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Agreement#: AG-15740
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Galileo Uk Health Benefit Policy

Effective Date: June 16, 1992
Parties:

Galileo

Sectors: Computer Software and Services, Leisure and Entertainment
Governing Law:  The United Kingdom
GUARDIAN HEALTH LETTERHEAD]







1. AIDS This POLICY does not cover MEDICAL TREATMENT

directly or indirectly related to Human

Immunodeficiency Virus (HIV) or Acquired

Immune Deficiency Syndrome (AIDS) or

any syndrome or condition of a similar kind

whatever it is called.



2. APPLIANCES This POLICY does not cover the provision of

surgical or medical appliances, aids or

equipment, including spectacles, contact

lenses, hearing aids, dentures or dental



3. CARE OF THE AGED This POLICY does not cover MEDICAL TREATMENT in

any establishment for care of the aged,

including the geriatric ward of a HOSPITAL.



4. CLAIM FORMS AND REPORTS This POLICY does not cover any charges or fees

for the completion of claim forms or for

medical reports needed on or before applying

for insurance under this POLICY or any other

insurance cover or enrolment in any insurance



5. COSMETIC TREATMENT This POLICY does not cover cosmetic treatment,

whether or not for psychological reasons,

unless necessary as a result of an accident

which happens while YOU are covered by this



6. DENTISTRY This POLICY does not cover dental, orthodontic

and periodontal treatment except SPECIFIED

OROSURGICAL PROCEDURES - see definitions.



7. DRUGS AND DRESSINGS This POLICY does not cover the cost of drugs

and dressings prescribed when YOU are receiving

MEDICAL TREATMENT as an OUT-PATIENT unless

used in the course of chemotherapy or



8. GP AND ROUTINE This POLICY does not cover the services of a GP,

EXAMINATIONS eye tests, hearing tests or medical

examinations of a routine or preventative



9. HEALTH-HYDROS AND This POLICY does not cover MEDICAL TREATMENT

NATURE CURE CLINICS in any health-hydro or nature cure clinic or

similar establishment, or occupying private

beds in a HOSPITAL attached to one of these



10. HOME NURSING This POLICY does not cover MEDICAL TREATMENT

CHARGES for home nursing for mental or

psychiatric illness or wholly or partly arranged

for domestic reasons.



11. HORMONE REPLACEMENT This POLICY does not cover Hormone Replacement

THERAPY Therapy (HRT) unless it follows the removal of

both ovaries, when the treatment will be

limited to a maximum of two years from

the date of removal.



12. KIDNEY FAILURE This POLICY does not cover supportive treatment

for renal failure including dialysis. YOU are

covered for dialysis immediately before and

after a kidney transplant or in connection

with acute secondary failure when the dialysis

is part of intensive care.







[GUARDIAN HEALTH LETTERHEAD]









EXCLUSIONS (continued)





13. MENTAL AND PSYCHIATRIC This POLICY does not cover MEDICAL TREATMENT as

ILLNESS, ALCOHOLISM, DRUG an IN-PATIENT or DAY-PATIENT for mental or

AND SUBSTANCE ABUSE psychiatric illness and for alcoholism, drug

or substance abuse or addiction or

conditions which may be directly attributed to

alcoholism or drug or substance abuse or

addiction for any period in excess of 28 days

per INSURED PERSON in any one POLICY YEAR.



14. ORGAN TRANSPLANT This POLICY does not cover any amount in EXCESS

of Pound 50,000 for each INSURED PERSON in a

POLICY YEAR relating to organ transplant. Any

MEDICAL TREATMENT CHARGES relating to a live

donor will be incorporated within this amount.



