If you have an excess on your policy, this is how it is applied:
• The excess (that is, the amount of money you have to pay towards the cost of eligible treatment) applies to every person covered by the policy in each policy year. • Your excess will renew at the beginning of each policy year even if you’re midway through treatment. So, your excess could apply twice to a single course of treatment if your treatment begins in one policy year and continues into the next policy year. The example below demonstrates this.
• We will not pay any claim or part of a claim which is subject to an excess. In this case we will only pay the balance of the claim after we have deducted the excess amount.
• The excess is deducted from any eligible treatment costs you incur.
• The excess is a single deduction that is made regardless of the number of individual medical conditions claimed for in that policy year.
• If the first claim relates to a benefit with a monetary limit, then we will reduce the monetary limit by the total cost incurred before we apply the excess.
• We will not apply the excess against medical costs for treatment that your policy does not cover.
EXAMPLE:
One | You require £800 of eligible outpatient treatment – your first claim for that policy year. |
Two | The £500 excess charge is applied. |
Three | We pay £300 towards the £800 cost of eligible outpatient treatment, while you pay the £500 excess. |
Four | The following policy year you require eligible outpatient treatment for the same condition which cost £3,000. We pay £2,500 towards the £3,000 cost of eligible outpatient treatment, while you pay the £500 excess. |