Insurance information - emPLANT Master

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Insurance scheme

The emPLANT Consortium has asked DR-WALTER Insurance Brokers to insure the emPLANT students with a combination of health, liability, accident and assistance insurance (named PROTRIP-WORLD-PLUS) complying with the EACEA’s minimum requirements.

You can find all the relevant information you need about the insurance scheme outlined in each sections below.

PS: The content on this page is subject to change.

For all current information, please see: www.erasmus-plus-insurance.com

Insurance scheme for emPLANT students

The program offers special cover to its emPLANT students at no extra-cost. Their families can also benefit from special premiums with the same insurers. When insured with PROTRIP-WORLD-PLUS, you are covered comprehensively during your Erasmus program.

The start of the insurance cover is linked to the departure date from the country of origin to the European Union and vice versa. The emPLANT Consortium takes on the registration and cancellation and covers the premiums.

You will receive all information regarding your insurance from your university on time before departure. Additionally, you can familiarize yourself with your insurance cover here:

Making use of assistance services

The staff of DR-WALTER’s emergency center will provide you with immediate assistance if you need help within your assistance insurance policy.

24-hour emergency number for assistance services:
+49 (0) 89 55 987 -641

The services include:

  • Assistance in case of loss of means of payment
  • Assistance in case of loss of travel documents
  • Assistance in the event of criminal prosecution
  • Return journey in case of an emergency
  • Arrival of a person in a position of trust in case of an emergency

If you require insurance services, please contact our 24 hour emergency number as early as possible to coordinate any further steps.

Further information can be found at the Erasmus-Plus-Insurance site here

Exclusion of benefits - the facts

No insurance cover is provided for damages:

  • intentionally caused by the insured person;
  • caused by the insured person as a result of an intentional criminal act or the intentional attempt of committing a criminal act.

Excluded benefits related to medical coverage:

It is specified that the following benefits are not covered by this policy, except benefits specified as covered in the coverage table attached to the policy:

  • costs for the treatment of prior illnesses including chronic illnesses, unless there is an acute and unforeseeable deterioration in health;
  • medical treatment and other measures ordered by a doctor where the insured person was aware when starting the insured stay that, if the insured stay took place as planned, the treatment would have to be given for medical reasons (e. g. dialysis);
  • procurement and repair of heart pacemakers, prostheses, aids to sight and hearing aids;
  • costs of accident or illness caused by mental illness or impaired consciousness, if this is a result of the consumption of alcohol, drugs, intoxicants or sedatives, sleeping tablets or other narcotic substances;
  • acupuncture, fango and massages;
  • need for care or safe-keeping;
  • psychoanalytical and psychotherapy treatment, if not covered under aforementioned details of benefits and hypnosis;
  • payments for pregnancy and labour, if the pregnancy has arisen more than 6 months before the commencement of the insured stay, unless there is an acute and unforeseeable deterioration in the health of the mother.

Insurance is provided during holidays at home as follows:

  • during a trip of less than six weeks, only for the costs resulting from an accident or an emergency illness, as these terms are defined in Title VI, provided the treatment was practiced by a general or specialized practitioner or the hospitalization was a necessity owing to the emergency and took place within twenty-four hours,
  • in all other cases, after express approval by the insurer.

You will find the detailed benefits and exclusion of benefits in the General Insurance Conditions .

Accident insurance does not cover:

  • accidents as a result of drunkenness or drug use;
  • illnesses and wear and tear, e. g. back pain resulting from a permanent sitting position, strokes or heart attack since they are not considered as accidents;
  • accidents caused directly or indirectly by nuclear power;
  • accidents as a result of mental illness or cognitive disorders;
  • accidents caused directly or indirectly by foreseeable acts of war.

You will find the detailed terms and conditions in the Insurance Conditions.

Liability insurance does not cover:

  • damages to leased, rented or borrowed equipment;
  • damages to the host family’s movable property;
  • damages to motor vehicles as a result of operating such vehicles;
  • damages caused by the exchange, transmission or provision of electronic data.

You will find the detailed terms and conditions in the Insurance Conditions.

Assistance insurance does not cover:

  • illnesses as a psychological reaction to war, unrest, an act of terror, a plane crash or the fear of war, unrest or acts of terror;
  • chronic mental illnesses, also if they occur in phases, and addiction.

You will find the detailed terms and conditions in the Insurance Conditions.

Further information can be found at the Erasmus-Plus-Insurance site here

What to do in the event of illness?

What to do outside the USA and Canada?

Do you suffer from influenza, a cold or toothache? Go see a doctor! You are covered by International Health Insurance. For information on our policy’s benefits and benefit exclusions, go to our section Benefits. Inform your treating doctor (where applicable) about your policy’s scope of benefits to avoid overtreatment.

After treating you, the doctor will give you an invoice. This invoice must include: name of the treated person, illness, type of individual medical services performed as well as the total treatment costs. If the invoice does not include sufficient information for a diagnosis, you can help us a lot by adding a short report about illness and treatment.

Please submit your original invoice along with your insurance number and bank data. Processing of your request usually takes 7 to 14 days. After that, we will refund your costs by means of bank transfer to the account mentioned by you.

In the event of illness outside the USA and Canada, please contact:

DR-WALTER GmbH
Abteilung Leistung (Claims Department)
Eisenerzstr.
34
53819 Neunkirchen-Seelscheid
Germany
Email:
claims@dr-walter.com
Tel: +49 (0) 2247 9194 -31
Fax: +49 (0) 2247 9194 -20

Click here for the correct claim forms.

