Common use of REFUND AMOUNTS Clause in Contracts

REFUND AMOUNTS. Refunds per item are detailed in the Table above (article 2.1): - Medical costs excluding Hospitalization: Without Excess, 100 % of Reasonable Routine Costs, within the limit, per person and claim, defined in the “Table of Coverage”. - Hospitalization costs: 100 % of actual costs within the limit, per person and claim, defined in the “Table of coverage” and Reasonable Routine Costs, without Excess, when the Policy holder is hospitalised in an establishment approved by the Assistance. - Emergency dental care (see detail further in this document): 100 % of actual costs within the limits, per person and per claim, defined in the "Table of coverage" and Reasonable Routine Costs incurred for urgent dental care (that cannot be postponed, due to the pathological condition of the Policy holder) and for the following dental care: dressing, filling, pulp removal, or tooth extraction. The refunded amounts are those: • remaining after deduction of the amount refunded by the European Health Insurance where applicable, • within the limit of the refund indicated in the Table of Coverage communicated with the subscription. The refund amounts in the Table of Coverage are expressed, depending on the case: • in Real costs (RC), • in amounts in euros. These amounts cannot be exceeded and represent the coverage caps per Claim and per beneficiary, except for the Emergency dental care cover which is annual. • in amounts per procedure expressed in euros. The applicable price we use to calculate services is the price on the date the healthcare was received. In the case of complementary cover over the European Health Insurance cover, only the costs that have been first covered by the basic health insurance will be refunded. In all cases, your refunds will be limited to the actual amount of costs incurred. It is explicitly agreed that the Insurer has the legal right to limit or dispute the cover if there is a failure to follow the Medical Ethics Code rules (article 4127-1 of the French Public Health Code).

Appears in 2 contracts

Samples: Assistance Agreement, Assistance Agreement

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REFUND AMOUNTS. Refunds per item are detailed described in the Table above (article 2.1): - Medical costs excluding Hospitalizationadmissions to hospital: Without without Excess, 100 % of Reasonable Routine Costs, within the limit, per person and claim, defined in the “Table of Coverage”. - Hospitalization costs: 100 % of actual real costs within the limit, per person and claim, defined in the “Table of coverage” and Reasonable Routine Costs, Costs without Excess, when the Policy holder is hospitalised in an establishment approved by the Assistance. - Emergency dental care (see detail further in this document): 100 % of actual real costs within the limits, per person and per claim, defined in the "Table of coverage" and Reasonable Routine Costs incurred for urgent dental care (that cannot be postponed, due to the pathological condition of the Policy holder) and for the following dental care: dressing, filling, pulp removal, or tooth extraction. The refunded amounts are those: • remaining after deduction of the amount refunded by the European Health Insurance where applicable, • within the limit of the refund indicated in the Table of Coverage communicated with the subscription. The refund amounts in the Table of Coverage are expressed, depending on the case: • in Real costs (RC), • in amounts in euros. These amounts cannot be exceeded and represent are the coverage caps cap per Claim and per beneficiary, except for the Emergency dental care cover which is annualbeneficiary and cannot be exceeded. • in amounts per procedure expressed in euros. The applicable price we use to calculate services is the price on the date the healthcare was received. In the case of complementary cover over the European Health Insurance coverOrganisation, only the costs that have been first covered by the basic health insurance will be refunded. In all cases, your refunds will be limited to the actual real amount of costs incurred. It is explicitly agreed that the Insurer has the legal right to limit or dispute the cover if there is a failure to follow the Medical Ethics Code rules (article 4127-1 of the French Public Health Code).

