1. Introduction
This document is designed to show all the features and benefits of the AXA Digital Health Plan. On the next few pages you will find details of your cover relevant to your plan.
1.1 A personal service
At AXA Mansard Health Limited, we are always aware that behind every claim there is a person who needs help and assistance. If there is anything you do not understand, or you have complaints about your facility or services, please do not hesitate to call Digital Health Customer Care Centre on: +234 708 808 8255 or Email: dhsupport@wellahealth.com
1.3 Binding Arbitration: The Arbitration shall be in accordance with the Arbitration and Conciliation Act Cap A18 Laws of the Federation of Nigeria 2004 which is deemed to be incorporated by reference into this Clause.
1.4 Data Protection policy: please visit https://www.axamansard.com/privacy-policy/
2. SERVICES DELIVERY, DURATION AND RENEWAL
2.1.1 A waiting period of two (2) working days applies for the pharmacy and Hospicash benefits with zero (0) waiting period for Telemedicine, this is the period during which underwriting takes place. This begins with the intending member registration, the HMO doing the necessary documentation of onboarding. This only applies to your 1
st purchase or renewal which has elapsed after 48hours.
2.1.2 This policy shall run for the specified period of cover applicable on the plan purchased by a customer either daily, weekly, quarterly, half yearly or yearly and shall continue to run subject to uninterrupted premium payment.
2.1.3 AXA shall provide the subscribers access to basic health care consultation and treatment for minor illnesses through in-network pharmacy arrange for provision to Beneficiaries of those Covered Services that are identified or stipulated in Schedule 1 attached hereto.
2.1.4 All Covered Services shall be provided in accordance with the generally accepted clinical and legal standards consistent with best practices in medical ethics and practices applicable internationally based on the cover limit.
SCHEDULE 1
AXA MANSARD DIGITAL HEALTH PRODUCTS
POLICY LIMIT
POLICY BENEFITS
Tele-medicine and Medication Covered Benefits:
Claims Documentation for Medication at the pharmacy
Customer shares phone number, generated tracking number from the Whatsapp chat with the doctor.
Hospicash
This covers the overnight, in-patient hospitalisation for two (2) or more consecutive nights in a NHIA registered hospital (“Hospitalisation”). This means a customer must have been on admission for 2 nights to be able to get this benefit. This benefit shall only be claimed once in a month. The maximum benefit available per incident/month is N40,000.
Exclusions
AXA Mansard shall not be liable to pay Benefits for claims occurring due to the following causes:
Hospital admissions attributed to self-inflicted injury, war, participation in riots or demonstrations, abuse of alcohol or illegal drugs.
Claims Documentation
The Beneficiary must provide the following Claims Documents as evidence of hospitalization within [30] days of the incident and must submit all Claims Documents within [90] days of the Claim notification.
· Official medical report signed and stamped from the hospital showing the date of admission, date of discharge and treatment received.
Hospital invoice or receipt with patient’s full name.