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Your little guide to health
cover with big benets
Good4you Health Cash Plan
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Hello
A warm welcome to your health
cover from Westeld Health.
We’ve been dedicated to making
a healthy dierence to the
quality of life of our customers
and the communities in which
they live and work.
A little bit about us
We are Westeld Health. From humble beginnings, we’ve evolved to
become a leading health and wellbeing provider.
We encourage positive changes in the wellbeing of our customers and the
wider population across the UK. Together, we can help everyone to live
healthier lives through better choices, ongoing support and a more proactive
approach to healthcare.
Through our charitable donations, we support the NHS and medically related
charities to help our customers and the community to lead healthier lives.
Getting started
Take a look through your handy little guide, which provides everything you
need to help you get the most from your cover. If you have any questions at all,
just give our friendly UK based Customer Care Team a call on 0114 250 2000.
Don’t forget to read the full Terms and Conditions at the
back of this guide.
A century on and
we still have the same
beliefs, vision and values
we’ve always had – to
support you throughout
your life with innovative,
best in class health cover.
Welcome
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Welcome
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Taking better care of you.
No one knows what’s around the corner where our health is
concerned. With your cover, you can be sure that we will work harder
on your behalf to help you pay for those essential health bills.
Money back and cash payouts.
We aim to ensure that as many of your health costs are covered as possible. From dental appointments to optical
check ups, therapy treatments and more, you can rest assured that your cover will help with your bills.
You can claim back a percentage reimbursement and, in some cases, 100% of the money you spend straight away, up
to the maximum allowance provided by your cover. You can also receive xed cash payouts for hospital stays and day
surgery. And you will also receive a sum of money if you have a baby or adopt a child.
Diagnosis and peace of mind.
We want you to stay at your t and healthy best and, to help you do that, we’ve included all kinds of additional
benets. As well as providing cash towards diagnostic consultations, your cover includes a 24 hour DoctorLine
service, because we know that illness doesn’t just strike during surgery hours.
Customer Testimonial
“I’ve been through a lot medically, but having my Westeld cover to help has been fantastic.
From getting quick access to consultations to receiving payment after my operation, the cover
played a big part in my treatment and rehabilitation. From run of the mill things like eye checks
and visits to the dentist, to more serious issues, I have always had excellent service.”
Introducing
your cover
Congratulations. Like
thousands of others, you’re
about to discover why so
many of our customers are
happy with their cover.
Your Cover
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Caring for your loved ones.
We’re here to help people be healthy and independent for as long
as possible, so it’s reassuring to know that our eldercare advice and
support services can help you make informed choices about putting
care in place for a loved one or yourself. There’s also a Care After
Hospital benet, giving you the reassurance of up to 18 hours of
home care following an overnight stay in hospital.
Health and wellbeing.
Your cover has been designed to help keep you in the best
possible shape, physically and mentally. So our 24 Hour Advice
and Information Line is a reassuring aspect of your cover as it
gives you help, support and advice by phone – day or night.
Your cover also includes Gym Discounts providing discounted
membership at local gyms, so you can actively start improving your
health right away.
Personal Accident cover too.
You have cover in place to help you and your family if the worst
should happen. Levels 3, 4 and 5 provide cash payouts in the event
of death or permanent disability as a result of an accident.
Your Cover
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DoctorLine.
From anywhere in the world, 24 hours a day, you can pick up the phone and arrange a call back from a
practising UK GP, to discuss any health issues and receive advice or a diagnosis. You can even choose
to have a webcam consultation so you can see and speak to a doctor while you’re at home or at work.
It’s the closest thing to a surgery appointment, but without the wait. Over 70% of DoctorLine
consultations result in the patient being recommended a course of action, without the need for referral
to another medical professional.
If the doctor believes that your treatment requires medication, they can oer you a private prescription.
You can choose for the medicine to be sent directly to you at an address of your choice or a local
pharmacy, or you could be sent a digitally secure electronic prescription to show at a nominated local
pharmacy.
Prescriptions can be raised for one-o occasions such as prescription-only painkillers/inammatory
drugs, digestive medication, or NHS prescription medication where the patient is away from home and
has forgotten or has insucient prescription medication, antibiotics or hormonal medication.
