Terms of Business

This document outlines the 'terms of business' between you and Aviva Health Insurance Ireland Limited ("Aviva Health"). Aviva Health Insurance Ireland Limited is a health insurance company which underwrites non-life insurance in classes 1 & 2.  Aviva Health, part of Aviva Group plc, has its registered office at One Park Place, Hatch Street, Dublin 2. Its Company Registration Number is: 376607. Its VAT number is 6396607G. Aviva Health may be contacted by phone on 1890 717 717 or by emailing support@avivahealth.ie

Authorisation

Aviva Health is regulated by the Central Bank of Ireland. Aviva Health has been entered onto the Register of Health Benefit Undertakings maintained by the Health Insurance Authority.

Codes of Conduct

Aviva Health is subject to a number of the Central Bank of Ireland’s codes of conduct including the Consumer Protection Code 2012 and the Minimum Competency Code 2011. These codes of conduct are in place to protect consumers when dealing with regulated financial service providers. A copy of these codes are available on the Central Bank of Ireland’s website, www.centralbank.ie.

Regulated Activities

Aviva Health is a health insurance provider. If you have purchased a hospital plan, your policy covers you for in-patient and out-patient medical expenses. If you have purchased a day-to-day plan this covers some of your day-to-day medical expenses.

Your Contractual Documentation

Your contractual documentation includes: the Membership Handbook (including the list of hospitals, scan and treatment centres); your completed application form; your Membership Certificate; your Table of Cover and the Schedule of Benefits. The Membership Handbook must be read in conjunction with the Table of Cover which sets out the level of benefits you are entitled to under your plan and states which lists of hospitals, scan and treatment centres that are covered under your plan. Your Membership Certificate will set out your level of cover, membership number and commencement date on which you joined Aviva Health. The Schedule of Benefits sets out the medical criteria that must be met before the procedures and treatments will be covered by Aviva Health and the procedures and treatments that must be pre-approved by Aviva Health before they will be covered. The Schedule of Benefits can be accessed on Aviva’s website at www.avivahealth.ie or a hard copy is available from Aviva Health on request.

Charges

The contract relating to your membership of your Aviva policy is for a 12 month contractual term, the details of which are specified on your membership certificate. Aviva Health will charge you a premium for this policy. If you cancel your policy prior to the end of the policy year, or do not pay your premium in accordance with the terms of your policy for the full duration of the policy year, Aviva Health will not pay any claims made in respect of the period following the date of cancellation or non-payment and will seek recovery of the health insurance levy calculated on a pro-rata basis for each adult, student and child on your policy, for the remainder of the time left on the policy, together with an administration fee of €25 euro per policy. Details of the annual amount of the health insurance levy are set out in your membership certificate.

Where contracts are terminated mid-term, we will also charge for service supplied in accordance with the contract, such charge being proportionate to the time on cover.  Aviva Health reserves the right to deduct the amount representing the cancellation charge referred to above against the amount (if any) due to be refunded to you as a result of your cancellation of your policy. In all other circumstances, an invoice will be issued to you in respect of the cancellation charge.

Personal Data

Aviva Health will keep the information you provide about yourself and about third parties confidential. We may use it to provide and administer insurance products provided by us or other Aviva companies and sometimes with our affiliates and/or commercial partners in order to comply with legal obligations imposed on us. We may share the information both inside and outside of the European Economic Area, in confidence for these purposes with agents or service providers we have appointed, regulatory organisations, other insurance and financial services companies (directly or via a central register), other Aviva group companies, those to whom we outsource certain business operations and as required by law.

Conflicts of Interest

It is our policy to avoid any conflict of interest when providing business services to our customers.   We have policies in place for our employees in relation to conflicts of interest. These are designed to ensure that potential conflicts of interest between you and us or our employees are avoided. However, if an unavoidable conflict arises we will advise you of this in writing before providing any business service.

Premium Default

If you do not pay your premium on time Aviva Health may cancel your policy with effect from the date the first missed payment was due and not received, and you will not be entitled to claim under that policy. You may also be subject to the cancellation charge as detailed above.

Cancellation

Both you and Aviva Health can cancel the policy by notice at any time, subject to applicable charges if relevant as set out above.  In order to cancel your policy, you should write to The Customer Services Manager, Aviva Health Insurance Ireland Limited, P.O.Box 764, Togher, Co. Cork outlining your name, address, and policy details or telephone us on 1890 717 717.

Cooling Off

You can cancel your policy within 14 days from the date the contract was entered into or from the date you are given the policy documentation, whichever is the later. This is known as the cooling off period. If during the cooling off period of 14 days you cancel your policy with effect from its start date, we will provide a full refund of premium paid. However, if you or any member has made an in-patient treatment and/or day case claim you will not be entitled to a refund of the premium paid.

Complaints Policy

Should you have any complaints or comments about any service provided by Aviva Health or about your health insurance contract you should:

• Call our Customer Care line on 1890 717717 or email us at support@avivahealth.ie
• Send your complaint in writing to The Managing Director, Aviva Health Insurance Ireland Limited, P.O. Box 764, Cork.

E-Mail: enquiries@financialombudsman.ie;         Website: www.financialombudsman.ie   

Law Applicable & Language of Terms and Conditions/Communications

Please note that Irish law will apply to your health insurance contract and Irish Courts will have jurisdiction to hear any disputes regarding the contents unless otherwise stated in our policy terms and conditions. All contractual terms and conditions and communications shall be in English.