MedICover Travel Medical Expenses Insurances Form

Underwritten by Ace Europe and arranged through O’Driscoll O’Neil Ltd

This policy provides private medical insurance for students travelling to Ireland as required by the visa requirements of the Irish Department of Justice Equality and Law Reform.

Summary of Cover

The Insurers will pay costs incurred by any insured student following any accidental injury whether hospitalisation is necessary or not, or any illness necessitating admission to hospital, up to a limit of €2,500,000.

Additionally, the following lump sum payments will be made in the following circumstances:

Accidental death	€10,000
Accidental loss of two or more limbs	€10,000
Accidental loss of sight in both eyes	€10,000
Accidental loss of one limb	€5,000
Accidental loss of one eye	€5,000

Each student is issued with a policy certificate and a ‘helpline card’.

The policy is subject to a €100 excess per incident. All costs incurred in relation to any particular injury or illness will be subject to one excess only, regardless of the timescale of the treatment necessary.

Exclusions:

The policy is subject to standard insurance exclusions including those detailed below.
The policy excludes claims arising from pre-existing illness or injuries known to the student prior to them travelling to Ireland.
The policy also excludes claims arising from suicide or attempted suicide, AIDS/HIV, criminal activity including drug abuse, organ transplants, radioactive contamination and injury arising from certain hazardous activities (e.g. scuba diving, rock climbing, hang gliding etc.).
The policy excludes cover for anyone not undertaking a course of study.

Personal Details

Your Name

Gender

Date Of Birth

Your Email (required)

Address

Country of Residence:

College

NUI Maynooth

Period of Insurance

Coverage commences from the date of entry into Ireland and ceases 7 days after completion of the course of study or on the date of exit from Ireland, whichever is the earlier.

Inception (Cover Start Date)

Expiry (Cover Finish Date)

Total Premium Incl Govt. Levy & Service Charge €120.00

Declaration & Anti SPAM

I declare that I am under the age of 60, that subject to receipt of a satisfactory visa I wish to be insured under this scheme, that I have read and understood the terms, conditions and events which are not covered by this insurance and that I understand that benefit will not be payable for an medical or physical condition in respect of which I have suffered or sought treatment or advice in the last 24 months prior to the inception of this insurance.

Agree I have read and agree to Declaration above.

For a copy of the policy schedule please Click here