GEN4963 20/12/13

Emirates Insurance Company (PSC)

Gulf Solutions – level 1

GEN4963 20/12/13

Your policy

Gulf Solutions 1 – provided by Emirates Insurance Company (PSC) for customers of Aviva. These are your policy details, including full terms and conditions. Please read them carefully and then keep them in a safe, accessible place. Throughout this booklet certain words are shown in bold type. These are defined terms and have specific meanings when used in this booklet. The meanings are set out in the ‘Definitions’ section.

We will pay costs up to the amount specified in the benefit table in the event that you sustain accidental injury or contract an illness during the policy year. We will only pay costs that you incur whilst you are a member on the policy for the medical services specified in the policy if they are provided within your selected area. If you have worldwide cover, we will pay for treatment in any country. If you have worldwide cover excluding the USA and Caribbean, we will pay for treatment in any country except the USA and the Caribbean.

You may choose to travel within your selected area to receive eligible elective treatment provided that you: • are fit to travel without medical assistance; and • make and pay for your own travel arrangements both to and from the place where you were injured or became ill. We cover treatment at any hospital within your area, but we do not cover travel costs unless we organise an evacuation.

GEN4963 20/12/13

Before you receive any treatment covered by this policy, we strongly recommend you contact NAS, who will administer any claims you make and advise if the treatment is eligible. They will also help you to find a suitable hospital. This will not apply to emergency admissions. Please note – All treatment and diagnostic tests at a hospital must be by, and under the care of specialists following referral by a general practitioner. Benefit limits apply in the currency in which the policyholder pays the premium. All benefit limits apply to each member each policy year unless otherwise stated.

Benefits Amount payable Notes

Overall annual limit $7,500,000 $ = US dollars

Treatment as an in-patient or a day-patient at a hospital

Hospital accommodation In full Lowest cost single en-suite room. See hospital accommodation benefit term

Intensive and high dependency care

In full

Nursing care In full

Operating theatre In full

Specialists’ fees In full Surgeons’, anaesthetists’ and physicians’ fees

Diagnostic tests In full

For example endoscopy, removal of tissue for biopsy, blood tests, X-rays, scans and ECGs

CT, MRI and PET scans In full

Treatment by a physiotherapist, dietician, occupational therapist and alternative therapist

In full On specialist referral

Reconstructive surgery In full

We will cover a surgical procedure to restore your appearance if the procedure immediately follows an accident or treatment for cancer. See reconstructive surgery benefit term

Internal prostheses In full For example heart valves and artificial joints

Kidney dialysis In full See kidney dialysis benefit term

Psychiatric treatment In full up to 30 days

Rehabilitation Up to 25 days

Physical therapies given as an in-patient immediately following treatment that is covered by the policy, for each medical condition every policy year

Treatment as an out-patient – by or under the care of a specialist

Consultations with a specialist

In full

Diagnostic tests In full For example blood tests,

GEN4963 20/12/13

X-rays, scans, ECGs

CT, MRI and PET scans In full

Radiotherapy/chemotherapy In full

Treatment for cancer In full

Surgical procedures In full

Emergency dental treatment Up to $2,250 See emergency dental treatment benefit term

Hire or purchase of medical aids such as wheelchairs, crutches, stoma supplies and podiatry appliances if needed after in-patient, day-patient or out-patient treatment

Up to $750 Subject to appliances exclusion

Specialist referred treatment by a speech therapist

In full

Up to 10 speech therapy sessions following eligible treatment as an in-patient or day-patient for trauma or a stroke

Physiotherapy following eligible treatment as an in-patient or day-patient

In full See physiotherapy benefit term

Additional benefits

Organ transplant

In full for the recipient. Harvesting costs only for the donor

We will cover heart, lung, pancreas, liver, kidney and bone marrow transplants only. Cover is only available for the donor if the recipient is covered by the policy

Complications of pregnancy and childbirth

In full See pregnancy complications benefit term

Newborn cover Up to $150,000

Cover is only available where the mother is covered by the policy, for acute conditions occurring during the first 112 days following birth. See newborn cover benefit term

External prostheses Up to $7,500 for each condition

For example artificial limbs

Parent hospital accommodation when staying with a child covered by the policy

In full

Child aged under 18 undergoing treatment covered by the policy, one parent only; see parent hospital accommodation benefit term

Cash benefit for each night spent as an in-patient in a government or charitable hospital

$225 each night

Up to 28 nights when undergoing treatment covered by the policy; see cash benefit benefit term

Nursing at home by a nurse Up to 60 days

Immediately following treatment as an in-patient or day-patient that is covered by the policy; see nursing at home benefit term

Hospice donation $225 each day Up to 90 days; see hospice benefit term

Local ambulance In full See local ambulance benefit term

GEN4963 20/12/13

Benefits Amount payable Notes

Everyday healthcare

Consultations with a general practitioner

Up to a combined limit of $3,750

Up to 20 consultations. We only cover home visits if they are clinically necessary

Minor surgery by a general practitioner

Carried out under local anaesthetic in the general practitioners surgery

Tests carried out by or referred by a general practitioner

Physiotherapy on referral by a general practitioner

In full Up to 10 sessions each condition; maximum of 30 sessions each policy year

