5
1.1
Accident
is an injury which is the result of an unexpected event, independent of the will of the
insured and which arises from a cause outside the individual’s control. The cause and symptoms must
be medically and objectively definable, allow for a diagnosis and require therapy.
1.2
Accidental death benefit
refers to an amount shown in the Table of Benefits that becomes payable if
the insured member (aged 18 to 70) passes away during the period of insurance as a result of an
accident (including industrial injury).
1.3
Accommodation costs for one parent staying in hospital with an insured child
refers to the
hospital accommodation costs of one parent for the duration of the insured child’s admission to
hospital for eligible treatment. If a suitable bed is not available in the hospital, we will contribute the
equivalent of a three star hotel daily room rate towards any hotel costs incurred. We will not, however,
cover sundry expenses including, but not limited to, meals, telephone calls or newspapers. Please
check your Table of Benefits to confirm whether an age limit applies with regard to your child.
1.4
Acute
refers to sudden onset.
1.5
Chronic condition
is defined as a sickness, illness, disease or injury which has one or more of the
following characteristics:
•
Is recurrent in nature.
•
Is without a known, generally recognised cure.
•
Is not generally deemed to respond well to treatment.
•
Requires palliative treatment.
•
Requires prolonged supervision or monitoring.
•
Leads to permanent disability.
Please refer to the “Notes” section of your Table of Benefits to confirm whether chronic conditions are
covered.
1.6
Complementary treatment
refers to therapeutic and diagnostic treatment that exists outside the
institutions where conventional Western medicine is taught. Such medicine includes chiropractic
treatment, osteopathy, Chinese herbal medicine, homeopathy and acupuncture as practiced by
approved therapists.
1.7
Complications of childbirth
refer only to the following conditions that arise during childbirth and
that require a recognised obstetric procedure: post-partum haemorrhage and retained placental
membrane. Complications of childbirth are only payable where your cover also includes a routine
maternity benefit. Where your cover includes a routine maternity benefit, complications of childbirth
shall also refer to medically necessary caesarean sections.
Definitions
The following definitions apply to benefits included in our range of Healthcare
Plans and to some other commonly used terms. The benefits you are covered for
are listed in your Table of Benefits. If any unique benefits apply to your plan(s), the
definition will appear in the “Notes” section at the end of your Table of Benefits.
Wherever the following words/phrases appear in your policy documents, they will
always be defined as follows.
