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COMPLETE HEALTH IPID EN

Résumé

Insurance Product Information Document issued by DKV Luxembourg S.A. for the COMPLETE HEALTH tariff, a Private Health Insurance described as complete protection independent from statutory health insurance. Cover concerns outpatient treatment, dental treatment and inpatient treatment, plus the BEST CARE + / BEST CARE PREMIUM + tariff services, and applies to Europe. The document states that the scope of insurance also includes the free of charge protection according to the TRAVEL + tariff; the corresponding TRAVEL / TRAVEL + information sheet is bound into the same PDF on pages 3-4.

  • Assureur : DKV Luxembourg · Branche : Complémentaire santé · Type : IPID / Fiche d'information

Garanties

Outpatient treatment – Medical treatments - p. 1

Medical treatments - Optionnelle : non

Outpatient treatment – Drugs and dressings - p. 1

Drugs and dressings - Optionnelle : non

Outpatient treatment – Remedies - p. 1

Remedies such as physiotherapy, massages - Optionnelle : non

Outpatient treatment – Services of a midwife - p. 1

Services of a midwife - Optionnelle : non

Outpatient treatment – Medical aids - p. 1

Medical aids such as hearing aids, arch supports - Optionnelle : non

Outpatient treatment – Visual aids - p. 1

Visual aids - Optionnelle : non

Outpatient treatment – Refractive eye surgery - p. 1

Refractive eye surgery (e.g. Laser) - Optionnelle : non

Outpatient treatment – Alternative treatment methods - p. 1

Alternative treatment methods - Optionnelle : non

Dental treatment – Dental treatment - p. 1

Dental treatment - Optionnelle : non

Dental treatment – Dental deep cleaning - p. 1

Dental deep cleaning - Optionnelle : non

Dental treatment – Replacement teeth - p. 1

Replacement teeth such as crowns, implants, inlays - Optionnelle : non

Dental treatment – Orthodontic treatment - p. 1

Orthodontic treatment - Optionnelle : non

Inpatient treatment – Medical treatment - p. 1

Medical treatment (including chief physician) - Optionnelle : non

Inpatient treatment – Accomodation costs - p. 1

Accomodation costs (including single room) - Optionnelle : non

Inpatient treatment – One-Day-Clinic - p. 1

One-Day-Clinic - Optionnelle : non

Inpatient treatment – Rooming-in for one parent - p. 1

Rooming-in for one parent with co-insured children - Optionnelle : non

Inpatient treatment – Transportation to the hospital in an ambulance - p. 1

Transportation to the hospital in an ambulance - Optionnelle : non

Inpatient treatment – Hospital daily benefit - p. 1

Hospital daily benefit - Optionnelle : non

Tariff BEST CARE + / BEST CARE PREMIUM + – Second opinion - p. 1

Preparation of a second opinion by recognised specialists for certain diseases requiring inpatient treatment, malformations and complications following accident injuries - Optionnelle : non - Condition : (in case of full insurance coverage for inpatient treatments)

Tariff BEST CARE + / BEST CARE PREMIUM + – Organization of a surgery - p. 1

If necessary, organization of a surgery by an expert within 5 working days - Optionnelle : non - Condition : (in case of full insurance coverage for inpatient treatments)

Tariff BEST CARE + / BEST CARE PREMIUM + – Expense flat rate - p. 1

Payment of an expense flat rate - Optionnelle : non - Condition : (in case of full insurance coverage for inpatient treatments)

TRAVEL + protection included free of charge - p. 1

The scope of insurance also includes the free of charge protection according to the TRAVEL + tariff (see separate information sheet) - Optionnelle : non

Territorial scope – Europe - p. 2

Insurance cover applies to Europe. - Optionnelle : non · Portée : Europe

Territorial scope – temporary sojourn in a non-European country - p. 2

Insurance cover is provided during the first month of a temporary sojourn in a non-European country. - Optionnelle : non · Portée : non-European country, first month

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Outpatient treatments – Medical treatments - p. 3

Medical treatments - Optionnelle : non · Limite : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Outpatient treatments – Drugs and dressings - p. 3

Drugs and dressings - Optionnelle : non · Limite : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Outpatient treatments – Remedies - p. 3

Remedies such as physiotherapy, massages - Optionnelle : non · Limite : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Outpatient treatments – Medical aids - p. 3

Medical aids that become necessary for the first time during a stay abroad and as a consequence of an accident (excluding vision or hearing aids) - Optionnelle : non · Limite : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Dental treatments – Pain-relieving treatment - p. 3