Vaccinations Up to $750

In line with World Health Organisation guidelines for your country of nationality and country of residence. This does not cover vaccinations for leisure travel

Child vaccinations (for members aged 17 or under)

In full

In line with World Health Organisation guidelines for your country of nationality and country of residence. This does not cover vaccinations for leisure travel

Child development assessments

In full See child development assessments benefit term

Prescription drugs and dressings, supports and appliances (including prostheses)

Up to $4,500 See prescription drugs and dressings benefit term

Routine maintenance of chronic conditions

Up to $30,000

For all chronic conditions except cancer. We do not apply this limit to cancer treatment; see chronic conditions benefit term

Hormone replacement therapy (HRT)

In full

If menopause is due to medical intervention and treatment is medically necessary. Up to 18 months in total whilst you are a member of the policy, not each policy year

Routine sight examinations Up to $150 for each examination

We cover one examination every two years

Prescription glasses, sunglasses or contact lenses

Up to $150 See optical benefit term

Benefits Amount payable Notes

Condition management

Treatment for HIV/AIDS Up to $15,000

Treatment for acute phases of chronic conditions

Up to a combined limit of $75,000

We will cover unexpected acute flare-ups of a chronic condition or a congenital condition until your

Treatment for acute phases of congenital conditions

GEN4963 20/12/13

after diagnosis condition is re-stabilised

Benefits Amount payable Notes

Evacuation and emergency assistance

Costs for your evacuation to a place where you can receive treatment that the policy covers

In full See evacuation benefit term

Worldwide extension for emergency evacuation and treatment

In full up to 60 days See areas of cover benefit term

Payment for accommodation costs (other than at a hospital) needed in connection with an evacuation. This benefit is not available if you choose repatriation

Up to $150 each night Up to $3,000 each evacuation

Local burial or transport of mortal remains

Up to $11,250 See local burial benefit term

Benefits Amount payable Notes

Repatriation and compassionate travel

Repatriation in the event of an evacuation

In full See repatriation benefit term

Economy return flight (or equivalent) following the death of a close relative

Up to $1,500 See compassionate travel benefit term

Economy return flight (or equivalent) for a close relative or legal guardian to supervise your dependent children in their country of residence following your evacuation or repatriation OR Economy return flight (or equivalent) for your dependent children to stay with a close relative or legal guardian following your evacuation or repatriation

Up to $1,500 each policy year Up to $1,500 for each child each policy year

You can choose from either option each time an evacuation or repatriation takes place

Accommodation and subsistence costs in the area you have been evacuated to for your husband or wife following an evacuation

Up to $150 for each night up to 30 nights

Cover is only available if your husband or wife is in the same country of residence

Costs for local travel each way between accommodation and a hospital for your husband or wife following an evacuation

Up to $37.50 each day up to 30 days

Cover is only available if you are receiving treatment as an in-patient and your husband or wife is in the same country of residence

Economy return flight (or equivalent) for a member’s

Up to $1,500 Cover is only available if your husband or wife is in

GEN4963 20/12/13

husband or wife to accompany them following an evacuation

the same country of residence

Return home to recuperate Up to $1,500

Covers cost of an economy return flight (or equivalent) following eligible evacuation. See compassionate travel benefit term

Option to increase cover Please see your policy schedule to see if this option applies to you.

Maternity option

Benefit limits shown below apply to each member each policy year unless otherwise stated.

Benefits Amount payable Notes

The following benefits are subject to a combined limit of $15,000 for each member every policy year; see maternity benefit term

Antenatal care See antenatal benefit term

Postnatal care See postnatal benefit term

Midwife led birth

Hospital led birth

Birth under charitable or nationally funded care

$750 See funded birth benefit term

Newborn cover Routine medical care for the baby during the first seven days after the birth

Investigations into the cause of infertility

See infertility benefit term

Benefit Terms The benefit tables tell you which benefit terms apply to you. Antenatal We cover antenatal costs for example:

consultations with a mid-wife

tests carried out in the first trimester – for example mucal translucency test, dating scan and blood tests

scans for abnormalities

medication to prevent complications of pregnancy, for example blood thinning

anti-D injections. We do not cover the costs of antenatal classes, 4d or 5d scans or mother massages. Areas of cover If you have worldwide cover we will cover you for treatment in any country.

GEN4963 20/12/13

If you have worldwide cover excluding the USA and Caribbean we will cover you for treatment in any country except the USA and Caribbean. You will be covered in the USA and Caribbean:

in the event of an emergency if you are there for holidays and business trips for a maximum cumulative total of 60 days in any one policy year. We will only cover emergency evacuation benefit, emergency in-patient hospitalisation and emergency treatment, administered by a general practitioner, and

for in-patient or day-patient treatment following an evacuation from your area, if we pre-authorise that treatment.

Cash benefit We will pay cash benefit if:

accommodation and all treatment is provided by a government or charitable hospital with no charge, and

you do not claim any other benefit under the policy for the same hospital stay.

We only pay cash benefit for a condition that we would pay for if the hospital charged you for the treatment. Child development assessments We cover costs for one of each of the following assessments once only at age up to 18 months:

speech and language,

height and weight,

fine motor skills,

sight and

hearing.

