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

Benefits on Nomad Health Insurance (Select plan) that are payable for covered charges for complex treatment including covered charges for periodontal surgery, inlays and implants, dental prosthesis - fitting of artificial oral appliances, apicectomy - molars and premolars, and the surgical extraction of wisdom teeth, limited to a maximum of €1,000 per Period of Cover per Insured Person.

Dental: Routine Dental Examination & Treatment

Benefits on Nomad Health Insurance (Select plan) that are payable for covered charges for basic treatment such as X-rays required prior to treatment, extractions, root canal fillings, treatment of abscesses, anterior or amalgam fillings, scaling, polishing and prophylaxis limited to a maximum of €750 per period of cover per insured person.

Dependant

A family member of the Primary Insured who is either:

a) the legally married spouse or partner with whom you permanently reside, provided the spouse/partner is at least 18 years of age and younger than 65 at the time of application for cover under this Policy and permanently resident with You, or

b) a child, who is unmarried, below 21 years of age, permanently resides with, and is financially dependent on You.

Diagnostics tests

Laboratory tests, X-rays, MRI, PET or CT scans which are ordered by a Physician or Specialist.

Directed Attacks

In the context of juvo:

Targeted actions by the authorities and/or population of the Country of Assignment against foreigners or foreign-owned businesses in the Country of Assignment.

Earnings Expense

In the context of juvo:

Earnings Expenses means:

   (a) Contractual Net Income paid by You to an Insured Person(s) who has been the subject of a Crisis Evacuation; and/or

   (b) Contingent Salary paid to an Insured Person(s).

   (c) reasonable expenses that have been agreed with Us prior to their expenditure by You or an Insured Person(s).

Educational or Rehabilitative Care

Care for restoration (by education or training) of one’s ability to function in a normal or near normal manner following an Illness or Injury. This type of care includes, but is not limited to, vocational or occupational therapy and speech therapy. Eligible Medical Expenses: Expenses for services and supplies for treatment of Injury or Illness.

Effective date

The date of first inclusion under this Policy of eachInsured Person, as noted on the Policy Schedule.

Emergency Medical Evacuation

A medical condition or situation, which in Our opinion, cannot adequately be treated in the location in which it has arisen. In this event the Emergency Assistance provider will arrange for You to be transferred to the nearest location where adequate appropriate Treatment can be provided.

Excess (Annual Excess)

The excess which corresponds to the amount to be born by the Member during one insurance year.

Expatriate Crisis Evacuation

In the context of juvo:

The necessary transport from the Host Country (or from the region of the Host Country in which the Insured Person(s) is located) of a Insured Person(s) who is not a national of the Host Country to the place considered by Emergency Response Provider to be the nearest place of safety or their Resident Country, caused by or relating to the InsuredEvent(s).

Exposure

The risk of possible loss. In health insurance is generally refers to an individual's susceptibility to various risks encountered in daily life. It denotes the individual's potential for accidents and other losses. Insurance companies evaluate the level of risk an individual faces and use it to calculate premiums.

Extended Care Facility

An institution, or a distinct part of an institution, which is licensed as a Hospital, Extended Care Facility or rehabilitation facility by the jurisdiction in which it operates; and is regularly engaged in providing twenty-four (24) hour skilled nursing care under the regular supervision of a Physician and the direct supervision of a Registered Nurse; and maintains a daily record on each patient; and provides each patient with a planned program of observation prescribed by a Physician; and provides each patient with active treatment of an Illness or Injury. Extended Care Facility does not include a facility primarily for rest, the aged, Substance Abuse treatment, Custodial Care, nursing care or for care of Mental Health Disorders or the mentally incompetent.

