routine screening
premium(s)
Any preventative treatment, health surveillance testing, or investigative procedures performed by a health care provider where the policy owner or life assured has no medical symptoms.
The amount of premium payable by you to Sovereign under this policy comprising the cost of the MajorCare benefits chosen by the policy owner plus the policy fee if any as detailed in the schedule .
schedule
The latest (in time) schedule of policy details including endorsements that forms part of this policy document.
premium due date
The date on which the premium is payable under the policy, as agreed with Sovereign.
Sovereign approved facility
Any hospital, day stay centre, or clinic licensed in accordance with the Health and Disability Services (Safety) Act 2001 approved or accredited by Sovereign . Any health provider who has been approved by Sovereign as having the appropriate qualifications/ registration to provide healthcare services to Sovereign or its policy owners and life assured s.
private hospital
A Sovereign approved privately owned hospital which is licensed as a private hospital in accordance with the Health and Disability Services (Safety) Act 2001.
Sovereign approved provider
prostheses
The artificial parts used to replace bodily parts when specific types of surgery are undertaken.
public hospital
A hospital service or institution licensed in accordance with the Health and Disability Services (Safety) Act 2001 directly or indirectly owned or funded by the New Zealand Government or any of its agencies. Charges for medical treatment that are determined by Sovereign in its sole discretion to be reasonable and within a range of fees charged under similar circumstances by persons of equivalent experience and professional status in the area in which the medical treatment is provided. A person, who is registered and practicing as a medical practitioner in New Zealand that is approved by Sovereign , other than; > you; > the life assured ; > a member of the life assured ’s family or your immediate family; > the life assured ’s or your business partner or associate. A person registered as a nurse (whether as a comprehensive nurse, or a general nurse, or otherwise), or as a midwife, under the Nurses Act 1977.
Sovereign, we, our or us
Sovereign Assurance Company Limited.
Sovereign benefit maximums
The listing established by Sovereign, which specifies the maximum amounts payable by Sovereign for the supply of
reasonable charges
prostheses and disposable laparoscopic equipment.
Sovereign Criteria
A set of criteria Sovereign uses to consider and approve chemotherapy or radiotherapy treatments under the Private Hospital Non-Surgical benefit in order to ensure the treatment falls within reasonable charges .
Registered Medical Practitioner
The criteria is determined by:
> Whether the medicine is
recommended for public funding by the Pharmaceutical Therapeutics Advisory Committee (or its successor); > The medical advice of the treating oncologists; > International evidence of clinical effectiveness;
registered nurse
> Other factors that Sovereign
reasonably assesses as relevant.
Risk commence- ment date
The commencement date that cover under this policy takes effect.
specialist(s)
A Sovereign approved medical practitioner who is qualified in a specialist field of medical or surgical practice and is registered as a
134 MAJUMB-SA version 7 Effective 5 December 2016
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