PHARMAC Medicines
These medicines are funded by PHARMAC for use in a private facility, and meets PHARMAC ’s required special authority or conditions in order to be subsidised for community use.
Policy
This contract of insurance between you and us and includes your application for insurance; this Policy wording; the Policy Schedule ; any addendum to the Policy Schedule; and any other written notice that we give you and vice versa.
Policy Fee
Charge for ongoing administration costs of this Policy which forms part of the Premium .
Policy Owner
The Policy Owner named in your Policy Schedule .
Policy Schedule
The most recent Policy Schedule issued to you by us, including any endorsements or special conditions.
Policy Year
The twelve month period which starts from the Cover Start Date and continues through to the end of the twelve month period.
Premium(s)
The amount(s) you pay us for cover under your Policy as shown in your Policy Schedule or in any other notice issued to you by us.
Preventative and Routine Screening
A diagnostic investigation or procedure undertaken when the Life Assured has no symptoms and is undertaken as a preventative measure to screen for early detection of diseases.
Private Hospital
A privately owned hospital approved by us which is licensed as a private provider of hospital care in accordance with the Health and Disability Services (Safety) Act 2001.
Qualifying Benefits
Means the insurance cover you must have in place to qualify for the Cancer Treatment Benefit, namely: Life Cover of at least $300,000; and/or Trauma Cover of at least $100,000; and/or Total Permanent Disability Cover of at least $300,000 Any person acceptable to us, who is registered with the Medical Council of New Zealand and holds an annual practising certificate. The medical practitioner cannot be you, your spouse, de facto spouse, civil union partner, relative or business partner/associate. For diagnoses made outside New Zealand, this definition covers any appropriately qualified medical professional approved by us. A medical specialist who is a member of an appropriately recognised specialist college and vocationally registered with the Medical Council of New Zealand in that speciality. This excludes general practitioners (who are considered to be Registered Medical Practitioners ). Charges and fees that are based on our estimate of what are Usual, Customary and Reasonable charges and fees for services provided under similar circumstances by persons or providers with equivalent experience or qualification.
Registered Medical Practitioner
Registered Medical Specialist
Usual, Customary and Reasonable
Cancer Treatment Benefit
AIA New Zealand
CTB 02/2018
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