Definitions
Accident means a sudden, unexpected and unforeseen,
identifiable event producing at the time objective symptoms of an Injury. The
Accident must occur while the Insured is covered under the Policy.
Injury means bodily injury caused by an Accident. The
Injury must occur while the Policy is in force and while the Insured is covered
under the Policy. The Injury must be sustained as stated on the face page of the
Policy, except where specifically stated otherwise in the Policy.
Reasonable Expense means the usual, reasonable and
customary fee or charge for the services rendered and the supplies furnished in
the area where and at the time such services are rendered or supplies furnished,
as determined by Us. Such services and supplies must be recommended and approved
by a Physician.
CATASTROPHIC
Accident
means a
sudden, unforeseeable external event which (1) Causes Injury to one or more
Covered Persons; and (2) Occurs while coverage is in effect for the Covered
Person.
Benefit Period means the period of time from the date of
Injury, as shown in the Schedule of Benefits.
Deductible means the amount of Eligible Expenses which
must be paid by the Covered Person before benefits are payable under the
Certificate. It applies separately to each Covered Person.
Injury
means bodily harm which results, directly and
independently of disease or bodily infirmity, from an Accident. All injuries to
the same Covered Person sustained in one accident, including all related
conditions and recurring symptoms of the Injuries will be considered one Injury.
Usual, Reasonable and Customary means: (1) With respect to fees or charges, fees for medical services
or supplies which are; (a) Usually charged by the provider for the service or
supply given; and (b) The average charged for the service or supply in the
locality in which the service or supply is received; or (2) With respect to
treatment or medical services, treatment which is reasonable in relationship to
the service or supply given and the severity of the condition.
EARLY CHILDHOOD DEVELOPMENT
Injury means bodily injury caused by an Accident. The
Injury must occur while the Policy is in force and while the Insured is covered
under the Policy. The Injury must be sustained as stated on the face page of the
Policy, except where specifically stated otherwise in the Policy.
Reasonable Expenses means the usual, reasonable
and customary fee or charge for the services rendered and the supplies furnished
in the area where and at the time such services are rendered or supplies
furnished, as determined by Us. Such services and supplies must be recommended
and approved by a Physician
VOLUNTEERS
Injury means bodily injury caused by an Accident. The
Injury must occur while the Policy is in force and while the Insured is covered
under the Policy. The Injury must be sustained as stated on the face page of the
Policy, except where specifically stated otherwise in the Policy.
Reasonable Expenses means the usual, reasonable
and customary fee or charge for the services rendered and the supplies furnished
in the area where and at the time such services are rendered or supplies
furnished, as determined by Us. Such services and supplies must be recommended
and approved by a Physician.