Accidental death benefit
Benefit payable for death when the Insured Person dies as a result of an accident.
Cash benefit
Benefit payable in terms of cash for –
- hospitalisation^;
- selected surgeries to be done as day case / outpatient basis;
- second claim; or
- no claim bonus.
^ Special requirement on hospital cash benefit – This benefit must not restrict the use of service in a public healthcare facility only.
Companion bed
Benefit payable for expenses incurred for an extra bed to accompany the Insured Person in the event of confinement.
Deductible
A fixed amount of eligible expenses that, in a Policy Year, the Policy Holder must pay before the insurance company shall reimburse the remaining eligible expenses.
Donor benefit
Benefit payable for expenses incurred –
- by the organ donor where the organ recipient is the Insured Person; and/or
- by the Insured Person as an organ donor.
Emergency dental treatment
Benefit payable for emergency treatment to the Insured Person’s sound natural teeth provided by a registered dentist on an outpatient basis.
Emergency outpatient care
Benefit payable for emergency treatment provided by a registered medical practitioner as a result of an accident at an emergency room or out-patient unit of a hospital.
Home nursing
Benefit payable for nursing services rendered by licensed or registered nurses at home, which is directly related to and a result of the condition arising from the same cause necessitating a confinement or day case procedure.
Private nursing
Benefit payable for private nursing services rendered by licensed or registered nurses during confinement, in addition to the general nursing services.
Hospice and palliative care
Benefit payable for hospice and/or palliative care provided for terminal health conditions in a hospice and/or palliative care centre or facility.
Life benefit or (compassionate) death benefit
Benefit payable if the Insured Person passes away.
Medical negligence benefit
Benefit payable when an Insured Person dies / or suffers from other defined conditions directly as a consequence of any negligence of defined personnel (e.g. medical professionals / healthcare services providers).
Outpatient kidney dialysis
Benefit payable for haemodialysis or peritoneal dialysis in an outpatient setting.
Note: Kidney dialysis treatment during confinement are covered under Standard Plan Terms and Benefits.
Pregnancy complications
Benefit payable for expenses incurred as a result of defined pregnancy related complications arising during antepartum stages of pregnancy or childbirth.
Reconstructive surgery
Benefit payable for expenses incurred as a result of reconstructive surgeries in the event of a defined condition/ sickness or disease (e.g. breast reconstruction surgery for cancer).
Rehabilitative care
Benefit payable for rehabilitative care in an inpatient rehabilitation centre or facility, which is directly related to and a result of the condition arising from the same cause necessitating a Confinement or Day Case Procedure.
Second opinion service /personal medical case management service
Service of providing access to medical expertise for second opinion on Insured Person’s medical condition.
Supplementary major medical (SMM)
Benefit payable for the expenses in excess of specific basic benefit items, usually subject to a coinsurance.
Post-Confinement medical devices
Benefit payable for medical services after confinement like the replacement of prosthetic device.