Bermuda Consolidated Legislation

 

BERMUDA STATUTORY INSTRUMENT

SR&O 20/1971

HOSPITAL INSURANCE (ARTIFICIAL LIMBS AND APPLIANCES) REGULATIONS 1971

[made under section 40 of the Hospital Insurance Act 1970 [title 18 item 9] and brought into operation on 1 April 1971]

ARRANGEMENT OF REGULATIONS

1 Standard hospital benefit in relation to artificial limbs

2 Interpretation

3 Liability limited

Standard hospital benefit in relation to artificial limbs

1 Where a contract of hospital insurance provides standard hos pital benefit, such contract shall, in relation to any benefit payable thereunder in respect of expenses for the supply, maintenance, repair and renewal of any artificial limb, or other artificial appliance, be con strued subject to the following provisions of these Regulations.

[Regulation 1 amended by BR 20/1990 effective 1 April 1990; and by BR 18/1995 effective 1 April 1995]

Interpretation

2 In these Regulations "artificial appliance" means any surgically implanted prosthetic appliance for the regulation, control or improve ment of any bodily function but does not include any cosmetic, dental, ophthalmic or hearing appliance.

Liability limited

3 (1) Subject to paragraph (1A), the liability for expenses in respect of the supply, mainte nance, repair and renewal of any artificial limb, or artificial appliance shall be that of the insurer under the contract of hospital insurance which is in effect on the relevant date.

(1A) Notwithstanding paragraph (1), where—

(a) prior to the date of the coming into operation of these Regulations a person was not insured; and

(b) that person, after that date, takes out a contract of hospital insurance,

the insurer shall not, before the expiration of twelve months next after the date of the taking out of such contract of hospital insurance, be liable in respect of artificial limbs or other artificial appliance, or both.

(2) The Liability of an insurer in respect of the supply of an artificial limb, orthopaedic brace or artificial appliance shall be limited to a maximum of $15,000; however, where the amount of the maximum liability is not exhausted in the supply thereof then liability can only be in respect of the maintenance, repair or renewal of any artificial limb, orthopaedic brace or artificial appliance and such liability shall be limited to 80% of the unexhausted portion of the $15,000.

(3) In this regulation "the relevant date" means—

(a) in relation to an accident or injury, the date on which the accident or injury giving rise to the need for an artificial limb, or artificial appliance occurs; and

(b) in relation to an illness, the date on which the surgical treatment for the removal of the natural limb or the im plantation of the artificial appliance occurs or the date on which the initial use of the occurs.

[Regulation 3 amended by BR 20/1990 effective 1 April 1990, by BR 18/1995 effective 1 April 1995; and by BR 21/1998 effective 1 April 1998]