Telephone Care Advisory Services.
It’s often emotional and unsettling when making the decision to nd care for elderly relatives or even
yourself. You need to feel condent that they’re comfortable and well cared for. Our service provides
expert advice and support to help you resolve your care issues.
Our care advisors will listen carefully to your needs and wishes and discuss your situation in detail.
They’ll guide and support you through your next steps, providing you with the information and advice
to help you make the best possible care decisions.
Working harder
for you.
As you start to use your health cover,
the advantages really add up. It
works harder for you by providing
excellent cash payouts and money
back for treatment – and this is just
part of your cover. It also provides
access to valuable services to help
keep you at your t and healthy best.
Your Benets
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Your Benets
Customer Testimonial
“Being a Westeld customer not only means I can save money and claim back my dental
and optical bills but I am now able to shop without feeling too guilty. I registered with Westeld
Rewards and in the past month I have saved money by using my reloadable cards. I am currently
in the process of buying my rst house and through Westeld Rewards I can save money on the
cost of my new kitchen.”
24 Hour Advice and Information Line.
It’s good to talk. Whatever the issue, support and advice is just a phone call
away. This freephone telephone service gives you and your resident family
access to condential guidance on medical, legal or domestic issues from
experienced counsellors, lawyers and medical advisors. From stress,
bereavement or relationship advice to health and money worries, you’ll be
able to talk to a qualied counsellor any time day or night.
You also have access to an app and wellbeing portal; an online dedicated
resource, designed to support your health and wellbeing. It provides you with
condential access to wellbeing fact sheets, videos, self-help programmes,
interactive tools and educational resources to help with life’s challenges.
For details on how to access your services, see page 17.
Westeld Rewards.
Helping your money go further. You have access to our exclusive rewards website.
It provides access to special oers on all your favourite goods and services from hundreds of leading
online and high street retailers. Make use of discount codes or purchase reloadable cards. The savings
are often on top of sale prices, money o vouchers and online promotions, so their money goes even
further. It’s retail therapy at its best.
Pick up exclusive discounts by purchasing reloadable cards for high street stores and supermarkets or
receive Cashback from participating retailers by connecting to them online via the Westeld Rewards
website.
Instant vouchers are a quick and easy way to save. Order the amount you want and then download the
voucher from your account to use in store or online for an instant discount. Instant vouchers can be
downloaded to the SmartSpending app whilst in a shop.
Even better, all discounts are on top of sale discounts or online promotions and you can even save on
utility services such as gas or electricity too.
Visit www.westeldrewards.co.uk to register. You can then use the SmartSpending app to make
savings while on the move.
£
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It feels good to be covered.
We know how much eort you put into your work and the stresses and strains you face in everyday life, so we’re committed to
ensuring that your policy works harder for you. Take a look at the full range of benets your cover provides.
Money back on everyday health and retail discounts
Diagnosis and treatment for body and mind
Help if you require hospital treatment
Caring for your loved ones
Optical For you.
DoctorLine For you, your partner and your children.
Hospital Benet For you. Per day/night up to 14 days/nights per year.
Personal Accident - Accidental Death For you.
Personal Accident - Permanent Disability For you.
Dental For you.
Specialist Consultation and Diagnostics Shared between you, your partner and dependent children.
Care After Hospital Shared between you and one relative aged 65 or over
(your partner or your parent).
- 18 hours of home care following an overnight hospital stay.
On Levels 1 and 2, Westeld Health will contribute 50% towards the cost.
On Level 3, Westeld Health will contribute 75% towards the cost.
Dental Accident For you.
24 Hour Advice and Information Line For you, your partner and your children.
- Legal, Debt, speak to a Counsellor and online resources.
Prescription Charges For you. Number of items.
Surgical Appliance For you.
Maternity/Paternity/Adoption For you, per child.
Health Screening/Assessment For you.
Gym Discounts For you.
Westeld Rewards For you.
Chiropody For you.
Therapy Treatments For you.
Physiotherapy, Acupuncture, Chiropractic, Osteopathy, Homeopathy.