We will also cover costs for one of each of the following assessments once only at pre-school age for:

fine and gross motor skills,

height and weight,

basic hearing and

visual acuity.

All tests must be carried out by a general practitioner or paediatrician. Chronic conditions We will cover:

treatment by a specialist of a chronic condition, follow-up consultations and diagnostic tests with a specialist to monitor you when you have finished treatment for an acute condition and

drugs prescribed by your specialist for the routine maintenance of a chronic condition. We cover drugs which are only available on prescription. We do not cover medication, vitamins or homeopathic treatments which are available over the counter unless they are needed to work in conjunction with your overall prescription.

The costs of palliative treatment for all conditions except cancer will fall within the chronic conditions benefit limit. We only cover treatment for conditions that are not excluded on your policy.

GEN4963 20/12/13

Compassionate travel We cover:

travel costs to return home to recuperate following an evacuation – we will cover economy class travel costs from: - the place where you received treatment to your country of nationality, and - back to your country of residence (or the place where you were evacuated to, or the place where you were before the evacuation if that is where you want to go) after your recuperation. We will cover these costs only when you are medically discharged and fit to travel on commercial transport. We do not cover the costs of treatment related to the recuperation.

the cost of one economy return flight (or equivalent), up to the benefit limit specified, for each member, to travel to attend the funeral of a close relative.

Emergency dental treatment We cover costs for treatment which you need as a result of an accidental dental injury caused by external trauma, for example a fall or accidental impact, to teeth. This includes the initial relief of pain, treatment necessary to preserve your natural dental structure, and any related permanent reconstruction work. The damage must become apparent within 7 days of the external trauma taking place. We cover treatment carried out up to a month after the accident. BUT: We do not cover treatment if the damage is caused by;

normal wear and tear,

food or drink, whether or not it contains a foreign body, or

participation in a contact sport if the appropriate mouth protection is not used. Evacuation If you are ill or injured, and the place where you are does not have either the facilities or equipment to treat you, we will discuss the situation with your general practitioner or specialist and decide whether or not there is a medical need for an evacuation. If you do need to be evacuated, we will make all arrangements for that evacuation through our assistance service. An evacuation will take you to the nearest appropriate facility for treatment as an in-patient or day-patient which you need. We, together with our assistance service, will decide whether it is safe for you to fly and whether you need an air ambulance, or whether an economy class commercial flight is more appropriate. If we, or our assistance service, give specific written authorisation, this benefit will include the cost of one other member or close relative travelling with, staying with or escorting you if it is necessary. For example, if you cannot conduct your own affairs and the member or close relative holds power of attorney authorising them to act for you. We do not cover:

any form of mountain rescue,

any evacuation from or to any seagoing vessel, or offshore installations such as oil rigs, or

any evacuation from or to any area or country if our assistance service consider it would endanger their safety for them to do so.

Funded birth

GEN4963 20/12/13

If a member gives birth and all costs for the birth are paid by national or charitable funding we pay the policyholder a bonus of $750. Hospice We will pay a donation directly to the hospice when:

you receive care as a patient of a hospice, and

we have previously covered treatment for the condition. Hospital accommodation We will pay for your accommodation as an in-patient or day-patient in the lowest cost single en-suite hospital room. If you are accommodated in a higher cost room we will only pay the cost of the lowest cost room and this could leave you with a shortfall that the policy does not cover. Infertility We cover consultations and diagnostic tests for infertility where you were unaware of your infertility when you joined the maternity option. Kidney dialysis

We cover short-term kidney dialysis:

if you are admitted to hospital for eligible treatment as an in-patient for another condition and you need your regular kidney dialysis during this admission, or

if required as a result of secondary kidney failure during eligible treatment as an in-patient, or

immediately before or after a surgical procedure to transplant a kidney as part of treatment as an in-patient.

BUT: We do not cover kidney dialysis as part of long-term treatment of a chronic condition. Local ambulance Road or air ambulance transport needed out of medical necessity to take you to the next available and appropriate hospital or licensed medical facility. We will only pay for an air ambulance if a road ambulance is not suitable and (unless it is an emergency) it is arranged by us. Local burial If a member dies, we will cover (up to the benefit limit specified) either:

burial or cremation at the place of death, or

the cost of transportation of body or ashes to the country of nationality. In either case, the policy does not cover the costs of a religious practitioner. Maternity If you pay for any maternity costs upfront, before you receive the treatment, we will only reimburse you for treatment that is covered by the policy after it has taken place.

GEN4963 20/12/13

Newborn cover This benefit covers treatment for:

all acute conditions which occur during the first 112 days following birth,

up to a combined maximum total of $150,000 during the life of the policy. If the child is added as a member of the policy, conditions which occur after the 112th day following birth will not be subject to this benefit limit. Nursing at home We cover home nursing if:

your specialist recommends and supervises it,

it takes place in your home,

it immediately follows treatment as an in-patient or day-patient that is covered by the policy,

it is carried out by a nurse and is the type of treatment that only a nurse can provide, and

you need it for medical reasons.

