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class=\"font-semibold\">Alafia Service Level Agreement<\/span>","bold":false,"colored":false,"custom_color":""}],"description":"","enable_dark_version":false,"headline_hx":"h1","id":"","class":"py-12","background_image":"","background_color":"#fff0ff","hide_section":false},{"acf_fc_layout":"blankSection","content":"","id":"","class":"bg-[url('https:\/\/getreliancehealth.com\/alafia\/wp-content\/uploads\/sites\/6\/2024\/09\/divider_mulberry_blush-pink.svg')] bg-cover bg-center bg-repeat sm:h-[30px] lg:h-[40px] h-[25px] mx-auto mb-[] mr-[] mt-[] ml-[]","background_image":"","background_color":"","hide_section":false},{"acf_fc_layout":"blankSection","content":"<b><span data-contrast=\"auto\">Service Level Agreement<\/span><\/b><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span>\r\n\r\n<span data-contrast=\"auto\">As part of signing up for Alafia by Reliance <\/span><span data-contrast=\"auto\">H<\/span><span data-contrast=\"auto\">MO<\/span> <span data-contrast=\"auto\">Health <\/span><span data-contrast=\"auto\">or <\/span><span data-contrast=\"auto\">the <\/span><span data-contrast=\"auto\">Tranquillity<\/span> <span data-contrast=\"auto\">by Reliance H<\/span><span data-contrast=\"auto\">MO<\/span><span data-contrast=\"auto\">, <\/span><span data-contrast=\"auto\">you agree to this Service Level Agreement effective from the day you sign up for the duration of activity of your plan.<\/span><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span>\r\n\r\n<span data-contrast=\"auto\">This serves as an agreement<\/span><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span>\r\n\r\n<b><span data-contrast=\"auto\">BETWEEN<\/span><\/b><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span>\r\n\r\n<span data-contrast=\"auto\">RELIANCE HMO LIMITED, a Health Maintenance Organization incorporated and registered under the laws of the Federal Republic of Nigeria having its place of business at 32, Lanre Awolokun Street, Gbagada Phase II GRA, Lagos, Nigeria. (hereinafter referred to as \u201cReliance\u201d or \u201cReliance HMO\u201d which expression shall wherever the context so permits or admits include its successors-in-title and assigns) of the one part.<\/span><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span>\r\n\r\n<b><span data-contrast=\"auto\">AND<\/span><\/b><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span>\r\n\r\n<span data-contrast=\"auto\">the buyer (person purchasing the plan) and enrollee (individual using the plan) of Alafia by Reliance H<\/span><span data-contrast=\"auto\">MO<\/span><span data-contrast=\"auto\">ealth<\/span><span data-contrast=\"auto\"> plans.<\/span><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span>\r\n\r\n<span data-contrast=\"auto\">These shall jointly be referred to as the \u201cParties\u201d and individually as a \u201cParty\u201d<\/span><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span>\r\n\r\n<b><span data-contrast=\"auto\">WHEREAS:<\/span><\/b><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span>\r\n<ol>\r\n \t<li aria-setsize=\"-1\" data-leveltext=\"%1.\" data-font=\"Arial\" data-listid=\"1\" data-list-defn-props=\"{"335552541":0,"335559685":720,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">The Parties and Reliance HMO have agreed upon the provision of health and medical services for the benefit of the parties herein referred to upon the terms and conditions hereinafter appearing.<\/span><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span><\/li>\r\n \t<li aria-setsize=\"-1\" data-leveltext=\"%1.\" data-font=\"Arial\" data-listid=\"1\" data-list-defn-props=\"{"335552541":0,"335559685":720,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">The Buyer seeks to procure a health insurance plan from Reliance HMO, either for personal coverage or for the benefit of a third-party beneficiary (the \u201cEnrollee\u201d).<\/span><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span><\/li>\r\n \t<li aria-setsize=\"-1\" data-leveltext=\"%1.\" data-font=\"Arial\" data-listid=\"1\" data-list-defn-props=\"{"335552541":0,"335559685":720,"335559991":360,"469769242":[65533,0],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">The Parties have agreed to enter into this Agreement to establish the terms and conditions governing the provision of health and medical services to the Enrollee pursuant to the selected plan.<\/span><span data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span><\/li>\r\n<\/ol>\r\n1.0 Now it is therefore agreed as follows:\r\n<h4>1.1 Definitions<\/h4>\r\n<table>\r\n<tbody>\r\n<tr valign=\"top\">\r\n<td>1.1.1<\/td>\r\n<td>\u201cThis Agreement\u201d means this Service Level Agreement and any schedules or annexures attached thereto as may be amended and substituted by the Parties from time to time;<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.2<\/td>\r\n<td>\u201cAlafia by Reliance HMO\u201d refers to the brand under which Reliance HMO Limited delivers healthcare services pursuant to this Agreement.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.3<\/td>\r\n<td>\u201cApproved affiliate(s)\u201d means other registered entities affiliated or connected to Reliance HMO through which Alafia by Reliance HMO or Tranquillity by Reliance HMO provides the medical services and meets its obligations herein stipulated which affiliates have been prior approved by the Buyer or Enrollee.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.4<\/td>\r\n<td>\u201cBuyer\u201d means the individual procuring a health insurance plan from Reliance HMO, either for personal coverage or on behalf of an Enrollee.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.5<\/td>\r\n<td>\u201cCare Balance\u201d means the prepaid healthcare credit funded by the Enrollee for use exclusively on eligible services within Reliance HMO\u2019s network. It is maintained exclusively within the Reliance platform and may only be applied toward eligible healthcare expenses under the Tranquility Plan. It is non-transferable, non-withdrawable, discretionary and not to be regarded as a deposit, bank account, electronic money or cash equivalent and does not confer any right of redemption or Refund except as provided in this Agreement.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.6<\/td>\r\n<td>\u201cConfidential Information\u201d means any and all information, whether written, electronic, oral, or in any other form, disclosed by one party ('Disclosing Party') to the other party ('Receiving Party') in connection with this Agreement, that is marked as confidential, or which, by its nature or content, should reasonably be understood by the Receiving Party to be confidential. This includes, but is not limited to:\r\n<ol type=\"i\">\r\n \t<li>Healthcare Data, including any personal health information, medical records, diagnoses, treatment history, prescriptions, laboratory results, claims information, and any other health-related data disclosed in connection with the services provided under this Agreement;<\/li>\r\n \t<li>Customer Information, including personal data of the Buyer or Enrollee, contact details, and any related financial or account information;<\/li>\r\n \t<li>Business and Proprietary Information, including trade secrets, business plans, financial data, proprietary technology, software, designs, formulas, marketing strategies, and technical specifications; and<\/li>\r\n \t<li>Customer Information, including personal data of the Buyer or Enrollee, contact details, and any related financial or account information;<\/li>\r\n<\/ol>\r\nConfidential Information shall not include information which:\r\n<ol type=\"i\">\r\n \t<li>is or becomes publicly available through no fault of the Receiving Party;<\/li>\r\n \t<li>is lawfully obtained from a third party without breach of any obligation of confidentiality;<\/li>\r\n \t<li>is independently developed by the Receiving Party without reference to the Disclosing Party's Confidential Information; or<\/li>\r\n \t<li>is required to be disclosed by law, court order, or regulatory authority, provided that the Receiving Party gives the Disclosing Party prompt written notice of such requirement and cooperates in any effort to obtain confidential treatment of the information.<\/li>\r\n<\/ol>\r\n<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.7<\/td>\r\n<td>\u201cCover Limit\u201d The overall cover limit refers to the maximum annual reimbursement by RELIANCE HMO to cater for the care and treatment of the Enrollee. These limits are plan specific as stated in this Agreement or any other related coverage documentation. Specific monetary or benefit limits may apply for specific services such as optical, dental, surgical procedures, cancer care. Some services are capped or restricted based on length of stay or number of procedures dispensed.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.8<\/td>\r\n<td>\u201cCovered services\u201d means the scope or extent of services to be provided by Reliance HMO under the Alafia by Reliance HMO brand and Tranquility by Reliance HMO brand, pursuant hereto and specified in Schedule \u2018A\u2019 annexed hereto and made an integral part of this Agreement by this reference. For the avoidance of doubt, Reliance HMO reserves the sole authority to interpret the Covered Services, in accordance with industry standards.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.9<\/td>\r\n<td>\u201cCritical or Life Threatening\u201d means a medical condition that poses a significant risk of imminent death or serious, irreversible harm to an individual, necessitating immediate medical intervention to prevent a fatal outcome or severe, long-term impairment.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.10<\/td>\r\n<td>\u201cEffective Date\u201d shall have the meaning ascribed to it under clause 8.1 of this Agreement.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.11<\/td>\r\n<td>\u201cEmergency Condition\u201d means a medical condition that manifests itself by symptoms of sufficient severity or seriousness, including severe pain, such that a prudent non-medical person with an average knowledge of health and medical care could reasonably expect the absence of immediate medical attention to result in:\r\n<ol type=\"a\">\r\n \t<li>Placing the Enrollee\u2019s health in serious jeopardy; or<\/li>\r\n \t<li>Serious impairment of vital bodily functions.<\/li>\r\n<\/ol>\r\n<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.12<\/td>\r\n<td>\u201cEnrollee\u201d means the individual who is designated to receive healthcare services under a selected plan, (Alafia or Tranquility by Reliance HMO) whether such person is the Buyer or a third-party beneficiary identified by the Buyer.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.13<\/td>\r\n<td>\u201cIn-network Provider, Provider or Plan-Provider\u201d means a duly licensed healthcare provider that has entered into an agreement with Reliance HMO to provide healthcare services to the Enrollee under the Medical Scheme, based on eligible network and subject to change.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.14<\/td>\r\n<td>\u201cMedically Necessary\u201d means health care services that a reasonably prudent physician would deem necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malfunctioning or malformed body or member of an Enrollee. This definition explicitly includes services necessary to prevent harm to vital body organs or processes and excludes services provided for aesthetic purposes or purely elective reasons.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.15<\/td>\r\n<td>\u201cMedical Scheme\u201d means the health and medical scheme offered, provided and administered by the Reliance HMO for the benefit of the Enrollee in pursuance of the terms to which this Agreement is made.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.16<\/td>\r\n<td>\u201cNon-Covered Services\u201d means health and medical care services that are not covered services as defined herein in Schedule B and as at the effective date of this Agreement.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.17<\/td>\r\n<td>\u201cOut-of-Area Services\u201d means healthcare services that are provided by a Provider outside the Enrollee\u2019s Service Area.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.18<\/td>\r\n<td>\u201cOut-Of-Network Provider\u201d means a healthcare provider not accessible to the enrollee. This includes providers not accessible on the enrollee\u2019s tier and providers not related to or affiliated to RELIANCE HMO under the Medical Scheme.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.19<\/td>\r\n<td>\u201cOut-Of-Network Services\u201d means healthcare services provided to an enrollee by an Out-Of-Network Provider or Non-Plan Provider.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.20<\/td>\r\n<td>\u201cPending Deduction\u201d means a provisional record of a service-related charge not yet deducted from the Care Balance, which does not constitute a negative balance or a liability.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.21<\/td>\r\n<td>\u201cPre-existing medical conditions\u201d means any injury, illness, disease, or other physical, medical, mental or nervous condition, disorder or ailment that, with reasonable medical certainty, existed at the time of application or at any time prior to the effective date of the insurance, whether or not previously manifested or symptomatic, diagnosed, treated or disclosed prior to the effective date, including any subsequent, chronic or recurring complications or consequences related thereto or arising there from. This includes the existence of Lumps, Masses, Past Surgeries, and\/or complications, proposed surgeries, Hypertension, Diabetes, Asthma, Sickle cell Disease, Multiple Sclerosis, Epilepsy, Blood disorders and others. The health plans have made provision to effectively manage pre-existing conditions, provided that such conditions do not fall under the stated exclusions of this policy.