Group Out-patient X-Ray & Lab Test Benefit Endorsement. ........This
Endorsement is attached to and forms a part of the Group Hospital
& Surgical Supplementary Contract in order to provide a coverage
for an insured member's expense incurred on X - ray & Laboratory
Tests required for the treatment of his injury or sickness.
Benefits
When
an insured member undergoes an X - ray & Laboratory Examination
upon the recommendation of a Registered Medical Practitioner
as a result of sickness or injury, AIA shall reimburse for the
actual charges of such examination up to the maximum benefit
stated in the Schedule of this Endorsement. The indicated maximum
benefit is classified as follow:
a.
Maximum per an examination
in case of accidental injury
b.
Maximum per a policy
year in case of sickness.
Exclusions
X - ray or Laboratory Tests not recommended by a registered
medical practitiones.
An examination made during an insured member's confinement
in a hospital in respect. of the other benefits covered
under the Supplementary Contract to which this Endorsement
is attached.
Eye refractions, dental examinations except that necessitated
by sound natural teeth as a result of an injury occurring
during the period of insurance.
Disorders of a functional nature including without limitation
constipation, dyspepsis, indigestion and anorexia.
Claims of which all original receipts and/or bill are
not submitted to AIA for processing within 3 months from
the date of incurring such expenses.