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Your cover
We would like to bring your attention to the following important points:
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 maximum we will pay for all benefits in total,
per member, per Insurance Year, under that particular plan. Some benefits also have a
specific benefit limit, which 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/US$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.
If you are covered for maternity benefits, these will be stated in your Table of Benefits along
with any benefit limit and/or waiting period which applies. Benefit limits for “Routine
maternity” and “Complications of childbirth” are payable on either a “per pregnancy” or
“per Insurance Year” basis (this will also be confirmed in your Table of Benefits). If your
benefit is payable on a “per pregnancy” basis and a pregnancy spans two Insurance Years,
Overview
Your Table of Benefits specifies the plan(s) selected and the associated benefits
available to you. You will find further details about our benefits in the “Definitions”
section of this guide. Not all of the benefits listed in our “Definitions” section are
necessarily covered under your policy, which is why it’s important to check which
ones are listed in your Table of Benefits. Your cover is subject to our policy
definitions, exclusions, benefit limits and any special conditions indicated on the
Insurance Certificate. If you have any queries about what you are covered for,
please don’t hesitate to call us.