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.22<\/td>\r\n<td>\u201cPremium\u201d means the agreed consideration paid by the Buyer to RELIANCE HMO per Enrollee per annum for all Covered Services rendered under the Medical Scheme, except the Excluded Services which shall be paid for separately under TPA when authorized by the Buyer. The Premium is subject to annual review upon plan renewal and may be adjusted based on factors including, but not limited to, overall plan utilization and changes in market conditions.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.23<\/td>\r\n<td>\u201cQuality Assurance\u201d means the process designed and\/or adopted by Reliance HMO to monitor and evaluate quality and appropriateness of care, pursue opportunities to improve care and resolve identified problems in the quality and delivery of care under the medical scheme generally and in furtherance of this Agreement.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.24<\/td>\r\n<td>\u201cReliance HMO\u201d or \u201cReliance\u201d means Reliance HMO Limited inclusive of its successors-in-title and assigns.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.25<\/td>\r\n<td>\u201cReimbursable\u201d means the amount paid for a medical service in a geographic area based on what providers in the area usually charge for the same or similar medical service. This amount payable as reimbursement is Usual, Customary and Reasonable (UCR).<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.26<\/td>\r\n<td>\u201cRefund\u201d means a discretionary reversal of unused Care Balance credits initiated solely by Reliance in limited exception-based circumstances.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.27<\/td>\r\n<td>\u201cService Area\u201d means the Federal Republic of Nigeria.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.28<\/td>\r\n<td>\u201cTerm\u201d shall have the meaning ascribed to it under clause 8.1 of this Agreement.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.29<\/td>\r\n<td>\u201cTranquility plan\u201d refers to the brand under which Reliance HMO Limited delivers healthcare services pursuant to this Agreement.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.30<\/td>\r\n<td>\u201cTPA\u201d means Third Party Administration. It is a system of managing healthcare in which a third party (here RELIANCE HMO), \u2018The Administrator\u2019, is contracted to manage provider networks and medical claims for the Enrollee to desired scope of cover.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.31<\/td>\r\n<td>\u201cUpgrade of Plans\u201d: If there are any changes in the plans selected by the Enrol<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<table>\r\n<tbody>\r\n<tr valign=\"top\">\r\n<td>1.1.32<\/td>\r\n<td>\u201cUtilization review\u201d means the evaluation exercise by which Reliance HMO or a duly appointed and authorized agent on its behalf determines on a prospective, concurrent and\/or a retrospective basis the medical appropriateness of the covered services provided to the Enrollee.<\/td>\r\n<\/tr>\r\n<tr valign=\"top\">\r\n<td>1.1.33<\/td>\r\n<td>\u201cWaiting Period\u201d means the period of uninterrupted plan coverage that must pass before an Enrollee becomes eligible to access specific benefit categories. The waiting period begins upon the Enrollee\u2019s successful registration and remains in effect for the duration specified for each applicable benefit. During this time, the Enrollee must maintain continuous coverage under the plan to qualify for the benefits subject to the waiting period.<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<h3>2.0 Engagement<\/h3>\r\n2.1 The Buyer hereby engages Reliance HMO to provide the Covered Services to the Enrollees under the Alafia by Reliance HMOealth brand, or Tranquility by Reliance HMO, and RELIANCE HMO hereby agrees to make such services available to the Buyer or designated Enrollee, subject to the terms and conditions set forth in this Agreement.\r\n\r\n2.2 For the avoidance of doubt, the services contemplated herein shall be provided by Reliance HMO under the Alafia by Reliance HMOealth brand and Tranquility by Reliance HMO.\r\n<h3>3.0 Delivery of Services<\/h3>\r\n<h4>3.1 Covered services:<\/h4>\r\n3.1.1 Reliance HMO shall provide, or arrange for the provision of, the Covered Services as specified in Schedule A, which is incorporated herein by reference. Reliance HMO reserves the right to amend the scope of Covered Services from time to time, subject to reasonable notice to the Buyer.\r\n\r\n3.1.2 The Covered Services shall be provided in accordance with the generally accepted clinical and legal standards consistent with medical ethics and practices applicable in Nigeria.\r\n<h4>3.2 Verification of beneficiaries<\/h4>\r\nExcept in the case of emergency, Reliance HMO shall at all times utilize mechanisms including but not limited to soft copy identification cards on enrolees\u2019 phones, hard copy identification cards, online services, telephone calls or messaging, which are part of the system of Reliance HMO to confirm an Enrollee\u2019s eligibility to benefit hereunder prior to rendering any Covered Service.\r\n<h4>3.3 Non-provision of non-covered services<\/h4>\r\n3.3.1 Reliance HMO shall not be obligated to provide any services that are expressly excluded under Schedule B or that fall outside the scope of the selected plan.\r\n\r\n3.3.2 Reliance HMO may only, at its sole discretion, offer or provide non-covered service(s) in an emergency condition, life-threatening condition or situation, or where a TPA services agreement for a particular condition has been mutually concluded. In such a situation, the Enrollee shall be liable for all costs arising therefrom and Reliance HMO shall as much as practicable obtain the prior consent of the Enrollee or where it is impracticable to obtain the prior consent of the Enrollee, inform the Enrollee within 48 (Forty-Eight) hours of commencing or rendering such non-covered service(s) and the Enrollee shall be liable for any costs arising therefrom notwithstanding that prior consent was not obtained.\r\n\r\n3.3.3 Where a service not covered by the medical scheme or plan is desired by an enrollee, Reliance HMO may undertake to arrange a discounted rate for this service(s). Reliance HMO shall be refunded the full cost incurred in the provision of this service plus 20% of the full cost of service as administrative fee. This service is only rendered at the instance of the Enrollee. This service would also be recommended when the limits of coverage for such aforementioned services have been exceeded.\r\n<h4>3.4 Reimbursements<\/h4>\r\n3.4.1 An Enrollee shall obtain Reliance HMO\u2019s prior written approval before accessing care outside our provider network (except in emergency cases), after approval is given, a reimbursement link is sent to the Enrollee to fill details such as evidence of payment (bills, prescription, doctor\u2019s report and receipt), account details after which reimbursement is processed within 7 (Seven) -14 (Fourteen) business days of submission. Provided that Reliance HMO shall not be obliged to process any reimbursement on a day other than a business day.\r\n\r\n3.4.2 An enrollee is entitled to a Refund where:\r\n\r\n3.4.2.1 In the case of an Emergency Condition, he\/she receives Out-of-Network Services; or\r\n\r\n3.4.2.2 He\/She is out of the service area and receives Out-of-Area Services, having being authorized by Reliance HMO before accessing such care.\r\n\r\n3.4.2.3 Where he\/she is made to pay for a Covered Service by his\/her In-Network Provider.\r\n\r\n3.4.3 In any of the above instances, the Enrollee will be required to explain the situation to RELIANCE HMO in writing, enclosing a valid medical report, duly signed by the doctor in charge at the Provider\u2019s facility. Provided that the Parties agree that RELIANCE HMO may request further information and documents from the Enrollee, and RELIANCE HMO shall not be under any obligation to commence processing the reimbursement until it receives the information and\/or document from the Enrollee.\r\n\r\n3.4.4 In all cases, RELIANCE HMO shall agree to the limit of payment covered by such out-of-network services, such limit shall be determined based on the cost RELIANCE HMO would have paid a Provider; once approved, Reliance HMO shall reimburse the Enrollee for approved payment.\r\n\r\n3.4.5 Refund under the Tranquility Plan are governed by Section 3.9.4 of this agreement.\r\n\r\n3.4.6 Referrals to secondary or tertiary facilities due to complications or specialist treatment will be reimbursed based on the amount it would have cost Reliance HMO to pay an In-network Provider under the plan purchased. In cases where no facility within the network is available near the Enrollee, the Enrollee will be reimbursed up to the limit of the plan purchased. Prior approval must be obtained from the Reliance HMO Care Coordination (RCC) team, accompanied by referral letters, medical reports, and proof of payment. For the avoidance of doubt, Reimbursement for specialist consultations outside the network is limited to what Reliance HMO would have paid for an in-network provider.\r\n\r\n3.4.7 Reimbursements without valid authorization from Reliance HMO shall not be paid.\r\n<h4>3.5 Age Limits for Enrollees<\/h4>\r\nReliance HMO plans have specific age limits for Enrollees. The principal Enrollee shall not be older than eighty-five (85) years at the time of enrollment. Unless otherwise negotiated and explicitly stated in the quote and contract, this standard age limit applies. Reliance HMO reserves the right to deny coverage for previously undisclosed age exceptions. Furthermore, Reliance HMO may request documentation, including government-issued identification, to verify the age of the principal Enrollee. Any discrepancies in the information provided may result in the termination of coverage.\r\n<h4>3.6 Limitations on Out-of-Network Services<\/h4>\r\nReliance HMO provides coverage for accidents and emergencies both within and outside the network, in accordance with applicable regulations. Documentation must be provided to demonstrate the medical necessity and emergency status before reimbursement is granted for out-of-network care. In the case of emergencies, Reliance HMO will reimburse 100% of the cost of stabilization. If treatment continues beyond the first 24 hours, reimbursement will be based on the tariff of a hospital accessible under the Enrollee\u2019s plan. All emergency care is subject to the overall plan benefit limit.\r\n<h4>3.7 Pre-Authorization and Referrals<\/h4>\r\nAll enrollees must comply with the pre-authorization and referral processes for specific treatments or services, as defined by Reliance HMO. Any failure to obtain the necessary pre-authorization or referral prior to treatment may result in the denial of care. The Enrollee acknowledges and accepts responsibility for ensuring compliance with this process to avoid unnecessary care denials.\r\n\r\nServices requiring pre-authorization include but are not limited to:\r\n<ul>\r\n \t<li>Specialist Consultations<\/li>\r\n \t<li>Prescribed Medications (Acute and OTC Medications)<\/li>\r\n \t<li>Prescribed Medications for Chronic Illness<\/li>\r\n \t<li>Telemedicine Consultations<\/li>\r\n \t<li>Accident and Emergency Care<\/li>\r\n \t<li>Inpatient Services<\/li>\r\n \t<li>Accommodation for Relative During Critical Care Admission<\/li>\r\n \t<li>Basic Lab Tests (Haematology, Chemistry and Microbiology)<\/li>\r\n \t<li>Basic Diagnostic Imaging and Procedures<\/li>\r\n \t<li>Advanced Laboratory Investigations<\/li>\r\n \t<li>Advanced Diagnostic Imaging and Procedures<\/li>\r\n \t<li>Surgery and Anaesthesia<\/li>\r\n \t<li>Intensive Care Unit<\/li>\r\n \t<li>Optical Care, Lenses and Frames<\/li>\r\n \t<li>Dental Care<\/li>\r\n \t<li>Behavioural\/Mental Health Support<\/li>\r\n \t<li>Weekly Gym Access<\/li>\r\n \t<li>Spa Facials or Body Massage<\/li>\r\n \t<li>Antenatal Care & Delivery<\/li>\r\n \t<li>Routine Newborn Care (First 29 Days)<\/li>\r\n \t<li>Fertility and Reproductive Health Tests<\/li>\r\n \t<li>Basic Immunizations<\/li>\r\n \t<li>Expanded Immunizations<\/li>\r\n \t<li>Family Planning<\/li>\r\n \t<li>Emergency Air Ambulance Service<\/li>\r\n \t<li>Neonatal Intensive Care and Incubators<\/li>\r\n \t<li>Occupational and Speech Therapy<\/li>\r\n \t<li>Physiotherapy Care<\/li>\r\n \t<li>Durable Medical Equipment<\/li>\r\n \t<li>Dialysis<\/li>\r\n \t<li>Cancer Care<\/li>\r\n \t<li>After Demise Compensation<\/li>\r\n \t<li>Wellness Checks<\/li>\r\n \t<li>Reimbursed Benefits<\/li>\r\n<\/ul>\r\n<h4>3.8 Benefits Category Coverage<\/h4>\r\nRefers to the classification of medical services and items covered under the Reliance HMO plan. It is essential for Enrollees to understand these categories, as they define which services are covered and the specific limits that apply to each category. Examples of benefit categories include: Specialist Consultations, Prescribed Medications (Acute and OTC Medications), Prescribed Medications for Chronic Illness, Telemedicine Consultations, Accident and Emergency Care, Inpatient Services, Accommodation for Relative During Critical Care Admission and others, all of which are detailed in the table of benefits.\r\n\r\nFor categories with specific limits, any care related to that category will be subject to the designated limit for that category alone, rather than the general plan limits. This means that all services including consultations, emergency treatments, inpatient hospitalizations, surgeries, diagnostics, and any other care related to a specific category (e.g., dental care, surgery or maternity services) will be covered exclusively under the limit assigned to that category. For example, all dental-related services, including consultations, diagnostics, hospitalizations and procedures, will count toward the dental care limit, not the general plan limit. Similarly, hospitalizations and surgeries related to a particular category (e.g., maternity, surgery) will be subject to that category\u2019s specific limit.\r\n<h4>3.9 Care Balance Operations<\/h4>\r\n<h5>3.9.1 Primary Care Services<\/h5>\r\nCharges for Primary Care services (including but not limited to telemedicine, prescriptions, and general consultations) shall be deducted from the Enrollee\u2019s Care Balance after the service has been rendered. The exact deduction amount will not be displayed to the Enrollee until processing is complete, which may occur on the same day or weeks later, as determined by Reliance HMO\u2019s TPA workflows.