We do not cover nursing at home to help with your mobility, personal care or preparation of meals. Optical We pay up $150 for each set of contact lenses, glasses or sunglasses bought as a result of a change in your optical prescription. You must buy the contact lenses or glasses within three months of the eye test which discovered the change in prescription. We do not cover the cost of optical solutions and accessories (for example cases, cleaning cloths) or contract schemes (for example monthly disposable contact lens schemes). Parent hospital accommodation We will pay for hospital accommodation for one parent only staying with a child aged under 18 undergoing treatment covered by the policy as an in-patient or day-patient. We will pay for accommodation in the lowest cost single en-suite hospital room. If the parent is accommodated in a higher cost room we will only pay the cost of the lowest cost room and this could leave you with a shortfall that the policy does not cover. Physiotherapy If you need more than 10 sessions of physiotherapy for the same medical condition in the same policy year we will require full clinical details from your specialist before we can make a decision about cover. If your condition has become chronic further treatment will be covered under the routine maintenance of chronic conditions benefit of your policy. Postnatal We will cover postnatal care including:

tests by a paediatrician within 24 hours of birth, including a hearing test,

heel prick test,

one consultation for the mother with a specialist or midwife up to 10 weeks after the birth.

We will also cover regular visits to a clinic or health centre for the baby to be weighed and measured during the first six months following birth. If these visits are carried out as home visits

GEN4963 20/12/13

we will not pay for more than six and any additional tests will need to be carried out in a clinic or health centre. We do not cover the costs of postnatal classes, or mother or baby massages. Pregnancy complications

The conditions which we cover as complications for the purposes of this benefit are:

ectopic pregnancy (development of foetus outside the womb)

miscarriage (if you have miscarried, but not investigations into the cause of repeated miscarriages)

still birth

hydatidiform mole (cell growth abnormality in the womb)

retained placenta (afterbirth retained in the womb)

pre-eclampsia (a condition with a number of symptoms, including high blood pressure and fluid retention)

eclampsia (a coma or seizure during pregnancy and following pre-eclampsia)

gestational diabetes (if diabetes begins in pregnancy, but not before)

caesarean sections – in specific clinical circumstances (we will need full clinical details from your specialist before we can make a decision about your cover)

termination of pregnancy if medically necessary.

Prescription drugs and dressings We will cover drugs, dressings, supports and appliances (including prostheses) which are only available on prescription. We do not cover medication, vitamins or homeopathic treatments which are available over the counter unless they are needed to work in conjunction with your overall prescription. We do not pay for pre-payment prescription cards. Reconstructive surgery We will cover a surgical procedure to restore your appearance if:

the surgical procedure immediately follows an accident, or treatment for cancer, and

the accident or cancer treatment took place when you were covered under the policy and you have had no break in cover since then. Repatriation If evacuation is medically necessary for your circumstances, you can choose repatriation. This means that, instead of taking you to the nearest appropriate facility, we will pay to transport you from the country where you are to:

your country of nationality, or

your country of residence.

We will only authorise and arrange repatriation if:

our assistance service and the doctors treating you agree that it is safe to do so

the country where you wish to travel to (either your country of nationality, or your country of residence) is in the area which the policyholder selected for the policy. For example, if:

– your country of nationality is the USA – the policy’s area for you is worldwide excluding USA and Caribbean, and – your country of residence is Germany

GEN4963 20/12/13

we will only be able to repatriate you to your country of residence because that is in the area covered by the policy. If you choose repatriation, we will not cover the accommodation costs element of the evacuation benefit.

Benefits for cancer treatment

This section explains what we will pay for cancer treatment.

Benefits Amount payable Notes

Hospital charges for surgery and medical admissions

In full

Lowest cost single en-suite room See hospital accommodation and preventative treatment benefit terms

Nursing care In full

Operating theatre In full

Specialists’ fees In full Surgeons’, anaesthetists’ and physicians’ fees

Reconstructive surgery In full

Post-surgery services In full For example, specialist nursing, feeding. See post-surgery services benefit term

Chemotherapy In full See chemotherapy benefit term

Radiotherapy In full See radiotherapy benefit term

Bisphosphonates (bone strengthening drugs)

In full We pay for bisphosphonates when they are being used to treat metastatic bone disease

Treatment for side effects of chemotherapy and radiotherapy

In full See side effects benefit term

Wigs Up to $150

In total whilst you are a member of the policy (not each policy year).See wigs benefit term

External prostheses Up to $7,500 See prostheses benefit term

Bone marrow transplants

In full for the recipient. Harvesting costs only for the donor

See bone marrow transplants benefit term. Cover is only available if the recipient is covered by the policy

Monitoring Up to 5 years See monitoring benefit term

Ongoing medical needs Up to 5 years See ongoing needs benefit term

Preventative treatment for cancer

In full See preventative treatment benefit term

End of life care In full

We will pay for end of life care in a hospital if it is medically necessary for you to be there

Hospice donation $225 each day, up to 90 days See hospice benefit term

Take home medication for oncology treatment

Up to $7,500 Prescribed by your specialist. This includes hormone therapy

GEN4963 20/12/13

Benefit Terms Bone marrow transplants We will pay for:

the collection of

storage of, and

implantation of

bone marrow. If the bone marrow comes from another person, we will pay for its collection. We do not pay for search costs to find a donor for a transplant. We will pay for drugs for you to take home at the time you are discharged from hospital following a bone marrow transplant. Chemotherapy We will pay for chemotherapy in full if you have the treatment:

as a day-patient or an in-patient

as an out-patient, or

at home. We will pay for hormone therapy in full if you need it to shrink a tumour before you have surgery or radiotherapy. Hormone therapy prescribed at any other time will be taken from the take home medication benefit. Hospice We will pay a donation directly to the hospice when:

you receive care as a patient of a hospice, and

we have previously covered treatment for the condition.

