SECTION D - OPTIONAL BENEFITS
ADDITIONAL
1 If Your Policy Schedule shows that You have selected this optional benefit, We will reimburse the costs of Specialist consultations and Diagnostic Procedures if they do not relate to a claim for treatment in a Private Hospital . To qualify for reimbursement the procedure or consultation must be recommended by a Specialist or General Practitioner . Diagnostic tests covered include, but are not limited to: • X-rays • Mammography • Ultrasound • Audiology (Performed by Audiologists ) • Urodynamic Assessments
SPECIALIST VISITS AND DIAGNOSTIC PROCEDURES
• Audiometric Tests • Laboratory Tests • Colposcopy (not performed under general anaesthetic) • Allergy Testing • Holter Monitoring
• ECG • EEG • EMG
But do not include Preventative and Routine Screening tests. We specifically exclude the payment of costs relating to Hearing Aid equipment. Specialist consultations with a Psychiatrist are covered for an initial assessment of mental health, for the first consultation only. This assessment should include one (1) or more of a review of previous records, a clinical assessment, or a production of a written summary and recommendations. All forms of psychiatric treatment are specifically excluded as set out in Section G “Exclusions”. We will reimburse You for the Usual, Customary and Reasonable costs of up to $3,000 per Policy Year on each person insured on the Policy Schedule . A $100 excess per Life Assured per claim form submitted will apply in all circumstances for the first two years from the Policy Commencement Date to the Additional Specialists Visits and Diagnostic Procedures benefit. If Your Policy Schedule shows that You have selected this Optional Waiver of Premium Benefit, Total Premiums will be waived in the event that an adult Life Assured meets the definition of disablement as set out below: The adult Life Assured continues, having provided supporting medical evidence acceptable to Us , to be totally disabled as a result of bodily injury or illness which commenced during the period of insurance which directly and independently of any other cause, wholly prevents the Life Assured from engaging in his/her normal or usual business, occupation or work from which he/she derives remuneration or income, or in any business, occupation or work for which he/she is suited by way of education, training or experience. The Waiver of Premium Benefit will cease at age sixty-five (65) or when the adult Life Assured returns to work, whichever is sooner.
OPTIONAL WAIVER 2
OF PREMIUM BENEFIT
Page 13 of 22
PC-S3HC-04/2022
[AIA – INTERNAL]
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