\r\n<h5>3.9.2 Secondary Care Services<\/h5>\r\nCharges for Secondary Care services (including but not limited to specialist consultations, diagnostics, and procedures) shall be deducted from the Enrollee\u2019s Care Balance immediately upon authorization. If the Enrollee cancels the service prior to delivery, the deducted amount shall be refunded to the Care Balance within 5 (five) business days.\r\n\r\nIt is important to note that where a Service is rendered before charges are confirmed, a \u2018Pending Deduction\u2019 may be displayed. This does not constitute a loan or obligation and is adjusted only against future Care Balance top-ups.\r\n<h5>3.9.3 Refunds<\/h5>\r\nThe Refund shall be governed by the below:\r\n<ul>\r\n \t<li>Enrollees may, in limited and exception-based cases (e.g., service unavailability, billing error or non-utilisation), request a discretionary reversal of unused Care Balance. Reliance shall assess such requests on a case-by-case basis and reserves full discretion to approve or deny any Refund.<\/li>\r\n \t<li>All Refunds are subject to Reliance\u2019s discretion and may be granted only where there are no outstanding or pending claims. It is not intended to provide cash-equivalent value or off-platform transferability.<\/li>\r\n \t<li>No Enrollee has an automatic or contractual right to a Refund or cash redemption of Care Balance.<\/li>\r\n \t<li>Approved Refunds shall be processed within 14 (fourteen) business days.<\/li>\r\n<\/ul>\r\n<h3>4.0 Payment of Premium<\/h3>\r\n4.1 Reliance HMO shall be entitled to the Premium to be paid by the Buyer, as consideration for the provision of Covered Services.\r\n\r\n4.2 Where the Buyer fails to pay the Premium on or before the subscription end date, Reliance HMO shall be at liberty to grant the Buyer a grace period of 7 (seven) days within which the outstanding payment must be made. During this grace period, the Buyer shall be restricted from accessing healthcare services under the HMO plan until payment is received.\r\n\r\n4.3 If the Buyer fails to make payment within the 7 (seven) days grace period, all graduated benefits under the plan shall be forfeited, and Reliance HMO shall have the right to terminate coverage. Any care or services accessed during the period of restriction or after termination shall be ineligible for reimbursement and shall remain the sole financial responsibility of the Enrollee.\r\n<h3>5.0 Obligations of Reliance HMO<\/h3>\r\n5.1 Reliance HMO covenants for the benefit of and hereby agrees with the Enrollee as follows:\r\n\r\n5.1.1 That Reliance HMO and each and every of its physicians, medical staff and all personnel shall be duly trained, knowledgeable, licensed and registered as may be required under any applicable law or regulation to perform and carry out the duties performed and carried out by such physician, medical staff or personnel in pursuance of this agreement and the said physicians, medical staff etc. will continue to be qualified to perform and carry out the said duties and render the services contemplated hereby.\r\n\r\n5.1.2 That it would employ and use equipment, methods, procedures and processes of highest professional standards in performing its obligations under this Agreement.\r\n\r\n5.1.3 That a list of approved Providers will be made available and furnished to the Enrollee which list shall be deemed annexed hereto (whether or not so annexed) and form an integral part of this Agreement. The Enrollee shall be duly informed of any modification to this list before the effective date of such modification, as this may be required from time to time in the course of running the Medical Scheme. The Enrollee shall have a right of choice among the list of approved Providers.\r\n\r\n5.1.4 That it represents and warrants that it shall and does have the full legal power and authority to bind its physicians and medical staff and personnel and the approved affiliates and their physicians and medical staff and personnel to the terms and provisions hereof.\r\n\r\n5.1.5 That Reliance HMO shall use its best endeavor to ensure that it and each of its physicians and medical staff and personnel shall not differentiate or discriminate in the provision of the Covered Services or meet their obligation hereto as a result of race, color, nationality, origin, ancestry, religion, sex, marital status, sexual orientation, income, health, status or age.\r\n\r\n5.1.6 That Reliance HMO reserves the right to include and\/or exclude partner hospitals for reasons of medical incompetence or otherwise, from time to time. All this, Reliance HMO shall do, bearing in mind its commitment to service excellence.\r\n\r\n5.1.7 That the covered services shall be provided on a 24 (Twenty-Four)-hour per day, 7 (Seven)-day per week, 365(6) (Three Hundred and Sixty-Five or Sixty-Six)-day per year basis, subject to the subscription duration and the activation of any graduated benefits, where applicable.\r\n\r\n5.1.8 That it shall carry out quality assurance and utilization review processes and inform the Enrollee of its findings.\r\n<h3>6.0 Obligations of the Buyer and Enrollee<\/h3>\r\n6.1 The Buyer and Enrollee (as applicable) hereby agrees with Reliance HMO as follows:\r\n\r\n6.1.1 That Reliance HMO shall be entitled to the Premium, calculated as the total sum of the Premiums applicable to each Enrollee under the subscribed plan(s) by the Buyer (as applicable). The aggregate Premium shall be determined based on the number of Enrolees and shall be payable in accordance with the selected payment schedule, which may be monthly, quarterly, or annually, as applicable.\r\n\r\n6.1.2 That the Premium is net of all applicable taxes, charges and out-of-pocket expenses (if any).\r\n\r\n6.1.3 That the Enrolee shall pay the Premium within the time stipulated in this Agreement. The scheme operates on a \u201cno premium, no cover\u201d basis.\r\n\r\n6.1.4 Reliance HMO reserves the right to suspend or deactivate any Enrollee account where there is strong suspicion of fraud. In cases where the issue is not resolved within 30 days, Reliance HMO may take independent action, including suspension of the account until the matter is satisfactorily addressed. Additionally, in the event of fraud that is deemed systemic or affects multiple Enrollees, Reliance HMO reserves the right to terminate the Agreement, in addition to any actions taken with respect to individual Enrollee accounts.\r\n\r\n6.1.5 It shall ensure that all communications with Reliance HMO, are conducted in a professional and respectful manner. The Enrollee agrees not to engage in any form of disparagement or abusive behaviour towards Reliance HMO staff, whether verbally, in writing, or through any other medium. Additionally, Reliance HMO expects all Enrollees to treat staff and members of the Provider network with respect. Verbal, physical, or any form of abusive behaviour towards Reliance HMO staff or Providers will not be tolerated. In cases of such behaviour, Reliance HMO reserves the right to issue warnings, suspend services, or take other appropriate actions, including termination of the contract in cases of repeated or severe misconduct.\r\n<h3>7.0 Confidentiality and Data Protection<\/h3>\r\n7.1 Reliance HMO shall maintain the confidentiality of all confidential data, information, and records obtained, created, or collected in connection with the Enrollee during the performance of this Agreement. Reliance HMO shall not disclose such confidential information to any third party, including but not limited to external vendors, without the prior written consent of the Enrollee, except where disclosure is required by law or a statutory obligation. Reliance HMO shall implement appropriate technical and organizational measures to prevent unauthorized access or disclosure.\r\n\r\n7.2 Reliance HMO shall indemnify the Enrollee for any loss, damage, cost or expense suffered or incurred by it for any breach of the provisions of clause 7.1 by Reliance HMO.\r\n\r\n7.3 The In-Network Provider shall remain responsible to the relevant authorities for any breach of confidence or other obligations imposed by the Hippocratic Oath, any Rules of Professional Conducts and generally accepted clinical\/legal standards consistent with best practices in medical ethics applicable internationally.\r\n\r\n7.4 Each Party undertakes to comply with all applicable data protection laws and regulations, including but not limited to the Nigeria Data Protection Regulation 2019 (NDPR), the Nigeria Data Protection Act 2023 (NDPA) and any successor legislation.\r\n\r\n7.5 The Parties agree that the processing of personal data under this Agreement shall be governed by a separate Data Processing Agreement (DPA). The DPA will outline in detail the roles, obligations, and responsibilities of each Party concerning the collection, processing, sharing, and protection of personal data.\r\n\r\n7.6 Enrollee consent is required before the processing or sharing of any sensitive personal data, including medical information. The Parties agree not to disclose enrollee medical data to third parties, including clients, friends and family, without such consent, except as required by law.\r\n\r\n7.7 Each Party agrees to implement appropriate security measures to protect personal data and to notify the other Party in the event of a data breach, as further detailed in the accompanying DPA.\r\n\r\n7.8 Both Parties agree to respect the rights of data subjects, including their right to access, rectify, or erase their personal data. These rights and the obligations of each Party shall be detailed in the DPA.\r\n\r\n7.9 Reliance HMO acknowledges its legal obligation to comply with applicable public health laws and regulations in Nigeria. Accordingly, Reliance HMO may be required to report certain contagious or notifiable diseases to public health authorities, even without the Enrollee\u2019s consent, where such reporting is mandated by law. Where Reliance HMO becomes aware of an Enrollee with a contagious disease, it shall:\r\n\r\n7.9.1 Promptly notify the affected Enrollee;\r\n\r\n7.9.2 Provide recommendations to the Enrollee, under confidential cover, on appropriate steps to contain, minimize, or eliminate the spread of the disease; and\r\n\r\n7.9.3 Limit any disclosures to public health authorities strictly to the extent required by law and ensure all other personal health information remains confidential.\r\n\r\n7.10 Reliance HMO reaffirms its commitment to protecting all personal and health information of Enrollees in compliance with this Agreement and applicable laws, including the Nigeria Data Protection Regulations 2019 (NDPR), Nigeria Data Protection Act 2023 (NDPA) and the National Health Act. All disclosures shall be limited, proportionate, and compliant with legal obligations.\r\n<h3>8.0 Effective date, term, renewal and termination<\/h3>\r\n<h4>8.1 Effective date<\/h4>\r\nNotwithstanding the date written above, this Agreement shall commence on the (the \u201cEffective Date\u201d) and shall subsist for a period of twelve (12) months unless terminated pursuant hereto (the \u201cTerm\u201d). Following the expiration of the current Term, the Parties agree that this Agreement shall automatically renew upon the successful payment of the Premium for the following year.\r\n<h4>8.2 Termination for cause<\/h4>\r\nIn the event that either Party fails to observe or perform any material covenant, term, or provision of this Agreement applicable to such party, the non-defaulting party shall provide written notice to the defaulting party specifying the nature of such default. If Reliance HMO discovers any irregularities in relation to the Plan, the Plan shall be immediately suspended, and the Enrollee shall be notified accordingly. A review period of thirty (30) days shall be granted for the irregularities to be addressed and resolved. If the defaulting party fails to remedy the irregularities within this period, Reliance HMO shall have the right to terminate the Plan upon written notice. Upon termination, both Parties shall immediately return all Confidential Information and comply with any outstanding obligations. Termination shall not affect any rights or liabilities accrued prior to termination. Reliance HMO reserves the right to terminate this Agreement immediately in the event of non-compliance with established fraud prevention policies or if the Enrollees fail to take reasonable steps to prevent waste, fraud, or abuse. In such instances, Reliance HMO shall have the authority to seek recovery of any amounts associated with fraudulent activities from the Enrollees, including but not limited to costs incurred as a result of fraudulent claims, losses due to improper billing, or any related financial damages.\r\n<h4>8.3 Effect of termination<\/h4>\r\nThis Agreement shall remain in full force and effect during the period between the date notice of termination is given and the effective date of such termination. As of the date of termination of this Agreement, this Agreement shall be of no further force and effect and each party shall be discharged from all rights, duties and obligations under this agreement except that the Enrolee shall remain liable for covered services then being rendered by Reliance HMO to the Enrollee until the episode of illness then being treated is completed and the obligation of Enrollee for covered services rendered pursuant to this agreement discharged.\r\n\r\nAny termination of this Agreement (however occasioned) shall not affect any accrued rights or liabilities of any of the parties nor shall it affect the coming into force or the continuance in force of any provision hereof which is expressly or by implication intended to come into or continue in force on or after such termination. In the event that a prepaid payment is made for the premium, upon termination by either party, the Enrollee shall be issued any outstanding sums as refund in excess of all received claims paid already at termination date, including 20% of all IBNRs (Incurred But Not Recorded), on the initial claims received and paid already as at termination date.