Beneficiary
The Enrolled employee or his Legal dependent listed in the application for this insurance Policy, or included thereafter, formally accepted by the insurer and listed in the Schedule or any subsequent Endorsement thereon, are considered under this Insurance Policy as eligible and referred to as beneficiaries.

Benefit
The smallest block of a Plan which is linked to a Family of Benefits and described by the Scope of Coverage.

Benefit Description
Describes the scope of cover and modalities of claims payment and is part of the contract.

Cancellation Date
The day (at 12:00 noon or night local time) month and year on which this Insurance Policy has been canceled as a result of the Policyholder’s written notice and/or as a result of the non-fulfillment of the Policyholder’s obligations as set forth in the general terms herein.

Chronic Disorder: An incurable disease requiring a regular, lifetime Treatment.
Claim
Information submitted by a Provider or by a Beneficiary to establish that medical services were provided to the Beneficiary, within the frame of the Benefits selected, and upon which processing for payment to the Provider or Beneficiary is made. The term generally refers to the liability of the Insurer for Healthcare services received by one of the Beneficiaries.

Co-participation
The participation of the Beneficiary, Policyholder and/or a Co-Payer in accordance with pre-defined percentages in the payment of Eligible Expenses covered under this Insurance Policy. The Insurer shall be liable for the balance of the Eligible Expenses.

Co-Payer
An entity or a person participating jointly with the Insurer in the payment of an Eligible Expense, in accordance with a defined percentage as specified under the Partnership Schedule and/or the Scope of Coverage Schedule.

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Day-Hospitalization
Sometimes called Day-Care. Same day surgery, medical treatment or diagnostic tests including but not restricted to oncology (chemotherapy) and cardiology related to any Non-Excluded cases, not requiring an overnight stay at a Hospital but, nevertheless, necessitating specialised medical attention and care in a Hospital, before, during and after the Treatment.

Declared Condition
Any pre-existing Condition that was declared by the Policyholder in an Application Form.

Deductible Excess per Beneficiary
The accumulated amount of money relating to Eligible Expenses, and as specified in the Applicable Scope of Coverage Schedule to be borne by the Policyholder on behalf of a specific Beneficiary in addition to Specific Deductible Excess and/or the Policyholder Co-Participation if and when applicable during the period of this insurance Policy.

Deletion Date
The day (at 12:00 noon local time), month, and year on which the Beneficiary’s coverage is terminated as the result of his/her deletion at the request of the Policyholder, and/or in case his/her status as Employee or Legal Dependant no longer holds, or upon the cancellation of this Insurance Policy.

Disease
Medical condition/sickness/illness involving fever, pain, and/or malfunction of a bodily organ or function.

Effective Date
The day (at 12.00 noon or night local time), month, and year from which this Insurance Policy commenced.

Expiry Date
The day (at 12:00 noon local time), month, and year on which this Insurance Policy expires.

Eligible Claim
Eligible Expenses net of Specific Deductible Excess, Co-Participation, Priority Payer share and Aggregate Deductible Excess, within the limits of liability of the Insurer as defined in the Schedules.

Eligible Expenses
All healthcare expenses incurred by a Beneficiary, relating to Non-Excluded Cases before allowing for any Specific Deductible Excess, Aggregate Deductible Excess, Co-Participation Priority Payer share and limits, within the limits of liability of the Insurer as defined in the Schedules.

Endorsement
Contractual document issued by the Insurer subsequent to this Insurance Policy, introducing alterations to this Insurance Policy in full conformity with its provisions.

Family of Benefits
A group of Benefits of one nature in term of utilisation and Treatment (e.g. Family of In-Hospital Benefits, Family of Out-of-Hospital Benefits)

General Exclusion
The Exclusions, which are applicable under this Insurance Policy to all Benefits and shown in the General Exclusions List.

