee which would have been charged for a normal delivery.
- We do not cover contraception, sterilisation, termination of pregnancy, infertility and/or any form of assisted reproduction, and treatment of sexual problems. Treatments arising from or related to a sex change are excluded.
- The cost of vaccinations, routine or preventive medical examinations, medical screening including health check-ups, sight and hearing tests are excluded.
- Treatments received in health hydros, spas, nature cure clinics or in any similar establishments, even if they are registered as a hospital, are not included.
- We do not cover regular or long-term kidney dialysis or end stage renal failure.
- We do not pay for treatments caused by a deliberate self-inflicted injury or attempted suicide.
- Treatments given to relieve any allergic condition or disorder are excluded.
- We do not pay for treatments arising in any way from alcohol, drug or substance abuse.