DESCRIPTION OF COVERAGES AND BENEFITS
This Description of Coverages and Benefits Section describes the Hospital Indemnity Coverages and Benefits provided by this Policy. Benefit amounts, benefit periods and any applicable aggregate and benefit maximums are shown in the Schedule of Benefits and may be subject to a Benefit Waiting Period and/or an Elimination Period before benefits can be paid. The Benefit Amounts shown in the Schedule of Benefits will be paid regardless of the actual expenses incurred. Certain words capitalized in the text of these descriptions have special meanings within this Policy and are defined in the General Definitions section. Please read these and the Common Exclusions sections in order to understand all of the terms, conditions and limitations applicable to these coverages and benefits.
HOSPITALIZATION BENEFITS
Hospitalization benefits will be paid on a per day basis and we will pay the maximum per day benefit as shown in the Schedule of Benefits .
HOSPITAL ADMISSION We will pay the per day Benefit Amount shown in the Schedule of Benefits, subject to the following conditions and limitations, if the Covered Person is admitted to and confined in a Hospital due to a Covered Injury or Covered Illness. This benefit will pay in addition to the Hospital Chronic Condition Admission Benefit, Hospital Stay and Hospital Intensive Care Unit Stay Benefit. Benefits are payable for up to the Maximum Benefit Period shown in the Schedule of Benefits .
Benefit Conditions 1.
The Hospital stay is as an Inpatient, as defined by the policy.
Benefit Limitation This benefit will not be payable if: 1.
Treatment is given only in the Emergency Room. 2. Treatment is provided on an Outpatient basis. 3. Treatment is for Hospital re-admission for the same Covered Injury or Covered Illness. 4. The benefit is limited to 1 Hospital admission per 365 days for different Covered Injury or Covered Illness.
The exclusions that apply to this benefit are in the Common Exclusions Section.
Exclusions
HOSPITAL CHRONIC CONDITION ADMISSION We will pay the per day Benefit Amount shown in the Schedule of Benefits, subject to the following conditions and limitations, if the Covered Person is admitted to and confined in a Hospital due to a Chronic Condition as specified in the Definitions section of the Policy. This benefit will pay in addition to the Hospital Admission, Hospital Stay or Hospital Intensive Care Unit Stay Benefit. Benefits are payable for up to the Maximum Benefit Period shown in the Schedule of Benefits .
Benefit Conditions 1.
The Hospital stay is as an Inpatient, as defined by the policy; and 2. Treatment, including an evaluation or consultation, for a Chronic Condition is provided by a specialist in that field of medicine.
Benefit Limitation This benefit will not be payable if: 1.
Treatment is given only in the Emergency Room. 2. Treatment is provided on an Outpatient basis. 3. Treatment is for Hospital re-admission for the same Chronic Condition. 4. The benefit is limited to 1 Hospital admission per 365 days for different Chronic Conditions.
The exclusions that apply to this benefit are in the Common Exclusions Section.
Exclusions
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