This benefit is the same as that available under core cover and is not an additional benefit. Monitoring We will pay for monitoring for up to five years after your treatment for cancer has finished. This includes diagnostic tests, consultations and one complex scan each policy year. We do not pay for monitoring after treatment for non-melanoma skin cancer. Ongoing needs If you have any ongoing medical needs, such as regular replacement of tubes, drains or stents, we will pay for up to five years after your treatment for cancer has finished. Post-surgery services Medical services Following surgery for cancer there are a number of different specialist services that you may need, depending on the type of cancer you have and the surgery you have had. We will pay for consultations immediately following surgery with, for example, a:

GEN4963 20/12/13

dietician in order to stabilise your diet following surgery or chemotherapy

stoma nurse to show you how to care for your stoma

nurse to show you how to manage lymphoedema. Artificial feeding

If, due to your cancer or treatment of your cancer, you have problems eating and need artificial feeding, we will pay for the insertion and replacement of a tube (for example, a central line, PICC line or PEG) to deliver the food (called nutrition). Whilst you are receiving treatment for cancer we will pay for the nutrition itself, although once your cancer treatment has finished we will no longer pay for the nutrition itself, or maintenance of the line (for example cleaning of the line). Preventative treatment We will pay for surgery to prevent further cancer only if you have already had treatment for cancer that we have paid for – for example, we will pay for a mastectomy to a healthy breast in the event that you have been diagnosed with cancer in the other breast. We will not pay for surgery where you have no symptoms of cancer, for example where you have a strong family history of cancer such as breast cancer, or bowel cancer. Prostheses We will pay in full for prostheses that are inserted into the body. For external prostheses following surgery for cancer – for example arms, legs, breasts, ears – we will contribute up to $7,500 towards the cost of the first prosthesis after your surgery. This includes any cost for fitting the prosthesis. This benefit is the same as that available under core cover and is not an additional benefit. Radiotherapy We will pay for radiotherapy in full as:

a day-patient or an in-patient if you need it for medical reasons, or

an out-patient. Side effects Whilst you are receiving chemotherapy or radiotherapy, we will pay for treatment prescribed by your specialist that you need to deal with their side effects, for example:

antibiotics

anti-sickness drugs

steroids

pain killers

drugs to boost your immune system, and

blood transfusions.

Wigs

We will pay up to $150 towards the cost of a wig if you need one due to hair loss caused by cancer treatment.

GEN4963 20/12/13

Exclusions Addictions and substance abuse We do not cover treatment of any illness or injury which is wholly or partially a result of any addiction (for example alcohol addiction or drug addiction), or substance abuse (for example alcohol abuse or solvent abuse), or which you need as a direct or indirect result of any such abuse or addiction.

Allergy testing We do not cover any diagnostic tests or treatment for allergies. Appliances We do not cover hearing aids or neurostimulators. BUT: We do cover

hand, back and knee braces required immediately after surgery,

heart pacemakers and implantable cardioverter defibrillators.

Areas of cover We do not cover non-emergency treatment outside your area of cover. This exclusion does not apply if you have worldwide cover. Birth control We do not cover birth control, for example contraceptive pills and devices, or sterilisation. Circumcision We do not cover circumcision. Complementary treatment We do not cover alternative or complementary treatments and medicines, for example pilates, colonic irrigation, ayurvedic medicine, Chinese medicine, acupuncture or homeopathy. Cosmetic treatment We do not cover treatment, or any consequence of treatment, that is intended to change your appearance (for example a tummy tuck, facelift, tattoo, ear piercing), whether or not this is carried out for psychological or medical reasons. We do not cover treatment, or any consequence of treatment, to remove undiseased tissue. BUT: We will cover a surgical procedure to restore your appearance if:

the surgical procedure immediately follows an accident, or treatment for cancer, and

the accident or cancer treatment took place when you were covered under the policy and you have had no break in cover since then.

We advise that you contact us before treatment begins so that we can confirm if you are covered.

GEN4963 20/12/13

Dental treatment We do not cover:

non medical items such as mouthwash, toothpaste, dental floss and teeth whitening agents

dental treatment performed for cosmetic reasons such as teeth whitening and veneers or

treatment carried out by a dentist or dental surgeon

treatment of gum disease or treatment carried out to help you wear dentures, bridges or implants.

BUT: We do cover treatment which you need as a result of an accidental dental injury caused by external trauma, as described in the emergency dental treatment benefit term.

