Allianz Worldwide Care SA, acting through its Irish Branch, is a limited company governed by the French Insurance Code. Registered in France: No. 401 154 679 RCS Paris. Irish Branch registered
in the Irish Companies Registration Office, registered No.: 907619, address: 18B Beckett Way, Park West Business Campus, Nangor Road, Dublin 12, Ireland.
DOC-TOB-IND-EN-0814
If you have any queries, please do not hesitate to contact us:
Notes
1. Area of cover
Allianz Worldwide Care offers a choice of three different geographical areas of
cover:
•
Worldwide, which provides cover anywhere in the world
•
Worldwide excluding USA
•
Africa only
The chosen area of cover will be specified in the Insurance Certificate.
2. Treatment Guarantee
Certain treatments and costs require submission of a Treatment Guarantee Form in
advance. Following approval by Allianz Worldwide Care, cover for these required
treatments or costs can then be guaranteed. In the Table of Benefits, benefits which
require pre-approval through submission of a Treatment Guarantee Form are
indicated by either a 1 or a 2. These benefits are listed below, along with further
important details:
•
All in-patient benefits¹ as listed.
•
Day-care treatment².
•
Kidney dialysis².
•
Out-patient surgery².
•
MRI (Magnetic Resonance Imaging) scan. Treatment Guarantee may be
required for this test if you would like to us to settle the bill directly with the
medical provider.
•
PET² (Positron Emission Tomography) and CT-PET² scans.
•
Nursing at home or in a convalescent home².
•
Complications of pregnancy².
•
Routine maternity² and complications of childbirth²
(in-patient treatment only).
•
Oncology² (in-patient and day-care treatment only).
•
Occupational therapy² (out-patient treatment only).
•
Rehabilitation treatment².
•
Medical evacuation² (or repatriation where covered).
•
Travel costs of insured family members in the event of an
evacuation/repatriation².
•
Repatriation of mortal remains².
•
Travel costs of insured family members in the event of the repatriation of
mortal remains².
•
Expenses for one person accompanying an evacuated/repatriated person².
•
Palliative care².
•
Long term care².
¹ If Treatment Guarantee is not obtained for the benefits listed with a 1, we reserve
the right to decline a claim. If the respective treatment is subsequently proven to be
medically necessary, we will pay only 80% of the eligible benefits.
² If Treatment Guarantee is not obtained for the benefits listed with a 2, we reserve
the right to decline a claim. If the respective treatment is subsequently proven to be
medically necessary, we will pay only 50% of the eligible benefits.
We should be contacted at least five working days before receiving treatment, so
that we can ensure that there will be no delays at the time of admission. This will
ensure that members benefit from cashless access to hospitals for in-patient
treatment, where possible, and have their treatment overseen by our team of
medical professionals.
In the case of an emergency, we should be informed within 48 hours of the event to
ensure that no Treatment Guarantee penalty will apply to the claim.
3. Claims process and turnaround
Allianz Worldwide Care has a simple claims process in place to ensure that
members can seek reimbursement for medical expenses. Members with access to
our Online Services can avail of our MyHealth app for quick and easy claims
submission.
Fully completed claims are processed and payment instructions issued to the
member’s bank within 48 hours. Where further information is required to
complete the claim, the member/medical practitioner will automatically be notified
by email or mail within 48 hours of receipt of the claim. An email is sent
automatically to the member (where email addresses are provided to us) to advise
themwhen the claim is processed.
This swift claims processing policy ensures that our members receive their claims
payment in the most effective and efficient manner.
4. Benefit limits
There are two kinds of benefit limits shown in the Table of Benefits. The maximum
plan benefit, which applies to certain plans, is the maximumwe will pay for all
benefits in total, per member, per Insurance Year, under that particular plan. Some
benefits also have a specific benefit limit, for example “Nursing at home or in a
convalescent home”. Specific benefit limits may be provided on a “per Insurance
Year” basis, a “per lifetime” basis or on a “per event” basis, such as per trip, per visit
or per pregnancy. In some instances we will pay a percentage of the costs for the
specific benefit e.g. “65% refund, up to £4,150/€5,000/$6,750/CHF6,500”. Where a
specific benefit limit applies or where the term “Full refund” appears next to certain
benefits, the refund is subject to the maximum plan benefit, if one applies to your
plan(s). All limits are per member, per Insurance Year, unless otherwise stated in
your Table of Benefits.
5. Policy terms and conditions
Please note that cover is subject to underwriting i.e. cover may be excluded for
pre-existing conditions, or a higher premium rate may apply to reflect the higher
risk due to pre-existing medical conditions or additional risk factors. Cover is
conditional upon acceptance of your application, which is only confirmed when an
Insurance Certificate is provided. This Table of Benefits provides an outline of the
cover we provide under each plan. Cover is subject to our policy terms and
conditions, as detailed in our Individual Benefit Guide, which is issued to members
upon policy inception. This Individual Benefit Guide can also be downloaded from
our website:
Allianz Worldwide Care
18B Beckett Way
Park West Business Campus
Nangor Road
Dublin 12
Ireland
Helpline
English:
+ 353 1 630 1301
German:
+ 353 1 630 1302
French:
+ 353 1 630 1303
Spanish:
+ 353 1 630 1304
Italian:
+ 353 1 630 1305
Portuguese:
+ 353 1 645 4040
Fax:
+ 353 1 630 1306
Awards 2014
