SANITA GROUP EYE COMPLICATION INSURANCE

Modified on Fri, 16 Jan at 7:05 AM

  1. POLICY HOLDER

  2. NET PREMIUM

  3. GROSS PREMIUM

  4. IN CASE OF ANY OCCURENCE

  5. COMPLICATION COVERAGE

  6. Scope Specifics

  7. Exclusions

  8. TRANSPORT COLLATERAL

  9. ACCOMMODATION COLLATERAL

  10. 3RD PARTY FISCAL LIABILITY

  11. LEGAL PROTECTION

TRAVEL COLLATERALS 

  1. MEDICAL TREATMENT

  2. TRANSFER OF THE FUNERAL OF THE INSURED

  3. TRAVEL AND TRANSFER OF THE INSURED

  4. LOSS OF LUGGAGE

  5. INTERFERENCE IN ONE'S OWN COUNTRY

  6. PARTICULAR CONDITIONS
     


1 POLICY HOLDER

SANİTA GRUP ULUSLARARASI SAĞLIK VE TEDAVİ HİZMETLERİ A.Ş.

2 NET PREMIUM

489.00 EUR

3 GROSS PREMIUM

498.45 EUR

4 IN CASE OF ANY OCCURENCE, THE CONTACT NUMBERS ARE

00-90-850-251 80 11

5 COMPLICATION COVERAGE 7500 EUROS 

The medical complications which arise due to the eye surgeries, interventions and medical practices  performed in a health institution with a Health Tourism Accreditation certificate within the borders of  Turkey are paid for treatments in line with the coverage limits indicated in this policy. 

The dissatisfaction due to personal preferences within the scope of their treatment is not included in the  scope of this policy. 

The revision surgery or intervention costs which are required to correct complications are covered.  Rehabilitation and physical therapy expenses that may be required after surgery or intervention are not  covered by this coverage. 

The relevant coverage is only effective for the surgeries or interventions indicated in the policy. The  complications which arise due to medical treatments or practices outside the policy plan are excluded from  coverage. 

The supportive treatments provided before and after the first surgery or intervention and revision surgery  or intervention (for example, blood pressure control, supportive drug treatments, IV drip, blood sugar  regulation, etc.), additional examinations and follow-up examinations required for other health problems  unrelated to the surgery are not included in the scope of and covered by this insurance policy. 

The tests and medications which are required for medical procedures related to the complications are  among the expenses paid under this policy. Yet, the diagnostic procedures performed other than the  diagnosis required by medical intervention and standard preliminary examinations that must be performed  before surgery, and medications unrelated to surgery are excluded from the coverage. 


6 THE FOLLOWING COMPLICATIONS ARE COVERED WITHIN THE POLICY LIMITS;


  1. Due to refractive error surgery; Flap damage, Keratitis, Haze formation under the flap, Epithelial migration  under the flap, Retinal detachment, Ptosis/Pseudoptosis surgeries, Exposure keratopathy, Hematoma and  infections, Suture opening/looseness, Recurrence of ptosis, Cataract surgery, Aphtha, Lens falling into the  retina, Cataract surgery Requirement for posterior vitrectomy, Posterior capsule opening, Corneal oedema  not exceeding 3 months, PHACO burn, Endophthalmitis, Posterior capsule opacification, Expulsive  hemorrhage 

  2. Glaucoma; Bleb leakage, Conjunctiva damage, Scleral flap damage, Opening of flap sutures, Suprochoidal  hemorrhage, Central vision loss, Endophthalmitis, Anterior segment hemorrhage, Posterior segment hemorrhage, Cataract development (it must be documented that it has not existed before), Corneal edema  not exceeding 3 months. 

  3. Due to retinal surgery; Unsubsided retinal, Endophthalmitis, Cataract development (it must be  documented that it has not existed before.) Development of glaucoma (it must be documented that it has  not existed before.) 


7 NO GUARANTEE IS GIVEN FOR THE SITUATIONS LISTED BELOW. 

  1. Problems caused by physician practice error 

  2. Damages that may arise as a result of other complications or malpractice that may occur during the  operation and interventions, operations and all kinds of examinations that shall need to be performed due  to the insured's additional diseases Due to refractive error surgery; Need for glasses/lenses due to  incomplete recovery after surgery, development of dry eye after surgery, itching, redness, complaints etc. 

  3. Ptosis/Pseudoptosis surgeries; Eyes that look different aesthetically even though their function is intact,  Cataractsurgery, Need for glasses/lenses due to incomplete recovery after surgery,Development of dry eye  after surgery, Itching, redness, complaints etc. 

  4. Glaucoma; Use of antiglaucomatous medication despite postoperative bleb work, postoperative dry eye development, itching, redness, complaints etc. 


  1. Retinal surgery; Need for glasses/lenses due to incomplete recovery after surgery, presence of vision  problem even though the retina is anatomically flat, development of dry eye after surgery, itching, redness,  etc. Complaints, Temporary intraocular pressure increases in the early postoperative period due to the  tampone used during surgery. 

8 TRANSPORT COLLATERAL MAX 1000 EUROS 

If the insured is obliged to return from his/her country to Turkey for the treatment of complications arising  from a treatment applied in Turkey or for the revision of the surgery, the expenses incurred for an economy  class flight ticket, max. It is guaranteed for 1000 Euros. A 100 EUR exemption is applied to transportation  coverage. 

