1.21
Emergency out-patient dental treatment
is treatment received in a dental surgery/hospital
emergency room for the immediate relief of dental pain, including temporary fillings limited to three
fillings per Insurance Year, and/or the repair of damage caused in an accident. The treatment must be
received within 24 hours of the emergency event. This does not include any form of dental prostheses
or root canal treatment. If you also selected a Dental Plan, you will be covered under the terms of this
plan for dental treatment in excess of the (Core Plan) emergency out-patient dental treatment
benefit limit.
1.22
Emergency out-patient treatment
is treatment received in a casualty ward/emergency room
within 24 hours of an accident or sudden illness, where the insured does not, out of medical necessity,
occupy a hospital bed. If you also selected an Out-patient Plan, you are covered under the terms of
this plan for out-patient treatment in excess of the (Core Plan) emergency out-patient treatment
benefit limit.
1.23
Emergency treatment outside area of cover
is treatment for medical emergencies which occur
during business or holiday trips outside your area of cover. Cover is provided up to a maximum period
of six weeks per trip within the maximum benefit amount and includes treatment required in the
event of an accident, or the sudden beginning or worsening of a severe illness which presents an
immediate threat to your health. Treatment by a physician, medical practitioner or specialist must
commence within 24 hours of the emergency event. Cover is not provided for any curative or
follow-up non-emergency treatment, even if you are deemed unable to travel to a country within
your geographical area of cover, nor does it cover charges relating to maternity, pregnancy, childbirth
or any complications of pregnancy or childbirth. Please advise us if you are moving outside your area
of cover for more than six weeks.
1.24
Expenses for one person accompanying an evacuated/repatriated person
refer to the cost of
one person travelling with the evacuated/repatriated person. If this cannot take place in the same
transportation vehicle, transport at economy rates will be paid for. Following completion of treatment,
we will also cover the cost of the return trip, at economy rates, for the accompanying person to return
to the country from where the evacuation/repatriation originated. Cover does not extend to hotel
accommodation or other related expenses.
1.25
Family history
exists where a parent, grandparent, sibling, child, aunt or uncle has been previously
diagnosed with the medical condition in question.
1.26
Health and wellbeing checks including screening for the early detection of illness or disease
are health checks, tests and examinations, performed at an appropriate age interval, that are
undertaken without any clinical symptoms being present. Checks are limited to:
•
Physical examination.
•
Blood tests (full blood count, biochemistry, lipid profile, thyroid function test, liver function test,
kidney function test).
•
Cardiovascular examination (physical examination, electrocardiogram, blood pressure).
•
Neurological examination (physical examination).
•
Cancer screening:
- Annual pap smear.
- Mammogram (every two years for women aged 45+, or earlier where a family history exists).
- Prostate screening (yearly for men aged 50+, or earlier where a family history exists).
- Colonoscopy (every five years for members aged 50+, or 40+ where a family history exists).
- Annual faecal occult blood test.
•
Bone densitometry (every five years for women aged 50+).
•
Well child test (for children up to the age of six years, up to a maximum of 15 visits per lifetime).
•
BRCA1 and BRCA2 genetic test (where a direct family history exists and where included in your
Table of Benefits).
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