Medical Protection
1. Provider and scope
- This policy describes the Total Medical Rescue cover provided by Seychelles Medical Services Limited trading as Doctor247 for visitors to Seychelles.
- Seychelles Medical Services Limited is a licensed medical services provider in the Republic of Seychelles.
- This document is the complete policy wording for Total Medical Rescue. It sets out what is covered, what is not covered, and the conditions that apply.
2. Overall limit of cover
- The maximum total amount payable by Seychelles Medical Services Limited under this policy for all covered medical costs and services for any one insured person during a single trip is 25000 United States dollars.
- This overall medical limit includes every amount paid for Medical rescue, Emergency hospital treatment, ICU cover, and any other benefit or service described in this policy.
- Once the overall medical limit of 25000 United States dollars has been reached for an insured person for a trip, no further benefit is payable under this policy for that insured person for that trip.
3. Definitions
For this policy the following words have these meanings
Insured person means any person named in a valid Total Medical Rescue confirmation issued by Doctor247 for whom the required premium has been received.
Trip means the period of temporary stay of the insured person in Seychelles. The trip starts when the insured person arrives in Seychelles and ends when they permanently leave Seychelles.
Period of cover means the period during the trip when cover under this policy is in force as shown in the confirmation from Doctor247. Cover cannot start before arrival in Seychelles and cannot continue after the end date shown.
Medical rescue means the coordinated arrangement and provision of emergency transport for an insured person by Aircraft Helicopter Boat or Ambulance to the nearest Approved hospital within Seychelles that can provide appropriate emergency medical care.
Emergency hospital treatment means medically necessary treatment provided in a hospital in Seychelles in an emergency department, procedure unit, or similar facility for an acute illness or injury that cannot reasonably be treated outside hospital and cannot reasonably be postponed until the insured person returns home.
Intensive care unit or ICU means a specialist hospital unit that provides constant monitoring and life supporting treatment for patients who are critically ill or injured and require a higher level of care than a standard ward.
ICU cover means payment of eligible ICU charges under this policy.
Approved hospital means a hospital in Seychelles that Doctor247 accepts as suitable to provide the necessary emergency care.
Pre existing medical condition means any illness, injury, disease, or symptom for which, before the start of the trip, the insured person has
(a) received medical advice, investigation, care, or treatment from a doctor or other health professional, or
(b) been prescribed medication, or
(c) been advised to undergo tests, investigations, or surgery which have not yet taken place, or
(d) experienced symptoms which a reasonable person would have consulted a doctor about.Doctor247 medical assistance team means the medical and coordination staff engaged by Seychelles Medical Services Limited to manage Medical rescue, hospital admission, ICU and case management.
4. Who is covered and when cover applies
- This policy covers each Insured person named in the Total Medical Rescue confirmation issued by Doctor247 once the required premium has been paid.
- Cover begins for each Insured person when they arrive in Seychelles on the start date shown in the confirmation from Doctor247.
- Cover ends at the earliest of
(a) the moment the Insured person permanently leaves Seychelles, or
(b) 23 59 local time in Seychelles on the end date shown in the confirmation from Doctor247, or
(c) the moment the overall medical limit of 25000 United States dollars has been reached for that Insured person for that trip. - Illnesses and injuries that begin outside the Period of cover are not covered, even if they continue into the Period of cover.
- ICU cover is only available for Insured persons who are aged at least 18 years and not more than 65 years on the start date of the trip.
- There is no age limit for access to Medical rescue and Emergency hospital treatment, subject to the exclusions in section 8.
5. What is covered
5 point 1 Medical rescue
Doctor247 will arrange and pay for Medical rescue when
- the Insured person suffers a sudden illness or injury during the Period of cover while in Seychelles, and
- in the opinion of the Doctor247 medical assistance team urgent transport to hospital is medically necessary, and
- the Doctor247 medical assistance team selects the method of transport as appropriate, taking into account clinical urgency, safety, and practicality.
Medical rescue is always to the nearest Approved hospital within Seychelles that can provide the required emergency care.
Medical rescue is always provided, even if the illness or injury is connected with a Pre existing medical condition, provided that no other exclusion in this policy applies.
Doctor247 will always use the most medically appropriate and cost effective method of transport. Use of Aircraft or Helicopter is subject to clinical need and availability and is not guaranteed in every case.
5 point 2 Emergency hospital treatment
Doctor247 will pay reasonable and customary charges for Emergency hospital treatment when
- the Insured person suffers an acute illness or injury during the Period of cover in Seychelles, and
- a doctor confirms that treatment must take place in a hospital and cannot reasonably be delayed until the Insured person returns home, and
- the treatment is not solely and directly due to a Pre existing medical condition, and
- the treatment does not involve admission to ICU.
Overnight admission to a non ICU ward is not covered unless the admission forms part of a period in ICU that is covered under this policy.
5 point 3 ICU cover
Doctor247 will pay ICU charges when
- during the Period of cover the Insured person suffers a sudden illness or injury in Seychelles that is not solely and directly due to a Pre existing medical condition, and
- as a direct result the Insured person is admitted to ICU in an Approved hospital in Seychelles, and
- ICU admission is certified as medically necessary by the treating ICU doctor and accepted by the Doctor247 medical assistance team, and
- the Insured person meets the age requirement for ICU cover.
ICU cover is limited as follows
- ICU cover is available only for Insured persons aged 18 to 65 years.
- ICU cover is limited to a maximum of 3 complete ICU days per trip for each Insured person.
- ICU cover applies only to ICU days that fall entirely within the Period of cover.