Extreme Sports

A sporting activity, including practice, preparation and actual sporting events, which involves a high degree of risk. These activities often involve speed, height, a high level of physical exertion and/or highly specialized gear, and often carry the potential risk of serious or permanent physical Injury and even death. These activities include, without limitation, the following and any combination or derivative of the following: Back country snow skiing, snowboarding or snowmobiling, Base jumping, Cave diving, Downhill mountain biking, Extreme Skiing, Free diving, Free flying, Free running and Parkour, Free skiing, Freestyle scootering, Gliding, Heli-skiing, Ice canoeing, Ice climbing, Jet skiing, Racing any vehicle or animal, including mountain bikes, motocross, motorcycle racing, motor rally, snowmobile racing, truck racing, horse racing, boat racing, Mountaineering above elevation of 4,500 meters from ground level, Piloting a commercial or non-commercial aircraft, Powerboking, Skateboarding, Snow skiing, snowboarding or snowmobiling off piste, Scuba diving or sub-aqua pursuits below a depth of 50 meters, Whitewater kayaking or whitewater rafting Class V or higher difficulty (Class V = A section of a river, stream or other waterway or watercourse where the current moves with enough speed or force to meet, but not to exceed, the qualifications of Class V as determined by the International Scale of River Difficulty or as commonly published by a local authority or government agency.) Wingsuit flying.

Family Compassionate Travel

A benefit on certain Nomad Health Insurance plans (see schedule of benefits) that is limited to the cost of economy class transport for up to two close relatives (being your parent(s), sibling(s) or child(ren)), who reside outside Your Country of Residence, to attend you if you are admitted to a hospital bed in respect of a valid claim for more than three consecutive nights. Limited to a maximum of €250 per period of cover.

Fulltime Student

A person who is enrolled in a program that leads to a degree, certificate or other recognized educational credential and regularly attends an Educational Institution for the minimum number of credit hours required by the Educational Institution in order to maintain a full-time student status. On-the-job training courses, correspondence schools, and schools offering courses only through the internet do not qualify as Educational Institutions, Full-time Scholar: A graduate student, teacher, researcher, or professor who is affiliated with an Educational Institution and is engaging in educational activities for at least thirty (30) hours per week. On-the-job training courses, correspondence schools, or schools offering courses only through the internet do not qualify as Educational Institutions.

Geographical Treatment Area

The geographical regions in which You are able to receive Treatment for Covered Charges. The countries in which You are able to receive covered Treatment is as detailed in Your Policy Schedule, to be read in conjunction with the Geographical Coverage Schedule.

HIPAA

Health Insurance Portability and Accountability Act of 1996 (USA) It was passed as an effort to

  • Reduces health care fraud and abuse;
  • Mandate industry-wide standards for health care information on electronic billing and other processes; and
  • Require the protection and confidential handling of protected health information

HMO

An HMO is a prepaid medical service plan which provides services to plan members. Medical providers contract with the HMO to provide medical services to plan members. Members must use contracted providers. The emphasis is on preventive medicine, and it is an alternative to employee benefit plans. Employers of more than 25 persons are required to offer the alternative of HMO to employees, but not if the cost exceeds that of present employee benefit plans.


Hazardous activity

Activities that carry an increased potential for injury. These may include, but are not limited to: professional, semi-professional or competitive sporting events of any kind; organized group, club, interscholastic or intercollegiate sports play; use of any type of firearms (any device that discharges a projectile of any type); any activity relating to flying except while traveling as a passenger in a fully licensed passenger carrying aircraft; parachuting, para-gliding, bob-sleighing, gliding/soaring, hang-gliding, micro-light flying, skeleton, luge; American football; bungee jumping; base jumping; trekking above 3,500 meters; mountaineering / rock-climbing; scuba diving in excess of 25meters or any flights within 24-hours of diving activity; whitewater canoeing, white water rafting; skiing or snowboarding, except on the normally marked publicly open ski trails at a ski resort; skating, off-road mountain biking, ice hockey; participation in any type of motor-sport, motor-sport race or motor-sport contest. Unless otherwise accepted by Us in writing.

Health check up

Medical examination carried out without any visible clinical symptom. These health check-ups aim at anticipating the detection of illnesses. They include the following tests: blood, sugar, cholesterol, kidney function, thyroid, lipids, bone densitometry.

Home care

Medical care provided by a registered nurse at the Member's home and in accordance with the prescription of a doctor, immediately following or in the place of a hospitalisation or outpatient care.

Hospice

An institution which operates as a Hospice, is licensed by the state or country in which it operates; and operates primarily for the reception, care and palliative control of pain for terminally ill persons who have, as certified by a Physician, a life expectancy of not more than six (6) months

Hospital

A facility which operates as a Hospital in accordance with the laws of the respective country, is open at all times, is operated mainly to diagnose and treat Illnesses as an Inpatient, has organized facilities for major Surgery, has a staff of one or more physicians on call at all times, has 24 hour nursing services by, or under, the supervision of government licensed nurses, is not, other than incidentally, a skilled nursing facility; clinic place for alcoholics or drug addicts, nursing home, rest home, convalescent home; home for the aged; place for the Treatment of mental disorders or a similar establishment, and maintains a daily medical record foreach patient, which is accessible by us.

