| 7- (a) Family Floater Coverage - Apollo DKV Insurance |
|
| Easy Health Individual Health Insurance Plan / Easy Health Family Floater Insurance Plan from Apollo DKV |
|
| 15.Experimental, investigational or unproven treatment devices and pharmacological regimens, or measures primarily for diagnostic, X-ray or laboratory examinations or other diagnostic studies which are not consistent with or incidental to the diagnosis and treatment of the positive existence or presence of any Illness for which confinement is required at a Hospital. |
|
| 16.Convalescence, cure, rest cure, sanatorium treatment, rehabilitation measures, private duty nursing, respite care, long-term nursing care or custodial care. |
|
| 17.Any non allopathic treatment. |
|
| 18.All preventive care, vaccination including inoculation and immunisations, any physical, psychiatric or psychological examinations or testing during these examinations; enteral feedings and other nutritional and electrolyte supplements, unless certified to be required by the attending Medical Practitioner as a direct consequence of an otherwise covered claim. |
|
| 19.Charges related to a Hospital stay not expressly mentioned as being covered, including but not limited to charges for admission, discharge, administration, registration, documentation and filing. |
|
| 20.Items of personal comfort and convenience including but not limited to television, telephone, foodstuffs, cosmetics, hygiene articles, body care products and bath additive, barber or beauty service, guest service as well as similar incidental services and supplies, and vitamins and tonics unless vitamins and tonics are certified to be required by the attending Medical Practitioner as a direct consequence of an otherwise covered claim. |
|
| 21.Treatment rendered by a Medical Practitioner which is outside his discipline or the discipline for which he is licensed; referral-fees or out-station consultations; treatments rendered by a Medical Practitioner who shares the same residence as an Insured Person or who is a member of an Insured Person's family, however proven material costs are eligible for reimbursement in accordance with the applicable cover. |
|
| 22.The costs of any procedure or treatment by any person or institution that We have told You (in writing) is not to be used. |
|
| 23.Save as and to the extent provided in 3c), the provision or fitting of hearing aids, spectacles or contact lenses including optometric therapy, any treatment and associated expenses for alopecia, baldness, wigs, or toupees, medical supplies including elastic stockings, diabetic test strips, and similar products. |
|
| 24.Any treatment or part of a treatment that is not of a reasonable cost, not medically necessary; non-prescription drugs or treatments. |
|
| 25.Artificial limbs, crutches or any other external appliance and/or device used for diagnosis or treatment. |
|
| 26.Any exclusion mentioned in the Schedule or the breach of any specific condition mentioned in the Schedule. |
|
| Section. 7 General Conditions |
|
- Condition precedent The fulfilment of the terms and conditions of this Policy (including the payment of premium by the due dates mentioned in the Schedule) insofar as they relate to anything to be done or complied with by You or any Insured Person shall be conditions precedent to Our liability.
- Insured Person
- Only those persons named as an Insured Person in the Schedule shall be covered under this Policy. Any person may be added during the Policy Period after his application has been accepted by Us, additional premium has been paid and We have issued an endorsement confirming the addition of such person as an Insured Person.
- Notification of Claim If any treatment for which a claim may be made is to be taken then:
|
| 1.If the treatment requires Hospitalisation, We or Our TPA must be informed immediately and in any event at least 7 days prior to the Insured Person’s admission. |
|
| 2.If Hospitalisation is required in an emergency, then We or Our TPA must be informed no later than the time of the Insured Person’s admission to Hospital. |
|
|
|