15. PREGNANCY a) This POLICY does not cover MEDICAL TREATMENT

for pregnancy or childbirth unless it

is either complicated by a MEDICAL

CONDITION needing MEDICAL TREATMENT during

the ante-natal stages of pregnancy or

needing a SPECIFIED OBSTETRIC PROCEDURE -

see definitions.



b) This POLICY does not cover intentional

termination of pregnancy unless medically

necessary during MEDICAL TREATMENT that is

insured under this POLICY.



c) This POLICY does not cover MEDICAL TREATMENT

for infertility or for inability to

conceive, other than investigations into

the cause of infertility, provided that YOU

and YOUR spouse:



i) have been insured by US under this

POLICY for a continuous period

of two years at the start of the

investigations and



ii) were unaware of YOUR infertility or

inability to conceive before

YOUR insurance started under this



d) This POLICY does not cover MEDICAL TREATMENT

related to any form of assisted reproduction

and/or any subsequent pregnancy,

delivery and, within three months of the

birth, post-natal care of the mother and

child or children.



e) This POLICY does not cover foetal surgery,

which is surgery performed on an unborn

child, or MEDICAL TREATMENT in connection

with such surgery whether undergone by the

mother or the unborn child.



16. RADIOACTIVITY This POLICY does not cover MEDICAL CONDITIONS

caused by, or attributed to radioactive



17. REFERRAL WITHIN PRACTICE This POLICY does not cover MEDICAL TREATMENT

from a chiropractor, osteopath or homeopath in

the same practice as the GP who referred YOU.



18. SELF-INFLICTED This POLICY does not cover intentional self-

CONDITIONS inflicted MEDICAL CONDITIONS.



19. SEX CHANGE This POLICY does not cover MEDICAL TREATMENT

in connection with sexual reassignment, whether

or not for psychological reasons.



20. SHORT-SIGHTEDNESS, This POLICY does not cover MEDICAL TREATMENT

LONG-SIGHTEDNESS for myopia (short-sightedness) or hyperopia

(long-sightedness).







[GUARDIAN HEALTH LETTERHEAD]



EXCLUSIONS (continued)



21. TREATMENT ABROAD This POLICY does not cover MEDICAL TREATMENT

outside the UK, if YOU are outside the UK

either against medical advice or specifically

to:



a) Obtain MEDICAL TREATMENT

b) Take up a permanent appointment to work

outside the UK

22. WAR This POLICY does not cover MEDICAL TREATMENT

for any MEDICAL CONDITIONS arising out of war,

invasion, act of foreign enemy, hostilities

(whether war is declared or not), civil war,

riot, civil commotion, acts of terrorism,

rebellion, revolution, insurrection, or

military or usurped power.



NOTE: THE HEADINGS USED IN THIS SECTION

OF THE POLICY ARE FOR CONVENIENCE OF REFERENCE

ONLY AND DO NOT AFFECT ITS CONSTRUCTION.



[GUARDIAN HEALTH LETTERHEAD]





1. CANCELLATION a) WE may cancel or alter the terms of this

POLICY for the following reasons after

giving seven days notice in writing to

the INSURED:

i) non-payment of the premium by the INSURED;

ii) the INSURED'S failure to observe the terms

of this POLICY or failure to act with

utmost good faith.



b) WE may cancel or alter the terms of cover for

an INSURED PERSON if the INSURED PERSON has:

i) mis-led US by mis-statement or concealment;

ii) agreed to any attempt by a third party to

obtain money unreasonably to OUR cost;

iii) failed to observe the terms of this POLICY

or failed to act with utmost good faith.



2. CHILDREN If a child is born during a POLICY YEAR and

YOU want him or her to qualify as an INSURED

PERSON without providing evidence of health,

YOU must ask US for this in writing within

three months of the birth.



3. CLAIMS If there is a claim under this POLICY, WE will

only pay BENEFIT if:

a) Written details on OUR claim form are sent

to US as soon as possible with original

bills or accounts (not copies). The claim

form must be sent no later than two months

after the start of the MEDICAL TREATMENT;

b) WE can ask for medical information from any

GP, SPECIALIST or other physician as often

as WE may reasonably require; and

c) WE are told as soon as reasonably possible

of any circumstances which may lead to a

claim against a third party; and

d) Premiums have been paid for the appropriate

POLICY YEAR; and

e) The MEDICAL TREATMENT takes place during

the POLICY YEAR.



4. FRAUD If there is or has been any fraud, hiding of

facts or untrue statement made whether before

the POLICY started or afterwards, WE will

cancel this POLICY. YOU must pay back any

BENEFIT we have already paid.



