Benefit
Benefit entitlement
Maximum cover
Private Health Cover and Private Health Plus
Covers the cost up to the maximum cover for this benefit of medically necessary obstetric care referred by the life assured ’ s registered medical practitioner, registered medical specialist or registered lead maternity carer (Midwife) for assessment and monitoring of a recognised risk factor(s) in respect of complications during pregnancy. This benefit includes cover for reasonable accommodation costs incurred by the life assured for related stays in an approved facility . Cover under this benefit is not provided if:
Up to $2,000 per life assured per policy year
OBSTETRIC CARE ALLOWANCE
the life assured is admitted to a public hospital ;
related to a pregnancy that is conceived prior to the risk commencement date;
related to conditions arising post birth.
Caesarean Sections are specifically excluded. No excess is payable for claims under this benefit.
If, during the course of any medical procedure or treatment in an approved facility, a life assured should die directly as a consequence of any erroneous or negligent action, omission or failure to observe reasonable and customary standards by a care provider in that approved facility, the maximum cover of this benefit will be paid, provided:
$30,000 per life assured per lifetime
> the death occurs within 30 days of such a recorded and proven incident
MEDICAL MISADVENTURE
> the incident is verified and confirmed by the relevant Government authority , a court of law, coroner’s inquest or the Medical Council of New Zealand the death is independent of any other cause other than the termination of the life support system after brain death has been established. Covers the cost up to the maximum cover for this benefit of sterilisation procedures including vasectomy, tubal ligation and hysteroscopic sterilisation.
Up to $5,000 per life assured per life of the policy
Prior approval must be obtained prior to the treatment or procedure takingplace.
STERILISATION
This benefit is available to a life assured after one year of continuous cover under this policy.
The excess applies to any claims under this benefit.
712 PH-UMB version 9 Effective 8 April 2022
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