Common use of Qualifying provisions Clause in Contracts

Qualifying provisions. There is no qualifying period for compulsory company schemes for existing disorders, with the exception of the special provisions for chronic disorders and for the optional cover ”Addiction therapy”. For co-insured parties, for private clients and for volun- tary schemes, there is a 6 months qualifying period for existing diseases and injuries. This means that you must have been covered by the insurance for 6 months before costs are covered for the examination and treatment of disorders that have arisen and/or been diagnosed before the insurance came into effect. Diseases and injuries that arise after the insurance comes into force will be covered on the basis of the applicable insurance conditions. Seniority from other health insurance can be transferred in case of direct transition without delay from other health insurance. However, this does not apply to chronic disor- ders, unless otherwise stated in the contract. The insurance covers examination and treatment in Denmark, and we refer to a treatment centre in the public or private healthcare system, unless otherwise stated in the individual cover. The choice of treatment centre must always be by agreement with us and we can decide that it should be performed at a particular therapist or at a particular treatment centre. For some forms of treatment, however, you can choose the therapist yourself.

Qualifying provisions. There is no qualifying period for compulsory company schemes for existing disorders, with the exception of the special provisions for chronic disorders and for the optional cover ”Addiction therapy”. For co-insured parties, for private clients and for volun- tary schemes, there is a 6 months qualifying period for existing diseases and injuries. This means that you must have been covered by the insurance for 6 months before costs are covered for the examination and treatment of disorders that have arisen and/or been diagnosed before the insurance came into effect. Diseases and injuries that arise after the insurance comes into force will be covered on the basis of the applicable insurance conditions. Seniority from other health insurance can be transferred in case of direct transition without delay from other health insurance. However, this does not apply to chronic disor- ders, unless otherwise stated in the contract. The insurance covers examination and treatment in Denmark, and we refer to a treatment centre in the public or private healthcare system, unless otherwise stated in the individual cover. The choice of treatment centre must always be by agreement with us and we can decide that it should be performed at a particular therapist or at a particular treatment centre. For some forms of treatment, however, you can choose the therapist yourself. Examination and treatment in Sweden, Norway or Ger- many can take place in agreement with us if we find it reasonable and relevant. The expenses must not, accor- ding to our assessment, exceed the total cost of a similar examination and treatment carried out in Denmark.