UK Signature Plans

This guide sets out the standard benefits and rules of a UK Signature Healthcare Plan policy, including information on:

Notes

1. Area of Cover

The geographical area of cover for Signature is Worldwide.

2. Pre-authorisation

Certain treatments and costs require submission of a Pre-authorisation Form in advance. Following approval by Allianz Worldwide Care, cover for these required treatments or costs (see list below) can then be guaranteed.

• All in-patient benefits listed
• Day-care treatment
• Out-patient surgery
• Nursing at home or in a convalescent home
• Rehabilitation treatment
• PET and CT-PET scans
• Oncology (in-patient and day-care treatment only)
• Long term care
• Elective overseas treatment
• Expenses for one person accompanying a repatriated person
• Repatriation of mortal remains
• Routine maternity and complications of pregnancy and childbirth
  (in-patient treatment only)
• Occupational therapy (out-patient treatment only)

For the treatments listed above, please note that you and your physician should complete the relevant sections of a Pre-authorisation Form and send it to us for approval prior to commencement of your treatment. This will provide you with the benefit of cashless access to hospitals for in-patient treatment, as well as giving you the advantage of your treatment being overseen by one of our doctors.

3. Claims process and turnaround

Direct settlement is in place for in-patient treatment in all UK hospital groups and for out-patient treatment in the majority of UK hospital groups. However, in any cases where a member needs to pay and claim for out-patient treatment, Allianz Worldwide Care has a simple claiming process in place.

Fully completed Claim Forms are processed and payment instructions issued to the member‘s bank within 48 hours. Where further information is required to complete the claim, the member/medical practitioner will automatically be notified by email or mail within 24 hours of receipt of the Claim Form. An email is sent automatically to the member (where email addresses are provided to us) to advise them when the claim is processed. This swift claims processing policy ensures that our members receive their claims payment in the most effective and efficient manner.

4. Benefit limits

There are two kinds of benefit limits shown in the Table of Benefits. The maximum plan benefit, which applies to certain plans, is the maximum we will pay for all benefits in total, per member, per Insurance Year, under that particular plan. Some benefits also have a specific benefit limit, for example “Nursing at home or in a convalescent home”. Specific benefit limits may be provided on a “per Insurance Year” basis, a “per lifetime” basis or on a “per event” basis, such as per trip, per visit or per pregnancy. In some instances we will pay a percentage of the costs for the specific benefit e.g. “80% refund”. Where a specific benefit limit applies or where the term “Full refund” appears next to certain benefits, the refund is subject to the maximum plan benefit, if one applies to your plan(s). All limits are per member, per Insurance Year, unless otherwise stated in your Table of Benefits. Please note that the routine maternity benefit is on a “per pregnancy” basis and can only be selected along with the Signature Plus Core Plan.

5. Hospital network

When setting up a company scheme, the employer will select the hospital list applicable to the scheme. The list chosen will be indicated on your Table of Benefits. Under your plan, you will be eligible for in-patient and day-care treatment in any of the hospitals on your list. There are no restrictions on where you can have out-patient treatment and you may go anywhere for treatment.

There are three hospital list options:

• Premium – a great range of private hospitals and NHS private facilities right around the UK.
• Premium Plus – an even more comprehensive range of hospitals than the Premium list. In addition to all of the hospitals on the Premium list, it includes a much broader range nationally and a much wider range of London based hospitals.
• Premium Unlimited – our full range of hospitals including those within the Premium and Premium Plus lists, as well as a greater provision of Central London hospitals.

Overseas treatment is based on the cost of the equivalent treatment in the UK, under your chosen hospital list. Please contact us in advance of your treatment to ensure that treatment costs in your chosen facility overseas will be covered by your plan. Failure to verify cover for your chosen facility with us in advance may impact on the settlement of your claim.

Full details of the hospitals included in your hospital list and out-patient facilities within our Provider Network can be found on our website at www.allianzworldwidecare.com/ukmembers.

6. Policy Terms and Conditions

Please note that cover for smaller groups is subject to underwriting i.e. cover may be excluded for pre-existing conditions, or a higher premium rate may apply to reflect the higher risk due to pre-existing medical conditions or additional risk factors. Cover is conditional upon acceptance of your application, which is only confirmed when an Insurance Certificate is provided. The Table of Benefits provides an outline of the cover we provide under each plan. Cover is subject to our policy terms and conditions, as detailed in our Signature Employee Benefit Guide, which is issued to members upon policy inception.

If you have any queries, please do not hesitate to contact us:
Allianz Worldwide Care
18B Beckett Way
Park West Business Campus
Nangor Road
Dublin 12
Ireland

sales@allianzworldwidecare.com
www.allianzworldwidecare.com/ukmembers

LoCall: 0203 5642 546
Fax: + 353 1 630 1306