Insurance Dictionary

Featured Term

Pre-Existing Condition

A Medical Condition, or a mental health disorder or any Related Condition for which You have suffered symptom (whether investigated or not), received Treatment or sought advice, prior to Your Date of Entry to the Plan. (as defined in the context of International Health Insurance: Preferred & Preferred Plus plans)

In the context of Nomad Health Insurance (Select, Primary Plus and Primary plans:

Any condition, disease, Illness or injury, secondary or associated complaint where you have sought or received advice, treatment, therapy, been submitted to a special diet or shown symptoms in the two years prior to your effective date (whether or not the condition has been diagnosed).

Any (1) condition for which medical advice, diagnosis, care, or treatment (includes receiving services and supplies, consultations, diagnostic tests or prescription medicines) was recommended or received during the two (2) years immediately preceding the Certificate Effective Date; (2) condition that had manifested itself in such a manner that would have caused a reasonably prudent person to seek medical advice, diagnosis, care, or treatment (includes receiving services and supplies, consultations, diagnostic tests or prescription medicines) within the two (2) years immediately preceding the Certificate Effective Date; (3) Injury, Illness, sickness, disease, or other physical, medical, mental, or nervous condition, disorder or ailment (whether known or unknown) that, with reasonable medical certainty, existed at the time of the Insured Person’s Application or within the two (2) years immediately preceding the Certificate Effective Date.

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AIDS

Acquired Immune Deficiency Syndrome as that term is defined by the United States Centers for Disease Control and Prevention

APS or Attending Physician Statement

An attending physician statement (APS) is a report by a physician, hospital or medical facility who has treated, or who is currently treating, a person seeking insurance. In traditional underwriting, an APS is one of the most frequently ordered additional sources of medical background information. Insurance companies that use medical underwriting request an APS during the application process and this can delay the application approval by many weeks while the insurance company waiting for the clinic/doctor/hospital to return it then it gets evaluated and a decision made (medical underwriting process).

ARC

AIDS Related Complex as that term is defined by the United States Centers for Disease Control and Prevention.

Accident

A sudden, unexpected event which causes a bodily injury, and which is unintentional from the Member.

Accidental Death

Death of the Insured Person resulting from an Accident.

Accidental Dismemberment

Complete severance from the body of one or more limbs or eyes resulting from an Accident. For purposes of the Accidental Dismemberment benefits provided by this insurance, the term “limb” shall mean: the arm, when the severance is at or above (toward the elbow) the wrist, or the leg, when the severance is at or above (toward the knee) the ankle. Loss of eye(s) shall include complete, permanent and irrevocable loss of sight.

Accommodation and Subsistence Expenses

In the context of juvo:

The costs of accommodation and essential subsistence (including food, clothing and necessary toiletries) incurred by You for or on behalf of a member following a Crisis Evacuation, provided that:

  1. the amount of Accommodation and Subsistence Expenses payable under this program will not exceed USD 10,000 per day per member; and
  2. the period for which Accommodation and Subsistence Expenses are payable under this program will not exceed thirty days, starting from the date of the Crisis Evacuation.
Act of Terrorism

An act, including but not limited to the threat or use of force or violence of any person orgroup of persons whether acting alone or on behalf of any organisations or governments, committed for political, religious, ideological or similar purpose or reasons include the intention to influence governments, and or put the public, or any section of the public, in fear.

Actual Cash Value

The replacement cost of an item, less proper deduction for depreciation at the time of the loss.

Acute Medical Condition

The sudden onset of a medical condition which is likely to respond quickly to medical Treatment and is aimed to return You to the state of health You were in immediately before suffering the medical condition or which leads to Your full recovery

Admission

Admission - hospital inpatient care for any medical condition.



Adventure Sports (World Explorer Max & add-on)

A sporting activity undertaken for the purposes of recreation or an unusual experience or excitement, typically performed outdoors, and involving a medium degree of risk, including only the following: Absailing, BMX, Bob-sledding, Bungee jumping, Canyoning, Caving, Downhill and/or cross-country snow skiing and snowboarding and snowmobiling, provided that such activity is not in any violation of applicable laws, rules or regulations or away from prepared and marked in-bound, patrolled territories or against the advice of the local ski school or local authoritative body, Hot air ballooning, Kitesurfing and Kiteboarding, Mountaineering below 4,500 meters from ground level, Motorcycle riding as a driver or passenger, Zip lining, Parachuting, Paragliding, Parascending, Rappelling, Scuba diving or sub-aqua pursuits at less than depth of 50 meters, Skydiving, Spelunking, Whitewater kayaking or whitewater rafting (in water less than Class V difficulty), Wildlife Safaris Windsurfing

Advice

Any information, consultation or Treatment received from a Nurse, Physician or Specialist; including the issuing of any medication or prescription.

Ambulatory Services

Health services provided to members who are not confined to a health care institution. Ambulatory services are often referred to as "outpatient" services.

Ancillary Services

All Hospital services for a patient other than room and board and professional services. Laboratory tests and radiology are examples of Ancillary Services.

Annual Aggregate Maximum

The yearly maximum that a policy will cover, regardless of how many claims are made.

