What does Gold, Gold Plus and Platinum medical emergency expenses cover?

Gold, Gold Plus and Platinum medical emergency expenses can help with emergency medical treatment, repatriation and related costs if you become ill or injured during your trip.
What this article helps you do

This article explains what medical emergency expenses are for. It also explains when to contact Zurich Assist, what costs may be included, and what is not included.

Applies to

• Applicable policies: AllClear Gold, Gold Plus and Platinum 
• Trip type: Single Trip and Annual Multi-Trips 
• Who it applies to: People insured under the policy 
• Region: Trips outside the United Kingdom 
• Also applies to: Channel Islands or Isle of Man residents visiting other parts of the United Kingdom, UK residents visiting the Channel Islands or Isle of Man, and participation in a cruise solely within the United Kingdom 
• Not included if: Other trips within the United Kingdom 

Quick answer

• This is not private health insurance. 
• Private treatment is only considered where there is no appropriate reciprocal health agreement and no public service available. 
• You must contact Zurich Assist as soon as possible if you are admitted to hospital, or outpatient treatment is likely to cost more than £350. 
• You must notify Zurich Assist immediately if you may need to return home early or extend your journey because of illness or accident. 
• Receipts must be kept and provided if you make a claim. 
• AllClear may arrange to move you between hospitals or bring you home if medical advisers decide you can safely travel.

Gold includes:

• Medical emergency expenses, repatriation and associated expenses: up to £10,000,000, with a £250 excess. 
• Medical inconvenience benefit: £25 per day while hospitalised, with Nil excess. 
• Loss of medication: £300, with a £75 excess. 
• Emergency dental treatment: £350, with a £75 excess. 
• Unused prepaid tours or activities: £500, with a £75 excess. 

Gold Plus includes:

• Medical emergency expenses, repatriation and associated expenses: up to £15,000,000, with a £75 excess. 
• Medical inconvenience benefit: £25 per day while hospitalised, with Nil excess. 
• Loss of medication: £300, with a £75 excess. 
• Emergency dental treatment: £1,000, with a £75 excess. 
• Unused prepaid tours or activities: £500, with a £75 excess. 

Platinum includes:

• Medical emergency expenses, repatriation and associated expenses: Unlimited, with Nil excess. 
• Medical inconvenience benefit: £25 per day while hospitalised, with Nil excess. 
• Loss of medication: £300, with Nil excess. 
• Emergency dental treatment: £1,000, with Nil excess. 
• Unused prepaid tours or activities: £500, with Nil excess.

Check your policy schedule for your selected level of cover and any selected excess option.
When medical emergency expenses can apply

Medical emergency expenses can apply if, during your trip, you become ill or are injured and incur costs outside your home country.

This can include:

• Usual, reasonable and necessary medical and surgical treatment prescribed by a medical practitioner.
• Emergency dental treatment for pain relief only. 
• Reasonable extra room-only accommodation and economy-class travel costs for you and one relative or friend, where medical advice says they must stay with you, travel to be with you, or accompany you home. 
• Escort costs if a child needs to be accompanied home. 
• Loss of medication. 
• Conveyance of the body or ashes to your home country if you die during the trip. 
• Local funeral costs abroad. 
• Reasonable cattery or kennel costs if you cannot return home as planned for medical reasons. 
• A medical inconvenience benefit for each full 24-hour period you are an inpatient during the journey. 
• Pre-paid tours or activities you cannot use because you are hospitalised for an illness or injury covered under medical emergency expenses.

You must have permission for a relative or friend to stay with you, travel to be with you, or accompany you home.

Coronavirus trip extension costs

If you have to extend your trip because you contract Coronavirus, or because you are quarantined abroad on the orders of the treating medical practitioner, additional travel and accommodation cover is limited to £2,000.

The policy conditions and exclusions still apply.

What to do in a medical emergency

If you are admitted to hospital, or outpatient treatment is likely to cost more than £350, contact Zurich Assist as soon as possible.

If you are taken into hospital, may need to return home early, or may need to extend your journey because of illness or accident:

1. Notify the emergency assistance company immediately. 
2. Follow the advice of Zurich Assist and the treating doctor. 
3. Keep receipts for any costs you may need to claim. 
4. Get permission before arranging for someone to stay with you, travel to be with you, or accompany you home. 
5. Keep medical evidence and any documents requested for the claim. 

Medical emergency expenses do not include:

1. Anything listed in the General exclusions. General conditions also apply. 
2. The excess shown for your level of cover and selected options. 
3. Costs recoverable from a national insurance scheme, reciprocal health agreement, another insurer, or another legally responsible party. 
4. Treatment that the attending doctor and Zurich Assist doctor believe can reasonably wait until you return to your home country. 
5. Medication or treatment that was known, at departure, to be needed or continued outside your home country. Preventative treatment that can wait until you return to your home country. 
6. Claims not confirmed as medically necessary by the attending doctor or Zurich Assist. 
7. Elective or non-emergency treatment or surgery, including cosmetic surgery or exploratory tests, unless directly related to the illness or injury that led to hospital admission. 
8. Costs after you choose not to move from a private hospital to a public hospital. 
9. Costs after you choose not to be repatriated once AllClear’s medical adviser says it is safe to return home. 
10. Extra hospital costs for a single or private room, unless medically necessary and authorised by Zurich Assist. 
11. Treatment or services from a health spa, convalescent home, nursing home or rehabilitation centre. 
12. Taxi fares that are not medically necessary, or where receipts are not provided. 
13. Telephone costs. 
14. Medical or surgical treatment received more than 52 weeks after the accident date or the start of the illness. 
15. Claims due to childbirth at or after the 32nd week for a single pregnancy, or the 24th week for a multiple pregnancy. 
16. Treatment or costs in the UK. 
17. Costs of more than £500 that AllClear has not agreed beforehand. 
18. Transport or repatriation costs that AllClear’s medical advisers do not consider necessary. 
19. Costs you or your dependants are not legally required to pay, or which would not have applied if no cover existed. 
20. Charges caused directly or indirectly by a medical provider’s error. 

AllClear’s medical advisers’ decision on the method of repatriation is final.

What “usual, reasonable and necessary” means

For medical treatment, “usual, reasonable and necessary” means the most common cost for similar services, medicines or supplies in the area where the cost is incurred, as long as those costs are reasonable.

AllClear may consider:

• The skill, training and experience needed for the procedure or service. 
• The time needed for the procedure or service. 
• The severity or nature of the illness or injury. 
• The amount usually reimbursed for similar services, medicines or supplies locally. 
• The amount usually reimbursed for similar services, medicines or supplies elsewhere in the country. 
• The medical provider’s cost of providing the service, medicine or supply. 
• Any other factors AllClear reasonably considers appropriate.