9 ACCOMMODATION COLLATERAL MAX. 1000 EUROS


If the insured has to stay outside the hospital for the treatment of complications that develop as a result  of the treatment implemented in Turkey or for the revision of the surgery, this is covered within the scope  of coverage. A maximum daily coverage limit of 100 EUR is covered. Accommodation expenses of 100 EUR  are exempt in all Plans. Accommodations that continue after this exemption period ends are covered. In  the event where there is no medical need, optional accommodation expenses are not covered by  insurance and accommodation requirements can be covered by mutual agreement, medical report and  approval of the doctor performing the operation and the company doctor. 


10 3RD PARTY FISCAL LIABILITY 3750 EURO 

As a result of an accident that may arise during the insured's travel period, coverage is provided up to the  total liability limit indicated in the policy, against the consequences of compensation claims that may be  made by third parties against the insured due to legal liability, which may arise due to material and physical  damages suffered by third parties. It provides assurance within the framework of the applicable provisions  of the Third Party Liability General Conditions and the coverage limits recorded in the policy. If there are  other insurance policies that cover the liability of the insured at the time the risk occurs, this coverage is  effective for the parts that exceed the liabilities of the insurers regarding other policies, provided that it does not exceed the limit written in the policy. 

Special exemptions; if the insured travels with his own vehicle, legal responsibilities that may arise from  the use or operation of the vehicle and that shall belong to the operator of the vehicle in accordance with  the Highway Traffic Law and other general provisions; Liabilities which arise due to the insured's profession,  business activities and products manufactured are outside the scope of this coverage. 

Total Liability Limit During the Policy Term/Period: In this insurance policy, it is the maximum compensation  amount that the insurer can pay in total and during the policy period, based on the bodily and material  damages covered within the policy special conditions and Third Party Financial Liability General Conditions. 


11 LEGAL PROTECTION 500 EUROS 

It provides protection for disputes between the insured and the policyholder that may arise from the  complications covered in the policy opened in Turkey without prejudice to the provisions of the Legal  Protection Insurance General Condition. The issue of guarantee does not cover disputes based on personal  taste and compensation obligations awarded in the case, and based on the guarantee amount of 500 Euros;  30% for attorney fees and 70% for litigation and enforcement expenses. In attorney fee  payments, the official minimum wage tariff shall be taken as basis. 

12 TRAVEL COLLATERAL - MEDICAL TREATMENT 30000 EUROS


In the event the Insured person occurs (or is injured) due to one of the emergency diseases covered by this  policy, the Insurance Company shall pay the hospital, surgery and treatment expenses, as well as the costs  of the drugs prescribed by the relevant doctor, on behalf of  Insurance Provider. 


13 TRAVEL COLLATERAL - TRANSFER OF THE FUNERAL OF THE INSURED 

In the event the insured dies due to sudden illness or injury within the scope of this policy, the Insurance  Company; He/she shall organize the transportation of the body to the requested address for burial. Funeral  and burial expenses are not covered. 

14 TRAVEL COLLATERAL - TRAVEL AND TRANSFER OF THE INSURED 

In the event the Insured becomes suddenly ill or injured under this policy, the Insurance Company shall  transport the Insured to the nearest appropriate medical centre or from one medical centre to another by  ambulance or any other means of transport deemed most appropriate by the accompanying doctor and  the Insurance Company's doctor which shall cover the required expenses. Transfer from one medical centre to another shall only be provided if the medical centre does not have the required equipment and medical  team for the treatment of the patient. In order for transplantation to take place, a medical report issued  by the treating doctor is required. Only the Insurance Company's doctor can decide on air ambulance  service. 

15 LOSS OF LUGGAGE 

In the event the baggage is lost, stolen or damaged on scheduled flights and cannot be found within the  period determined by the Airline Company (Minimum 21 days), the guarantee shall be considered effective  subject to the loss, damage or theft report of the airline. Insurance Provider shall make payment to the  insured within the limit of 350 EUR.  The amount of compensation to be paid by the  airline shall be determined by deducting the compensation amount paid by the responsible airline  company from the damage reported by the insured. The insured is obliged to submit the list of baggage contents, estimated price and purchase dates, and the compensation payment document received from  the airline company. 

Money, jewellery, credit cards and any documents are outside the scope of this guarantee. A depreciation  allowance shall be implemented in the calculation of the cost of the declared and covered baggage content.  In practice, items purchased six months before the date of damage and declared with an invoice shall be  paid based on the invoice amount, within the coverage limit and participation rate. A 50% depreciation  allowance shall be implemented to items that are longer than six months old (invoice submission for the  relevant item is required). 

16 INTERFERENCE IN ONE'S OWN COUNTRY 7500 EUROS


Treatments related to early complications that may occur after medical intervention or surgery undergone  by the insured following their return to their home country, which do not require readmission (such as  discharge at the wound site, infection, etc.), will be covered within the limits specified in the policy. 


17 PARTICULAR CONDITIONS 

  1. This policy is only issued to foreign nationals and is not issued to dual citizens, provided that one of them  is a Turkish citizen. 

  2. Although the geographical limit of the policy is specified in the policy, any complication treatment that  may occur outside Turkey is excluded from coverage. 

  3. This policy provides coverage to insured people between the ages of 18-65. 

  4. For travel coverage, the policy is effective for trips lasting a maximum of 92 consecutive days. Even if a  new policy is issued for travels exceeding 92 days, this period cannot be extended without entering the  borders of the country of residence, and the new policies shall be deemed invalid. 

  5. In the event of false declaration, the policy shall not be considered effective and no compensation 
    liability  shall arise. The coverage specified in the policy is effective provided that the treatments for the  complications of surgeries / interventions and medical treatments performed in Turkey after the policy  start date are performed within the borders of the Republic of Turkey. 

  6. Policy coverage is effective if the hospital where the insured undergoes the operation is arranged by  selecting the insured. 


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