Developmental delay We do not cover treatment in relation to the developmental delay of children, for example mobility, learning, continence and social and behavioural disorders, for example attention deficit hyperactivity disorder (ADHD). Dialysis We do not cover kidney dialysis as part of long-term treatment of a chronic condition. Epidemics We do not cover treatment directly or indirectly arising from or required as a consequence of epidemics which have been put under the control of local public health authorities. Experimental treatment We do not cover experimental treatment, unless it meets the criteria set out below. We only pay for treatment that is:

proven or established within common UK practice, for example, a drug used within the terms of its licence or approved by NICE for use in the NHS, or

supported by peer reviewed and published clinical evidence which proves that the treatment has positive clinical outcomes, and

is acceptable clinical practice, practised widely by specialists in your country of residence. If your treatment meets these requirements, we will not exclude treatment on the basis that it is experimental. Before we can decide if your proposed treatment is eligible, we must receive all the clinical details we need from your specialist. We must confirm your cover in writing before any treatment begins. BUT: Even if we consider your treatment to be experimental because it does not satisfy all the requirements listed above, we will still pay for the lowest cost of either:

the experimental treatment or

the equivalent established treatment usually provided for your condition, if this is available. Please note: No payment will be made if there is no established treatment available for your condition (for which the experimental treatment is being proposed). If you undergo experimental treatment that is not successful, we will not pay towards further treatment of your condition or for any other condition that you develop as a result of undergoing experimental treatment.

GEN4963 20/12/13

Eyesight We do not cover treatment for:

short sight or long sight, such as laser eyesight correction surgery, or

macular degeneration. Fertility We do not cover:

any treatment related to gender selection,

the freezing of eggs or sperm following treatment for cancer,

sterilisation or any other form of family planning,

the reversal of sterilisation, or

vasectomy reversal. General practitioner charges We do not cover charges or fees for:

registering with a general practitioner or medical facility,

completion of a claim form or referral letter by a general practitioner,

a general practitioner to write a prescription, or

home visits by a general practitioner unless they are clinically necessary. Genetic conditions We do not cover genetic conditions. Growth hormone therapy We do not cover any growth hormone therapy. Hair loss and dandruff We do not cover treatment or associated expenses for hair loss including:

treatment for alopecia, or

wigs or hair pieces. BUT: We will pay up to $150 towards the cost of a wig if you need one due to hair loss caused by cancer treatment. We do not cover treatment for dandruff. Health hydros We do not cover treatment received in health hydros, nature care clinics or similar establishments. Infertility - please see your policy schedule to see which options your policy includes

We do not cover treatment directly or indirectly arising from or required in connection with:

infertility, or

any form of assisted reproduction. OR

GEN4963 20/12/13

If your policy includes the maternity option, the exclusion that applies to you is:

We do not cover treatment directly or indirectly arising from or required in connection with:

infertility (although we do cover investigations into the causes of infertility), or

any form of assisted reproduction. Multiple consultations We do not cover more than one consultation with a medical specialist in any 24 hour period unless you are referred by a general practitioner. Natural Disasters We do not cover treatment for illness or injury arising directly or indirectly from a natural disaster such as earthquakes, flood or tornado. Non-medical admissions We do not cover treatment received in private beds registered as nursing homes or a hospital where the hospital has effectively become your home or place where you live permanently or if the reason you have been admitted is that you need help with mobility, personal care and preparation of meals. We only pay if you have been admitted to hospital for medical reasons. Non–medical services We do not cover treatment that is not medically necessary, or any treatment not directly related to medical care. This includes:

nursing at home to help with your mobility, personal care, preparation of meals or nursing care whilst travelling,

television, barber or beauty services or services for your guests whilst they are visiting you in hospital,

non-medical treatment such as mouthwash, toothpaste, lozenges, antiseptics, milk formula, food supplements, skin-care products, shampoos and multi-vitamins (unless they are prescribed as replacement therapy for known vitamin deficiency symptoms), and all equipment not intended to improve a medical condition or injury including but not limited to air conditioners or air purifying systems, arch supports, convenience items/options, exercise equipment and sanitary supplies,

supplies, treatment and services for smoking cessation programmes and treatment for nicotine addiction,

any treatment or diagnostic tests for purposes other than medical treatment and/or diagnosis such as for employment, travel, licensing or insurance purposes, or

any additional services or educational programmes related to disability. Organ transplants We do not cover:

mechanical implants, unless they are used whilst awaiting an organ transplant,

animal organs,

donor purchase, or

the costs associated with searching for an organ. BUT: We will cover the cost of transporting an organ within the country of treatment/transplant to the medical facility where the transplant is to take place.

GEN4963 20/12/13

Pregnancy and childbirth – please see your policy schedule to see which options your policy includes We do not cover pregnancy and childbirth. BUT: we do cover the specific complications of pregnancy listed under the treatment for complications of pregnancy and childbirth benefit. OR If your policy includes the maternity option the exclusion that applies to you is: We do not cover:

surrogacy or the associated costs of surrogacy including ante-natal care and delivery and artificial fertilisation for surrogates, or

termination of pregnancy unless it is medically necessary. Preventative treatment We do not cover treatment, for example drugs or surgery, which aims to prevent a disease or illness. BUT: We do cover:

surgery to prevent further cancer if you have already had treatment for cancer that we have paid for, and

vaccinations in line with World Health Organisation guidelines for your country of nationality and country of residence.