100
2yr
100 1yr
100 1yr
75 1yr
75 1yr
75 1yr
75 1yr
1yr
1yr
1yr
1yr
50 1yr
Level
Price per month
Level 1
£8.09
Level 2
£16.58
Level 3
£24.33
Level 4
£33.26
Up to £45
£13
Up to £33
Up to £70
18 hours
Up to £75
Up to £35
Up to £200
Up to £55
£55
Up to £90
£24
Up to £75
Up to £135
18 hours
Up to £165
Up to £75
Up to £425
Up to £125
£115
Up to £145
£42
£10,000
Up to £10,000
Up to £120
Up to £290
18 hours
Up to £265
Up to £115
Up to £625
Up to £175
£195
1
Up to £205
£61
£20,000
Up to £20,000
Up to £165
Up to £390
18 hours
Up to £350
Up to £155
Up to £850
Up to £230
£265
Up to £200
2
Level 5
£49.39
Up to £295
£85
£30,000
Up to £30,000
Up to £245
Up to £575
18 hours
Up to £500
Up to £225
Up to £1,250
Up to £335
£385
Up to £300
3
2 year benet period
2yr
1 year benet period
1yr
Key
100% money back
100
50% money back
50
75% money back
75
Important information.
The featured premiums include Insurance Premium Tax at the current rate and are subject to review in respect of any changes in taxation.
In the case of Therapy Treatments, the amount shown represents a combined total for all the treatments. This amount can be used for any
one or combination of treatments.
To access the Health and Wellbeing Services please refer to the full Terms and Conditions within this guide, and see page 17.
More information on each benet and service, including details of limitations, exclusions and any qualifying periods, can be found in the
Terms and Conditions within this guide.
Telephone Care Advisory Services
For you and your/your partner’s elderly relatives aged 65 or over.
- Understand your rights, navigate NHS/private residential and home care choices, resolve care issues.
- Have the most appropriate care providers researched for you to make an informed choice.
- Get practical and emotional support for your caring responsibilities.
Your Benets Your Benets
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Cover for your
children too.
If you have dependent children,
it’s nice to know that they are
covered on certain key benets at
no additional cost, giving you that
extra peace of mind.
The table below shows what cover is included for children. The amounts allow you to claim money back towards
optical and dental expenses as well as xed cash payouts for unexpected events like overnight hospital stays and
day surgery.
And you have the reassurance of having access to valuable health services including DoctorLine, a 24 Hour Advice
and Information Line and access to an online wellbeing app and website.
Please refer to page 32 for the denition of a dependent child and age limits.
2 year benet period
2yr
1 year benet period
1yr
Key
100% money back
100
50% money back
50
75% money back
75
Customer Testimonial
“I have been able to access treatment for my family. The cover prompted us to make
appointments for our children to have their eyes tested. It gives my whole family extra peace of
mind knowing that these expenses are covered when we need them.”
Money Back - Shared between dependent children
Cash payout - for each dependent child
Optical
Hospital Benet Per day/night up to 14 days/nights per year.
Dental
Dental Accident
100
100
100
1yr
1yr
1yr
Level Level 1 Level 2 Level 3 Level 4 Level 5
Up to £45
Up to £33
Up to £75
£6
Up to £90
Up to £75
Up to £165
£10
Up to £145
Up to £120
Up to £265
£18
Up to £205
Up to £165
Up to £350
£23
Up to £295
Up to £245
Up to £500
£36
2yr
Your Benets Your Benets
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Making the most of your benet periods.
Every benet has its own benet period.
The majority of your money back benet allowances have a one year benet period. Each benet period will be
activated when you submit your rst claim, and will start from the date you paid your practitioner.
For Hospital Benet your benet period begins on the rst day or night that we pay benet for.
For Care After Hospital your benet period begins on the rst day we pay benet for.
For Maternity/Paternity/Adoption, your benet period begins on the date of birth or the date the child is placed with
you for adoption.
You can keep sending in claims for a benet until you reach your maximum allowance, or your benet period
expires. When your benet period expires, the full allowance will renew, but your next benet period will not be
activated until you submit your next claim.
Example:
If the rst claim you make on your Dental benet has a receipt date of the 6th April 2022 your Dental benet
period activates on this date, giving you one year to use your Dental allowance, before it expires on the 5th April
2023. Once your benet period expires your next Dental benet period will not be activated until you submit your
next Dental receipt.
