Dear customer,
we thank you for trusting us with your insurance.
We are determined to provide you with the best service at all times and to insure you in the easiest and most convenient way.
This manual provides you with all the details you need to know about your insurance policy.
Please read this manual along with the Table and Confirmation of Proposal.
We are pleased to attach the updated documents with the changes we mentioned.
What you need to do now is to…
• Determine the Pricing Policy
• Insurance Table
• Insurance Proposal
• Insurance Contract
• Contract Summary
If any of the above elements are incorrect, please call us at 800 5 10 15. If you modify your contract within 14 days of its start, we will not charge administration fees.
Check the correctness of your documents
GAN GUARANTEE
The best offer in Price, Coverage, and Service levels of the Market.
PRICE & COVERAGE
The best offer in Price and Coverage guaranteed.
SERVICE
Guaranteed money back if you are not satisfied with our services within 14 days of purchasing your contract. Guaranteed service through our EasySwitch, EasyPay, 24hr Assistance, and 24hr FastClaim services.
EasySwitch
Visit one of our branches with your existing insurance and we will take care of all the transfer and correspondence procedures.
EasyPay
Pay your insurance in 6 or 12 monthly installments with your credit card without any additional charge.
24hr Assistance
Free 24hr Medical Assistance:
• 24hr Medical Consultation
• 24hr Coordination Center
• 24hr Casualty Care
• Second Opinion
• Travel Assistance
24hr FastClaim
Why wait? Service of your claim within 24 hours. Either by choosing one of our Approved Network Partners or by check.
The Direct Care Insurance Booklet, 012014
2
1. Introduction
3
2. Customer Service
3
3. Customer Information
3
3.1 Had an Accident? Don't Panic!
4
3.2 Simple and Effective
6
4. Information about your Requirements
7
4.1 Our Promise
7
5. Additional Important Information
8
5.1 Automatic Renewal
8
6. Important Details about your Insurance
9
6.1 Prepare with a Checklist
9
6.2 Important Exclusions and Limitations
11
6.3 24 hours at your Service
11
6.4 Excellent Customer Service
11
7. Insurance Guide
13
7.1 Types of Medical Insurance
13
7.2 What you need before applying for Insurance
13
7.3 Factors that affect your Premium
14
7.4 Ways to reduce your Insurance Cost
14
7.5 What to do in case of a Medical Incident
15
8. 24hr Assistance Service
16
8.1 Main Features and Benefits
16
8.2 Important Limitations or Exclusions
16
8.3 Duration of your Subscription
17
8.4 What to do if you need to call for Help
17
9.
Direct Care Insurance Contract
18
9.1
Part One: Inpatient & Day Patient Treatment (In-hospital Benefits)
23
9.2
Part Two: Outpatient Treatment and Wellness Benefits (Out-of-hospital benefits)
25
9.3
Part Three: Travel, Transportation, and Out-of-Area Benefits
25
9.4
Part Four: Travel Insurance
29
9.5
Part Five: Serious Illness, Disability, and Death Benefits
39
9.6
Part Six: Exclusions
41
9.7
General Terms
46
9.8
Binding Text
49
10. 24hr Assistance Membership Plan
50
10.1 Important Information
50
10.2 What is Available
50
10.3 General Terms and Conditions
52
10.4 Service Control-Call Limits
55
11. Claims Guide
56
11.1 The Moment of Truth
56
11.2 It's the Person, not the Procedures that Matter
58
11.3 Submitting a New Claim
59
11.4 Medical Management Services
63
12. Data Protection Notice
66
CONTENTS
The Direct Care Insurance Booklet, 012014
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1. INTRODUCTION
This contract, along with your Insurance Table, constitutes your legal contract and it is essential that you study it carefully to ensure that it meets all your needs. If you have any questions, do not hesitate to contact us as soon as possible.
Please check your Table and your details carefully to ensure that, to the best of your knowledge, the information is correct. Do not fail to inform us of any changes or if any detail is incorrect. If you do not, it is possible that you will no longer have insurance coverage.
The Insurance Proposal, which is issued with your documents, is part of your contract, so please read it carefully.
In exchange for the payment or agreement to pay the premiums, we will provide you with insurance according to the terms of your contract for every event that occurs during the insurance period within the territorial limits.
2. CUSTOMER SERVICE
Our commitment to you
We will ensure the accuracy and correctness of all the information we provide you. We will be fair and reasonable in every case where you need the protection provided by your contract.
We will act promptly to provide you with the protection you need.
In case something goes wrong
Although we will make every possible effort to maintain these standards, we recognize that it is possible that there may be some cases where we do not meet the specific requirements of our customers. Consequently, we have created procedures for investigating and addressing every concern.
In these cases:
• We promise to accept every formal complaint within 24 hours.
• We promise to evaluate all issues with the help of experienced and competent staff within 5 working days.
• We will try to provide a full and final response to your problems or complaints within 30 days. If for any reason this is not possible, we will send you a letter explaining why we were unable to resolve the issue quickly.
If you have any complaint regarding any aspect of the service you receive from us, please call us and provide your Customer Code.
Alternatively, you can send us a letter to the address:
Gan Direct Insurance Company Headquarters, P.O. Box: 51998, 3509, Limassol, Cyprus.
When contacting us, please ensure that you mention your contract or claim number, as applicable.
3. CUSTOMER INFORMATION
Prepare with a checklist before getting insured
Before making your first call or visiting our website to get a quote, take a minute to gather all the important information you need to get a quote.
Your date of birth, weight, and height.
• Declare any hereditary, congenital, or pre-existing conditions.
Are you a smoker? If yes, how many cigarettes do you smoke per day;
• Introduction
Customer Service
Customer Information
