IAK Supplementary Health Care Insurances - IAK Verzekeringen

6
1.19
1.20
1.21
1.22
1.23
1.24
1.25
1.26
1.27
1.28
1.29
1.30
1.31
1.32
1.33
1.34
1.35
1.36
1.37
1.38
Family: two married or registered partners, or long-term cohabiting couples and unmarried biological children,
stepchildren, adopted children or foster children up to the age of 18, or a single person with one or more children as
described above. The term 'registered partner' means the person with whom the insured person has entered into a
registered partnership by means of a deed of registration drawn up by the civil registrar; the term 'long-term
cohabiting person' refers to a person who has proof of cohabiting for at least one year with the insured person in a
joint household or a person who has signed a cohabitation contract with the insured person, in which case the health
care insurer shall have the exclusive discretion to assess the durability of cohabitation.
First-line psychologist: a health care psychologist listed as such in the Register of first-line psychologists maintained
by the NIP.
Fraud: the perpetration or attempted perpetration of forgery, deceit, suppression of facts that may be relevant to
effecting the insurance, prejudicing the rights of claimants and/or fraudulent diversion by the persons and
organisations party to a non-life insurance contract in the process of entering into and/or performing such a contract
with the intention of obtaining a benefit or performance to which there is no entitlement or obtaining insurance cover
under false pretences.
General practitioner: a doctor listed as a general practitioner in the register maintained by the HVRC (registration
committee for general practitioners, nursing home doctors and doctors for the mentally handicapped) of the KNMG.
GGD: Municipal Health Service (Gemeentelijke Gezondheidsdienst).
Group health insurance contracting party: the legal entity or individual with whom the group health insurance
policy for health care costs and/or health care insurance has been entered into. A group health care policy is a policy
entered into between the health care insurer and an employer or legal entity with the purpose of offering participants
the opportunity to take out IAK Health Care Insurance (and, if desired, IAK supplementary insurances) under the
conditions described in the policy.
Health care insurance: a non-life insurance contract between the health care insurer and the policyholder for the
benefit of a person obliged to take out insurance, which should comply with what has been provided in this respect in
or pursuant to the Zvw (Health Care Insurance Act). The performances insured by it should not extend beyond the
provisions laid down in or pursuant to the Zvw.
Health Care Insurance Decree (Besluit zorgverzekering): Decree of 28 June 2005 providing for an Order in Council
as referred to in articles 11, 20, 22, 32, 34 and 89 of the Zvw.
Health Care Insurance Regulations (Regeling Zorgverzekering): Regulations issued by the Minister of Health,
Welfare and Sport dated 1 September 2005, number Z/VV-2611957, containing rules on the implementation of the
Zvw as published in the Staatscourant (Government Gazette) 2005, no. 171.
Health care insurer: the health care insurer as named on the policy schedule or other proof of insurance, in whose
name and for whose risk IAK Verzekeringen B.V. offers and implements these insurances as authorised agent as
referred to in the Wft (Act on Financial Supervision).
Health care psychologist: a person listed as such in the register referred to in section 3 of the Wet BIG.
Hospital: an establishment for specialised medical care that is duly licensed under the WTZi. Stays of 24 hours or
more are covered.
IAK Health Care Insurance (IAK Zorgverzekering): a health care insurance policy (including main insurance)
concluded between the health care insurer and the policyholder in relation to the person obliged to take out insurance
pursuant to the Zvw and in whose name and for whose risk IAK Verzekeringen B.V. offers and performs this insurance
as authorised agent.
IAK Verzekeringen B.V.: the authorised agent granted a mandate by the health care insurer as referred to in the
Wft in respect of health care insurances.
Independent treatment centre: an establishment for specialised medical care that is duly licensed under the WTZi and
with which the health care insurer has entered into a contract for certain forms of care. This does not cover stays of 24
hours or more for treatments for which the DBC in question falls under the A segment.
Insurance: one or more of the health insurances described in these policy conditions, entered into as a supplement to
the IAK Health Care Insurance.
Insured person: a person in respect of whom this insurance policy has been entered into and who is mentioned on
the policy schedule or other proof of insurance issued by the health care insurer.
Main insurance: the health care insurance policy entered into by the policyholder with the health care insurer
pursuant to the Zvw.
Manual therapist: a physiotherapist listed as a manual physiotherapist in the Register of Specialist Physiotherapists
maintained by the KNGF or a person registered as an E.S. ® manual therapist with the NVMT (Dutch Society of Manual
Therapists).
Maternity assistant: a qualified maternity assistant or a nurse working in that capacity.