5. MATERIAL CHANGES WE must be informed as soon as possible of any

material change affecting the INSURED or an

INSURED PERSON. WE reserve the right to alter

the terms of the POLICY following a material



6. OTHER INSURANCE If MEDICAL TREATMENT CHARGES claimed under this

POLICY are or may be covered by any other

insurance or indemnity, WE will not pay BENEFIT

or contribute towards that claim. If the other

insurance or indemnity does not cover all of

the MEDICAL TREATMENT CHARGES, WE will pay the

balance, but only up to our limit of BENEFIT.



7. PAYMENT OF BENEFITS WE will pay the BENEFITS directly to the person

or organisation who provides the MEDICAL



For MEDICAL TREATMENT outside the UK WE will

pay all BENEFITS to YOU in Sterling at the

rate of exchange in use when the claim is





[GUARDIAN HEALTH LETTERHEAD]





8. PAYMENT OF PREMIUM Premium is payable in advance of any cover

being provided by this POLICY and must be paid

in the manner agreed by US.



9. SUBROGATION If YOU have a right to claim payment from

another person in respect of anything covered

by this POLICY WE may take over YOUR rights

against that person.



10. WAIVER OF TERMS If WE do not at any time apply or enforce any

of the terms of this POLICY this will not

prevent US from doing so at a later date.



NOTE: THE HEADINGS USED IN THIS SECTION OF THE

POLICY ARE FOR CONVENIENCE OF REFERENCE ONLY

AND DO NOT AFFECT ITS CONSTRUCTION.









[GUARDIAN HEALTH LETTERHEAD]





WHEN YOU REQUIRE TREATMENT



1. VISIT YOUR GP If your GP can provide treatment, YOU need not

inform us, as consultations and treatments

carried out by a GP are not covered under this



If YOUR GP recommends that YOU should see a

specialist, explain that YOU have private

health insurance with Guardian Health. YOUR GP

will pass YOUR details to a SPECIALIST in order

that an appointment can be made.



2. CALL THE GUARDIAN Before YOU go to see the SPECIALIST YOU must

HEALTH HELPLINE BEFORE YOU call the helpline. Either the member or the

SEE YOUR SPECIALIST patient may call, whichever YOU

prefer. The helpline will check the name and

address of the patient against OUR records

using the POLICY number. YOU will need to

provide the POLICY number which YOU will find

on YOUR certificate of insurance and membership

card. The helpline will already know the

details of the cover. YOU will then need to

supply details of the condition being treated

so that WE can check this information against

the cover provided.



3. TAKE YOUR YOU will be sent a claim form together with an

PRE-AUTHORISED CLAIM FORM explanatory letter by the helpline which will

TO THE SPECIALIST contain YOUR policy number, name and address

etc. Please check that this information is

correct and complete any missing details on the

front of the form, then sign and date the form.

The REVERSE of the form must be completed by

YOUR GP or the SPECIALIST in charge of



Please note: the GP signing the form can make

a small charge for this service which is not

covered by the POLICY.



4. WHEN AND WHERE TO SEND Once the form is fully completed PLEASE send it

YOUR CLAIM FORM to Guardian Health. The form should be sent to

US within two months of the start of the



5. WHEN YOU RECEIVE THE When YOU have received treatment and start to

ACCOUNTS receive the accounts, please check them

carefully and make sure YOU have received all

the treatments for which YOU are being charged.

Once YOU are happy with the bill, sign and

forward it to Guardian Health. WE will pay the

bill and send YOU a statement telling YOU what

payments have been made on YOUR behalf.



6. ADDITIONAL TREATMENT After the initial treatment YOU will probably

need to see YOUR SPECIALIST for a routine

post-treatment check-up. However, if YOUR

SPECIALIST recommends any additional treatment

call the Guardian Health helpline before going

for further treatment. They will help YOU and

advise whether an additional claim form needs

to be completed.









[GUARDIAN HEALTH LETTERHEAD]





7. ANY QUESTIONS? Remember the helpline is there for YOU. The

people who take YOUR call will understand YOUR

needs and be able to answer YOUR questions.