\r\n<h3>9.0 Limitation of Liability and Indemnity<\/h3>\r\n9.1 The Enrollee acknowledges that Reliance HMO shall not be liable for any act or omission of an In-Network Provider or third-party providing services under this Agreement. Reliance HMO shall use its best efforts to ensure that all providers within its network meet the required professional standards; however, any liability arising from medical malpractice or negligence shall rest with the Provider, and Reliance HMO shall not bear responsibility for the same.\r\n\r\n9.2 In no event shall Reliance HMO be liable for any indirect, incidental, special, consequential, punitive, or exemplary damages, including but not limited to loss of profits, loss of goodwill, loss of business opportunity, or anticipated savings.\r\n\r\n9.3 Notwithstanding anything to the contrary in this Agreement, the total aggregate liability of Reliance HMO, whether in contract, tort (including negligence), or otherwise arising out of or in connection with this Agreement, shall not exceed the total amount of premiums paid by the Enrollee to Reliance HMO during the twelve (12) months immediately preceding the event giving rise to such liability.\r\n\r\n9.4 Reliance HMO shall not be liable for any failure or delay in performing its obligations under this Agreement to the extent such failure or delay is caused by events beyond its reasonable control, including but not limited to acts of God, war, civil unrest, strikes, epidemics, pandemics, or government actions.\r\n\r\n9.5 The limitations set forth in this clause shall survive the termination or expiration of this Agreement and shall apply to any claims made thereafter relating to events that occurred during the term of this Agreement.\r\n\r\n9.6 The Enrollee shall indemnify and hold Reliance HMO harmless from any claims, liabilities, losses, or damages arising from or related to any act or omission by the Enrollee in relation to the performance of this Agreement, including but not limited to claims made by the Enrollee for non-covered services or any breach of confidentiality.\r\n\r\n9.7 The Enrollee shall not hold Reliance HMO liable for the negligence, malpractice, or misconduct of any in-network provider or third-party administrator, except where such claims arise from the direct fault or willful misconduct of Reliance HMO.\r\n\r\n9.8 Reliance shall not be liable for any expectation that Care Balance is equivalent to or convertible into money or any assumption of liquidity, financial return or transferability associated with the Care Balance.\r\n<h3>10.0 Governing Law and Dispute Resolution<\/h3>\r\nThis Agreement shall be governed and construed in accordance with the laws of the Federal Republic of Nigeria and shall be deemed to have been made in Lagos.\r\n<h4>10.1 Initial mediation of dispute<\/h4>\r\nIn the event of a dispute between the parties to this Agreement, the following procedure shall be used to resolve this dispute prior to either party pursuing other remedies:\r\n<ol>\r\n \t<li>A meeting shall be held within 14 (fourteen) days of one party notifying the other that a dispute has arisen, at which all parties are present or represented by individuals with full decision making authority regarding the matters in dispute (initial meeting).<\/li>\r\n \t<li>If within 30 (thirty) days following the initial meeting, the parties have not resolved the dispute, the dispute shall be referred to mediation in accordance with clause 10.2 hereof.<\/li>\r\n \t<li>The Parties agree to negotiate in good faith in the initial meeting.<\/li>\r\n<\/ol>\r\n<h4>10.2 Mediation<\/h4>\r\nEither Party may submit any dispute arising out of this Agreement that is not resolved following the processes above to Mediation. The Mediation shall be conducted under the auspices of the Lagos Multi-Door Courthouse (LMDC) in accordance with its rules and procedures as in force at the time of the dispute. The Parties agree that the decision or settlement reached through mediation shall be final and binding on both Parties, and no further appeal or litigation may be pursued thereafter. The costs of mediation shall be shared equally between the Parties unless otherwise agreed.\r\n<h4>10.3 Dispute Resolution for the Care Balance & Refund issues<\/h4>\r\nIn relation to the Tranquility Plan, any disputes concerning the Care Balance or delayed Refunds shall first be reported via the \u201cContact Us\u201d page. Reliance will review and resolve disputes within 5\u201310 business days of receiving full documentation. This provision shall not override the general dispute resolution procedure set out in Clause 10 of this Agreement.\r\n<h4>11.0 Disclaimer on the Nature and Use of the Care Balance<\/h4>\r\nThe Care Balance is a non-transferable healthcare credit facility provided solely to enable access to prepaid healthcare services available within the Reliance network. It does not represent funds held on behalf of Enrollees, nor does it confer any entitlement to cash or monetary redemption outside the context of covered healthcare services.\r\n\r\nReliance does not hold, manage or safeguard Enrollee funds and shall not be deemed a bank, trustee, escrow agent or financial intermediary in respect of any amounts credited to the Care Balance. No fiduciary or custodial relationship is created between Reliance and the Enrollee through the operation of the Care Balance.\r\n\r\nRefunds of unused Care Balance credits may be initiated at Reliance\u2019s sole discretion and are subject to internal review and verification. Any such Refund, where applicable, will be processed only in respect of unused service credits and not as a withdrawal or return of money. Enrollees acknowledge that Refunds are not guaranteed, not claimable as of right and may be subject to timing, eligibility or compliance checks.\r\n\r\nEnrollees further agree that the Care Balance may not be assigned, pledged, exchanged for cash or consideration or transferred to third parties and that no interest, yield or other financial benefit shall accrue in connection with any unused credit.\r\n<h4>12.0 <span class=\"TextRun SCXW210270727 BCX0\" lang=\"EN-GB\" xml:lang=\"EN-GB\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW210270727 BCX0\">Miscellaneous provisions<\/span><\/span><span class=\"EOP SCXW210270727 BCX0\" data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span><\/h4>\r\n<strong>12.1 Non-interference with medical care: <\/strong>\r\n\r\nNothing in this Agreement is intended to create (nor shall be construed or deemed to create) any right of the Enrollee to intervene in any manner in the professional methods or means by which Reliance HMO renders health services to the Enrolee pursuant hereto. Further, nothing herein shall be construed to require Reliance HMO to take any action inconsistent with professional judgment with respect to the medical care and treatment to be rendered the Enrollee in pursuance hereof.\r\n<h4>12.2. Anti-Bribery<\/h4>\r\nEach Party acknowledges that it is (as applicable)\r\n<ol>\r\n \t<li>committed to abide by the applicable laws and regulations prohibiting Bribery; and<\/li>\r\n \t<li>has implemented and will maintain within its organization, policies including but not limited to the Compliance and Ethics Guide, that prohibit any such actions by its officers, employees, affiliates, agents, subcontractors, and any other third parties acting on their behalf.<\/li>\r\n<\/ol>\r\nEach Party shall comply with all applicable anti-bribery and anti-corruption laws, statutes, directives and\/or regulations including but not limited to the Corrupt Practices and Other Related Offences Act, 2004, the Economic and Financial Crimes Commission (Establishment) Act; the Money Laundering Prohibition Act, 2004 and all other applicable anti-bribery and anti-corruption regulations and codes of practice.\r\n\r\n<span class=\"TextRun SCXW128519453 BCX0\" lang=\"EN-GB\" xml:lang=\"EN-GB\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW128519453 BCX0\">The Parties further <\/span><span class=\"NormalTextRun SCXW128519453 BCX0\">represents<\/span><span class=\"NormalTextRun SCXW128519453 BCX0\">, <\/span><span class=\"NormalTextRun SCXW128519453 BCX0\">warrants<\/span><span class=\"NormalTextRun SCXW128519453 BCX0\"> and covenants that, in connection with this Agreement:<\/span><\/span><span class=\"EOP SCXW128519453 BCX0\" data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335559740":276}\">\u00a0<\/span>\r\n<ol>\r\n \t<li>Neither the Parties, nor their officers, employees, affiliates, agents, subcontractors, nor any other third party acting on their behalf, have committed or will commit any bribery of a customer\u2019s officer, employee, affiliate, agent, subcontractor, or any other third party acting on its behalf<\/li>\r\n \t<li>The Parties have implemented and will maintain adequate anti-bribery policies and controls in place to prevent and detect bribery throughout their organization, whether committed by their officers, employees, affiliates, agents, subcontractors or any other third party acting on their behalf.<\/li>\r\n \t<li>To the extent permitted by the applicable law a Party shall notify the other Party immediately upon becoming aware or upon becoming reasonably suspicious that an activity carried out in connection with this Agreement has contravened or may have contravened this clause or any anti-bribery law or regulation<\/li>\r\n \t<li>A Party may at any-time request evidence of the other Party\u2019s compliance with its obligations under this Agreement.<\/li>\r\n \t<li>A Party may terminate this Agreement with immediate effect upon written notice- as of right and without any judicial authorization \u2013 if during the term of this Agreement, the other Party is convicted of an act of bribery or fails to comply with this clause or any anti-bribery law or regulation even if not connected to this Agreement.<\/li>\r\n \t<li>To the extent permitted by the applicable law, either Party shall indemnify the other, their officers, employees, affiliates, agents, subcontractors, or any other third party acting on behalf of either Party, against any losses, liabilities, damages, costs (including legal fees) and expenses incurred by, or awarded as a result of any breach of this clause<\/li>\r\n<\/ol>\r\n<h4>12.3 Nature of relationship<\/h4>\r\nIn the performance of its work, duties and obligations under this Agreement, it is mutually understood and agreed that Reliance HMO and the approved affiliates and their physicians medical staff and personnel are at all times acting and performing as independent contractors offering and rendering medical services and shall not be deemed or construed as agents of one another.\r\n<h4>12.4 Additional assurances<\/h4>\r\nThe provisions of this Agreement shall be self-operative and shall require no further agreement by the parties except as may be specifically provided in this agreement. However, at the request of either Party, the other Party may execute such additional instruments and take such additional acts as may be reasonably requested in order to effectuate this agreement.\r\n<h4>12.5 Assignment<\/h4>\r\nThis Agreement shall inure to the benefit of and be binding upon the parties hereto and their respective legal representatives, successors and assigns and neither party may assign this agreement without the prior written consent of the other except that in the event of an assignment to a related entity by ownership, or control or to any successor entity or organization.\r\n<h4>12.6Waivers<\/h4>\r\nNo waiver by either Party of any breach or violation of any provision of this agreement shall operate as or be construed to be a waiver of any subsequent breach of the same or other provisions.\r\n<h4>12.7 Notice:<\/h4>\r\nAny notice, demand, letter or communication required, permitted or desired to be given hereunder shall be deemed effectively given when personally delivered by electronic mail, hand or courier addressed to the addresses of the parties as herein contained above or their last known address. The parties may by notice in writing change their addresses for delivery of communication.\r\n<h4>12.8 Severability<\/h4>\r\nShould any portion of this agreement be judicially determined to be illegal or unenforceable, the remainder of the agreement shall continue in full force and effect, and the parties may renegotiate the terms affected by the severance.\r\n<h4>12.9 Entire agreement<\/h4>\r\nThis Agreement supersedes any prior agreements, promises, negotiations or representations; either oral or written relating to the subject matter of this agreement and, except as provided herein may not be modified without the express written approval of both parties.\r\n<h4>12.10 Force majeure<\/h4>\r\nNeither Party shall be liable for nor deemed to be in default for any delay or failure to perform under this agreement deemed to result, directly or indirectly, from acts of god, civil or military authority, acts of public enemy, war, accidents, fires, explosions, earthquake, flood, failure of transportation, strike or other work interruptions by either party\u2019s employees or any other cause beyond the reasonable control of either Party.\r\n<h4>12.11 Survival<\/h4>\r\nNotwithstanding any provisions contained herein to the contrary, the obligations of the Parties under the provisions of clauses 7 and 9 shall survive the determination of this Agreement.","id":"","class":"pro-paddingBottomLarge pro-paddingTopLarge","background_image":"","background_color":"","hide_section":false},{"acf_fc_layout":"blankSection","content":"<h2>Schedule A: Details of coverage<\/h2>\r\nThe benefits table (Schedule A) has been attached to the SLA.