Pain-relieving treatment - Optionnelle : non · Limite : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Dental treatments – Simple dental filling - p. 3

Simple dental filling - Optionnelle : non · Limite : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Dental treatments – Repair of existing tooth replacement - p. 3

Repair of existing tooth replacement in order to re-establish ability to chew - Optionnelle : non · Limite : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Dental treatments – Provisional prostheses - p. 3

Provisional prostheses - Optionnelle : non · Limite : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Inpatient treatments – Medical treatment - p. 3

Medical treatment (incl. surgery) - Optionnelle : non · Limite : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Inpatient treatments – Accommodation costs - p. 3

Accommodation costs (incl. additional costs for individual room) - Optionnelle : non · Limite : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Ambulance services - p. 3

Medical necessary transport using approved rescue services to the nearest hospital or doctor - Optionnelle : non · Limite : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Repatriation and return transport – return transport - p. 3

Organization and assumption of the costs for a medically reasonable and justifiable return transport of the insured person - Optionnelle : non · Limite : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Repatriation and return transport – transfer in the event of death - p. 3

Organization and assumption of costs for a transfer in the event of the death of the insured person - Optionnelle : non · Limite : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Territorial scope – journey abroad - p. 4

Your insurance cover is valid for the journey abroad indicated on your insurance application. - Optionnelle : non · Portée : the journey abroad indicated on the insurance application

TRAVEL / TRAVEL + (separate information sheet, p. 3) – Territorial scope – definition of foreign countries - p. 4

Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence. - Optionnelle : non · Portée : all territories outside the Grand Duchy of Luxembourg and the country of permanent residence

Exclusions

Exclusion Description S'applique à Page
Not medical necessary treatments Not medical necessary treatments all p. 1
Preventive, health cure and sanatorium treatments Preventive, health cure and sanatorium treatments all p. 1
Aesthetic treatments Aesthetic treatments all p. 1
Diet, nutrition and tonics Diet, nutrition and tonics all p. 1
Radiation, nuclear energy, war, terrorism Damage caused by exposure to radiation and nuclear energy and damage caused by war, civil war, unrest, terrorism or similar circumstances all p. 1
Claims before commencement of the insurance contract Benefits for insurance claims before commencement of the insurance contract all p. 1
Post-insurance expenses Benefits for post-insurance expenses all p. 1
Cover defined by the Terms and Conditions Insurance cover is defined by the type and extent of cover described in the General Terms and Conditions of Insurance and in the tariff conditions of the corresponding tariff. all p. 1
Claims occurring during the waiting period No reimbursement of expenses for claims occurring during the waiting period all p. 1
Reimbursement limited to expenses incurred The amount of reimbursement is limited on expenses incurred. all p. 1
Other limitations Other limitations such as: Breach of obligations; If the policyholder does not arrange for payment of instalments due in due time; During sojourn in a non-European country all p. 1
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Treatments that were a reason for the journey Treatments abroad if the treatments were the only or at least one of the reasons for your journey; TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Existing illnesses known before the journey Treatments of existing illnesses where the necessity of the treatment abroad was known before the journey started (based on medical diagnosis) TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Contraceptive Costs for contraceptive TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Prevention medicine, vaccination and serum Costs for prevention medicine, vaccination and serum TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Diseases based on intention or addiction Costs for diseases based on intention or addiction TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Suicide or attempted suicide Costs in connection with suicide or attempted suicide TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Mental, psychogenic and psychosomatic illnesses Costs of treatments for mental, psychogenic and psychosomatic illnesses TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Pregnancy known prior to the journey Costs related to an insured person’s pregnancy known prior to the beginning of the journey TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Dental prostheses and dental crowns Dental prostheses and dental crowns TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Aesthetic treatments Costs for aesthetic treatments TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Insured events prior to the beginning of cover Costs for insured events that occurred prior to the beginning of insurance cover TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Costs after the termination of cover Costs occurring after the termination of insurance cover TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Cover defined by the Terms and Conditions Insurance cover is defined by the type and extent of cover described in the General Terms and Conditions of Insurance. TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Reimbursement limited to expenses incurred The amount of reimbursement is limited on expenses incurred. TRAVEL / TRAVEL + p. 3
TRAVEL / TRAVEL + (separate information sheet, p. 3) – Territories under a travel warning Further limitations such as: No insurance cover applies to the territories for which the Ministry of Foreign Affairs of Grand-Duchy of Luxemburg (“Ministère des affaires étrangères”) or a relevant Ministry or competent authority in the bordering countries of Luxemburg has issued a travel warning for this territory. TRAVEL / TRAVEL + p. 3

