Voluntary health insurance
Insurance in the event of critical illnesses and surgical interventions (operative procedures)
Voluntary health insurance in the event of surgical interventions/operative procedures and critical illnesses is a type of voluntary health insurance which provides a single payment of the stipulated indemnity to the insured in the event of occurrence of a critical illness or surgical intervention/operative procedure.
Voluntary health insurance can be written as a group insurance, for all employees, members of an organization, etc., as per the policyholder – legal entity’s official records, or as per the list of insured persons. The insurance premium can be paid by the policyholder – legal entity or insured by way of deduction withheld from salary.
What does the policy cover?
- Insurance in the event of surgical interventions (operative procedures) covers surgical interventions and operative procedures performed during the insurance period: heart surgery, abdominal surgery, urinary and genital tract surgery, orthopedic and other surgery, i.e. operative procedures – pursuant to the Special Terms and Conditions of VHI in the event of surgical interventions, i.e. operative procedures. Exercise of rights stemming from this insurance dos not depend on the location where the surgical intervention/operative procedure was performed, whether costs were borne by the insured, whether he refunded them or was indemnified on any other grounds.
- Insurance in the event of critical illnesses covers illnesses which occurred and were indisputably diagnosed during the insurance period: all malignant illnesses, stroke, myocardial infarction, etc. – pursuant to the Special Terms and Conditions of VHI in the event of critical illnesses. The right to the stipulated indemnity does not depend on any expenses refunded on any other grounds, and it may be cumulated with other rights.
What premium and indemnity depend on?
Premium depends on the amount of insured sums and number of persons for whom insurance is being written.
Amount of insurance indemnity depends on the stipulated insured sum and surgical intervention or operative procedure performed, or on the critical illness which occurred during the insurance period, and is encompassed by this insurance. Indemnity is paid out in the corresponding percentage of the stipulated insured sum, as per the Special Terms and Conditions.
How is right to indemnity exercised?
When an insured event occurs, i.e. when a critical illness or surgical intervention (operative procedure) is indisputably diagnosed or performed, the insured is supposed to submit a written claim report on the insurer’s form, as well as the corresponding medical documentation: discharge papers, specialist’s report, and other necessary medical documentation attesting to the right to be paid out the stipulated indemnity.
What is not covered by the policy?
Voluntary health insurance does not cover illnesses which the insured had prior to insurance conclusion, surgical interventions and operative procedures performed prior to insurance conclusion, as well as those for which the need was ascertained previously, or illnesses, surgical interventions and operative procedures not listed in Special Terms and Conditions.
Insurance for packages of surgical interventions/operative procedures
DDOR Novi Sad has created NEW additional voluntary health insurance – PACKAGE OF SURGICAL INTERVENTIONS/OPERATIVE PROCEDURES, which provides a wider, more comprehensive scope of insurance coverage in the event of health deterioration and operative treatment of the insured, when additional security and financial support are necessary.
Insurance may be written as group insurance, for all employees, persons engaged in work, union members, etc. Premium can be paid by the employer (policyholder) or insured by way of deduction from salary.
Which risks are covered?
Insurance for packages of surgical interventions/operative procedures encompasses over 1,150 different types of interventions, from the most complex of operative procedures to minor surgical interventions.
Insurance can be written for the basic package, or for several packages of surgical interventions.
Basic Package 5 includes the following surgical interventions/operative procedures: single and multiple coronary artery bypass, heart valve replacement, total thyroidectomy, heart transplantation, liver, pancreas, lung, kidney transplantation, operative procedure for acute pancreatitis, radical hysterectomy, knee prosthesis, operative procedure for malignant nose or sinus tumor, and other interventions.
Package 4 includes: radical mastectomy, thyroid gland surgery, and laparotomy with colonic resection, operative procedure for malignant lung neoplasm, vascular surgery, radical hysterectomy, craniotomy for epidural hematoma, ligamentoplasty with meniscectomy, and other operative procedures.
Package 3 includes: coronary angioplasty – single, breast operative procedure – subcutaneous mastectomy, quadrantectomy, parathyroid gland operations, cholecystectomy, colonic resection, spleen operative procedure, hernia operative procedure, volvulus surgery, bilateral adnexectomy, ectopic pregnancy, rhinoseptoplasty, etc.
Package 2 includes: catheterization, coronarography, hand arthroplasty, thyroid gland operative procedure, lobectomy, cholecystectomy – for inoperable neoplasm, adhesiolysis, conisation, hysterectomy, etc.
Package 1 includes: interventions on urinary and genital tract, multiple coronary angioplasty, pacemaker placement, incision after breast abscess, hand amputation, emergency tracheotomy, numerous minor surgical interventions, interventions in reconstructive and plastic surgery, oral and maxillofacial surgery, thoracic surgery, gynecology, etc.
This insurance is subject to Special Terms and Conditions of voluntary health insurance for packages of surgical interventions/operative procedures.
Along with insurance for packages of surgical interventions/operative procedures, it is possible to arrange insurance in the event of critical illnesses, pursuant to the Special Terms and Conditions of VHI in the event of critical illnesses.
What does premium depend on?
Premium depends on the stipulated scope of coverage, number of persons being insured, and insured sums to which insurance is written.
The amounts specified above are purely for informational purposes.
What does the amount of indemnity depend on?
The amount of insurance indemnity depends on the stipulated insured sum for the Package of surgical interventions in which the performed surgical intervention has been classified.
Pecuniary indemnity is paid out to the insured upon the performed intervention, in the amount of the stipulated insured sum for the Package in which the performed intervention has been classified, as per the Special Terms and Conditions.
If an insured event occurs, you simply need to submit the following:
▶Written claim report on the insurer’s form
▶Medical documentation (discharge papers, specialist’s report, and other necessary medical documentation as requested by the insurer), attesting to the right to receive the stipulated indemnity.
The stipulated indemnity will be paid out to the insured within 14 days, at the latest.