\r\n<table>\r\n<thead>\r\n<tr>\r\n<th style=\"border: 1px solid #e1e1e1; padding: 5px;\">PLAN NAME<\/th>\r\n<th style=\"border: 1px solid #e1e1e1; padding: 5px;\">SERENITY LITE PLAN<\/th>\r\n<th style=\"border: 1px solid #e1e1e1; padding: 5px;\">SERENITY PLAN<\/th>\r\n<\/tr>\r\n<\/thead>\r\n<tbody>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">ANNUAL BENEFITS LIMITS IN NAIRA (per enrollee)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">1,000,000<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">2,000,000<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\" colspan=\"3\">PREMIUM (per enrollee)<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">INDIVIDUAL (ANNUAL - 5% DISCOUNT)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">342,000<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">931,000<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">INDIVIDUAL (QUARTERLY)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">90k<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">245,000<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">INDIVIDUAL (MONTHLY)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">90k followed by 24,500 per month \u00d7 11 months; 30k per month after month 12<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">210,000 followed by 11\u00d770,000 for 1 year; 82,000 per month from month 13 onwards<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">TERRITORY<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NIGERIA<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NIGERIA<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">HOSPITAL TIER<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">TIER 4<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">TIER 2, 3 & 4<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">HOSPITAL WARD\/ROOM<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">GENERAL WARD<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">PRIVATE ROOM<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">ACCOMMODATION & ADMISSION (2 weeks waiting period applies)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered up to limit of 14 days per year<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered up to limit of 28 days per year<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Accommodation for a relative of a patient on ICU or Neonatal Unit Admission<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Not covered<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Not covered<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">GENERAL CONSULTATIONS<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">100% covered to plan ceiling<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">100% covered to plan ceiling<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">SPECIALIST CONSULTATIONS<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered (limit of 8 sessions per year)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered (limit of 12 sessions per year)<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">PRESCRIBED MEDICATIONS (Acute & OTC)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered to a limit of \u20a630,000 acute and chronic medication per month<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered to a limit of \u20a680,000 acute and chronic medication per month<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">PRESCRIBED MEDICATIONS for Chronic Illness<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered to a limit of \u20a630,000 per month<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered to a limit of \u20a680,000 per month<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">TELEMEDICINE & TELETHERAPY<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered (unlimited consultations)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered (unlimited consultations)<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">ACCIDENT & EMERGENCY CARE (2 weeks waiting period)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered \u2013 2-week waiting period<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered \u2013 2-week waiting period<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">ROAD AMBULANCE SERVICES (2 weeks waiting period)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered \u2013 limit of 2 rides per annum, 2-week waiting period<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered \u2013 limit of 4 rides per annum, 2-week waiting period<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">INPATIENT SERVICES (2 weeks waiting period)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">100% covered to plan ceiling \u2013 2-week waiting period<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">100% covered to plan ceiling \u2013 2-week waiting period<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">BASIC LAB TESTS (Hematology, Chemistry & Microbiology)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered to outpatient sublimit of \u20a6250,000; covered to ceiling for inpatient<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered to outpatient sublimit of \u20a6500,000; covered to ceiling for inpatient<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">BASIC DIAGNOSTIC IMAGING & PROCEDURES<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered to outpatient sublimit of \u20a6250,000; covered to ceiling for inpatient<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered to outpatient sublimit of \u20a6500,000; covered to ceiling for inpatient<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">ADVANCED LAB INVESTIGATIONS \/ PATHOLOGY (life-threatening cases only)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered to outpatient sublimit of \u20a6250,000; covered to ceiling for inpatient<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered to outpatient sublimit of \u20a6500,000; covered to ceiling for inpatient<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">ADVANCED DIAGNOSTIC IMAGING & PROCEDURES (life-threatening cases only)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered to outpatient sublimit of \u20a6250,000; covered to ceiling for inpatient<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered to outpatient sublimit of \u20a6500,000; covered to ceiling for inpatient<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">SURGERY & ANAESTHESIA (3 month waiting period)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered up to \u20a6150,000 global surgical limit per year<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered up to \u20a6500,000 global surgical limit per year<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">INTENSIVE CARE UNIT (3 month waiting period)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered up to 24 hours per year (emergency cases only; \u20a6100,000\/day)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered up to 48 hours per year; \u20a6100,000\/day<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">BASIC & ADVANCED EYE TESTS<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Optical ceiling of \u20a615,000 annual limit<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Optical ceiling of \u20a630,000 annual limit<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">OPTICAL LENSES & FRAMES<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Optical ceiling of \u20a615,000 annual limit<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Optical ceiling of \u20a630,000 annual limit<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">DENTAL CARE (excludes prosthesis & orthodontics)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Dental ceiling of \u20a625,000 annual limit<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Dental ceiling of \u20a650,000 annual limit<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">MENTAL & BEHAVIOURAL HEALTH CONSULTATIONS & THERAPY (outpatient only)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered for outpatient care (8 sessions per year)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered for outpatient care (12 sessions per year)<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">WEEKLY GYM ACCESS<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">COVERED 1 SESSION PER WEEK<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n \r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\" colspan=\"3\"><strong>MATERNITY CARE<\/strong><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">ANTENATAL CARE & DELIVERY<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">FERTILITY & REPRODUCTIVE HEALTH COUNSELLING & CONSULTATIONS<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">FERTILITY & REPRODUCTIVE HEALTH TESTS<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">CARE IN A NEONATAL\/SPECIAL BABY CARE UNIT<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">CARE FOR BABIES < 29 DAYS NOT ON THE PLAN<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\" colspan=\"3\"><strong>HOSPITAL & HOME IMMUNIZATIONS<\/strong><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">. NPI univalent vaccines (BCG, Hepatitis B, OPV\/IPV, Rotavirus, Yellow Fever, Measles, & Vitamin A)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Adult immunizations covered under outpatient annual \u20a6250,000 limit (Hepatitis B, Yellow Fever & Meningitis only)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Adult immunizations covered under outpatient annual \u20a6500,000 limit (Hepatitis B, Yellow Fever & Meningitis only)<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">. Trivalent (DPT, MMR) & Tetravalent (DPT & IPV)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\"><\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\"><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">. Pentavalent (DPT, Hepatitis B & Hib) & Hexavalent (DPT, Hepatitis B, Hib & IPV)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\"><\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\"><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">. Non-NPI univalent vaccines \u2013 Pneumococcal, Chicken Pox, Meningitis, & HPV<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\"><\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\"><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\" colspan=\"3\">FAMILY PLANNING<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">. Copper T Intrauterine Device<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">. Injectables (Depo Provera, Noristerat)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">. Contraceptive pills<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">. Intradermal implants<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">. Surgical methods are covered up to the surgery limit (vasectomy & tubal ligation)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\" colspan=\"3\"><strong>WELLNESS SERVICES & ANNUAL HEALTH CHECK FOR 15 YEARS AND ABOVE (3 months waiting period)<\/strong><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">BMI check, general physical exam & blood pressure check \u2013 once per year<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">PCV, urinalysis, blood sugar & fasting\/random lipid panel \u2013 once per year<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Annual visual acuity check (using Snellen chart) \u2013 once per year<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Mammography (for women \u2265 40 years) \u2013 once every two years<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Fecal occult blood test for colon cancer \u2265 40 years \u2013 once per year<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">PSA check (for men \u2265 40 years) \u2013 once per year<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Cognitive & memory screening for the elderly (65+ years) \u2013 once per year<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">HIV antibody & Hepatitis B antigen\/antibody & Hepatitis C antibody screening \u2013 once per lifetime<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Chest X-ray \u2013 once per year<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Pap smear \u2013 once per year<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Liver & kidney function tests \u2013 once per year<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Blood group & genotype \u2013 once per lifetime<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">On-site health checks, health talks\/education forums or wellness fairs \u2013 twice per year<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">PHYSICAL\/SPEECH THERAPY SESSIONS<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered under 8 specialty consultation per year limit<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered under 12 specialty consultation per year limit<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">8 SESSIONS PER YEAR<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\"><\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\"><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">PHYSIOTHERAPY CARE<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered under 8 specialty consultation per year limit<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered under 12 specialty consultation per year limit<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">DURABLE MEDICAL EQUIPMENT<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered with prescription & medical justification to \u20a650,000 limit, 3-month waiting period<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">CONGENITAL, Autoimmune, Sickle Cell, Cancer & Chronic Kidney Disease (1-year waiting period)<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered under applicable limits after 1-year waiting period<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered under applicable limits after 1-year waiting period<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">DIALYSIS<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered under applicable limits after 1-year waiting period<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered under applicable limits after 1-year waiting period<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">AFTER DEMISE COMPENSATION<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Covered after 1-year waiting period (up to \u20a6100,000 limit)<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n \r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\" colspan=\"3\"><strong>OTHER BENEFITS<\/strong><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">HOME VISITS BY DOCTORS & NURSES<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">OCCUPATIONAL HEALTH SCREENING<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">EMERGENCY AIR AMBULANCE SERVICE<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">REIMBURSEMENT FOR OUT-OF-COUNTRY EMERGENCIES<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">REIMBURSEMENT FOR DELIVERY ABROAD<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">PERMANENT & TOTAL DISABILITY ARISING FROM ACCIDENTS<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">EMPLOYEE ASSISTANCE PROGRAMS<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">NOT COVERED<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n ","id":"","class":"pro-paddingBottomLarge pro-paddingTopLarge","background_image":"","background_color":"","hide_section":false},{"acf_fc_layout":"blankSection","content":"<h2>Schedule B: Policy exclusions (non-covered services)<\/h2>\r\nExclusions and limits apply to all costs associated with benefits, diagnoses, or services that are not covered under this policy. \"Services\" include all drugs, equipment, devices, treatments, therapeutic procedures, and diagnostic procedures required to treat the excluded or limited benefit category or diagnosis.