Health Insurance

The amount paid for preparation and transportation of the human remains of an Insured to another country, billed by a licensed facility and is paid in lieu of, not in addition to, the Final Expense Benefit.

The amount paid with respect to funeral expenses for an Insured and is paid in lieu of, not in addition to, the Repatriation of Human Remains benefit.

The thirty (30) day period following the premium due date during which the insurance remains in force and the Policyowner may pay the premium without penalty.

A listing of descriptive terms and identifying codes for reporting medical services and procedures performed by Physicians, which terms and codes are published by the American Medical Association.

An Accident or Illness of unexpected occurrence or event causing a threat to life or limb and requiring urgent and immediate treatment (within twenty-four (24) hours of occurrence), deemed to be Medically Necessary.

The choice exercised by the Insured to have the Company pay benefits directly to a medical Provider by signing the appropriate section of the claim form or by any other means acceptable to the Company.

Claims can be submitted on your behalf by:

• Medical providers (Online submission available).
• Submitting your claim forms and original receipts for reimbursement.

Yes. Once they are declared on your enrollment form.

Premiums are affected by utilization of your health benefits.

• Non-disclosure of medical conditions
• Existing exclusions from previous coverage/insurer

• Deductible – The amount of eligible expenses that must be borne by each Insured during each Calendar Year, before the application of the Policy benefits.
• Co-payment – A flat amount that the insured is responsible for at the time of service.
• Coinsurance – The percentage of eligible benefits paid by the Company to or on behalf of the Insured.

By completing an Insured Change Request form.

Yes. You may add eligible family members, as follows:

• The Spouse of the Enrollee, as defined below, who is living permanently with the Insured; or
• Each Child of the Enrollee, from birth through age eighteen (18), inclusive but less than nineteen (19); or
• Each Child of the Enrollee who is over age 18, provided he is a full-time student or financially dependent, but who is less than thirty (30) years old. The Enrollee may be required by the Company at any time to present proof of any such Child’s current enrollment in school or evidence of financial dependency; and is
• Legally and Ordinarily resident in the Cayman Islands.