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Important Definitions |
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“Accident”
means bodily injury caused by violent accidental and external
physical means.
“Hospital” means
any institution in the territory of RSA which in the opinion of
the Company meets each of the following criteria:
- Has a diagnostic and therapeutic facility for surgical and
medical diagnosis treatment and care of insured and sick persons
by or under the supervision of a staff of medical practitioners.
- Provides nursing service supervised by registered nurses
or nurses with equivalent qualifications.
- Is not other than incidentally either a mental institution
or a convalescent home.
- Is not a place of rest for the aged or a place for drug addicts
or alcoholics or a health hydro or natural cure clinic or similar
establishment.
- Is not an institution providing long-term care for the blind
deaf dumb or other handicapped persons.
“Illness” means
any one somatic (Definition; relating to or affecting the body,
especially the body as considered to be separate from the mind)
illness or disease which manifests itself during the period of
insurance and includes premature senile degenerative changes,
but not an illness which is of such a nature as to be incapable
of diagnosis by objective evidence or which though capable of
diagnosis by such evidence has not been so diagnosed.
“Incident” means
any one accident or illness that causes an insured person to be
confined to hospital and to undergo certain medical or surgical
procedures and/or operations.
“Medical and surgical procedures
and/or operations” means any procedure or operation
in the Recommended Scale of Benefits issued as the National Health
Reference Price List (NHRPL). In the event of a procedure and/or
operation not being listed the Company will agree an appropriate
allocation of units in consultation with an independent medical
practitioner.
“Medical practitioner”
means a legally qualified registered medical practitioner.
“Treatment” means
any form of investigation or examination by or consultation with
or treatment by a medical practitioner for the purpose of treating
or monitoring an insured person’s medical condition arising out
of an insured incident.
“Hospital Confinement”
means admission to a hospital ward, limited to General Ward, Maternity
Wards, Private Wards and Special Care Units
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