Please refer to our Terms and Conditions for full details.
Your cover: a few
useful pointers
Here’s a little helpful guidance to help
you make the most of your cover.
Please feel free to contact us if there’s
anything else you need to know.
You have 26 weeks to make a claim.
Please submit your claim within 26 weeks. Those 26 weeks start from the date you make each payment for treatment,
goods or services, the date you were discharged as an in-patient, or the date you attended for day surgery. In the case
of the Maternity/Paternity/Adoption Benet, it is 26 weeks from the date of birth or adoption placement.
Full details can be found in the Terms and Conditions at the back of this guide.
It’s easy to check your benet balance
0114 250 2000
8:30am-5:30pm, Mon-Fri (except public
holidays)
westeldhealth.com
Your Benets
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including your name, full practitioner details, date and payment amounts, details of
treatment, goods or services and a list of any sundry items purchased.
When submitting your claim, make sure your receipt has all
the right details.
Make sure you use a qualied practitioner.
One simple rule. Your practitioner must be registered with, or a member of an approved professional organisation.
Just click on the ‘Find an approved practitioner’ link on the My Westeld area of our website or refer to the Benet
Rules and Denitions sections of this guide to locate the required qualications for each practitioner.
Did you know you’re covered emergencies worldwide?
You can even use your cover for emergencies when abroad. For example, if you damage your glasses whilst
overseas, you can still claim towards the optician’s costs, up to the limits of your plan. We ask that all relevant
documentation relating to your claim is in English.
Get your claims paid directly into your bank account.
Direct Credit is the easiest and fastest way to reclaim your payments. We recommend that you register for a My
Westeld account at westeldhealth.com where you can add your bank details. Alternatively, you can contact us on
0114 250 2000 to set this up.
Your Benets
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Making life simple.
For money back and cash payout benets, we aim to process correctly presented claims within four working days
and pay the money directly into your bank or building society account. If we hold your email address, we’ll also send
conrmation straight to your inbox.
For our fastest service, you can submit claims for all benets on our My Westeld mobile app (available on Apple
App Store & Google Play for Android), or online at www.westeldhealth.com/my-westeld . Alternatively, you can
use a claim form, this is available on your My Westeld account or contact us for a paper claim form.
Personal Accident claims.
We understand that it is likely to be in dicult circumstances that you or a family member will be considering making
a Personal Accident claim. You or the person acting on your behalf should contact us on 0114 250 2000. We will send
out a Personal Accident claim form, which should be completed and returned to us. We will then start to assess your
claim and contact you to discuss it.
Cover that puts
you in control
Your cover puts you in control
by enabling you to budget for
your healthcare as never before.
And claiming is easy too. Some
people say you only nd out how
good our cover is when you make
a claim, which is why we make
it so simple.
1. Receive and pay for your healthcare treatment as normal
2. Submit your claim online, through our mobile app or by using a claim form and sending it to us by post,
which is available on your My Westeld account or contact us for a paper claim form. You must submit your
claim with your receipt, within 26 weeks of the date of each payment
3. Receive payment directly into your bank or building society account
Claim money back in three easy steps
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Your Benets
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My Westeld
It’s all about you.
We want you to make the most of your cover. That’s why My Westeld makes life
simple. Think of it as your personal online account manager – a secure area on our
website that’s totally devoted to you as a customer, where you can either manage or
view your account online. Just visit westeldhealth.com/my-westeld and you can view
your plan guide, claim online for all benets, change your details, check benet balances
and access your wellbeing services.
Your Benets
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Managing your account
We are here to make things easy for you.
My Westeld
We want you to make the most of your cover. That’s why My Westeld makes life simple. Think of it as your personal
online account manager - a secure area on our website that’s totally devoted to you as a customer, where you can
view and manage your account online. Just visit westeldhealth.com/my-westeld and you can register and log in to
change your details, view your plan guide, check benet balances and make a claim.
Email
You can email us at enquiries@westeldhealth.com – we’re only a click away.
Phone
An easy and convenient way to access your account details. Simply call our Customer Care Team on 0114 250 2000.