Application

The fully answered and signed (including electronic signatures) form that is submitted by or on behalf of the Insured Person for acceptance into the insurance provided under this Master Policy, submitted to the Plan Administrator and maintained on file with the Plan Administrator. Any insurance agent/broker or other person or entity assigned to, soliciting, or assisting with the Application is the agent and representative of the applicant/Insured Person and is not and shall not be deemed or considered as an agent or representative for or on behalf of Underwriters or the Plan Administrator.

Bed finding

The task of locating a hospital/facility that will accept an injured (or especially when critically ill) is called bed finding. Excellent providers of this service are Going Home Medical (USA) and Mayday Group (UK and global). The case managers will step in to identify the best medical facilities along with the most qualified accepting physicians to address all of the medical needs of the patient.

Beneficiary

On the World Explorer plans, the beneficiary is the individual named in the Insured Person's Application to be the recipient of any Accidental Death or Common Carrier Accidental Death benefit. For Insured Persons age 18 and older who do not designate a Beneficiary on the Application, the Beneficiary is automatically as follows: 1) Spouse (if any), 2) Children (if any) equally, 3) Estate of the Insured Person. For Insured Persons who are under age eighteen (18) who do not designate a Beneficiary on their Application, the Beneficiary is automatically as follows: 1) Custodial parent(s) (if any), 2) Siblings (if any) equally, 3) Estate of the Insured Person.

Broker

An intermediary, who acts on behalf of a person who is applying for insurance. They earn a commission from the insurer; however, they have a responsibility to obtain cover appropriate to the needs of the insured. In certain circumstances a broker can also act as an agent for the insurer in terms of issuing a policy or collecting a premium.

Certificate Period

The Certificate Period is the period of time beginning on the Certificate Effective Date and ending on the Certificate Termination Date.

Certificate of insurance

The document issued to You stating details of the Policyholder, the Insured Persons, the period of Cover, the Date of Entry of each Insured Person, the Area of Cover, the Plan level, the name of the Insurer, the medical underwriting terms including any special exclusions or restrictions to the Plan.

Chronic Conditions

According to Nomads Health Insurance:

An illness that fails to respond effectively to treatment, or is ongoing or frequently recurring without likelihood of complete cessation, or requires Palliative Treatment, or requires constant or long periods of supervision.

Benefits under this section are not subject to the Policy Excess in Nomad Health Insurance (verify in benefit schedule)

   i) Curative: Benefits are limited to Covered Charges and Surgeries related to costs in relation to Inpatient curative Treatment       of a Chronic Condition.

   ii) Stabilisation of an Acute episode: Benefits are limited to Covered Charges and Surgeries related to costs in relation to         Inpatient stabilisation of an acute attack of a Chronic Condition.
   

    iii) Routine Management: Benefits are limited to Covered Charges and Surgeries related to a Chronic condition, subject to a          limit of $/€2,000 per Insured Person per Period of Cover.

According to International Health Insurance:

A disease, Illness or Bodily Injury that has 2 (two) or more of the followingcharacteristics:

It has no known recognised cureIt continues indefinitely
It is recurrent in nature

It is permanent

It needs Palliative Treatment
It requires prolonged monitoring and/or supervision through consultations, examinations, check-ups, tests ormedication
It is Degenerative

Civil commotion

In the context of juvo:

A substantial violent uprising by a group of persons assembled together and acting with common purpose of religious, ideological or political intent.

Civil war

In the context of juvo:

Civil War means a hostile contention by armed forces carried on between opposing citizens or subjects of the same country or nation.

Co-insurance

The percentage You must pay in respect of any Covered Charges, as detailed in the Policy Wording or as shown in the Benefit Schedule. In all instances any Excess applicable must be satisfied before the Co-insurance becomes effective.

Cohabitant

A cohabitant is defined as the person living with the Member and fulfilling together the following two cumulative conditions:

a.) they are both free of any former marriage or partnership agreement bond,

b.) cohabitation must be declared by the Member upon enrollment, along with a cohabitation certificate or proof of residency mentioning both names and a sworn statement that they live together. The certificate must be in force and legally recognized by a competent authority in the country of cohabitation. Termination of cohabitation must be declared in writing by the Member. Only one person can be enrolled as a cohabitant.

Commencement Date

The date on which the Policy becomes effective as shown on the Policy Schedule.

Company/Our/Us/We

Expatriate Group, administering Nomad Health Insurance, acting on behalf of certain Underwriters, including any organization appointed by Us to act on Our behalf.

Compassionate Home Travel

A benefit in certain Nomad Health Insurance plans that is limited to an economy return airfare, for the Primary Insured (or their spouse/partner, who is insured under this Policy) to return to Your Country of Nationality to attend the funeral of a parent, sibling or child. This benefit is limited to costs incurred 12 months after Your Effective Date and is limited to one claim every 2 years of cover.

Complementary Medicine/Therapies

According to the plans: International Health Insurance (Preferred & Preferred+):

Therapeutic and diagnostic Treatments which exist outside of institutions where conventional medicine is taught and specifically within this Plan refers to acupuncture, homeopathy, osteopathy, chiropractic Treatment, traditional Chinese medicines, ayurvedic Treatments, provided by a practitioner who is qualified and licensed to practice in the country where Treatment is given.

