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Group Clinical
Benefit Endorsement
.........This
Endorsement is attached to and forms a part of the Group Hospital
& Surgical Supplementary Contract in order to provide a supplement
benefit to compensate an insured member for his medical expense
incurred in OPD of a clinic or hospital as a result of his sickness
or injury.
Coverage
.........This
benefit covers 24 hours, everywhere all over the world and both
in and out of occupation when Insured Member is treated into hospital or clinic as an outpatient as a result of sickness or accidental injury.
Benefits
AIA shall reimburse for the actual expenses in the Schedule of this Endorsement up to the maximum
benefit shown there. The reimbursement is limited to one visit
per day and to maximum number of visits as specified in the
aforementioned Schedule. The medical expenses to be reimbursed
hereof shall cover the charges of consultation, injection, drugs,
x-ray & laboratory examination.
Exclusions
No benefit shall be payable for the following
services, examinations, products or conditions.
- Drugs purchased
without doctor's prescription.
- Eye refractions, fitting of glasses,
contact lenses or hearing aids, gingivitis, oral care.
- Disorders of a functional nature
including without limitation constipation, dyspepsia, indigestion,
anorexia.
- Claims for which all original receipts
and/or bills are not submitted for processing within three(3)
months of incurring such expenses.
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