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Worldwide Travel Options  (2010) ( Castellano )

 

Art 6. Medical expenses

 

6.1 The Basic Cover must be taken out before any other options can be added. The insurance shall cover the medical expenses incurred by the insured in case of acute illness and injury.

 

6.2 Treatment by authorised physicians and specialists, prescribed hospitalisation, prescribed medicines and local transport to and from the place of treatment shall be compensated at 100% of the expenses.

 

6.3 Treatment by physiotherapists and chiropractors prescribed by an authorised physician shall be compensated at 100% of the expenses, not exceeding, however, USD 2,500 / EUR 2,000 / CHF 3,400 / GBP 1,375 per insured.

 

6.4 Provisional pain-stilling dental treatment by authorised dentists and prescribed medicines in connection herewith shall be compensated within a maximum of USD 300 / EUR 250 / CHF 400 / GBP 165 per  insured.

 

6.5 The insurance shall not cover expenses for treatment of pre-existing, chronic or recurrent illnesses and disorders if the insured:

 

a) has been hospitalised within 6 months prior to commencement of the insurance period or, if Annual Travel has been chosen, prior to each departure from the country of permanent residence,

 

b) has been treated by a physician (routine check-ups excepted) within 6 months prior to the commencement of the insurance period or, if Annual Travel has been chosen, prior to each departure from the country of permanent residence,

 

c) has had a change of medication within 6 months prior to commencement of the insurance period or, if Annual Travel has been chosen, prior to each departure from the country of permanent residence,

 

d) has not received medical treatment, has refused or given up treatment, even though the insured should know that the illness / disorder ought to be treated, or has deteriorated,

 

e) has reached a state where any attempt of further treatment has been abandoned, or has refused treatment,

 

f) is waiting to receive treatment, or has been referred to another place of treatment,

 

g) has omitted to go to prearranged controls.

 

The insurance does not cover expenses for control, treatment and medicines in connection with stabilisation and regulation of a pre-existing, chronic or recurrent illness / disorder. The insurance does not cover a need for treatment which was expected before departure.

 

6.6 Physicians, specialists, dentists, etc. performing the treatment must have authorisation in the country of practice. Furthermore, the method must be approved by the public health authorities in the country where the treatment takes place. Methods of treatment not yet approved by the public health authorities, but under scientific research, will only be covered if approved in advance by the Company's medical consultants.

 

6.7 The Company has the right to demand that the insured be repatriated to the country of permanent residence, if the Company's medical consultant and the treating physician agree that the insured is medically fit  to be transferred to his / her country of permanent residence. In case of disagreement , the decision of the Company's medical consultant shall prevail.

 

 

 

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Art 7. Medical evacuation / repatriation