UNDERSTAND THE Words

Insurance Dictionary

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Country of residence

The country stated in Your Policy Schedule.

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.

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.

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.

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

The amount payable by You, as detailed in Your Policy Schedule, in respect of each new medical condition, before any claims are payable by us. In all instances the Excess must be satisfied before any Co-insurance becomes effective.

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.