According to the plans: Nomad Health Insurance (Select, Primary+, Primary):

Treatment or medicine provided by a registered and properly qualified Osteopath, Chiropractor, Homeopath and Acupuncturist on the written recommendation of Your treating Physician for a Covered Charge.

Conflict evacuation

In the context of juvo, the benefit includes:

In the event of Conflict in the Country of Assignment (or where travel is taking place to) of the member(s), the program will cover the costs of Crisis Evacuation by the Emergency Response Provider for member(s) and Additional Costs if:

  1. The increase in Conflict in the Country of Assignment (or where travel is taking place to) materially contributes to the Risk Rating equaling or exceeding the relevantRisk Rating Trigger Point for that country set out in the Schedule; and/or
  2. The increase in Conflict in the Country of Assignment (or where travel is taking place to) that in the opinion of Response Consultants and with Our agreement places the member in physical danger.
  3. Acts of Terrorism, Strikes, Riots or Civil Commotion event in the Country ofAssignment (or where travel is taking place to) that in the opinion of Alert 24 and with Our agreement places the member(s) in physical danger
Contact Sport(s)

A sport in which the participants purposely hit or collide with each other, inanimate objects, the ground or water, with force, including without limitation: American football, Basketball, High diving and cliff diving, Fighting or combat sports, including without limitation, boxing, wrestling, martial arts, mixed martial arts, fencing and kickboxing Hockey, including ice and field hockey, Lacrosse, Polo, Rodeo, Rugby, Ski jumping, Soccer.

Copay

An arrangement where the covered person pays a specified amount for various services and the health care provider pays the remainder. The covered person usually must pay his or her share when the service is rendered. Similar to coinsurance, except that coinsurance is usually a percentage of certain charges where the co-payment is a dollar amount.

Cosmetic surgery

Surgery performed primarily to change or restore physical appearance.

Country of residence

The country of expatriation of the Member.

The country stated in Your Policy Schedule.

Coup d’Etat

The sudden, violent and illegal overthrow of a sovereign government.

Covered Electronics and Communication Equipment

The following items exclusively: mobile phones, tablets and laptop computers.

Covered Personal Equipment

Covered Sports Equipment, Covered Photography Equipment and Covered Electronics and Communication Equipment exclusively.

Covered Photography Equipment

The following items exclusively: cameras, camera flash accessories and camera lenses.

Covered Sports Equipment

The following items exclusively: skis, ski boots, ski poles, snowboards, snowboard boots, golf clubs, golf bags, tennis rackets.

Covered charges

A charge incurred for Your Medically Necessary Treatment which is Reasonable and Customary and incurred during the Period of Cover.

Crisis Evacuation

In the context of juvo:

An Expatriate Crisis Evacuation and/or a National Crisis Evacuation.

Daily Living

A twenty-four (24) hour period during which an Insured Person engages in normal daily activities including but not limited to eating, drinking and washing.

Day care treatment

Medically Necessary Treatment received in a hospital that requires the use of an operating theatre, but where You are not admitted to a hospital bed overnight.

Deductible

The dollar amount of Eligible Medical Expenses, specified in the Master Policy, that the Insured Person must pay before receiving benefits or coverage hereunder, not including any applicable Coinsurance.

Dental: Acute Onset of Dental Pain

Sudden and unexpected experience of severe pain in the teeth, gums or bones supporting the teeth.

Dental: Basic Restorative Dental Treatment: (Nomad Health Insurance: Select plan)

Benefits on Nomad Health Insurance (Select plan) that are payable for covered charges for restorative treatment to natural teeth including capping, crowns and bridges in plastic or porcelain fused to gold, limited to a maximum of €750 per period of cover per insured person.

Dental: Emergency Dental Treatment (World Explorer plans)

A benefit of World Explorer plans for emergency dental treatment necessary to restore or replace sound natural teeth lost or damaged in an accident which was covered under this insurance; however, loss or damage to sound natural teeth while eating or biting into hard objects such as, but not limited to, pencils, ice cubes, nuts, popcorn and hard candies, are not covered. It also includes limited dental treatment necessary to resolve acute onset of dental pain, subject to a maximum of $100 per insured person per certificate period, only if the certificate period is thirty (30) days or more.

Dental: Emergency Dental Treatment following Accident (Nomad Health Insurance)

Benefits on Nomad Health Insurance plans that are payable for covered charges incurred as a result of an accident for dental Treatment received within 48 hours of the occurrence of the accident to restore or replace sound natural teeth lost or damaged.

Insured Nomads Underwriting GmbH, based in Hamburg, Germany (IDK: D-614H-AG1IB-19) and Insured Nomads - UK branch  in London, England, United Kingdom.

Insured Nomads Corporation (NPN#19616300) acting as the agent in selling these insurance policies in the USA. It receives compensation based on the premiums for the insurance policies it sells.

Coverage may not be available in all jurisdictions.   Further information is available upon request.   Available direct and through select brokerage firms.