Psychiatric We do not cover treatment of

psycho-geriatric conditions of any kind, or

eating disorders .

or any related conditions. Rehabilitation We do not cover rehabilitation unless it takes place as an in-patient immediately following treatment covered by the policy, and then only for a maximum of 25 days for each medical condition every policy year. Routine medical examinations and screening We do not cover routine physical examinations by a general practitioner, for example gynaecological investigations and tests, prostate screening, hepatitis, HIV or STI tests, or hearing tests. BUT: We do cover child development assessments. Self-inflicted injury We do not cover treatment directly or indirectly arising from or required as a result of self inflicted injury.

GEN4963 20/12/13

Sexual dysfunction We do not cover treatment of sexual dysfunction, such as impotence. BUT: We do cover investigations, including diagnostic tests, to find the cause of sexual dysfunction.

Sexually transmitted disease We do not cover venereal disease or any other sexually transmitted diseases. This exclusion does not apply to treatment for HIV/AIDS. Sleep disorders and sleep problems We do not cover treatment directly or indirectly related to sleep disorders and sleep problems, such as snoring, insomnia or sleep apnoea (when breathing stops temporarily during sleep). Sport – hazardous sports We do not cover treatment of an injury sustained whilst you are taking part in hazardous sports including aerial flight, power vehicle racing, water sports, horse riding, mountaineering, martial arts such as judo, boxing, wrestling and bungee jumping. Sport – professional sports We do not cover treatment of an injury sustained whilst you are:

training for, or

taking part in sport for which you are paid or funded by sponsorship or grant (unless you receive travel costs only). This exclusion does not apply if you are coaching the sport. Stem cell transplants We do not cover stem cell transplants. Travelling against medical advice

We do not cover treatment if it is needed after travelling against medical advice. War and hazardous substances We do not cover treatment directly or indirectly arising from or required as a consequence of:

war, invasion, acts of foreign enemy hostilities (whether or not war is declared), civil war, rebellion, revolution, insurrection or military or usurped power, mutiny, riot, strike, martial law or state of siege, attempted overthrow of government or any acts of terrorism, or

chemical contamination or contamination by radioactivity from any nuclear material whatsoever or from the combustion of nuclear fuel

when

you have entered a known area of conflict identified by an EU government department, such as the British Foreign and Commonwealth Office, or

you were an active participant. Warts / verrucas We do not cover treatment of warts or verrucas.

GEN4963 20/12/13

Weight loss surgery We do not cover treatment that is directly or indirectly related to:

bariatric surgery (weight loss surgery), such as gastric banding or a gastric bypass, or

the removal of surplus or fat tissue.

Underwriting Medical History Disregarded (MHD) We do not apply any personal medical exclusions to your policy as a result of pre-existing conditions.

Conditions Who can be a member? The policy covers everyone named on the policy schedule.

The policyholder

the policyholder’s husband or wife and

their children

can all be members. Adding members The policyholder may add new members to the policy at any time by contacting us. Newborn babies A member can add his or her newborn baby to the policy without underwriting if the policyholder applies to us within three months of the baby’s birth. Policy duration and premiums The policy lasts for one year and (if we still offer Gulf Solutions) we will automatically renew it unless the policyholder notifies us that they do not wish to renew it. We also have the option not to renew the policy, for example if trade sanctions were imposed or legislation passed which meant that we could no longer offer cover. If we do not renew the policy, we will tell the policyholder. We reserve the right to close the Gulf Solutions product at the renewal date. If this happens, we will contact the policyholder to discuss the options. The policy schedule shows how much to pay, when and by which payment method. We will advise the policyholder if the premium changes. We will collect premiums:

in advance of the date they are due

unless the policyholder tells us to cancel the policy in time for us to stop collecting the payment.

GEN4963 20/12/13

We do not pay any claims if premiums are not paid to date at the time your treatment takes place. Each annual premium payment is for one year’s cover. Compliance with policy terms We shall not be liable under this policy if you fail to comply with its terms and conditions, except where the

circumstances of any claim are unconnected with that failure and no fraud is involved.

Change of risk The policyholder must tell us as soon as possible about:

any changes relating to members, for example a change of name, address, if somebody works for the diplomatic service or a foreign embassy, or

of any other changes that affect information given to us relating to the application for cover under this policy, such as a change of country of residence or area.

We reserve the right to alter the premiums or policy terms or cancel cover for a member of the policy following a change of risk, to the extent permissible by the laws of your country of residence. We will always write to your last known address with details of any changes to your cover. Changes to cover We may change the terms and conditions of the policy at the renewal date. If there are changes to the policy, we will let you know before the next renewal date. If the policyholder decides to cancel the policy as a result of those changes, they must let us know in writing. Only we can make changes to the terms and conditions of the policy. Territorial limits Territorial limits under this policy are arranged into two geographical areas. The policyholder selects the area that they need at the start date and can change this:

at any renewal date, or

at any time if they can show us that a member will live in a different area for 6 months or more.

Benefit under this policy is limited to that described in the areas of cover benefit term. Payments for ineligible treatment If we agree to pay for treatment that is not normally eligible on the policy, this does not mean that we will make another payment for treatment in the same or similar circumstances. Any payments we do make towards the cost of ineligible treatment will count towards any benefit limit listed in the policy terms and conditions. Second opinions We will only pay for a second (or subsequent) opinion from a general practitioner or specialist in respect of the same condition if we authorise it. If we ask for a second opinion, we will make and pay for the arrangements.