Délais d'attente

  • COMPLETE HEALTH : No reimbursement of expenses for claims occurring during the waiting period. Insurance cover commences not before the termination of waiting periods. The length of the waiting periods is not stated in the document. p. 1

Obligations de l'assuré

  • The policyholder and the person insured are obliged to furnish on demand any information and documentation necessary in order to determine an insurance claim. (on demand) p. 2
  • Persons insured are obliged to undergo a medical examination performed by a medical consultant on behalf of the company if requested to do so by the insurance company. (if requested by the insurance company) p. 2
  • The policyholder is obliged to pay the agreed premium plus taxes on time. (on time · Other limitations such as: If the policyholder does not arrange for payment of instalments due in due time) p. 2
  • In order to check our obligation to pay benefits, we may need information from you or the insured person. You or the insured person are obliged to provide us with the requested information. (on request) p. 4
  • The insured person is obliged at our request to have himself/herself examined by a medical practitioner commissioned by us. (at the insurer's request) p. 4
  • You are obliged to pay all due premiums including taxes within due time. (within due time) p. 4

Durée & résiliation

  • Durée : Insurance cover commences in accordance with the time period stated in the policy document (commencement of insurance); however, not before the insurance contract has been concluded, i.e. not before the insurance policy has been signed by both contractual partners and not before the termination of waiting periods. Insurance cover ends – including any insurance claims which may be still pending – when the insurance contract is terminated. For TRAVEL / TRAVEL + (p. 4): The beginning and the end of the insurance cover are indicated in the General Terms and Conditions.
  • Reconduction tacite : oui
  • Préavis : Period of notice to cancel the insurance contract is 30 days.
  • Modalité : Cancellation must be effected in writing.
  • Droit spécial : The policyholder can contest the automatic renewal of the insurance contract by notifying the insurance company with effect at the end of the insurance year, however, not before termination of the second insurance year at the earliest.
  • Droit spécial : As a policyholder, you may limit the cancelation of the insurance to a single insured person in your insurance contract.
  • Droit spécial : The cancellation is only valid provided that the policyholder can prove that the insured persons affected by this were informed of notification to cancel.
  • Droit spécial : In some situations, you might have an extraordinary cancellation right, e.g. if premium contributions are subject to an increase.
  • Droit spécial : Insurance cover is terminated, for example; in case of: Cancellation of the insurance contract; Death of the insured person; Non-compliance with the requirements of a risk/person to be insured stipulated in the tariff conditions.
  • Droit spécial : TRAVEL / TRAVEL + (p. 4): The insurance contract ends automatically with the termination date indicated on the policy. There is no automatic renewal of the insurance contract.

Prime

  • The first instalment/premium payment must be paid at the latest immediately after the insurance policy has been given to the policy holder, however, not before the inception date of insurance cover indicated on the insurance policy.
  • All other premiums are due, depending on the agreed method of payment, at the beginning of the agreed contribution period.
  • Premium payment can be effected via bank transfer or via direct debit mandate in favor of the insurer. Should you opt for monthly instalments, it is indispensable to arrange for a direct debit mandate in favor of the insurer.
  • In some situations, you might have an extraordinary cancellation right, e.g. if premium contributions are subject to an increase.
  • TRAVEL / TRAVEL + (p. 4): Premium payment has to be effected immediately.
  • TRAVEL / TRAVEL + (p. 4): Premium payment can be effected via credit card or Digicash.

Conditions particulières

  • The entire content is listed in the following documents: Your insurance application and our offer; The insurance policy and any further stipulated agreement; The General terms and conditions of insurance GCI; The tariff conditions of the insured tariff. p. 1
  • The entire content is listed in the following documents: Your insurance application and our offer; The insurance policy and any further stipulated agreement; The General terms and conditions of insurance GCI. (The tariff conditions line present on page 1 is absent from this list.) p. 3
  • Travel Insurance for journeys abroad p. 3
  • The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified. p. 3

