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EASY HEALTH IPID EN

Résumé

Insurance Product Information Document (IPID) of DKV Luxembourg S.A. for the product EASY HEALTH, a private health insurance providing additional protection for holders of a statutory insurance. Cover comprises outpatient treatment, dental treatment and inpatient treatment, plus a BEST CARE + / BEST CARE PREMIUM + service tariff. The scope of insurance also includes the free of charge protection according to the TRAVEL + tariff, whose own information sheet is bound into the same PDF (pages 3-4). Insurance cover applies to Europe, extended to the first month of a temporary sojourn in a non-European country.

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

Garanties

Medical treatments - p. 1

  • Optionnelle : non
  • Condition : Outpatient treatment

Drugs and dressings - p. 1

  • Optionnelle : non
  • Condition : Outpatient treatment

Remedies such as physiotherapy, massages - p. 1

  • Optionnelle : non
  • Condition : Outpatient treatment

Services of a midwife - p. 1

  • Optionnelle : non
  • Condition : Outpatient treatment

Medical aids such as hearing aids, arch supports - p. 1

  • Optionnelle : non
  • Condition : Outpatient treatment

Visual aids - p. 1

  • Optionnelle : non
  • Condition : Outpatient treatment

Refractive eye surgery (e.g. Laser) - p. 1

  • Optionnelle : non
  • Condition : Outpatient treatment

Alternative treatment methods - p. 1

  • Optionnelle : non
  • Condition : Outpatient treatment

Dental treatment - p. 1

  • Optionnelle : non
  • Condition : Dental treatment

Dental deep cleaning - p. 1

  • Optionnelle : non
  • Condition : Dental treatment

Replacement teeth such as crowns, implants, inlays - p. 1

  • Optionnelle : non
  • Condition : Dental treatment

Orthodontic treatment - p. 1

  • Optionnelle : non
  • Condition : Dental treatment

Medical treatment (including chief physician) - p. 1

  • Optionnelle : non
  • Condition : Inpatient treatment

Accomodation costs (including single room) - p. 1

  • Optionnelle : non
  • Condition : Inpatient treatment

One-Day-Clinic - p. 1

  • Optionnelle : non
  • Condition : Inpatient treatment

Rooming-in for one parent with co-insured children - p. 1

  • Optionnelle : non
  • Condition : Inpatient treatment

Transportation to the hospital in an ambulance - p. 1

  • Optionnelle : non
  • Condition : Inpatient treatment

Hospital daily benefit - p. 1

  • Optionnelle : non
  • Condition : Inpatient treatment

Preparation of a second opinion by recognised specialists - p. 1

Preparation of a second opinion by recognised specialists for certain diseases requiring inpatient treatment, malformations and complications following accident injuries - Condition : Tariff BEST CARE + / BEST CARE PREMIUM +

Organization of a surgery by an expert within 5 working days - p. 1

If necessary, organization of a surgery by an expert within 5 working days - Condition : Tariff BEST CARE + / BEST CARE PREMIUM +

Payment of an expense flat rate - p. 1

  • Condition : Tariff BEST CARE + / BEST CARE PREMIUM +

Medical treatments - p. 3

  • Optionnelle : non · Portée : Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence.
  • Condition : Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4)
  • Condition : Outpatient treatments
  • Condition : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

Drugs and dressings - p. 3

  • Optionnelle : non · Portée : Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence.
  • Condition : Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4)
  • Condition : Outpatient treatments
  • Condition : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

Remedies such as physiotherapy, massages - p. 3

  • Optionnelle : non · Portée : Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence.
  • Condition : Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4)
  • Condition : Outpatient treatments
  • Condition : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

Medical aids first necessary during a stay abroad - 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 · Portée : Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence. - Condition : Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) - Condition : Outpatient treatments - Condition : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

Pain-relieving treatment - p. 3

  • Optionnelle : non · Portée : Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence.
  • Condition : Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4)
  • Condition : Dental treatments
  • Condition : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

Simple dental filling - p. 3

  • Optionnelle : non · Portée : Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence.
  • Condition : Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4)
  • Condition : Dental treatments
  • Condition : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

Repair of existing tooth replacement - p. 3

Repair of existing tooth replacement in order to re-establish ability to chew - Optionnelle : non · Portée : Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence. - Condition : Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) - Condition : Dental treatments - Condition : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

Provisional prostheses - p. 3

  • Optionnelle : non · Portée : Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence.
  • Condition : Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4)
  • Condition : Dental treatments
  • Condition : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

Medical treatment (incl. surgery) - p. 3

  • Optionnelle : non · Portée : Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence.
  • Condition : Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4)
  • Condition : Inpatient treatments
  • Condition : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

Accommodation costs (incl. additional costs for individual room) - p. 3

  • Optionnelle : non · Portée : Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence.
  • Condition : Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4)
  • Condition : Inpatient treatments
  • Condition : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

Medical necessary transport to the nearest hospital or doctor - p. 3

Medical necessary transport using approved rescue services to the nearest hospital or doctor - Optionnelle : non · Portée : Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence. - Condition : Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) - Condition : Ambulance services - Condition : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

Return transport of the insured person - p. 3

Organization and assumption of the costs for a medically reasonable and justifiable return transport of the insured person - Optionnelle : non · Portée : Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence. - Condition : Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) - Condition : Repatriation and return transport - Condition : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

Transfer in the event of the death of the insured person - p. 3

Organization and assumption of costs for a transfer in the event of the death of the insured person - Optionnelle : non · Portée : Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence. - Condition : Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) - Condition : Repatriation and return transport - Condition : The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.