Hospital Cash Benefit/Hospital Indemnity

A benefit that pays a fixed amount for each day that you are hospitalized. The amount paid is fixed at the time of taking the policy and would remain fixed. This benefit amount is stated in your schedule of benefits for your policy.

Hospitalized, hospitalization

Confined and/or treated in a Hospital as an Inpatient.

Host Country

In the context of juvo:

The country being visited by the Insured Person, or where the Insured Person resides temporarily. Host Country does not include the Insured Person’s Home Country.

House country

A country of origin for which You hold a passport.

Illness

A disease or body impairment, which is not a consequence of an Accident, and which requires Medically Necessary Treatment.

Incidental Trip Home

A period of time not to exceed fourteen (14) days during a Certificate Period during which an Insured Person is covered for Eligible Medical Expenses incurred in his or her Home Country. An Incidental Trip Home begins on the date and time the Insured Person departs his or her Host Country to return to his or her Home Country, and ends on the next date and time the Insured Person departs his or her Home Country, subject to a maximum of 14 days. The Incidental Trip Home benefit is only available to Insured Person’s with Certificate Periods of ninety (90) days or more.

Inpatient treatment

Medically Necessary Treatment received where You are admitted to a Hospital bed overnight.

Insured Person/You/Your

Any person who is covered under the Policy and is named as such in the Policy Schedule.

Insurer: International Health Insurance

The insurance organisation covering the insured risk. This is MFPrévoyance, registered by Code desassurances, RCS 507 648 053 PARIS, Head office: 4, place Raoul DAUTRY, 75015 Paris, France.

Insurer: Nomad Health Insurance

The organisation that has underwritten the policy is Guardrisk Insurance Company Mauritius Ltd PCC, authorised and regulated by the FSC in Mauritius (Registration number: C142417/C1/GBL). It is administered by Expatriate Group & Expatriate Healthcare (trading styles of Strategic Insurance Services Limited), authorised and regulated by the Financial Conduct Authority (FCA). FCA Firm reference Number is 307133. Strategic Insurance Services Limited is authorised to carry on Regulated Activities in accordance with the permissions granted by the FCA under PART IV of the Financial Services and Markets ACT 2000.

Insurer: Travel Insurance

The insurance organization covering the insured risk. This is HDI/Hannover Specialty, who has granted global delegated authority to Point Comfort Underwriters, 306 Prospect St, Indianapolis, IN 46225, USA.

Insurrection

In the context of juvo:

A violent uprising of citizens in resistance to their government.

Investigational, Experimental or for Research Purposes

Terms used to describe procedures, services or supplies that are by nature or composition, or are used or applied, in a way which deviates from generally accepted standards of current medical practice.

Kidnap/Ransom Insurance

An insurance policy providing coverage for ransom or extortion costs and related expenses. Also referred to as K&R


Lapse

The termination of a policy due to failure to pay the required renewal premium.


Lawful Permanent Resident(s) of the US; US Resident(s)

An individual who is not a citizen of the US who is living in the US under legally recognized and lawfully recorded permanent residence as an immigrant.

Limitation period

In the context of International Health Insurance (Preferred & Preferred Plus plans):

The period beyond which a party's rights may no longer be invoked.

Lloyd's of London

A corporation and an association (marketplace, or market).

The Corporation of Lloyd's, the company that oversees the insurance marketplace. The corporation ensures that the syndicates are financially sound and that the marketplace operates efficiently.

The Association offering membership in various syndicates of wealthy individuals organized for the purpose of writing insurance for a particular hazard.

Lloyd's began as a place where ship captains, vessel owners, traders and others interested in shipping gathered in the 1600's to buy or sell insurance for their ocean cargo. Now, brokers and underwriters convene at the Lloyd's office building in East Central London. Lloyd's is now a major hub for buying and selling a variety of coverages.

Local Ambulance

Transportation and accompanying treatment provided by licensed, qualified professional emergency personnel from the location of a covered Accident, Injury or acute Illness to a Hospital or other appropriate health care facility.

