Accident or emergency admission

An admission to:

• hospital directly following an accident, or
• to a hospital ward directly from the emergency department for urgent or unplanned treatment, or
• to a hospital ward on the same day as a referral for treatment is made either by a GP or specialist, when immediate treatment or diagnostic tests are medically necessary.

Accidental dental injury

An injury which causes damage or deformity to teeth or gums which have not previously been decayed, diseased, repaired, restored or treated (other than scaling or polishing). This does not include damage to dentures or implants. The injury must be caused by an accident which occurs after you joined the policy.

Acupuncturist

A doctor registered with the General Medical Council (GMC) who is also either:

• a Medical Member or
• Accredited Member of the British Medical Acupuncture Society, and who is recognised by us.

Acute condition

A disease, illness or injury that is likely to respond quickly to treatment which aims to return the child to the state of health they were in immediately before suffering the disease, illness or injury, or which leads to their full recovery.

Advice

Any

• consultation,
• advice or
• prescription

from a GP or specialist.

Cancer

A malignant tumour, tissues or cells, characterised by the uncontrolled growth and spread of malignant cells and invasion of tissue.

Child / children

A child named as an insured person in the policy schedule.

Chiropractor

A practitioner who is:

• included in the Register of Chiropractors kept by the General Chiropractic Council, and
• recognised by us.

Chronic condition

A disease, illness or injury that has one or more of the following characteristics:

• it needs ongoing or long-term monitoring through consultations, examinations, check-ups and / or tests,
• it needs ongoing or long term control or relief of symptoms,
• it requires the child’s rehabilitation or for them to be specially trained to cope with it,
• it continues indefinitely,
• it has no known cure,
• it comes back or is likely to come back.

Day-patient

A patient who is admitted to a hospital or day-patient unit because they need a period of medically supervised recovery but does not occupy a bed overnight.

Diagnostic centre

A hospital or facility recognised by us to carry out a CT, MRI or PET scan. Diagnostic tests Investigations, such as X-rays or blood tests, to find or to help to find the cause of a child’s symptoms.

Full Medical Underwriting (FMU)

This means we ask you questions about your child's past health and any pre-existing conditions, and related conditions will be excluded unless we agree to accept them.

GP

A general medical practitioner included in the GP Register kept by the General Medical Council.

Hospice

A hospital or part of a hospital recognised as a hospice by us which is devoted to the care of patients with progressive disease (where curative treatment is no longer possible) on an in-patient or domiciliary basis.

Hospital

A hospital included on the extended hospital list for children, or an NHS pay-bed which we recognise to provide the type of treatment undertaken, or: any establishment which we agree is an appropriate facility for the provision of treatment, prior to treatment being carried out.

In-patient

A patient who is admitted to hospital and who occupies a bed overnight or longer, for medical reasons.

Member

A child named as an insured person in the policy schedule.

Moratorium

Instead of filing out a health questionnaire, an automatic exclusion applies to any disease, illness or injury (whether or not diagnosed), or any related condition if:

• your child had symptoms of, medication or treatment for, or advice about such a disease, illness or injury within five years before joining Child Health Solutions

and

• there has not been a clear two-year period after joining during which your child has been free of medication for, treatment for, and advice about such a disease, illness or injury or related condition.

After this clear two-year period, your cover will be extended to include that disease, illness or injury, subject to policy terms and conditions.

Nurse

A qualified nurse who:

• is on the register of the Nursing and Midwifery Council (NMC), and
• holds a valid NMC personal identification number.

Osteopath

A practitioner who is:

• included in the Register of Osteopaths kept by the General Osteopathic Council, and
• recognised by us.

Out-patient

A patient who attends a hospital, consulting room or out-patient clinic and is not admitted as a day-patient or in-patient.

Physiotherapist

A practitioner who is:

• included in the register of the Health Professions Council as a physiotherapist, and
• recognised by us.

Policy

Our contract of insurance with the policyholder providing the cover as detailed in this policy document. The application and policy schedule form part of the contract and must be read together with this policy document (as amended from time to time).

Policyholder

The person named as policyholder in the policy schedule who is the child’s parent or guardian.

Policy schedule

The schedule giving details of (amongst others):

• the policyholder
• members
• amendments and
• exclusions that apply to specific members (if any).

Policy year

The period of time from the date the policy began until the day before the first renewal date or, if the policy has been renewed, from one renewal date to the next.

Pre-existing condition

Any disease, illness or injury for which:

• the child has received medication, advice or treatment, or
• they have experienced symptoms, whether the condition has been diagnosed or not before they joined the policy.

Related

Diseases, illnesses or injuries are related if, in our reasonable medical opinion, one is a result of the other or if each is a result of the same disease, illness or injury.

Renewal date

The annual anniversary of the date on which this policy began.

Routine dental treatment

Dental treatment carried out by a dental practitioner in a dental surgery including examinations, tooth cleaning, white fillings (where appropriate), crowns, extractions and surgery.

Specialist

A registered medical practitioner who:

• has at any time held and is not precluded from holding a substantive consultant appointment in an NHS hospital, or
• holds a Certificate of Higher Specialist Training issued by the Higher Specialist Training Committee of the relevant Royal College or faculty, or
• is included in the Specialist Register kept by the General Medical Council and who is recognised by us to provide the treatment the child requires for their condition.

Speech therapist

A practitioner who is:

• included in the register of speech and language therapists kept by the Health Professions Council and
• recognised by us.

Treatment

Surgical or medical services (including diagnostic tests) that are needed to diagnose, relieve or cure a disease, illness or injury.

UK

Great Britain and Northern Ireland (for the purposes of this policy).

We/our/us

Aviva Health UK Limited, who administers your policy on behalf of Aviva Insurance Limited, who underwrites and provides your contract of insurance.

You / Your

The person named as policy holder in the policy schedule.