Hospitalisation
Any Hospital Confinement, for a minimum of one night, of Medically Necessary Treatment/ observation, of any Non-Excluded Disease or Bodily Injury necessitating specialised medical attention and care in a Hospital before, during and after the Treatment/observation, and which cannot be performed on an Out-of-Hospital basis.

Hospitalisation Class
The class of Hospital accommodation services which the Policyholder has selected on behalf of the Beneficiary to be applied for his/her Hospital Confinement and which are identified in the Policy Schedule.

In-Patient
A patient who occupies a bed overnight, or been formally admitted as a Day-Hospitalisation patient in a Hospital.
Insurer
The Insurance Company duly registered & Licensed to operate in the country of issuance of this Insurance Policy for Better Healthcare.

Medically Necessary
A service or Treatment, which, in the medical opinion of the MCC, is appropriate and consistent with diagnosis, and which, in accordance with generally accepted medical standards, could not have been omitted without adversely affecting the Beneficiary’s condition or the quality of medical care rendered.

Network
Providers forming the MedNet Liban Network(s) through a special and formal contractual arrangement whereby they agree to avail the Beneficiary, usually on his Access Card presentation, with Free Access on a direct billing basis to their healthcare services in conformity with the terms of this Insurance Policy and as set forth in the Policy Schedule and in the Beneficiary User’s Guide.

Non-Network Provider
Any Providers that are not part of the Network

Out-of-Hospital
Physician’s consultation, prescribed drugs, diagnostic tests and Treatment not requiring Hospitalisation nor necessitating specialised medical attention and care in a Hospital before, during and after the procedure.

Physician
Any doctor of medicine (MD) duly licensed and qualified to render the Treatment provided under the law of jurisdiction in which such Treatment is provided.

Plan
The combination of Benefits offered by the Insurer and selected by the Policyholder on the Application Form.

Policyholder
Initially the applicant for this Insurance Policy for Better Healthcare acting in the name and on behalf of, his Employees and their Legal Dependants whose Application has been formally accepted by the Insurer. By virtue of acceptance, this Insurance Policy has been issued and the applicant becomes the Policyholder.

Policy Schedule
In which all Beneficiary and the Insurer information are specified, together with the specific conditions of this Insurance Policy (the Contractual Parties’ Data, the Effective Date, the Expiry Date, the Beneficiaries Date, the Enrolment Dates, the Category, the Specific Exclusions and related waiting periods if any, the Lifetime Limits when applicable, the Hospitalisation Class, the Selected Plans, the Premium, the Frequency of Payment and any reference(s) to other schedule(s).

Pre-existing Condition
Any health condition known/unknown to the Beneficiary and/or to the Policyholder which exhibited symptoms or was a consequence of injury or illness for which Medical, Surgical, and/or Pharmaceutical treatment, Medical diagnosis, or advice was provided prior to the Beneficiary’s enrollment Date.

Premium
The periodic payment is required to provide coverage and to keep the Insurance Policy in force.

Priority Payer
An entity identified under the Partnership Schedule as being the first party fully liable towards the Eligible Expenses of a specific Beneficiary up to a

Renewal
New coverage under a new Insurance Policy following a previous term and the acceptance of a Premium for a new Insurance Policy insurance period.

Renewal Date
The day (at 12:00 noon local time) month and year on which a Renewal takes place and which coincides with the Expiry date.

Specific Exclusions
The Exclusions resulting from Underwriting to be applied specifically to a certain Beneficiary.

Territory
The country (or group of countries) as selected by the Policyholder to allow Beneficiaries to access In-Hospital Benefits at the rates prevailing there in.

Underwriting
The process of evaluation to which the Insurer submits all Application Forms prior to issuance of the Insurance Policy and any other subsequent related Endorsement in full conformity with the provisions of this Insurance Policy.

Unnecessary Treatment
A service or Treatment, which is not Medically Necessary.

Waiting period
The period starting from the first enrollment date of the beneficiary during which an Exclusion is in force under a specific benefit covered under this Insurance Policy.