\r\n\r\nIf a benefit category, service, or diagnosis is not covered, all related services necessary for its treatment will also be excluded, even if those services would otherwise be covered under different circumstances. Non-covered services can still be accessed through our approved providers via our TPA (Third-Party Administrator) service platform.\r\n\r\n<span class=\"TextRun SCXW23003473 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW23003473 BCX0\">Except otherwise specifically <\/span><span class=\"NormalTextRun SCXW23003473 BCX0\">stated<\/span><span class=\"NormalTextRun SCXW23003473 BCX0\">, any services or benefits not listed in (Schedule A<\/span><\/span><span class=\"TrackChangeTextDeletionMarker TrackedChange SCXW23003473 BCX0\"><span class=\"TextRun SCXW23003473 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun TrackChangeTextDeletion SCXW23003473 BCX0\">)<\/span><\/span><\/span><span class=\"TrackChangeTextInsertion TrackedChange SCXW23003473 BCX0\"><span class=\"TextRun SCXW23003473 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW23003473 BCX0\">, including, but not limited to, <\/span><\/span><\/span><span class=\"TrackChangeTextInsertion TrackedChange SCXW23003473 BCX0\"><span class=\"TextRun SCXW23003473 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW23003473 BCX0\">Care Balance<\/span><\/span><\/span><span class=\"TrackChangeTextInsertion TrackedChange SCXW23003473 BCX0\"><span class=\"TextRun SCXW23003473 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW23003473 BCX0\">-related services such as third-party payment processing fees, currency conversion charges, and non-healthcare<\/span><\/span><\/span> <span class=\"TrackChangeTextInsertion TrackedChange SCXW23003473 BCX0\"><span class=\"TextRun SCXW23003473 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW23003473 BCX0\">transactions <\/span><\/span><\/span><span class=\"TextRun SCXW23003473 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW23003473 BCX0\">are automatically excluded from coverage under this policy in addition to the following:<\/span><\/span><span class=\"EOP SCXW23003473 BCX0\" data-ccp-props=\"{"201341983":0,"335551550":6,"335551620":6,"335557856":16448511,"335559738":150,"335559739":150,"335559740":276,"335572071":2,"335572072":0,"335572073":15460325,"335572075":2,"335572076":0,"335572077":15460325,"335572079":2,"335572080":0,"335572081":15460325,"335572083":2,"335572084":0,"335572085":15460325,"469789798":"single","469789802":"single","469789806":"single","469789810":"single"}\">\u00a0<\/span>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Medical examinations, services and supplies.<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following medical examinations services and supplies are excluded from coverage under this policy unless otherwise stated in schedule A, including but not limited to:\r\n<ul>\r\n \t<li>Educational or Licensing Examinations<\/li>\r\n \t<li>Employment-Related Examinations<\/li>\r\n \t<li>Medical examinations conducted for the purposes of obtaining, maintaining, or certifying fitness for employment, including any tests, screenings, or related procedures required by employers or potential employers.<\/li>\r\n \t<li>Medical examinations required as part of admission into schools, compliance with school obligations, or as a condition for obtaining professional licenses, certifications, or insurance coverage.<\/li>\r\n \t<li>Non-Covered Durable Medical Equipment<\/li>\r\n \t<li>Preventive and Non-Essential Services: Services unrelated to medical improvement or patient care.<\/li>\r\n \t<li>Provision, rental, or repair of durable medical equipment, prosthetics, orthotics, hearing aids, or similar devices unless explicitly listed as covered under Schedule A of this policy.<\/li>\r\n \t<li>Advanced surgeries<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Advanced surgeries<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following advanced surgical procedures and any associated costs are excluded from coverage under this policy unless otherwise stated in Schedule A, including but not limited to:\r\n<ul>\r\n \t<li>Cardiac and Cardiothoracic Surgeries: Surgical interventions involving the heart, major blood vessels, or chest cavity.<\/li>\r\n \t<li>Foetal Surgeries: Any surgical procedures performed on a foetus in utero.<\/li>\r\n \t<li>Liver Surgeries: Surgical procedures involving the liver, including but not limited to resections and other complex interventions.<\/li>\r\n \t<li>Neurosurgeries: Surgical procedures involving the brain, spinal cord, or peripheral nerves.<\/li>\r\n \t<li>Organ Transplants: Transplantation of organs or tissues, including but not limited to heart, liver, kidney, lung, pancreas, and bone marrow transplants.<\/li>\r\n \t<li>Shunt Operations: Procedures involving the placement, adjustment, or removal of shunts, including those for cerebrospinal fluid drainage.<\/li>\r\n \t<li>Subspecialist Surgeries and Procedures: Surgeries or medical procedures performed by surgical subspecialists This is including but not limited to joint replacements and other similar high-risk procedures which may require tertiary, critical care or otherwise specialized postoperative care.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Cosmetic Services<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following cosmetic services and any associated costs are excluded from coverage under this policy unless otherwise stated in Schedule A, including but not limited to:\r\n<ul>\r\n \t<li>Artificial Limbs: Provision, replacement, or maintenance of prosthetic limbs, except where explicitly listed as covered under this policy.<\/li>\r\n \t<li>Cosmetic Surgery: Surgical procedures performed primarily to enhance or alter physical appearance without medical necessity. Medical necessity is defined as procedures required to treat a condition or illness that directly improves medical outcomes, such as survival, or preservation of functionality, of vital organs.<\/li>\r\n \t<li>Dental Aesthetics: Procedures such as the provision of dentures, advanced conservative restorations, orthodontic treatments, or any associated cosmetic dental services.<\/li>\r\n \t<li>Hair Treatments: Services for alopecia, baldness, or wigs.<\/li>\r\n \t<li>Orthodontic and Related Treatments: Any dental or maxillofacial treatments primarily for aesthetic purposes.<\/li>\r\n \t<li>Personal Comfort Items: Non-essential items that may be claimed as part of care provision including Television or entertainment, beauty services, etc.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Custodial care<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following types of care and associated costs are excluded from coverage under this policy unless otherwise stated in Schedule A:\r\n<ul>\r\n \t<li>Custodial Care: Non-medical care provided to assist with activities of daily living (ADLs), such as bathing, dressing, feeding, toileting, mobility, or other personal care tasks, regardless of whether such care is provided by licensed personnel or family members. This includes care that does not require the supervision of medical professionals or is not intended to treat or improve a specific medical condition.<\/li>\r\n \t<li>Home Care: Care provided at home primarily for convenience, comfort, or maintenance, including but not limited to homemaker services, companionship, or general supervision. This exclusion applies regardless of whether such care is recommended by a healthcare provider or involves periodic visits by medical personnel.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Cosmetic Dental care<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following cosmetic dental services and any associated costs are excluded from coverage under this policy unless otherwise stated in Schedule A, including but not limited to:\r\n<ul>\r\n \t<li>Associated Supplies and Procedures: Any materials, tools, or follow-up treatments related to cosmetic dental enhancements.<\/li>\r\n \t<li>Cosmetic Dental Surgeries: Surgical procedures performed to enhance the appearance of teeth, gums, or jawline, including but not limited to gum contouring, tooth reshaping, or other non-medically necessary interventions.<\/li>\r\n \t<li>Dental Appliances: Provision, replacement, or repair of dental appliances used primarily for cosmetic purposes, such as veneers, crowns, or bridges not required for medical necessity.<\/li>\r\n \t<li>Dental Implants: Placement, maintenance, or replacement of dental implants or any associated supplies and procedures conducted for aesthetic enhancement.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Experimental, unorthodox or trado-medical care<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following types of care and associated costs are excluded from coverage under this policy:\r\n<ul>\r\n \t<li>Alternative Medicine: Including but not limited to acupuncture, aromatherapy, homeopathy, and herbal remedies.<\/li>\r\n \t<li>Experimental or Unproven Treatments: Any medical, surgical, or therapeutic procedures, devices or drugs that are not scientifically validated or officially recognized by the relevant regulatory or professional medical bodies as effective and standard care.<\/li>\r\n \t<li>Traditional Bone-Setting: Treatment of bone fractures or musculoskeletal conditions in traditional bone-setting facilities or by practitioners not recognized within the framework of orthodox medicine.<\/li>\r\n \t<li>Trado-Medical Practices: Treatments, remedies, or procedures rooted in traditional, cultural, or herbal medicine that lack endorsement or recognition within orthodox medical practice.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Eye Care<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following eye care services and any associated costs are excluded from coverage under this policy:\r\n<ul>\r\n \t<li>Cosmetic or Convenience Treatments: Procedures performed primarily for cosmetic or convenience purposes, including but not limited to laser vision correction (e.g., LASIK, PRK) or other refractive surgeries that are not medically necessary to treat an underlying eye disease or condition.<\/li>\r\n \t<li>Non-Covered Treatments: Any eye care treatments, procedures, or associated costs not explicitly listed as covered in Schedule A of this policy, which describes the specific benefits included under this plan.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Audiology<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following hearing-related services, investigations, and treatments are excluded from coverage under this policy:\r\n<ul>\r\n \t<li>Hearing Assessments: Tests such as pure tone audiometry, tympanometry, otoacoustic emissions, or any similar diagnostic procedures not explicitly listed as covered under Schedule A.<\/li>\r\n \t<li>Non-Covered Treatments: Any ear-related treatments, procedures, or associated costs not specifically mentioned in Schedule A of this policy, which outlines the covered benefits.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Force majeure<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following conditions and associated costs are excluded from coverage under this policy due to force majeure events, including but not limited to:\r\n<ul>\r\n \t<li>Epidemics and Pandemics: Events arising from outbreaks of infectious diseases, including epidemics, pestilence and pandemics, that impact the general population.<\/li>\r\n \t<li>Natural Disasters: Injuries caused by earthquakes and, weather related fire, drought, flooding, heatwaves, landslides etc.<\/li>\r\n \t<li>Other Force Majeure Events: Any other unforeseeable events beyond the control of the parties involved, such as natural disasters, terrorism, or governmental actions, which disrupt normal operations and services.<\/li>\r\n \t<li>War, Terrorism and Civil Strife: Injuries or damages sustained because of participation in acts of war, riots, terrorism, strikes, civil unrest, or any form of civil strife.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Professional and Amateur Sports and High-Risk Recreational Activities<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following bodily injuries and associated costs are excluded from coverage under this policy:\r\n<ul>\r\n \t<li>Professional and Amateur Sports: Injuries arising from participation in professional or amateur sports, or any sports where the individual is compensated for their involvement or where participation is for competitive purposes.<\/li>\r\n \t<li>High-Risk Activities: Bodily injuries resulting from participation in high-risk recreational activities, including but not limited to mountaineering, aviation, hand gliding and parachuting, horse racing, motor racing.