Sanitas Mundi - Excess ( health insurance )

A. In general, the Insurer shall refund only the percentage specified in the Particular Conditions of the Policy of the sum of medical and / or hospital expenses actually incurred by the Member as a result of medical and / or hospital care for the covered and non-excluded risks stipulated under Benefits "A ", " B", "C ", "D ", " E" and "F " above, in accordance with the provisions of Clause One , and the Member shall be liable for the remaining percentage difference.

B. Nonetheless, where the Member uses medical and / or hospital services recommended by the Insurer in Spain, the Policyholder or Member shall not be liable for any excess whatsoever for the aforesaid services, and all the medical and / or hospital expenses shall be charged to the Insurer, who shall pay for such services directly. The Member shall have to produce his or her Sanitas-card for the purpose, and shall not have to make any payment whatsoever. He or she shall also be under obligation to produce the latest premium receipt paid and his or her identity card or residence permit, if asked to do so.

C. Likewise, in the event that the Member should use medical and / or hospital services recommended by the Insurer abroad, subject to prior Insurer authorisation, the Policyholder or Member shall have to make no payment whatsoever for such services, and the Insurer shall be liable and charged for all medical and / or hospital expenses and shall pay for the aforesaid services directly. The prior authorisation and arrangement by the Insurer shall be required for the purpose, and shall not have to make any payment whatsoever.

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For more information your English Sanitas agent is: David Harris

Mobile / cell: (00 34) 609 522 300

email: saniprof@wanadoo.es

Any questions or comments to saniprof@mail.ddnet.es - thanks.

(Free messenger service - I cover the whole of Spain (click here...))

Preliminary clause Definitions I. Purpose of the insurance

II. Excluded risks III. Grounds for contract IV. Excess

V. Waiting periods VI. Claims procedure VII. Refunds of expenses

VIII. Term of insurance policy IX. Insurance premiums X. Other obligations and duties of policyholders and / or members

XI. Rights of policyholders and / or members XII. Other obligations of the insurer XIII. Disputes

XIV. Duplicate copies of policy XV. Subrogation XVI. Prescription

XVII. Notifications XVIII. Claims-control and procedure XIX. Others

Apartado (PO Box) 19

28760 Tres Cantos Madrid

Tlf: ( 00 34) 91 804 3802 Fax: (00 34) 91 803 2484

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