GEN4963 20/12/13

Definitions Acute condition A disease, illness or injury that is likely to respond quickly to treatment which aims to return you to the state of health you were in immediately before suffering the disease, illness or injury, or which leads to your full recovery. Advice Any

consultation,

advice or

prescription

from a general practitioner or specialist. Area The area of the world for which the policyholder has selected cover. These are identified as:

worldwide - any country

worldwide excluding the USA and Caribbean - any country except the USA and the Caribbean.

Cancer A malignant tumour, tissues or cells, characterised by the uncontrolled growth and spread of malignant cells and invasion of tissue. Chemotherapy Drugs that are used to treat cancer. These include:

drugs used to destroy cancer cells or prevent tumours from growing (these could be cytotoxic drugs, targeted or biological therapy drugs), and

drugs used to strengthen bones (these are called bisphosphonates). For this policy, hormone therapy is not chemotherapy. Chronic condition A disease, illness or injury which has one or more of the following characteristics:

it needs ongoing or long-term monitoring through consultations, examinations, check-ups and/or tests

it needs ongoing or long-term control or relief of symptoms

it requires your rehabilitation or for you to be specially trained to cope with it

it continues indefinitely

it has no known cure

it comes back or is likely to come back.

Close relative A member’s:

husband or wife

GEN4963 20/12/13

child or step-child

brother

sister

parent

parent-in-law

grandparent

brother-in-law or

sister-in-law.

Congenital conditions A medical condition that is present at birth, acquired at the foetal development stage. Country of nationality For the purposes of the policy, this will be the country for which you hold a passport. If you hold more than one passport, the country of nationality will be the country you were born in. Country of residence The country in which you normally live and for which you hold a visa enabling you to work or reside there at the time the policy is first taken out, or at each subsequent renewal date. Day-patient A patient who is admitted to a hospital or day-patient unit because they need a period of medically supervised recovery but does not occupy a bed overnight. Diagnostic tests Investigations, such as X-rays or blood tests, to find or to help to find the cause of your symptoms. Evacuation The transportation of a member from the country of residence, or country of incident (if different), to the nearest appropriate facility, as determined by a member’s general practitioner or specialist in conjunction with our medical advisers and the prescribed assistance service for the sole purpose of receiving treatment as an in-patient or day-patient. General practitioner A general medical practitioner who:

holds a primary degree in medicine or surgery recognised by the World Health Organisation and

is legally licensed to practice in the country where treatment is provided. Hospice A hospital or part of a hospital recognised as a charitable or government funded hospice by us which is devoted to the care of patients with progressive disease (where curative treatment is no longer possible) on an in-patient or domiciliary basis. Hospital An establishment which is legally licensed as a medical or surgical hospital under the laws of the country in which it is situated.

GEN4963 20/12/13

In-patient A patient who is admitted to hospital and who occupies a bed overnight or longer, for medical reasons. Medically necessary Treatment or a medical service which is needed for your diagnosis and is appropriate in the opinion of a qualified general practitioner or specialist. By generally accepted medical standards, if it is withheld your condition or the quality of medical care you receive would be adversely affected. Member / you / your A person named as the policyholder or a member on the policy schedule. Midwife A practitioner who has:

completed a midwifery education program based on the ICM Essential Competencies for Basic Midwifery Practice and the framework of the ICM Global Standards for Midwifery Education, recognised in the country in which he/she is resident and

has the required qualifications to be registered and/or legally licenced to practice midwifery in the country in which he/she is resident.

Newborn Any child from birth up to 112 days old. Nurse A qualified resident or daily nurse whose name is currently on any register of nurses maintained by any statutory nursing registration body within the country in which he/she is resident. Out-patient A patient who attends a hospital, consulting room, or out-patient clinic and is not admitted as a day-patient or an in-patient. Policy Our contract of insurance with the policyholder providing cover as detailed in the policy document. The application and policy schedule form part of the contract and you should read these together with the policy document (as amended from time to time). Policyholder The person named as the policyholder in the policy schedule. Policy year The period of time from the date the policy began or renewed until the day before the next renewal date. Rehabilitation Physical therapies given with the aim of restoring health and mobility after illness or injury, until the member can be self-sufficient.

GEN4963 20/12/13

Related Illnesses or injuries are related if, in our medical opinion, one is a result of the other or if each is a result of the same illness or injury. Renewal date The annual anniversary of the start date. Specialist A registered medical or dental practitioner who:

has at any time held, and is not precluded from holding, a substantive consultant appointment in that specialty in the United Kingdom in a National Health Service hospital, or

has at any time held and is not precluded from holding a substantive consultant appointment which we on professional advice accept as being of equivalent professional status, or

is recognised as a specialist by the statutory bodies of the country in which he/she practices and who is recognised by us to provide the treatment you require for your condition.

Start date The start date shown on the policy schedule. Cover starts at 00.01am UK time on that date. Treatment Surgical or medical services (including diagnostic tests) that are needed to diagnose, relieve or cure a disease, illness or injury. You/your See member. We/our/us Emirates Insurance Company who administer the policy and who underwrite and provide the contract of insurance. Emirates Insurance Company (PSC) Abu Dhabi Office: PO Box 3856, UAE