They are there for YOUR benefit to provide

advice, guidance and information, so do make

use of their experience. Using the helpline

will assist YOU to get the best value-for-money

treatment and consequently help to keep down

costs. Above all the helpline is completely

confidential so YOU can discuss YOUR needs

without reserve.



Our helpline number is 01303 853400.



[GUARDIAN HEALTH LETTERHEAD]



YOUR QUESTIONS ANSWERED



1. ARE THERE ANY FINANCIAl There is no overall maximum amount that YOU may

LIMITS TO THE AMOUNT I MAy claim in the UK. However, some parts of the

CLAIM? cover, such as private ambulance usage do have

a maximum amount which YOU may claim in any one

POLICY YEAR. Overseas treatment also has an

annual maximum amount that YOU may claim.

Please check YOUR table of benefits for further



2. CAN I SEE MY GP No. WE do not cover the costs of private

PRIVATELY? consultations or treatment with YOUR GP.



3. CAN I GO STRAIGHT TO a No. YOUR GP must refer YOU to the SPECIALIST.

SPECIALIST? If YOU go directly to a SPECIALIST without

referral from YOUR GP it will not be covered,

except in the case of an emergency.



4. WHICH HOSPITALS CAN I Go If YOU are covered on A scale you may use any

TO? HOSPITAL on the Hospital List. If you are

covered on the B scale YOU may use any

HOSPITAL on the Hospital List providing B or C

accommodation. If YOU ARE covered on C scale

YOU may only use A HOSPITAL providing C

accommodation. To ensure correct room

allocation and charges YOU must advise the

HOSPITAL of YOUR level of cover before

treatment. Should YOU wish to use a HOSPITAL

which is not on the Hospital List please

telephone OUR helpline on 01303 853400 who will

be able to advise YOU.



5. IS PREGNANCY COVERED? No. Pregnancy or childbirth is not covered

unless it is complicated by a MEDICAL CONDITION

requiring MEDICAL TREATMENT during pregnancy or

requiring a SPECIFIED OBSTETRIC PROCEDURE.

Details of SPECIFIED OBSTETRIC PROCEDURES may

be found in the definitions section of this



6. IS DENTAL TREATMENt Dental treatment is not covered. However,

COVERED? certain procedures, referred to as SPECIFIED

OROSURGICAL PROCEDURES, are covered. Details

of these may be found in the definitions

section of this documentation.



7. IS EYE TESTING COVERED? No. Eye testing of a routine or preventative

nature is not covered. Neither is the supply

of spectacles.



8. AS I AM COVERED By No. YOU do not lose the benefit of the NHS.

GUARDIAN HEALTH, DOES Indeed, if YOU ARE treated as an IN-PATIENT in

THIS MEAN I CANNOT BE a NHS HOSPITAL YOU will receive a cash benefit

TREATED UNDER THE NHS? for each night YOU stay.



9. IS PRIVATE NURSING At Yes. YOU can receive private nursing at home as

HOME COVERED? long as YOUR SPECIALIST considers it medically

necessary and it is not in any way for

domestic reasons or for mental or psychiatric

illness. It must be carried out by a QUALIFIED

NURSE. Where home nursing for more than 14 days

is required, we may need to request a medical

report from YOUR SPECIALIST to establish YOUR

entitlement to further nursing care.











[GUARDIAN HEALTH LETTERHEAD]





10. AM I COVERED WHILE I Yes. YOU are covered while YOU are abroad on

AM ABROAD? holiday or business. This cover applies in

every country in the world and in addition WE

provide an overseas helpline (details on YOUR

membership card) to help arrange emergency

treatment or repatriation where necessary.



REMEMBER, IF YOU HAVE ANY QUESTlONS PLEASE DO

NOT HESITATE TO CONTACT OUR HELPLINE ON 01303









[GUARDIAN HEALTH LETTERHEAD]



COMPLAINTS PROCEDURE





Any complaint you may have regarding

YOUR POLICY should be addressed in the first

instance, to the intermediary who arranged the

POLICY. If for any reason YOU are dissatisfied,
...

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Agreement#: AG-15740
Pages: 50 pages
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Price: $35.00
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