GlobeHopper Platinum International Private Medical Insurance plan- IMG Europe

GlobeHopper Platinum International Private Medical Insurance plan

Schedule of Cover

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Summary Schedule of Cover & Plan Highlights
The Company/Insurer will pay for charges and expenses incurred during the Period of Coverage so long as the charges are Usual, Reasonable, and Customary, Medically Necessary and otherwise payable under the terms of the Insurance (“Eligible Medical Expenses”).

Plan Information & Highlights

Plan Maximum Limit Options–per insured person, per period of insurance	Currency Options £2,000,000 / €2,000,000 / $2,000,000 £3,000,000 / €3,000,000 / $3,000,000 £5,000,000 / €5,000,000 / $5,000,000
Excess Options–per insured person, per period of insurance	£0 / €0 / $0 £100 / €100 / $100 £250 / €250 / $250 £500 / €500 / $500 £1,000 / €1,000 / $1,000
Treatment in the United States Coinsurance in addition to Excess	Treatment received through a network provider will be paid at 100%
	Treatment not received through a network provider will be paid at 90% for the first £5,000 / €5,000 / $5,000 of eligible charges then plan pays full cover to chosen maximum plan value
Area of Cover Options (As shown on your Certificate of Insurance. Refer to Area of Cover definition for further details)	Area 1: Europe Area 2: Worldwide excluding USA Area 3: Worldwide
Coverage Duration Options	30 days to 12 months, extendable to maximum of 36 months
Pre-Existing Medical Conditions	No cover except as expressly provided for under the Sudden and Unexpected Reoccurrence of a Pre-Existing Condition benefit
Preauthorisation
Preauthorisation must be obtained before any of the following treatment, service or medical supply*: Inpatient or day-patient admission in hospital Treatment, services, or medical supplies of any kind in hospital Surgery in hospital or in a surgical centre Outpatient MRI and CAT scans, echocardiograph, endoscopy, gastroscopy, colonoscopy, & cystoscopy Care in a licensed extended care facility Home Nursing Care Physiotherapy Durable Medical Equipment Emergency Medical Evacuation Mortal Remains

A Medical Benefits

Refer to your Policy Wording for full details on cover, exclusions, terms, conditions, and limitations. Subject to excess and coinsurance when applicable. Maximum Limits are per Period of Insurance unless otherwise stated.

B Additional Benefits

Maximum Limits are per Period of Insurance unless otherwise stated.

Sudden & Unexpected Reoccurence of a Pre-Existing Condition For Insured Persons under age 65	Up to £20,000 / €20,000 / $20,000 Policy Limit for Medical Benefits Up to £50,000 / €50,000 / $50,000 for Emergency Medical Evacuation
Adventure Sports	Up to £50,000 / €50,000 / $50,000
Teleconsultation*	Online and telephone access to a network of medical professionals available to discuss new, non-emergency medical issues. The best medicine brought to you and your family 24 hours a day, seven days a week.
Hospital Cash Benefit	Up to £250 / €250 / $250 Up to a maximum of 14 nights Nil excess
Incidental Return Trip	Up to a cumulative of 2 weeks within a 12-month Period of Insurance Subject to Excess
Personal Liability	Injury to third person: Up to £50,000 / €50,000 / $50,000 Excess: £100 / €100 / $100 per Injury Damage to third person’s property: Up to £5,000 / €5,000 / $5,000 Excess: £100 / €100 / $100 per damage
Identity Theft Assistance	Up to £500 / €500 / $500
Terrorism	Full Cover
Remote Transportation	Up to £5,000 / €5,000 / $5,000 per Period of Insurance Up to £20,000 / €20,000 / $20,000 Policy Limit
Criminal Assault Benefit	Up to £1,000 / €1,000 / $1,000 per admitted night Up to £10,000 / €10,000 / $10,000
Death as a result of Accident only Age at date of death	15 days to 16 years of age: £5,000 / €5,000 / $5,000 17 to 65 years of age: £50,000 / €50,000 / $50,000 66 to 74 years of age: £10,000 / €10,000 / $10,000
Loss of Sight/Loss of Limb as a result of accident only Age at date of injury/loss	15 days to 16 years of age: £5,000 / €5,000 /$5,000 17 to 65 years of age: Sight of one eye: £25,000 / €25,000 / $25,000 1 hand or 1 foot: £25,000 / €25,000 / $25,000 1 hand & 1 foot: £50,000 / €50,000 / $50,000 1 hand & sight of 1 eye: £50,000 / €50,000 / $50,000 1 foot & sight of 1 eye: £50,000 / €50,000 / $50,000 Both hands or both feet: £50,000 / €50,000 / $50,000 Sight of both eyes: £50,000 / €50,000 / $50,000 66 to 74 years of age: £5,000 / €5,000 / $5,000

C International Emergency Care & Assistance

Maximum Limits are per Period of Insurance unless otherwise stated

*Teleconsultations will not support a diagnosis for Mental or Nervous Disorders. Coverage for a Teleconsultation is not a determination that any specific condition discussed, raised or identified during such Consultation is covered under this insurance. We reserve the right to decline future claims relating to or arising from any condition discussed, raised or identified during a Teleconsultation where the illness or injury is directly or indirectly related to any Pre-existing

This website contains only a brief summary of current coverage, terms, conditions, limitations and exclusions, and is subject to all the terms and conditions of the full Plan and Policy Wording The complete Policy Wording (and any applicable Endorsements) with all terms, conditions and exclusions will be included in the fulfilment kit sent to approved applicants. These plans are amended, modified or replaced from time to time, and IMG reserves the right to issue the most current Policy Wording for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Samples of current Policy Wording are available upon request.

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Choosing Coverage

GlobeHopper Platinum International Private Medical Insurance

Short-Term International Private Medical Insurance

GlobeHopper Platinum International Private Medical Insurance plan

Schedule of Cover