Personal - A-Z Hospital Cash Cover Glossary

 

 

 

Accident

A sudden, uncertain and unexpected event which is caused solely and directly by violent, external, physical and visible means and independently of any other cause.

 

Administration Fee

A percentage deduction from the Sum Assured which covers the claims administration costs.

 

Child

An unmarried dependent child, step-child, illegitimate child or adopted child (legally or by custom) of the Life Insured and includes a child who is over 21 and becomes dependant on the Life Insured by reason of mental or physical incapacity during the currency of the Policy.

 

Day

A period of 24 (twenty-four) consecutive hours of hospitalisation, including the day of admission but excluding the day of discharge.

 

Hospital Cash Plan

An insurance policy that pays a specified amount to the insured in the event that he/she goes to hospital. This is usually to compensate for lost income. Hospital cover pays you a daily lump sum and you can chose what you want to do with that money. It's up to you. You can pay for groceries, or pay for unforeseen expenses.

 

Illness

A sickness or disease contracted and commencing during the currency of this Policy.

 

Insured Person / Life Insured

The person(s) named as such in the Policy Schedule who is/are a resident(s) of the RSA (Republic of South Africa) residing in the RSA and in possession of a valid RSA identity document.

 

Intensive Care Unit

Means a separate, clearly designated service area, which is maintained within a Hospital solely for the care and treatment of patients who are critically ill. This also includes what are referred to as a Coronary Care Units or Acute Care Units. They also have:

1. Facilities for special nursing care not available in regular rooms and wards of the Hospital; and

 

2. special life saving equipment which is immediately available at all times; and

 

3. at least two beds for the accommodation of the critically ill; and

 

4. at least one registered nurse in continuous and constant attendance 24-hours a day.

 

 

Payment of Premiums and Commencement of Benefits

The Benefits together with the relevant waiting periods commence upon receipt of the first Premium.

 

Physician

A medical practitioner duly qualified, registered, licensed and practicing within the scope of his/her license pursuant to the laws of South Africa.

 

Policy Owner

The person named as such in the Policy Schedule and is the initial payer of the Policy unless the Company is advised otherwise in writing.

 

Pre-existing Medical Condition

Sickness or Bodily Injury sustained or contracted by an Insured Person for which he or she has or should reasonably have received relevant medical treatment or advice by a Physician, prior to such Insured Person’s initial Commencement Date or Reinstatement Date of Insurance under the Policy, whichever is more recent. Including but is not limited to, any physical or mental defect, disease, infirmity or condition which existed prior to the initial Commencement or Reinstatement Date of their Policy whichever is more recent.

 

Spouse

The person married (whether by civil, customary, tribal or religious union) to the Life Insured and named in the Schedule.

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