Master Policy Period

The Master Policy Period is the period of time beginning on the Effective Date and ending on the Termination Date indicated on the Master Policy Declaration.

Medicaid

These are policies issued in the USA in association with the Federal/State entitlement program created by Title XIX of the Social Security Act of 1965 that pays for medical assistance for certain individuals and families with low incomes and resources. Visit www.medicaid.gov for more information

Medical Inflation

The increase in healthcare costs associated with medical trends and developments. It often includes the costs of advanced treatments and procedures, and the increased availability and usage around the world. Therefore, the expenditure on health has increased year to year, affecting governments, employers, insurance companies and individuals.

Medical check-up

A physical examination with a Physician, including the cost of the Physician’s fee, blood test (red blood count, white blood count, blood sugar, cholesterol, triglyceride, uric acid) and urine test (sugar, protein).

Medical prosthesis

Hearing aid, phonation aid (electronic larynx), wheelchair and personal mobility aid, artificial limb, ostomy product, hernia support, abdominal bandage, elastic support stockings or orthopaedic sole and any other medically prescribed apparatus.

Medically Necessary Treatment

As defined for International Health Insurance:

Medically Necessary Treatment which in the opinion of a qualified Medical Practitioner/Specialist is appropriate and consistent with the diagnosis, is proven and has demonstrated to give medical value, and which isin accordance with the generally accepted medical standards and could not have been omitted without adversely affecting the Insured Person’s condition or the quality of care rendered. Treatments must be required for purposes other than comfort or convenience of the patient and provided only for an appropriate duration of time.Member: The party in respect of which the risk is insured. For the purpose of this policy, this refers to the mainMember and, where relevant, his/her Dependants.

Medically necessary: Corresponds to services and goods that are defined from a medical point of view as appropriated and necessary. They must:

a)  Be necessary to define or treat the condition, the illness or the injury of a patient,

b) Be appropriated to the symptoms, diagnosis or treatment of the patient,

c) Comply with the medical practices generally accepted and with the professional medical standards applied by the medical community at the time the patient receives the relevant care,

d) Be required for other reasons than comfort or pleasure of the patient or his/her doctor,

e) Have medical proven and demonstrated effects,

f) Be considered as from the most appropriate type and level,

g) Be provided with an equipment, in quantity and quality appropriate to the level of care required by the patient condition,

h) Be only provided during the period appropriate to the patient condition.

As defined for Nomad Health Insurance (Select, Primary+, Primary):

A service, supply or Period of Hospitalization which is ordered by a Physician or a Specialist for the diagnosis and/or Treatment of an Accident or Illness and is:

a) appropriate and consistent with the symptoms and findings or diagnosis, and

b) provided in accordance with generally accepted medical practice on a national basis, and

c) the most appropriate supply or level of service which can be provided on a cost effective basis, and

d) not of an experimental or research nature and is not of an investigative nature for the purposes of experiments or research, and

e) is not solely of a preventative nature.

Medicare

In the USA, there is a state assistance program, passed under Title XVIII of the Social Security Amendments of 1965, to provide hospital and medical expense insurance to those over 65 years of age, it is called Medicare.

Part A provides inpatient/hospital coverage.

Part B provides outpatient/medical coverage.

Part C covers all of the same Part A and B services that you get from Medicare. You will have both hospital and outpatient benefits. However, instead of paying deductibles and 20% of your medical services, you will pay the plan's copays.

Part D - Stand-Alone - stand-alone Part D coverage written through individual contracts; stand-alone Part D coverage written through group contracts and certificates; and Part D coverage written on employer groups where the reporting entity is responsible for reporting claims to the Centers for Medicare & Medicaid Services (CMS).

Medicare Supplement - Insurance coverage sold on an individual or group basis to help fill the "gaps" in the protections granted by the federal Medicare program. This is strictly supplemental coverage and cannot duplicate any benefits provided by Medicare. It is structured to pay part or all of Medicare's deductibles and co-payments. It may also cover some services and expenses not covered by Medicare. Also known as Medigap" insurance.

Insured Nomads Underwriting GmbH, based in Hamburg, Germany (IDK: D-614H-AG1IB-19) and Insured Nomads - UK branch (FCA: 946962) in London, England. 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.