Bermuda Consolidated Legislation

 

BERMUDA STATUTORY INSTRUMENT

SR&O 8/1971

HOSPITAL INSURANCE (CERTIFICATE OF ENTITLEMENT) REGULATIONS 1971

[made under sections 38 and 40 of the Hospital Insurance Act 1970 [title 18 item 9] and brought into operation on 1 April 1971]

ARRANGEMENT OF REGULATIONS

1 Form of application

2 Form of certificate

Form of application

1 The form of application for a certificate of entitlement under sec tion 38 of the Hospital Insurance Act 1970 shall be in accordance with the form set out in the Schedule or as near thereto as circumstances admit.

Form of certificate

2 Where the Insurance Officer is satisfied that a person in respect of whom an application is made is entitled to subsidized hospital treat ment he shall issue to the applicant a certificate of entitlement in the following form—

"CERTIFICATE OF ENTITLEMENT

(issued In pursuance of section 38 of the Hospital Insurance Act 1970)

Certificate No.

I hereby certify that (full name of person in respect of whom application is made) of (full address) is entitled to subsidized hospital treatment un der paragraph ( ) of subsection (1) of section 2 of the Hospital Insurance Act 1970.

(signed) Insurance Officer.".

SCHEDULE

Application for a Certificate Entitlement

Full Name

Present Address

Date of Birth

Place of Birth

Age on Last Birthday

Nationality

Present Employer (if any)

Do you possess Bermudian Status

Date of Entry to Bermuda

Is Your Home in Bermuda

Have you resided in Bermuda for a continuous period of not less than ten years during the period of twenty years immediately preceding the date of application

What periods in excess of 3 months have been spent abroad (otherwise than for the purposes of educational or vocational training or on holiday) give details, date of each such absence and reasons therefor.

Signature of Applicant

Date