For the purpose of this policy
- an ICU day means a continuous period of 24 hours during which the Insured person is admitted and physically located in ICU, and
- a part day in ICU does not count as an ICU day and is not paid as ICU cover unless Doctor247 agrees in writing in exceptional circumstances.
ICU charges include
- the ICU bed,
- monitoring equipment and devices used routinely in ICU,
- ICU nursing services, and
- routine visits and rounds by ICU doctors.
ICU charges do not include
- surgery and procedures billed separately,
- drugs, blood products, and consumables billed outside the ICU day rate,
- personal or non medical services, or
- any charges for stays on standard wards before or after ICU.
All ICU payments are subject to the overall medical limit in section 2.
5 point 4 Case management and support services
When a covered medical event occurs, Doctor247 will provide
- rapid coordination with the Approved hospital for admission and stabilisation,
- daily monitoring and updates from a medical case manager while the Insured person remains in hospital,
- direct communication with the Insured person designated family contact during serious medical events,
- international senior doctor oversight including review of diagnosis and treatment plan,
- assistance with prioritising tests, imaging, and emergency treatment where reasonably possible,
- assistance with translation and communication between the Insured person and hospital staff where there are language difficulties,
- support with hotel or villa coordination during the medical event,
- assistance with pharmacy sourcing and urgent medicine collection when prescribed medication is required,
- support with travel changes and documentation if travel plans need to be adjusted because of a covered medical event, and
- guidance after discharge to help the Insured person prepare to return home safely.
These services are coordination and support services and do not increase the overall medical limit in section 2.
6. General limits
- All payments under this policy for each Insured person for each trip, including Medical rescue, Emergency hospital treatment, ICU cover, and any other covered costs, together must not exceed 25000 United States dollars.
- Doctor247 will pay only amounts that are reasonable and customary for the services provided in Seychelles in the opinion of Doctor247.
- Doctor247 may direct the Insured person to particular hospitals, clinics, or providers as a condition of cover.
7. ICU specific conditions
ICU cover is subject to all of the following
- age between 18 and 65 years at the start of the trip,
- no direct and sole link to a Pre existing medical condition,
- maximum of 3 complete ICU days per trip,
- admission and all ICU days must begin and occur during the Period of cover,
- acceptance by the Doctor247 medical assistance team as clinically necessary and within this policy.
If these conditions are not met, ICU charges are not covered.
8. General exclusions
No benefit is payable and no service is required under this policy for any claim that directly or indirectly arises from or is in any way related to
- a Pre existing medical condition, except that Medical rescue to move the Insured person to hospital in Seychelles may still be provided,
- deliberate self harm, attempted suicide, or suicide by the Insured person, whatever their mental state,
- the Insured person taking part in any criminal or illegal act under the law of Seychelles,
- the Insured person using alcohol to the point of intoxication where that intoxication is a direct and material factor in the illness or injury,
- the Insured person using illegal drugs or misusing prescription drugs where that use is a direct and material factor in the illness or injury,
- participation in fights other than in genuine self defence,
- participation in or training for professional sports or any sport where the Insured person receives payment or significant prize money,
- hazardous activities that Doctor247 has classified as excluded activities, including but not limited to
(a) mountaineering that requires ropes or guides,
(b) base jumping and other extreme aerial activities,
(c) scuba diving deeper than 30 meters or without a recognised diving qualification,
(d) motor racing or riding in any motor competition or speed test, - war, invasion, act of foreign enemy, hostilities, civil war, rebellion, revolution, insurrection, or military or usurped power,
- nuclear reaction, nuclear radiation, or radioactive contamination,
- any act of terrorism involving biological, chemical, or nuclear materials,
- pregnancy after week 28, pregnancy with known complications, childbirth, or care of the newborn, except where a sudden life threatening emergency arises during the trip and Doctor247 agrees to provide cover,
- elective, cosmetic, or non urgent treatment that can reasonably be postponed until the Insured person returns home,
- long term care, rehabilitation, or stays in convalescent homes, nursing homes, or similar facilities,
- experimental or unproven treatments that are not widely accepted as standard care in Seychelles.
9. Duties of the insured person
- The Insured person or someone acting on their behalf must contact the Doctor247 medical assistance team as soon as reasonably possible after any serious illness or injury and must always contact Doctor247 before hospital admission or as soon as possible afterwards, unless this is not possible in an emergency.
- The Insured person must follow the advice of the Doctor247 medical assistance team and the treating doctor. If the Insured person refuses recommended transfer, treatment, or discharge without a valid medical reason, Doctor247 may reduce or refuse benefits to the extent its position is prejudiced.
- The Insured person must provide all information and documents reasonably requested by Doctor247, including proof of identity, travel dates, medical reports, and itemised bills.
- Doctor247 has the right to obtain medical reports and records from any hospital or doctor involved in the treatment, subject to applicable law.
- If Doctor247 pays any amount that is later found not to be covered under this policy, the Insured person must refund that amount on request.
10. Fraud and misrepresentation
- If any claim or statement made by or on behalf of the Insured person under this policy is fraudulent, dishonest, or intentionally exaggerated, Doctor247 may
(a) refuse to pay the claim,
(b) cancel cover for that Insured person from the start of the Period of cover, and
(c) recover from the Insured person any amount already paid in respect of that claim. - If the Insured person fails to disclose a material fact when buying this policy, Doctor247 may adjust or refuse any claim affected by that non disclosure.
11. Law and language
- This policy is governed by the law of the Republic of Seychelles.
- Any dispute under this policy is subject to the jurisdiction of the courts of Seychelles.
- This policy wording is issued in English. If there is any difference between this wording and any translation, this English wording will prevail.