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Illnesses of unknown cause<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following conditions and associated costs are excluded from coverage under this policy unless otherwise stated in Schedule A:\r\n<ul>\r\n \t<li>Diseases of Unknown Cause: Any illnesses, diseases, or medical conditions where the underlying cause is undetermined or unknown, and no conclusive diagnosis can be made based on available medical evidence.<\/li>\r\n \t<li>All autoimmune conditions.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Injuries related to intoxication or fights and physical brawls.<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following injuries and associated costs are excluded from coverage under this policy:\r\n<ul>\r\n \t<li>Drug Addiction: Treatment for drug addiction or rehabilitation services for substance abuse disorders.<\/li>\r\n \t<li>Fights and Physical Brawls: Injuries sustained while engaging in or as a result of participation in fights, physical brawls, or violent altercations.<\/li>\r\n \t<li>Injuries Resulting from Criminal Activities: Injuries or disabilities caused while engaging in or attempting to engage in illegal activities, including but not limited to theft, assault, or any criminal action.<\/li>\r\n \t<li>Intoxication: Injuries or disablement caused wholly or partly by the influence of intoxicating liquor, illegal drugs, or other substances (excluding those prescribed by a licensed medical practitioner).<\/li>\r\n \t<li>Self-Inflicted Injuries: Injuries resulting from attempted suicide, self-harm, or other willfully inflicted injuries.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Obstetrics<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following obstetric services and associated costs are excluded from coverage under this policy unless otherwise indicated in Schedule A:\r\n<ul>\r\n \t<li>Excessive Pregnancies: Ante-natal care and delivery services for pregnancies in excess of allowable number of plan dependents, whether the offspring are born under the scheme or not. This applies once the insurance quota of allowed dependent quota has been reached. Any additional dependent will attract an additional premium to be charged by Reliance HMO prior to coverage.<\/li>\r\n \t<li>Fetal Anomaly Scans: Any costs related to fetal anomaly scans, including screenings or diagnostics, are excluded.<\/li>\r\n \t<li>Molecular Diagnostics and In-Utero Testing: All costs related to molecular diagnostics of parent or foetus or genetic testing performed in utero are excluded.<\/li>\r\n \t<li>Newborns coverage: RELIANCE HMO shall not cover or pay for any treatment incurred by or for any new-born that is not registered after 6weeks of birth.<\/li>\r\n \t<li>Non-Covered Individuals: Antenatal and delivery services for individuals other than the principal insured or covered legal spouse of the principal insured. RELIANCE HMO shall not cover or pay for any treatment incurred by or for any new-born in the first 6 weeks of life delivered to persons who are not covered or enrolled under this policy. We only provide automatic cover for specified services, as listed in the benefit schedule, to new-borns in the first 6 weeks of life delivered to Principal Enrollees or Spouses covered by this policy.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Mental Health and Behavioural Services<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following mental health services and associated costs are excluded from coverage under this policy unless explicitly specified in Schedule A:\r\n<ul>\r\n \t<li>Inpatient Mental Health Treatment: Inpatient care or hospitalization for mental health conditions is excluded unless specifically covered under the policy.<\/li>\r\n \t<li>Medication for Psychiatric Conditions: The cost of medications prescribed for the treatment of psychiatric or behavioural conditions is excluded unless otherwise explicated stated under the policy benefits in Schedule A.<\/li>\r\n \t<li>Suicide or Self-Inflicted Injuries: Medical treatment for injuries sustained from attempted suicide, deliberate self-harm, or other wilfully inflicted injuries.<\/li>\r\n \t<li>Treatment for Addiction and Intoxication: Services related to the treatment of substance abuse disorders, including addiction to drugs or alcohol.<\/li>\r\n \t<li>Treatment for injuries or conditions resulting from intoxication or substance use is also excluded.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Excluded Conditions and Treatments<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following conditions and associated costs are excluded from coverage under this policy unless otherwise stated in Schedule A, including but not limited to:\r\n<ul>\r\n \t<li>Age-Related Conditions: Excludes conditions primarily caused by aging, including but not limited to Alzheimer\u2019s disease and cognitive impairments.<\/li>\r\n \t<li>Autoimmune Diseases: Exclusions include but are not limited to conditions such as lupus, rheumatoid arthritis, and celiac disease.<\/li>\r\n \t<li>Congenital Abnormalities: Treatment for congenital abnormalities or birth defects is excluded, except for life-threatening cases.<\/li>\r\n \t<li>Gender-Affirmation and Sterility Treatments: Consultations, Surgeries, treatments, or medications related to gender affirmation or gender transition.<\/li>\r\n \t<li>Growth Hormone Therapy: Treatments or medications for growth hormone deficiencies or hormonal therapies unless otherwise specified.<\/li>\r\n \t<li>Illnesses of Unknown Cause: Coverage is excluded for illnesses without a conclusive diagnosis or determined cause.<\/li>\r\n \t<li>Newborn Treatment: Excludes treatment for newborns of non-covered mothers. No coverage is provided for newborns not registered within six (6) weeks of birth.<\/li>\r\n \t<li>Obesity Treatments: Surgical and non-surgical treatments for obesity (including morbid obesity) and weight control programs are excluded. Specifically, the use of GLP-1 agonist drugs for weight management or obesity treatment is excluded unless explicitly covered under Schedule A.<\/li>\r\n \t<li>Sexual Dysfunction and Virility Enhancing Drugs: Consultations, treatments, and medications related to sexual dysfunction or performance enhancement.<\/li>\r\n \t<li>Smoking Cessation Programs: Treatments, supplies, and therapies aimed at quitting smoking or nicotine addiction.<\/li>\r\n \t<li>Treatments for sterility, infertility, or related conditions, including sexual dysfunction, are not covered unless otherwise stated in Schedule A.<\/li>\r\n \t<li>Work-Related Accidents: Injuries or conditions arising from workplace accidents are excluded as per applicable laws.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Overseas treatment<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">All medical expenses incurred for treatments, procedures, or services provided outside the country of Nigeria, except as otherwise outlined and covered in Schedule A.<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Treatment, service or supplies considered not to be medically necessary.<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following services, treatments, or supplies are excluded from coverage under this policy, even if prescribed, recommended, or approved by the attending physician or dentist:\r\n<ul>\r\n \t<li>Unproven Treatments: Not validated by regulatory bodies.<\/li>\r\n \t<li>Alternative Medicine: Including acupuncture, homeopathy, and herbal remedies.<\/li>\r\n \t<li>Experimental Devices and Drugs.<\/li>\r\n<\/ul>\r\nFor a treatment, service, or supply to be considered Medically Necessary, it must meet the following criteria:\r\n<ul>\r\n \t<li>Effectiveness: The service or supply must be likely to produce a significant positive outcome, and no more likely to produce a negative outcome than any alternative service or supply, both in relation to the specific sickness or injury and the person\u2019s overall health condition.<\/li>\r\n \t<li>Diagnostic Procedures: A diagnostic procedure must be indicated by the person's health status and should be likely to provide information that could influence the course of treatment, and no more likely to result in a negative outcome than any alternative diagnostic procedure.<\/li>\r\n \t<li>Cost Considerations: The diagnosis, care, and treatment must not be more costly (considering all related health expenses) than any alternative service or supply that meets the above criteria.<\/li>\r\n<\/ul>\r\nIn determining whether a service or supply is appropriate under the circumstances, Reliance HMO will consider:\r\n<ul>\r\n \t<li>Information relating to the affected person's health status;<\/li>\r\n \t<li>Reports from peer-reviewed medical literature;<\/li>\r\n \t<li>Guidelines published by nationally recognized healthcare organizations that include supporting scientific data;<\/li>\r\n \t<li>Opinions from health professionals in the relevant medical specialty; and<\/li>\r\n \t<li>Any other relevant information brought to Reliance HMO's attention.<\/li>\r\n \t<li>The following services or supplies will never be considered Medically Necessary:<\/li>\r\n \t<li>Non-Technical Services: Services that do not require the technical skills of a medical, mental health, or dental professional.<\/li>\r\n \t<li>Personal Comfort or Convenience: Services provided mainly for the personal comfort or convenience of the individual, their caregivers, family members, healthcare providers, or healthcare facilities.<\/li>\r\n \t<li>Inpatient Services Not Required: Services provided solely because the person is an inpatient on any day when their sickness or injury could safely and adequately be diagnosed or treated while not confined to a healthcare facility.<\/li>\r\n \t<li>Inappropriate Setting: Services furnished solely because of the setting (e.g., inpatient care) when the service could safely and adequately be furnished in a physician\u2019s or dentist\u2019s office, or in a less costly setting.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">Miscellaneous Exclusions<\/td>\r\n<td style=\"border: 1px solid #e1e1e1; padding: 5px;\">The following services and associated costs are excluded from coverage under this policy unless explicitly stated otherwise in Schedule A:\r\n<ul>\r\n \t<li>Excluded Populations: Coverage is not provided for adults over the age of 65 or dependent children above the age of 24, unless explicitly stated as covered under the policy agreement in Schedule A.<\/li>\r\n \t<li>Injuries Sustained During Criminal Actions: Coverage is excluded for injuries resulting from participation in or as a consequence of criminal actions by the insured individual.<\/li>\r\n \t<li>Molecular Diagnostics: Molecular diagnostics, including genetic, genomic, and other molecular testing, is excluded from coverage under this plan.<\/li>\r\n \t<li>Search and Rescue Operations: Expenses related to search and rescue activities for individuals lost in remote areas are excluded.<\/li>\r\n \t<li>Solicitation of Specific Treatments or Drugs: Any treatment or medication specifically requested by the enrollee but not deemed medically necessary or appropriate by the attending physician is excluded.<\/li>\r\n \t<li>Unapproved Inpatient Treatment: Inpatient care obtained without documented prior authorization from Reliance HMO is excluded. Queries and concessions must be granted prior to care delivery for coverage.<\/li>\r\n \t<li>Unlisted Benefits: Any benefit or service not explicitly included in the list of covered services is excluded.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>","id":"","class":"pro-paddingBottomLarge pro-paddingTopLarge","background_image":"","background_color":"","hide_section":false},{"acf_fc_layout":"blankSection","content":"","id":"","class":"bg-[url('https:\/\/getreliancehealth.com\/alafia\/wp-content\/uploads\/sites\/6\/2024\/09\/divider_mulberry-wood_blush-pink.svg')] bg-cover bg-center bg-repeat sm:h-[30px] lg:h-[40px] h-[25px] mx-auto mb-[] mr-[] mt-[] ml-[]","background_image":"","background_color":"","hide_section":false}]},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>SLA | Alafia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/getreliancehealth.com\/alafia\/serenity-policy\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"SLA | Alafia\" \/>\n<meta property=\"og:url\" content=\"https:\/\/getreliancehealth.com\/alafia\/serenity-policy\/\" \/>\n<meta property=\"og:site_name\" content=\"Alafia\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Reliancehealthng\/\" \/>\n<meta property=\"article:modified_time\" content=\"2025-09-09T09:10:40+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" 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Introduction<\/h3>\r\nThis document (together with any documents mentioned herein) sets out the terms and conditions governing the use of this website and the purchase of health insurance plans (\u201c<strong>Plans<\/strong>\u201d) through this website (hereinafter, the \"<strong>Terms<\/strong>\"). Please read through these Terms, and our <a href=\"\/nigeria\/privacy\/\">Privacy Policy<\/a> (together the \"Data Protection Policies\") prior to using this website.\r\n\r\nBy using this website or placing an order for any Plan through it, you hereby give your consent to and agree to be bound by these Terms and our Data Protection Policies. If you do not agree to all of the Terms and the Data Protection Policies, <strong>do not use this website<\/strong>.\r\n\r\nIn this document \u201cyou\u201d or \u201cyour\u201d refers to the user of this website and \u201cwe\u201d refers to Reliance HMO Limited. \u201cwebsite\u201d means getreliancehealth.com, any other URL operated by us and our mobile applications.\r\n<h3>2. Use of this Website<\/h3>\r\nBy using this website and\/or by placing any order through it, you undertake:\r\n<ul>\r\n \t<li>To use the website exclusively to make legitimate enquiries or orders<\/li>\r\n \t<li>Not to make any speculative, false or fraudulent enquiries or orders. If we are reasonably of the opinion that such an order has been made, we shall be entitled to cancel the order and inform the relevant authorities.