Exclusions

Exclusion Description S'applique à Page
Not medical necessary treatments all p. 1
Preventive, health cure and sanatorium treatments all p. 1
Aesthetic treatments all p. 1
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 General Terms and Conditions and the tariff 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: Breach of obligations Breach of obligations all p. 1
Other limitations: late payment of instalments If the policyholder does not arrange for payment of instalments due in due time all p. 1
Other limitations: during sojourn in a non-European country During sojourn in a non-European country all p. 1
Treatments abroad 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; Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Existing illnesses whose treatment abroad was known before departure Treatments of existing illnesses where the necessity of the treatment abroad was known before the journey started (based on medical diagnosis) Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Costs for contraceptive Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Costs for prevention medicine, vaccination and serum Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Costs for diseases based on intention or addiction Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Costs in connection with suicide or attempted suicide Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Costs of treatments for mental, psychogenic and psychosomatic illnesses Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Costs related to a pregnancy known prior to the journey Costs related to an insured person’s pregnancy known prior to the beginning of the journey Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Dental prostheses and dental crowns Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Costs for aesthetic treatments Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Costs for insured events prior to the beginning of insurance cover Costs for insured events that occurred prior to the beginning of insurance cover Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Costs occurring after the termination of insurance cover Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Cover defined by the General Terms and Conditions Insurance cover is defined by the type and extent of cover described in the General Terms and Conditions of Insurance. Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Reimbursement limited to expenses incurred The amount of reimbursement is limited on expenses incurred. Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3
Further limitations: territories under a travel warning 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. Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4) p. 3

Délais d'attente

  • all : No reimbursement of expenses for claims occurring during the waiting period. Insurance cover does not commence before the termination of waiting periods. The length of the waiting periods is not stated in this 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 / on a claim) 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. (during the contract · Limitation if the policyholder does not arrange for payment of instalments due in due time (see restrictions, page 1)) 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 a claim) 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. (during the contract) 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.
  • 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 : Insurance cover ends – including any insurance claims which may be still pending – when the insurance contract is terminated.
  • Droit spécial : TRAVEL / TRAVEL + (page 4): The insurance contract ends automatically with the termination date indicated on the policy. There is no automatic renewal of the insurance contract.
  • Droit spécial : TRAVEL / TRAVEL + (page 4): The beginning and the end of the insurance cover are indicated in the General Terms and Conditions.

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.
  • TRAVEL / TRAVEL + (page 4): Premium payment has to be effected immediately.
  • TRAVEL / TRAVEL + (page 4): Premium payment can be effected via credit card or Digicash.

Conditions particulières

  • Insurance cover applies to Europe. Insurance cover is provided during the first month of a temporary sojourn in a non-European country. (Territorial scope stated once for the whole contract, not per guarantee.) p. 2
  • Your insurance cover is valid for the journey abroad indicated on your insurance application. Considered as foreign countries are all territories outside the Grand Duchy of Luxembourg and the country in which you have your permanent residence. p. 4
  • The scope of insurance also includes the free of charge protection according to the TRAVEL + tariff (see separate information sheet). That separate sheet is physically bound into this same PDF as pages 3-4. p. 1
  • This information sheet is not complete and the examples given below are only an extract of the total benefit catalogue. The entire content is listed in: 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: your insurance application and our offer; the insurance policy and any further stipulated agreement; the General terms and conditions of insurance GCI. p. 3