Appears in 2 contracts

Samples: Assistance Agreement, Assistance Agreement

REFUND AMOUNTS. Refunds per item are detailed described in the Table above (article 2.1): - Medical costs excluding Hospitalizationadmissions to hospital: Without without Excess, 100 % of Reasonable Routine Costs, within the limit, per person and claim, defined in the “Table of Coverage”. - Hospitalization costs: 100 % of actual costs within the limit, per person and claim, defined in the “Table of coverage” and Reasonable Routine Costs, Costs without Excess, when the Policy holder is hospitalised in an establishment approved by the Assistance. - Emergency dental care (see detail further in this document): 100 % of actual costs within the limits, per person and per claim, defined in the "Table of coverage" and Reasonable Routine Costs incurred for urgent dental care (that cannot be postponed, due to the pathological condition of the Policy holder) and for the following dental care: dressing, filling, pulp removal, or tooth extraction. The refunded amounts are those: • remaining after deduction of the amount refunded by the European Health Insurance where applicable, • within the limit of the refund indicated in the Table of Coverage communicated with the subscription. The refund amounts in the Table of Coverage are expressed, depending on the case: • in Real Actual costs (RCAC), • in amounts in euros. These amounts cannot be exceeded and represent are the coverage caps cap per Claim and per beneficiary, except for the Emergency dental care cover which is annualbeneficiary and cannot be exceeded. • in amounts per procedure expressed in euros. The applicable price we use to calculate services is the price on the date the healthcare was received. In the case of complementary cover over the European Health Insurance coverOrganisation, only the costs that have been first covered by the basic health insurance will be refunded. In all cases, your refunds will be limited to the actual amount of costs incurred. It is explicitly agreed that the Insurer has the legal right to limit or dispute the cover if there is a failure to follow the Medical Ethics Code rules (article 4127-1 of the French Public Health Code).

Appears in 2 contracts

Samples: Assistance Agreement, Assistance Agreement

REFUND AMOUNTS. Refunds per item are detailed in the Table above (article 2.1): - Medical costs excluding Hospitalization: Without without Excess, 100 % of Reasonable Routine Costs, within the limit, per person and claim, defined in the “Table of Coverage”. - Hospitalization costs: 100 % of actual costs within the limit, per person and claim, defined in the “Table of coverage” and Reasonable Routine Costs, Costs without Excess, when the Policy holder is hospitalised in an establishment approved by the Assistance. - Emergency dental care (see detail further in this document): 100 % of actual costs within the limits, per person and per claim, defined in the "Table of coverage" and Reasonable Routine Costs incurred for urgent dental care (that cannot be postponed, due to the pathological condition of the Policy holder) and for the following dental care: dressing, filling, pulp removal, or tooth extraction. The refunded amounts are those: • remaining after deduction of the amount refunded by the European Health Insurance where applicable, • within the limit of the refund indicated in the Table of Coverage communicated with the subscription. The refund amounts in the Table of Coverage are expressed, depending on the case: • in Real costs (RC), • in amounts in euros. These amounts cannot be exceeded and represent the coverage caps per Claim and per beneficiary, except for the Emergency dental care cover which is annual. • in amounts per procedure expressed in euros. The applicable price we use to calculate services is the price on the date the healthcare was received. In the case of complementary cover over the European Health Insurance cover, only the costs that have been first covered by the basic health insurance will be refunded. In all cases, your refunds will be limited to the actual amount of costs incurred. It is explicitly agreed that the Insurer has the legal right to limit or dispute the cover if there is a failure to follow the Medical Ethics Code rules (article 4127-1 of the French Public Health Code).

Appears in 1 contract

Samples: Assistance Agreement

REFUND AMOUNTS. Refunds per item are detailed described in the Table above (article 2.1): - Medical costs excluding Hospitalizationadmissions to hospital: Without without Excess, 100 % of Reasonable Routine Costs, within the limit, per person and claim, defined in the “Table of Coverage”. - Hospitalization costs: 100 % of actual costs within the limit, per person and claim, defined in the “Table of coverage” and Reasonable Routine Costs, Costs without Excess, when the Policy holder is hospitalised in an establishment approved by the Assistance. - Emergency dental care (see detail further in this document): 100 % of actual costs within the limits, per person and per claim, defined in the "Table of coverage" and Reasonable Routine Costs incurred for urgent dental care (that cannot be postponed, due to the pathological condition of the Policy holder) and for the following dental care: dressing, filling, pulp removal, or tooth extraction. The refunded amounts are those: • remaining after deduction of the amount refunded by the European Health Insurance where applicable, • within the limit of the refund indicated in the Table of Coverage communicated with the subscription. The refund amounts in the Table of Coverage are expressed, depending on the case: • in Real costs Costs (RC), • in amounts in euros. These amounts cannot be exceeded and represent are the coverage caps cap per Claim and per beneficiary, except for the Emergency dental care cover which is annualbeneficiary and cannot be exceeded. • in amounts per procedure expressed in euros. The applicable price we use to calculate services is the price on the date the healthcare was received. In the case of complementary cover over the European Health Insurance coverOrganisation, only the costs that have been first covered by the basic health insurance will be refunded. In all cases, your refunds will be limited to the actual amount of costs incurred. It is explicitly agreed that the Insurer has the legal right to limit or dispute the cover if there is a failure to follow the Medical Ethics Code rules (article 4127-1 of the French Public Health Code).

