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since 2/2000
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www.e-agentelocaldeseguros.com Spain: Sanitas agent (BUPA Group) Sanitas Multi - General Conditions (English) a) How the services are provided As specified in the applicable regulatory provisions, care will be provided in all the towns and cities where the Insurer possesses duly authorised representation or has an approved medical facilities arrangement. When in any of the towns and cities where such a representation or approved medical facilities arrangement operates, any of the services comprised in the contract are not available, they will be provided in the province of the Insured's choosing where such facilities do exist. Policy-holders are free to consult the specialist forming part of the Insurer's medical staff. In addition, the Insurer may assign the Insured the general practitioner and, where appropriate, the paediatrician from amongst those listed on the Insurer's Medical Staff in order to allocate him/her to act as the family doctor. The Insured may change family doctor by simply notifying the Insurer, without having to give any reason. Upon receiving the due services, the Insured should show the Sanitas card, as well as the last premium paid receipt as evidence of being up to date in the payments. The Insured is also obliged to show his / her National Identity Card if so required. As a rule, the Insurer's prior authorisation is needed for surgical operations, hospitalisation, consultants and certain therapeutic methods and diagnostic tests, subject to prior prescription by one of its doctors. The Insurer will give this authorisation unless it is considered to be a service that is not covered by the Policy. This authorisation will be financially binding on the Insurer. Despite what is stated in the previous paragraph, in emergency cases an order by one of the Insurer's physicians will suffice for these purposes, although the Insured should notify the Insurer of the fact and obtain its confirmation within 72 hours of admission to the hospital institution or the provision of the healthcare service. In these emergency circumstances, the Insurer shall be bound financially up to the time when it expresses objections to the physician's order, in the event of considering that the policy does not cover the medical act or hospitalisation. The Insurer undertakes to provide home service at the address appearing in the Policy only, and any change thereof will have to be notified by registered letter at least eight days prior to the request for any service. In the event of travelling temporarily to places where the Insurer does not have an office of its own but does have approved external facilities, the Insured should present his / her Sanitas card to request the services at the offices of the entities approved by the Insurer and comply with the administrative formalities of said entities. b) Care at facilities not approved by the insurer c) Description of the services
Return to Index (English Conditions) For more information your English Sanitas agent is: David Harris Mobile / cell: (00 34) 609 522 300 email: saniprof@wanadoo.es or saniprof@mail.ddnet.es - thanks. (Free messenger service - I cover the whole of Spain (click here...))
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