The insurer agrees to pay for hospital accommodation, including semi-private room, and for reasonable and customary services and supplies necessary for your emergency care during confinement as a resident in-patient.
2. Emergency Medical
The insurer agrees to pay for the following services,supplies, or treatment, when provided by a health practitioner who is not related to you by blood or marriage:
- Emergency medical, surgical or anaesthetic services when performed and authorized by a physician.
- Private duty services of a Registered Nurse when approved in advance by TIC. Not to exceed $10,000.
- The services of a legally licensed physiotherapist when ordered by the attending physician as treatment for a covered injury. Not to exceed $500 for out-patient treatment.
- The services of the following legally licensed practitioners for treatment of a covered injury:
Not to exceed $500 per profession.
- When performed at the time of the initial emergency, lab tests and/or X-ray examinations as ordered by a physician for the purpose of diagnosis.
- The use of a licensed local air, land, or sea ambulance (including mountain or sea evacuation) to the nearest hospital, when reasonable and necessary.
- Rental of crutches or hospital-type bed, not exceeding the purchase price; and the cost of splints,
trusses, braces or other approved prosthetic appliances approved in advance by TIC.
- Emergency out-patient services provided by a hospital.
- When not hospitalized as an in-patient, drugs or medications that require a physician’s written prescription, not exceeding a 30-day supply, to a maximum of $1,000.