Benefit Limitations 1.
This benefit pays for 1 diagnostic examination per Covered Accident.
The exclusions that apply to this benefit are in the Common Exclusions Section.
Exclusions:
AMBULANCE BENEFIT
We will pay the benefit shown in the Schedule of Benefits, if the Covered Person requires ambulance services due to a Covered Injury resulting directly and independently of all other causes from a Covered Accident.
Benefit Conditions 1.
The ambulance services provided must be for ground, water, and air transportation from the scene of the Covered Accident to the nearest Hospital that is able to provide appropriate care, or for transportation to the nearest Hospital within 90 days of the Covered Accident or between Hospitals. 2. This benefit is payable once per Covered Accident, per Covered Person.
Benefit Limitations 1.
We will pay this benefit in addition to the Emergency Care Treatment benefit. 2. We will only pay one benefit, ground, water, or air ambulance whichever is the greater amount.
The exclusions that apply to this benefit are in the Common Exclusions Section.
Exclusions:
HOSPITAL BENEFITS
HOSPITAL ADMISSION
We will pay the benefit shown in the Schedule of Benefits, if the Covered Person requires a Hospital Admission. This benefit will pay in addition to the Emergency Care Treatment benefit, Hospital Stay Benefit or Intensive Care Unit Stay Benefit.
Benefit Conditions 1.
admission occurs within 90 days of the Covered Accident; and 2. the Hospital Stay is as an inpatient, as defined by the Policy; and 3. the admission is the first Hospital admission for such Covered Accident; and 4. the benefit is payable on Day 0; and 5. this benefit will be paid only one time per Covered Accident.
Benefit Limitation This benefit will not be payable if: 1.
treatment is given in the emergency room; or 2. treatment is provided on an Outpatient basis; or 3. treatment is for Hospital re-admission for the same Covered Accident.
The exclusions that apply to this benefit are in the Common Exclusions Section.
Exclusions:
HOSPITAL STAY BENEFIT
We will pay the daily Hospital Stay benefit shown in the Schedule of Benefits, subject to the following conditions and exclusions, if the Covered Person requires a Hospital Stay due to a Covered Loss resulting directly and independently of all other causes from a Covered Accident. Benefits are payable for up to 365 days.
Benefit Conditions
9
Made with FlippingBook flipbook maker