Private Health Insurance Act 2007

CHAPTER 3 - COMPLYING HEALTH INSURANCE PRODUCTS  

PART 3-3 - REQUIREMENTS FOR COMPLYING HEALTH INSURANCE PRODUCTS  

Division 69 - Coverage requirements  

SECTION 69-1   COVERAGE REQUIREMENTS  

69-1(1)    
An insurance policy meets the coverage requirements in this Division if:

(a)    the only treatments the policy ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

covers are:

(i) specified treatments that are ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

hospital treatment; or

(ii) specified treatments that are hospital treatment and specified treatments that are ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

general treatment; or

(iii) specified treatments that are general treatment but none that are hospital-substitute treatment; and

(b)    if the policy provides a benefit for anything else - the provision of the benefit is authorised by the Private Health Insurance (Complying Product) Rules.

69-1(2)    
Despite paragraph (1)(a) , the policy must also ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

cover any treatment that a policy of its kind is required by the Private Health Insurance (Complying Product) Rules to cover.

69-1(3)    
Despite paragraph (1)(a) , the policy must not ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

cover any treatment that a policy of its kind is not allowed under the Private Health Insurance (Complying Product) Rules to cover.