|
EXTENDED HEALTH BENEFIT STOP-LOSS COVERAGE |
|
Aggregate
Limit (per injury or sickness)
Per person coverage |
$997,000
($1,000,000 less $3000 deductible)
*Note:
*Deductible of $3000 (per injury or sickness) can be run
through the Client's PHSP within the employee annual limits
and/or paid personally
Deductible must be satisfied annually.
|
| Eligibility |
Up to age 70,
single or family.
Must have current and valid Canadian government health insurance
plan coverage in force |
| Benefits |
Provides for
the "reasonable and customary"expense of necessary
medical treatment only in the even of an injury or sickness
of the Insured Person.
Please note: Medical expenses eligible for reimbursement under
this policy shall not necessarily include expenses which may
otherwise qualify as a "Medical expense"as defines
in the Income Tax Act. |
Hospital
($3000 deductible does NOT apply) |
Semi-private
room for up to 14 days |
| Prescription
Drugs |
$3000 deductible
applies* |
| Paramedical
Services |
$3000 deductible
applies* |
| Other Medical
Expenses (including ambulance services) |
$3000 deductible
applies* |
| Pre-existing
Condition Exclusion |
Does NOT cover
Injury or Sickness manifested or occurring prior to coverage
going into force under this policy. |
| Co-ordination
Condition Benefits |
Subject to
and shall not contravene any Canadian federal or provincial
statutory requirements regarding hospital and/or medical plans,
nor shall it duplicate any benefits provided under any Canadian
government health insurance plans or acts or any other policy
providing a reimbursement benefit. |
| War Risk/Terrorism
Exclusion |
Does NOT cover
any claims directly or indirectly arising from in consequence
of war or any act of war (declared or undeclared), invasion,
acts of terrorism or acts of foreign enemies, civil war, rebellion,
revolution or insurrection. |
| Exclusions
and Limitations |
Subject to
all the terms, conditions, limitations, deductibles and exclusions
stated in the policy wording. |
