Definitions
* For the purpose of the Policy and Certificate, reference to "he," "him" or "his" refers to both the male and female gender.
Accident - A sudden, violent, external, unexpected specific event, which occurs at an identifiable time and place: a) which is independent of Sickness; b) over which the Insured Person has no control; and c) that takes place during the Period of Insurance.
Accidental Bodily Injury - An Accident which solely and independently of any other cause results, within twelve months of the date of occurrence, in the death or disablement of an Insured Person.
Benefit - The amount due to the Insured Person resulting from the occurrence of an insured event.
Certificate - The individual certificate issued to the Insured Person. It describes the coverage under the Policy.
Company - Global Benefits Group, acting on behalf of Gulf Insurance PCC Limited - IWB Cell. (by whom benefits under this Policy are underwritten).
Dangerous Sports - Aviation, parachuting, or participation in any other aerial activities other than as a fare-paying passenger on scheduled flight; fighting or self-defense sports; (semi)professional sports; motor sports; racing of any kind other than on foot; mountaineering expeditions; free climbing without ropes; scuba diving; deep sea diving; pot-holing, caving or cave diving; solo sea sailing; jet-skiing; ski jumping, bobsleighing, skeleton, lugeing and all other winter sport activities not mentioned under ‘Hazardous Sports including Death and Permanent Disablement'; use of fire- or other arms; hunting; hunting on horseback, polo, point-to-point, steeple-chasing or horse-racing of any kind; and any other sport involving an exceptional risk of an Accident or Injury.
Dental Treatment as a result of an Accident - Treatment received for the immediate relief of pain caused by natural teeth being lost or damaged in an Accident.
Dependants - Dependant children of the Insured Person (including adopted children) under the age of 19 who permanently reside with the Insured Person.
Hazardous Sports excluding Death and Permanent Disablement - Means parachuting, bobsleighing, aviation other than as a fare-paying passenger on scheduled flight, gliding, hang-gliding, micro-light flying, jet skiing, skeleton, lugeing and all other winter sport activities not mentioned under Hazardous Sports including Death and Permanent Disablement or Dangerous Sports, and any other sport involving an extra risk or Accident.
Hazardous Sports including Death and Permanent Disablement - American Football; bungee jumping; horse riding; trekking above 2,500 meters; mountaineering or rock-climbing with the use of ropes, rappelling; white water canoeing, white water rafting; water skiing; winter sport activities including downhill skiing, cross-country skiing, snowboarding, big foot skiing, mono-skiing on the normally marked public open ski trails, skating, off-trail skiing (provided accompanied by a guide or instructor); off-road mountain biking; ice hockey; white water canoeing; and any sport involving a higher than normal (but not exceptional) risk of an Accident.
Hospital - A place that: (a) holds a valid license; (b) is run mainly for the care and treatment or sick or injured persons as in-patients; (c) has a staff of one or more Physicians available at all times; (d) provides 24-hour nursing services and has at least one registered nurse on duty at all times; (e) has organized diagnostic and surgical facilities, either on the premises or on a contract basis with another Hospital; and (f) is not mainly a clinic, or facility for nursing, rest or convalescence, or a place for the aged, drug addicts, alcoholics or persons with mental or nervous disorders.
Please note that the benefits payable under the Policy vary depending on whether our Preferred Provider Organization is utilized or not for treatment.
Injury - An injury sustained by an Insured Person, as a result of a violent, external, unexpected specific event, which occurs at an identifiable time and place during the Period of Insurance and resulting directly and independently of all other causes in a loss covered by the Policy.
Insured Person - The person named on the Certificate, for whom premium is paid and for whom coverage is in force as set forth under the provisions of the Policy.
Insurer - Gulf Insurance PCC Limited - IWB Cell.
Loss - Loss by physical severance, or the total and irrecoverable permanent loss of use or function.
Period of Insurance - The period stated on the Certificate for which the appropriate premium has been paid.
Physician - A legally licensed medical practitioner who is recognized by the law of the country where treatment covered under this Policy is provided and who, in rendering such treatment is practicing within the scope of his license and training. The attending Physician may not be the Insured Person or a member of the Insured Person's immediate family.
Policy - The master policy issued by the Insurer. The policy document contains full and important information on cover provided, benefits, conditions, exclusions and claim procedures.
Return Destination - The place to which the Insured Person expects to return from his trip, as shown on the Insured Person's Application Form, and confirmed on the Certificate.
Sickness - A sudden and unforeseen illness, disease or deleterious change in physical condition commencing while the Insured Person is insured under the Policy and which requires emergency treatment by a Physician.
Total Permanent Disablement - Permanent and total disability which, having lasted for a period of at least twelve consecutive months from the date of accident/occurrence will, in the opinion of the Company's medical advisor, entirely prevent the Insured Person from engaging in, or giving any attention to, any and every business or occupation for the remainder of his life.