<\/li>\r\n \t<li>To provide correct and accurate contact details to us and acknowledge that we may use these details to contact you in the event that this should prove necessary (see our Data Protection Policies). If you do not give us all of the information that we need, we may not be able to complete your order. By placing an order through this website, you warrant that you are at least 18 years old and are legally capable of entering into binding contracts.<\/li>\r\n \t<li>Not to: use this website in any way that is, or may be, damaging to this website; use this website in any way that impacts user access to this website; use this website contrary to applicable laws and regulations, or in a way that causes, or may cause, harm to the website, or to any person or business entity; engage in any data mining, data harvesting, data extracting or any other similar activity in relation to this website, or while using this website; or use this website to engage in any advertising or marketing.<\/li>\r\n<\/ul>\r\n<h3>3. Change<\/h3>\r\nThese Terms and the Data Protection Policies may be amended. It is your responsibility to regularly read through them, as the Terms and the Data Protection Policies in force at the time that you use this website or at the time of the formation of the Contract (as defined below) shall be the applicable ones. We reserve the right to modify or withdraw this Website at any time without recourse or liability to you.\r\n<h3>4. Your Details<\/h3>\r\nThe information or personal details that you provide us with shall be processed pursuant to the Data Protection Policies. By using this website you are consenting to the processing of such information and details and you represent that the whole information or details you have provided us with are true and accurate. We shall not be responsible for any loss which you may suffer as a result of any false information or details which you have provided to us.\r\n<h3>5. Purchase of a Plan<\/h3>\r\nThe information set out in the Terms and the detail contained on this website do not constitute an offer for sale, but rather an invitation to treat. No contract in respect of any Plan will exist between us and you until your order has been expressly accepted by us, whether or not funds have been deducted from your account. If we do not accept your offer and funds have already been deducted, these will be fully refunded.\r\n\r\nThe contract for the purchase of any Plan between us will only be formed when you complete a purchase and we send you the confirmation of purchase. By purchasing any Plan from this website, you enter into a contract with us on these terms and on the terms contained in the Retail Plan Terms and Conditions (\u201c<strong>the Contract<\/strong>\u201d) which can be accessed be found this page and which will be provided to you as a check box before you pay through the payment platform on the website.\r\n\r\nThe Contract will relate only to those Plans whose purchase we have confirmed in the confirmation.\r\n<h3>6. Price and Payment<\/h3>\r\nThe price of any Plan will be as stipulated on our website from time to time, except in cases of obvious error. While we try to ensure that all prices on this website are accurate, errors may occur. If we discover an error in the price of items you have ordered, we will inform you as soon as possible and give you the option of reconfirming the order at the correct price or cancelling it. If we are unable to contact you, the order will be treated as cancelled and if you have already paid for the Plan you will receive a full refund.\r\n\r\nWe are under no obligation to provide the items to you at the incorrect (lower) price (even after we have sent you a confirmation) if there is a pricing error. The prices on this website include VAT which will be added to the total amount due. Prices are liable to change at any time, but (other than as set out above) changes will not affect orders in respect of which we have already sent you a confirmation.\r\n\r\nIf you are a registered user, a record of all the orders placed by you is available in the \"My Account\" area. Payment can be made by Visa, Verve and Mastercard.\r\n\r\nYou confirm that the debit or credit card used in purchasing the Plan is yours or that you are the legitimate holder and have the authority of the owner to use it. Credit and debit cards are subject to validation checks and authorisation by your card issuer, but if your card issuer fails to authorise payment to us, we will not be liable for any delay and may not be able to form a contract with you.\r\n<h3>7. Indemnity<\/h3>\r\nYou agree to indemnify and hold us, our affiliates, officers, directors, agents and\/or employees, as the case may be, free from any claim or demand, including reasonable legal fees, related to your breach of these Terms.\r\n<h3>8. Liability and Disclaimers<\/h3>\r\nThis website and the Plans on this site are provided \u201cas is\u201d and without warranties of any kind, whether express or implied. To the fullest extent permissible pursuant to applicable law, we disclaim all warranties, express or implied, including, but not limited to, implied warranties of merchantability and fitness for a particular purpose and non-infringement. We do not represent or warrant that the functions contained in the site will be uninterrupted or error-free, that the defects will be corrected, or that this website or the server that makes the website available are free of viruses or other harmful components. We do not make any warranties or representations regarding the use of the materials in this website in terms of their correctness, accuracy, adequacy, usefulness, timeliness, reliability or otherwise.\r\n\r\nNeither Reliance HMO nor its directors, officers, employees, agents, contractors, or licensors shall be liable for any direct or incidental, special or consequential damages under or arising from the Data Protection Policies, the use of this website or any internet site linked to or from this website, whether for breach of contract, tortuous behaviour, negligence, or under any other cause of action, unless such action was caused by the wilful conduct of Reliance HMO or such other persons mentioned above.\r\n\r\nNeither Reliance HMO nor its directors, officers, employees, agents, contractors or licensors shall be liable to you or any other third party for any decision made or action taken by you in reliance on the content contained on the website or the content contained within any internet site linked to or from this webite. You specifically acknowledge and agree that Reliance HMO is not liable for any defamatory, offensive, fraudulent, or otherwise illegal conduct of any user. If you are dissatisfied with any content of the website, your sole and exclusive remedy is to discontinue using the website.\r\n\r\nDue to the open nature of this website and the potential for errors in the storage and transmission of digital information, we do not warrant the accuracy and security of information transmitted to or obtained from this website unless otherwise expressly set out on this website. All item descriptions, information and materials posted on this website are provided \"as is\" and without warranties express, implied or otherwise howsoever arising.\r\n<h3>9. Intellectual Property<\/h3>\r\nYou acknowledge and agree that other than content you own, which you may have opted to include on this website, all copyright, trademarks and all other intellectual property rights in all material or content supplied as part of this website shall remain at all times vested in us or our licensors. You may not modify, copy, reproduce, transmit, distribute, publish, create derivative works from, display or otherwise transfer or commercially exploit any of the contents of our website, in whole or in part other than as permitted under these Terms. You are granted a limited license only, subject to the restrictions provided in these Terms, for purposes of viewing the material contained on this website. You are expressly and emphatically restricted from all of the following: publishing any website material in any media; selling, sublicensing and\/or otherwise commercializing any website material; publicly performing and\/or showing any website material\r\n<h3>10. Viruses, Hackering and other Cybercrimes<\/h3>\r\nYou may not misuse this website by knowingly introducing viruses, Trojans, worms, logic bombs or other material which is malicious or technologically harmful. You will not attempt to have any unauthorized access to this website, to the server which hosts this website or to any other server, computer or data base related to our website. You undertake not to attack this website via a denial of service attack or a distributed denial of service attack. By breaching this provision you may commit a criminal offence under the applicable regulations. We will report any such breach to the relevant law enforcement authority and we will co-operate with the appropriate authority to disclose the identity of the hacker. Likewise, in the event of such a breach, your right to use this website will cease immediately. We will use reasonable care and skill to ensure that this website is safe, secure and free from bugs, viruses and other defects. Except to the extent it results from our failure to do so, we accept no liability for any loss or damage resulting from any denial of service attack, virus or any other software or material which is malicious or technologically harmful to your computer, equipment, data or material resulting from the use of this website or from the downloading of the contents thereof or of such contents to which this website redirects.\r\n<h3>11. Links from our Website<\/h3>\r\nWe may have links from our website to other third party websites and materials; such links are provided exclusively for information purposes and we do not have any control whatsoever over the contents of such websites or materials. Accordingly, we accept no liability whatsoever for any loss or damage which may arise from the use of such links.\r\n<h3>12. Events outside our control<\/h3>\r\nWe will not be liable or responsible for any failure to perform, or delay in performance of, any of our obligations under the Contract or these Terms that is caused by events outside our reasonable control. An event outside our control includes any act, event, non-happening, omission or accident beyond our reasonable control and includes in particular (without limitation) the following:\r\n<ul>\r\n \t<li>Strikes, lock-outs or other industrial action<\/li>\r\n \t<li>Civil commotion, riot, invasion, terrorist attack or threat of terrorist attack, war (whether declared or not) or threat or preparation for war.<\/li>\r\n \t<li>Fire, explosion, storm, flood, earthquake, subsidence, epidemic or other natural disaster.<\/li>\r\n \t<li>The acts, decrees, legislation, regulations or restrictions of any government.<\/li>\r\n<\/ul>\r\n<h3>13. Written Communications<\/h3>\r\nWhen using our site, you accept that communication with us will be mainly electronic. We will contact you by e-mail or provide you with information by posting notices on our website. For contractual purposes, you agree to this electronic means of communication and you acknowledge that all contracts, notices, information and other communications that we provide to you electronically comply with any legal requirement that such communications be in writing.\r\n<h3>14. Notices<\/h3>\r\nAll notices given by you to us should be given to us via email to <a href=\"mailto:hellonigeria@getreliancehealth.com\">hellonigeria@getreliancehealth.com<\/a>. Subject to and as otherwise specified in Clause 13, we may give notice to you at either the e-mail or postal address you provide to us when purchasing a Plan. Notice will be deemed received and properly served immediately when posted on our website, 24 hours after an e-mail is sent, or three days after the date of posting of any letter. In proving the service of any notice, it will be sufficient to prove, in the case of a letter, that such letter was properly addressed, stamped and placed in the post and, in the case of an e-mail that such e-mail was sent to the specified e-mail address of the addressee.\r\n<h3>15. Waiver<\/h3>\r\nIf we fail, at any time during the term of the Contract, to insist upon strict performance of any of your obligations under the Contract or any of these Terms, or if we fail to exercise any of the rights or remedies to which we are entitled under the Contract, this shall not constitute a waiver of such rights or remedies and shall not relieve you from compliance with such obligations. A waiver by us of any default shall not constitute a waiver of any subsequent default arising from the Contract or the Terms. No waiver by us of any of these Terms shall be effective unless it is expressly stated to be a waiver and is communicated to you in writing in accordance with the paragraph on Notices above.\r\n<h3>16. Severability<\/h3>\r\nIf any of these Terms or any provisions of the Contract are determined by any competent authority to be invalid, unlawful or unenforceable to any extent, such term, condition or provision will to that extent be severed from the remaining terms, conditions and provisions which will continue to be valid to the fullest extent permitted by law.\r\n<h3>17. Law and Jurisdiction<\/h3>\r\nThe use of our website and the Contracts for the purchase of the plans through such website will be governed by Nigerian Law. Any dispute arising from, or related to the use of this website or to such Contracts shall be subject to the non-exclusive jurisdiction of the Nigerian courts.\r\n\r\n \r\n\r\n ","id":"","class":"pro-paddingBottomLarge pro-paddingTopLarge","background_image":"","background_color":"","hide_section":false},{"acf_fc_layout":"blankSection","content":"","id":"","class":"bg-[url('https:\/\/getreliancehealth.com\/alafia\/wp-content\/uploads\/sites\/6\/2024\/09\/divider_jade50_indigo.svg')] bg-cover bg-center bg-repeat sm:h-[30px] lg:h-[40px] h-[25px] mx-auto mb-[] mr-[] mt-[] ml-[]","background_image":"","background_color":"","hide_section":false}]},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>General terms | Alafia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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