Lacunes d'extraction

  • STRUCTURE: ce PDF de 4 pages contient DEUX IPID complets et distincts, pas un seul. Pages 1-2 = 'DKV Luxembourg S.A. - Product : EASY HEALTH'. Pages 3-4 = 'DKV Luxembourg S.A. - Product : TRAVEL / TRAVEL +', avec son propre bandeau de tete, sa propre rubrique 'What type of insurance is it ?' ('Travel Insurance for journeys abroad') et ses propres rubriques obligations / paiement / duree / resiliation. Le second feuillet est ici parce que la page 1 le dit: 'The scope of insurance also includes the free of charge protection according to the TRAVEL + tariff (see separate information sheet)'. Les deux jeux de garanties et d'exclusions sont donc conserves dans ce fichier, chaque item du second IPID etant marque dans conditions[] / applies_to par 'Tariff TRAVEL / TRAVEL + (separate information sheet bound into the same PDF, pages 3-4)' et cite avec sa vraie page (3 ou 4). Consequence pour un relecteur: 21 des 34 garanties et 13 des 28 exclusions relevent d'EASY HEALTH; les autres relevent du feuillet TRAVEL / TRAVEL +, dont la branche serait 'voyage' et non 'sante'. Le schema ne peut pas porter deux produits ni deux branches dans un objet; product_name et branch suivent le produit principal des pages 1-2, comme l'annonce la metadonnee de tache.
  • Un IPID TRAVEL / TRAVEL + AUTONOME existe par ailleurs dans le meme lot. Aucun contenu n'a ete repris de lui: les pages 3-4 ont ete extraites de leur propre texte. (Observation seulement, hors champ de ce fichier: la version allemande autonome porte une garantie de plus que la copie encartee.)
  • edition_date null: aucune date d'edition, aucune reference interne et aucun folio ne sont imprimes sur les 4 pages. Metadonnee XMP non retenue (creationDate 2019-12-12, modDate 2019-12-19): elle n'est pas imprimee.
  • Polarite etablie sur le MARQUEUR, pas sur la colonne. Les puces sont des IMAGES bitmap invisibles a get_text() et a get_drawings(): coche verte 7,16 x 7,94 pt (source 120x133 px) = insured, croix rouge 7,16 x 7,22 pt (source 120x121 px) = not insured, point d'exclamation orange 2,39 x 8,87 pt (source 40x148 px) = restriction on cover. Les comptes ferment page par page: p1 = 21 coches + 7 croix + 4 exclamations; p2 = 2 coches; p3 = 13 coches + 12 croix + 3 exclamations; p4 = 2 coches. Rattachement item par item par coordonnees (ordonnee ET abscisse).
  • Controle negatif d'inversion de colonnes: effectue sur CE document, resultat negatif sur les quatre pages. L'attribution par marqueur coincide avec l'ordre du texte plat. Anomalie d'ordre sans consequence: les bandeaux de tete des pages 1 et 3 sont emis EN DERNIER par le texte plat alors qu'ils sont imprimes en haut de page.
  • Sous-items sans marqueur image (simple tiret), conserves comme exclusions distinctes: 3 sous 'Other limitations such as:' page 1, 1 sous 'Further limitations such as:' page 3. Le compte des marqueurs ne les couvre donc pas, et c'est normal.
  • is_optional null (et non false) pour les 3 garanties de la rubrique 'Tariff BEST CARE + / BEST CARE PREMIUM +': le document anglais ne dit PAS qu'elles sont optionnelles, il les range seulement sous un tarif nomme. La version francaise d'un produit voisin du meme editeur intitule la rubrique equivalente 'Couverture optionnelle', mais completer l'anglais depuis le francais mettrait dans les donnees un fait que CE document n'enonce pas. Pour toutes les autres garanties, is_optional false traduit leur presence sous 'What is insured ?' sans mention de tarif separe.
  • La rubrique 'Are there any restrictions on cover ?' est rendue en exclusions[]: elle enonce des restrictions de couverture plutot que des risques exclus.
  • target_audience 'particuliers' repose sur 'Additional protection for holders of a statutory insurance' (personnes physiques). Le libelle exact est dans target_audience_note.
  • Le document imprime 'Accomodation costs' page 1 (un seul m) et 'Accommodation costs' page 3 (deux m). Les deux graphies sont conservees verbatim, non harmonisees.
  • Deux exclusions portent le meme libelle 'The amount of reimbursement is limited on expenses incurred.' (page 1 et page 3). Elles sont conservees comme deux items distincts car elles appartiennent a deux IPID differents, distingues par applies_to et par page. Ce n'est pas un doublon.
  • Aucune definition contractuelle, aucune franchise, aucune procedure de declaration de sinistre detaillee et aucun delai de prescription: definitions[], deductibles, claims_procedure[] et prescription_period restent vides.
  • Aucun montant, plafond ni pourcentage n'est chiffre nulle part dans ce document: coverages[].limits est null partout. Le seul chiffre du document est un delai (5 working days) et il figure dans le libelle de la garantie. Les plafonds du feuillet TRAVEL sont renvoyes aux conditions generales ('The maximum amounts specified in the General Terms and Conditions of insurance apply to the benefits specified.'), conserve en condition sur chaque garantie concernee.
  • La duree des waiting periods est mentionnee mais jamais chiffree; waiting_periods[0].duration reste null.
  • Portee territoriale enoncee une fois par IPID, jamais garantie par garantie. Pour les garanties du feuillet TRAVEL / TRAVEL +, territorial_scope a ete renseigne parce que ce feuillet est une assurance de voyage dont la portee est constitutive de l'objet; pour les garanties EASY HEALTH elle reste null et figure dans special_conditions.
  • Controles negatifs supplementaires: aucun texte hors du rectangle de page, aucun glyphe de zone privee (PUA), aucun U+0007 (pas de texte vectorise), aucune ligature perdue, aucun accent NFD. Le texte contient des espaces fines U+2009 et U+200A (bandeau 'TRAVEL /TRAVEL+'), une apostrophe courbe U+2019 et des guillemets courbes: toutes les citations ont ete decoupees programmatiquement dans le calque texte.
  • Verification d'identite de source: les 4 pages du prompt sont octet pour octet identiques a ma propre extraction PyMuPDF du PDF local. Prompt non tronque.

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