Further information can be found at the Erasmus-Plus-Insurance site here

What to do when staying in the USA and Canada?

When you travel to the USA and to Canada, please contact our partner GMMI in the USA for advice and support – if possible prior to a medical treatment (24 hour emergency number). The staff of GMMI will help you to choose the right doctor or hospital, will explain all the billing details and can take care of direct billing with doctors and hospitals. You can call GMMI 24/7 in the USA and in Canada at +1-855-488-5523 (toll-free) and at +1-954-308-3923 (local call).

Please present your insurance certificate to your treating doctor prior to the start of treatment. Your insurance certificate provides the doctor or hospital with all necessary information about the billing of their services. In most cases, direct billing with the treating doctor will be possible without you having to make an advance payment.

After treating you, the doctor will give you an invoice. This invoice must include: name of the treated person, illness, type of individual medical services performed as well as the total treatment costs. Please submit the invoice to our office in the USA. Under normal circumstances, our office will then settle the billing directly with the treating doctor.
If you need medical treatment in the USA or Canada, please contact:

GMMI for Dr. Walter GmbH
880 SW 145th Avenue, Suite 400
Pembroke Pines, FL 33027
Toll-Free:
+1-855-488-5523 or +1-954-308-3923 (local)
Email:
customerservice@gmmi.com

Further information can be found at the Erasmus-Plus-Insurance site here

How are your invoices refunded?

Direct billing with doctors or hospitals

After the admission of a patient, hospitals usually contact our claims department. Billing then takes place directly with the hospital.

In the USA and Canada, doctors and dentists can settle their bills directly with our partner GMMI. For this purpose, you should contact GMMI – if possible prior to falling ill. Doctors send their invoices to GMMI who, in return, transfers the invoice amount directly to the doctor’s account.

Advantage of direct billing: if the treatment costs are within the sums insured under the policy, you do not need to bother with the billing at all.

Phone: +49 (0) 2247 9194 -21
Fax: +49 (0) 2247 9194 -40
Email: international@dr-walter.com

If you receive an invoice

If you receive a doctor’s invoice after the treatment, please send the original invoice along with your completed claim form to Dr. Walter and name the account you want the reimbursement transferred to.

Please note: laboratory bills as well as prescriptions can only be reimbursed when we receive the doctor’s original invoice (along with the diagnosis). Processing of bills/invoices usually takes 7 to 14 days.

Please send your invoice to:
Dr. Walter GmbH
Abteilung Leistung (Claims Department)
Eisenerzstr. 34
53819 Neunkirchen-Seelscheid
Germany

Further information can be found at the Erasmus-Plus-Insurance site here

Claim forms

Here you will find all claim forms as PDF files that you can fill in and print out at home.

Claim documents overview:

The content on this page is courtesy of our insurance provider and is subject to change. For all current information, please see our insurance provider’s website for details:

www.erasmus-plus-insurance.com

Questions & Answers

Do you want to have detailed information before purchasing your PROTRIP-WORLD-PLUS insurance? In this section, we collected a number of frequently asked questions regarding the scope of coverage. If you have any other questions, feel free to contact DR-WALTER.

Which doctor may I consult in case of illness?

In principle, our insurance offers free choice of medical practitioners. However, in case of major out-patient treatment or any kind of in-patient treatment, please contact our claims office or emergency service as soon as possible. This will enable us to quickly settle the costs for your medical treatment with the doctor or clinic and you won’t be asked to make an advance payment.

Which documents do I need to submit to be reimbursed for medical costs?

We kindly ask you to submit original invoices (practitioners’ invoices, prescriptions, etc.). Invoices must carry the following information: name of patient, description of illness, itemised list of medical treatments, and overall treatment costs. In addition, please submit a copy of supporting documents (medical reports, police reports, etc.).
Please send the complete documentation along with the claim form to our claims department.

What do I need to do in case of in-patient treatment?

For any kind of in-patient treatment, please contact our emergency service. This will enable us to attend to your needs as quickly as possible. You will also avoid an advance payment.

What do I need to do in case of emergency?

In any kind of emergency, please contact our emergency service staff who will provide cost guarantees or arrange for quick repatriation.

In which countries am I covered?

The insurance coverage applies to stays abroad. In the case of intermediate stays at home, for example during the holidays, insurance coverage also applies to the home country (i. e. the country of permanent residence) for a maximum stay of six weeks within one year. For academic stays at universities in the home country (i. e. the country of permanent residence) within the Erasmus-Plus programme, coverage only applies in liability and accident insurance.

Which rules apply in case of pre-existing conditions?

The acute and unforeseeable deterioration in health related to prior or chronic illnesses shall be covered. If you suffer from a pre-existing or chronic illness, it is advisable to ask your general practitioner in your home country to certify in writing that you are fit to travel before you go abroad.

Am I covered for sports activities during my stay abroad?

In principle, any kind of sports activity is covered. However, your accident insurance does not cover claims resulting from participation in private or official high speed racing.

Does this insurance cover third party liability if I drive a motor vehicle in a foreign country?

No, the use of motor vehicles is not covered by this liability insurance.

Can I extend my insurance period if I decide to prolong my stay abroad?

Yes, that is no problem at all. For this purpose, please contact your contact person at the coordinating university in good time before your insurance expires. If the extension of coverage is no longer related with the emPLANT academic program, you may have to pay on your own the part corresponding to the extension of warranty.

Further information can be found at the Erasmus-Plus-Insurance site here

Last updated : July 16, 2018