Appears in 1 contract

Samples: Assistance Agreement

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REFUND AMOUNTS. Refunds per item are detailed in the Table above (article 2.1): - Medical costs excluding Hospitalization: Without ExcessExcess per claim 30€, 100 % of Reasonable Routine Costs, within the limit, per person and claim, defined in the “Table of Coverage”. - Hospitalization costs: 100 % of actual costs within the limit, per person and claim, defined in the “Table of coverage” and Reasonable Routine Costs, without ExcessExcess per claim 30€, when the Policy holder is hospitalised in an establishment approved by the Assistance. - Emergency dental care (see detail further in this document): 100 % of actual costs within the limits, per person and per claim, defined in the "Table of coverage" and Reasonable Routine Costs incurred for urgent dental care (that cannot be postponed, due to the pathological condition of the Policy holder) and for the following dental care: dressing, filling, pulp removal, or tooth extraction. The refunded amounts are those: • remaining after deduction of the amount refunded by the European Health Insurance where applicable, • within the limit of the refund indicated in the Table of Coverage communicated with the subscription. The refund amounts in the Table of Coverage are expressed, depending on the case: • in Real costs Costs (RC), • in amounts in euros. These amounts cannot be exceeded and represent the coverage caps per Claim and per beneficiary, except for the Emergency dental care cover which is annual. • in amounts per procedure expressed in euros. The applicable price we use to calculate services is the price on the date the healthcare was received. In the case of complementary cover over the European Health Insurance cover, only the costs that have been first covered by the basic health insurance will be refunded. In all cases, your refunds will be limited to the actual amount of costs incurred. It is explicitly agreed that the Insurer has the legal right to limit or dispute the cover if there is a failure to follow the Medical Ethics Code rules (article 4127-1 of the French Public Health Code).

Appears in 1 contract

Samples: Assistance Agreement

REFUND AMOUNTS. Refunds per item are detailed in the Table above (article 2.1): - Medical costs excluding Hospitalization: Without Excess, 100 % of Reasonable Routine Costs, within the limitlimit and with no Excess, per person and claim, defined in the “Table of Coverage”. - Hospitalization costs: 100 % of actual costs within the limit, per person and claim, defined in the “Table of coverage” and Reasonable Routine Costs, without with no Excess, when the Policy holder is hospitalised in an establishment approved by the Assistance. - Emergency dental care (see detail further in this document): 100 % of actual costs within the limits, per person and per claim, defined in the "Table of coverage" and Reasonable Routine Costs incurred for urgent dental care (that cannot be postponed, due to the pathological condition of the Policy holder) and for the following dental care: dressing, filling, pulp removal, or tooth extraction. The refunded amounts are those: • remaining after deduction of the amount refunded by the European Health Insurance where applicable, • within the limit of the refund indicated in the Table of Coverage communicated with the subscription. The refund amounts in the Table of Coverage are expressed, depending on the case: • in Real costs Costs (RC), • in amounts in euros. These amounts cannot be exceeded and represent the coverage caps per Claim and per beneficiary, except for the Emergency dental care cover which is annual. • in amounts per procedure expressed in euros. The applicable price we use to calculate services is the price on the date the healthcare was received. In the case of complementary cover over the European Health Insurance cover, only the costs that have been first covered by the basic health insurance will be refunded. In all cases, your refunds will be limited to the actual amount of costs incurred. It is explicitly agreed that the Insurer has the legal right to limit or dispute the cover if there is a failure to follow the Medical Ethics Code rules (article 4127-1 of the French Public Health Code).

Appears in 1 contract

Samples: Assistance Agreement

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