10. Third party liability:
If you or any of your dependants are eligible to claim benefits
under a public scheme or any other insurance policy which pertains to a claim submitted to
us, we reserve the right to decline to pay benefits. You must inform us and provide all
necessary information if and when you are entitled to a claim from a third party. You and
the third party may not agree any final settlement or waive our right to recover outlays
without our prior written agreement. Otherwise, we are entitled to recover the amounts
paid from you and to cancel the policy. We have full rights of subrogation and may institute
proceedings in your name, but at our expense, to recover, for our benefit, the amount of
any payment made under another policy.
11. Use of MediLine:
Please note that the MediLine and its health-related information and
resources are not intended to be a substitute for professional medical advice or for the care
that patients receive from their doctors. It is not intended to be used for medical diagnosis
or treatment and information should not be relied upon for that purpose. Always seek the
advice of your doctor before beginning any new treatment or if you have any questions
regarding a medical condition. You understand and agree that Allianz Worldwide Care is
not responsible or liable for any claim, loss or damage directly or indirectly resulting from
your use of this advice line or the information or the resources provided through this
service. Calls to the MediLine will be recorded and may be monitored for training, quality
and regulatory purposes.
12. What we cover:
a) The extent of your cover is determined by your Table of Benefits, the Insurance
Certificate, any policy endorsements, these policy terms and conditions, as well as any
other legal requirements. We will reimburse, in accordance with your Table of Benefits
and individual terms and conditions, medical costs arising from the occurrence or
worsening of a medical condition.
b) Treatments and procedures are only covered if they have a palliative, curative and/or
diagnostic purpose, are medically necessary, appropriate and performed by a licensed
physician, dentist or therapist. Claims/costs will be paid/reimbursed if the medical
diagnosis and/or prescribed treatment are in accordance with generally accepted
medical procedures.
c) This policy may not provide any cover or benefit to the extent that either the cover or
benefit would violate any applicable sanction, law or regulations of the United Nations,
the European Union or any other applicable economic or trade sanction, law or
regulations.
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