GLOBAL SURGICAL BENEFIT
14 You can elect to have a medically necessary surgery, treatment, procedure, consultation, test, diagnostic imaging, support or care at Your choice of overseas Approved Facility , provided that: The surgery, treatment, procedure, consultation, test, diagnostic imaging, support or care has been recommended by a New Zealand Registered Medical Specialist ; and The surgery, treatment, procedure, consultation, test, diagnostic imaging, support or care is available in New Zealand; and You seek prior-approval for Your claim from Us (subject to AIA New Zealand’s criteria); and The surgery, treatment, procedure, consultation, test, diagnostic imaging, support or care would have otherwise been covered by Us in New Zealand under the applicable Benefit . We will reimburse up to a maximum of 85% of the Usual, Customary and Reasonable costs, which would have been incurred for the surgery, treatment, procedure, consultation, test, diagnostic imaging, support or care (as outlined in the applicable Benefit ) if it had been undertaken in New Zealand per Life Assured per Policy Year . An Annual Excess applies. Should the costs of the surgery, treatment, procedure, consultation, test, diagnostic imaging, support or care be less than the 85% maximum detailed above, then AIA New Zealand will also reimburse the following costs up until the 85% maximum is reached: accommodation costs for the Life Assured as deemed medically necessary and/or one (1) support person of up to NZ $500 per day for a maximum of ten (10) days; and ordinary public transport costs to and from the destination for the Life Assured and one (1) support person (including economy airfare, taxi, bus, ferry and train). We will not accept responsibility for the costs associated with any complications that might arise as a direct or indirect result of the treatment undertaken at Your choice of overseas Approved Facility , unless the treatment costs for these complications (including medical emergency evacuation costs) and the other costs listed above remain below the 85% limit detailed above and occurs within six (6) months of the treatment. After six (6) months of the treatment referred above occurring, We will not accept responsibility for on-going treatment costs directly or indirectly associated with the surgical treatment undertaken at Your choice of overseas Approved Facility . No Medical Misadventure Benefit is payable should You claim under the Global Surgical Benefit . 15 Covers treatment at an overseas Approved Facility where the treatment cannot be provided in New Zealand. This Benefit provides Top-Up cover for the treatment and reasonable return economy travel costs of the person requiring treatment and one (1) support person, less any amount payable by the New Zealand Government up to a
OVERSEAS TREATMENT BENEFIT
REAL Health – 0324
Page 16 of 26
Powered by FlippingBook