Lacunes d'extraction

  • THIS PDF CONTAINS TWO DIFFERENT IPIDs, and the schema carries one product. Pages 1-2 are the IPID for 'DKV Luxembourg S.A. - Product : COMPLETE HEALTH'; pages 3-4 are a complete, self-standing IPID for 'DKV Luxembourg S.A. - Product : TRAVEL / TRAVEL +' — its own 'What type of insurance is it ?' ('Travel Insurance for journeys abroad'), its own covered / not-covered / restrictions boxes, its own obligations, payment, start-end and cancellation sections. product_name is COMPLETE HEALTH (the task metadata and the first sheet agree). The second sheet was NOT discarded: page 1 states that 'The scope of insurance also includes the free of charge protection according to the TRAVEL + tariff (see separate information sheet)', so its content belongs to what a COMPLETE HEALTH policyholder is covered for. Every item taken from it is prefixed 'TRAVEL / TRAVEL + (separate information sheet, p. 3) – ' and cites page 3 or 4, so a reader can always tell the two sheets apart. Note that branch is 'sante' from the task metadata while the second sheet is a travel product; both sheets are nevertheless badged 'Private Health Insurance' in their own footer line.
  • edition_date: null — neither sheet prints an edition/version date or a reference code. The whole text layer of all four pages was searched for date and version patterns: no hit. The PDF metadata carry a creation date (2019-12-12) and a modification date (2019-12-19); that is metadata, not print, and was NOT used as edition_date.
  • Polarity of the lists: the markers are BITMAP IMAGES, neither text nor vector drawings. Page 1: 32 image markers — 21 green ticks (7.16 × 7.94 pt, x0 = 29.8), 7 red crosses (7.16 × 7.22 pt, x0 = 307.4), 4 orange exclamation marks (2.39 × 8.87 pt, x0 = 309.4); 21 + 7 + 4 = 32. Page 3: 28 markers — 13 ticks, 12 crosses, 3 exclamation marks; 13 + 12 + 3 = 28. Page 2 and page 4: 2 ticks each ('Where am I covered ?'). Every count closes against the extracted items. Marker shape and colour were confirmed on a 6× render of a sibling document from the same template. These facts cannot appear in key_quotes: they are not in the text layer.
  • One item on page 1 is printed WITHOUT a marker and was kept: 'The scope of insurance also includes the free of charge protection according to the TRAVEL + tariff (see separate information sheet)'. It sits below the last BEST CARE tick, inside the 'What is insured ?' box, and it is the sentence that ties the two sheets together — dropping it to make the tick count match the item count would have hidden the link. Page 3 carries the same kind of unmarked line: 'The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.', recorded as the limits of every TRAVEL item and in special_conditions.
  • Column-inversion check NEGATIVE on both sheets: the flat text emits each left column in full before its right column, with no interleaving, although the y-ranges overlap throughout (a tick at y = 369.5 and a cross at y = 369.5 on page 1). Attachment was rebuilt marker by marker on the abscissa rather than taken from reading order. Recorded because a negative control is only valid for the document it was run on.
  • The two sheets carry different item sets in identically-named boxes — for instance 'Medical aids such as hearing aids, arch supports' is covered on sheet 1, while sheet 2 covers 'Medical aids that become necessary for the first time during a stay abroad and as a consequence of an accident (excluding vision or hearing aids)'. They were kept strictly separate; nothing from one sheet was used to complete the other.
  • target_audience: null. Neither sheet names a customer category; the document's own wording is in target_audience_note. Not deduced from the product type.
  • The length of the waiting periods is never stated; waiting_periods.duration stays null. Sheet 2 mentions no waiting period at all.
  • Neither sheet states a deductible/franchise, a prescription period or a claims procedure; deductibles, prescription_period and claims_procedure stay empty.
  • No item on either sheet is presented as optional — unlike the sibling COMPACT HEALTH and HOSPITAL HEALTH sheets, the BEST CARE block here is headed 'Tariff BEST CARE + / BEST CARE PREMIUM +' with the condition '(in case of full insurance coverage for inpatient treatments)' rather than 'Optional service'. is_optional is therefore false throughout, and that condition is recorded in conditions[].
  • Spelling kept verbatim as printed, not corrected: 'Accomodation costs (including single room)' on sheet 1 against 'Accommodation costs' on sheet 2, and 'co-insured' on sheet 1.
  • Text-layer trap check: no zero-width spaces, no soft hyphens, no NFD combining accents, no PUA glyphs, no U+0007, no text outside the page rectangle, no stacked headers. One curly apostrophe (U+2019, in 'an insured person’s pregnancy') and 24 thin spaces U+2009 were found and preserved verbatim in the quotes rather than normalised.
  • The risk carrier is named on BOTH sheets: 'DKV Luxembourg S.A.' (page 1 and page 3 footers, with legal form). No third party (claims handler, assistance company, broker) is named anywhere in the document.
  • The PyMuPDF re-extraction performed here is BYTE-IDENTICAL to the text supplied in the prompt (10234 = 10234 characters); the text was not truncated.

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