> Terms and conditions of insurance

Definition of terms

• beneficiary (insured person) is the person to whose health the insurance cover relates
• insurance event is an accidental occurrence with which there is linked a duty on the part of the insurer to provide a settlement
• insurance settlement is restricted by an upper limit. The upper limit of the insurance settlement is decided by the settlement limits specified in the insurance policy

Direct payment of damage

If the client makes direct payment of the damage which resulted from the insurance event, the insurer will subsequently pay reasonable costs after receiving the originals of the required documents.

Basic insurance terms and conditions for Foreigners' Basic Medical Insurance

Urgent and necessary healthcare includes:

• essential examinations required to determine diagnoses and medical procedure
• essential treatment
• essential hospitalization of a sick person in a multi-bed room with standard equipment
• necessary operations including associated necessary expenses
• transport required for health reasons from the place in which the insured event occurred to the nearest first aid facility or hospital and back

Insurance exclusions:

The insurer does not provide insurance benefits in the following cases:

• birth including premature birth, confinement and abortion
• examination and treatment of psychological disorders
• preventative examinations
• rehabilitation

Complete text of the Insurance Terms and Conditions for Foreigners' Basic Medical Insurance

Basic insurance terms and conditions for Foreigners' Comprehensive Medical Insurance

The insurer provides insurance benefits to the following extent:

• in a similar manner to public medical insurance
• repatriation of a sick insured person is covered
• transportation of the bodily remains of the insured person arranged
• it also includes additional, extended services:

Insurance exclusions:

The insurer does not provide insurance benefits in the following cases:

• examination and treatment of innate defects and illnesses as of diagnosis
• insulin treatment and diabetes
• AIDS examinations and treatment
• treatment of addictions
• transplantations

Complete text of the Insurance Terms and Conditions for Foreigners' Comprehensive Medical Insurance

Basic insurance terms and conditions for PREMIUM Medical Insurance for Foreigners

The insurer provides insurance benefits to the following extent:

• in a similar manner to public medical insurance
• repatriation of a sick insured person is covered
• transportation of the bodily remains of the insured person arranged
•  

Insurance exclusions:

The insurer does not provide insurance benefits in the following cases:

• examination and treatment of innate defects and illnesses as of diagnosis
• insulin treatment and diabetes
• AIDS examinations and treatment
• treatment of addictions
• transplantations

 Complete text of the Insurance Terms and Conditions for PREMIUM Medical Insurance for Foreigners

 Complete text of the Insurance Terms and Conditions for PREMIUM Medical Insurance for Foreigners - hospitalization

Basic insurance conditions for Accident insurance

  Complete text of the Insurance Terms and Conditions for Accident insurance

Basic insurance conditions for PATRON insurance

• injury
• illness
• pregnancy
• birth

The insurance event for Insurance for incapacity for work is incapacity for work of the insured person which began within the duration of the insurance and after the waiting period on the territory of the Czech Republic due to:

• injury
•  illness

• The waiting period begins on the day the insurance is entered and lasts for 3 months
• The waiting period is 8 months for hospitalization due to pregnancy or birth
• Waiting period is applied for hospitalization due to injury

Basic insurance terms and conditions for Guaranty Plus insurance

The insured event involves damage arising during the hospitalization of the insured person in a healthcare establishment in the Czech Republic due to:

• injury
• illness
• pregnancy
• birth

• an injury is understood to mean the unintentional, sudden and unexpected exertion of external forces or of the insured person’s own physical strength, or the unexpected and uninterrupted effects of high or low external temperatures, gases, fumes, radiation, electric current or poisons (except for microbial toxins and immunotoxic substances), independent of the will of the insured person, resulting in damage to the health of the insured person or his/her death
• illness is understood to mean the sudden onset of an illness that endangers the health or the life of the insured person and requires immediate provision of medical care
• the qualifying period commences on the date the insurance commences; its length is three months
  • for hospitalization due to pregnancy or birth the qualifying period is eight months
  • no qualifying period applies to hospitalization due to injury

Complete text of the Insurance Terms and Conditions for Guaranty Plus insurance

Basic terms and conditions for the insurance of medical expenses

Exclusions from insurance The insurer will not provide a settlement in the following cases, unless agreed otherwise in the additional provisions of the insurance policy:

• uninsurable activities, e.g. contact combat sports, bungee jumping, rock climbing, potholing, Alpine skiing, canyoning, parasailing
• the organisation of competitions and contests, including training therefor; this exclusion will not apply if the insurance arranged is "sports competitions"
• dangerous types of sports, especially aerial sports, car sports, motorised water sports, including water skiing, wild water rafting, scuba diving, mountain trekking in mountainous terrain above 2000 m or along routes secured by chains, ropes and ladders, horse riding, skateboarding, bobsleighing, skeleton, acrobatics and ski jumping, ice hockey; this exclusion will not apply if the option "dangerous sports" is selected

You can find the full text of the terms and conditions of insurance for insurance of medical expenses here