We’re here
for you
If there’s anything you need to know
about your health cover, your account
or your claim, just get in touch. With
our help, it’s easy to start accessing
the treatment you need to keep you
at your healthy best.
Contact us
0114 250 2000
8:30am-5:30pm, Mon-Fri (except public holidays)
westeldhealth.com
enquiries@westeldhealth.com
Get in Touch
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Get in Touch
Accessing your services:
DoctorLine
0345 612 3861 or 0203 858 9094
(Available 24 hours a day. Calls will be recorded but remain condential)
Telephone Care Advisory Services
0114 303 1060
(Available 8.30am-5.30pm, Mon-Fri, except public holidays)
Care After Hospital
0114 303 1060
(Available 8.30am-5.30pm, Mon-Fri, except public holidays)
24 Hour Advice and Information Line
0800 092 0987
(Available 24 hours a day. Call charges will apply)
Wisdom app
Download: Wisdom, available on Apple App Store for iOS
and Google Play Store for Android
Westeld Rewards
Register/log in www.westeldrewards.co.uk
Helpdesk 0203 583 7020
(Available 24 hours a day)
Gym Discounts
via the My Westeld area
Helpdesk 0345 123 5327
(Available 9am-5pm, Mon-Fri, except public holidays)
Change of circumstance?
If your circumstances change and you are no longer eligible for cover under this plan, don’t worry – your cover with
Westeld Health can continue on an alternative plan.
Monitoring and condentiality.
To keep improving our service, we record and monitor all calls. This includes recording and monitoring information
relating to health and medical conditions.
We will not discuss policy details with anyone other than the policyholder, unless you have given us specic approval
for a relative or friend to obtain account information on your behalf. If you need to access our service in this way, we
can explain how you need to provide this authority.
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We promise to collect, process, store and share your data safely and securely.
• You’re always in control: Your privacy will be respected at all times and we will put you in control of your privacy
with easy-to-use tools and clear choices.
• We work transparently: We will be transparent about the data we collect and how we use that data so that you
can make fully informed choices and decisions.
• We operate securely: We have achieved ISO27001certication and we will protect the data that you entrust to us
via appropriate security measures and controls. We’ll also ensure through the contracts we have in place, that
other businesses we work with are just as careful with your data.
• For your benet: When we do process your data, we will use it to benet you and to make your experience better
and to improve our products and services.
If you’d like to know more, please read our detailed Privacy Policy available on our website and page 39 in this
plan guide.
If you need to speak to us in relation to how your personal data is processed please feel free to contact our Data
Protection Ocer, whose details are provided below:
Email: dpo@westeldhealth.com
Post: Data Protection Ocer
Westeld Health
PO Box 340
Sheeld
S98 1XB
Our Privacy
Promise
We are committed to protecting the
privacy of our users and customers whilst
improving people’s quality of life by
enabling them to make healthier choices.
We believe in being open and up front
with users and customers and have
developed our Privacy Promise, a quick
and simple summary explaining how we
manage, share and look after your
personal data.
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Everything you
need to know
This section contains important information
about your cover, so please read it carefully.
If you have any questions, please get in touch.
Important Information Pages 20 to 21
Benet Rules. Pages 22 to 31
General Terms and Conditions.
Pages 32 to 39
Denitions Pages 32 to 33
1. Who can have cover Page 34
2. Pre-existing medical conditions Page 34
3. The contract between Westeld Health and you Page 34
4. Premiums Page 35
5. Qualifying periods Page 35
6. Exclusions Page 36
7. Benet period Page 36
8. How to claim Page 36
9. Worldwide cover Page 38
10. Making a complaint Page 38
11. Compensation Page 39
12. General conditions Page 39
Our Privacy Policy. Pages 39 to 40
Apply Now. Page 42
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Important
information
The Financial Conduct Authority
(FCA) is an independent body that
regulates the general insurance
industry. It requires us to give you
certain information so that you can
decide if our products and services
are right for you.
Statement of Demands and Needs.
This plan meets the demands and needs of someone who is looking for help towards the cost of a selected range of
everyday healthcare expenses. Exclusions and restrictions apply, more information can be found in the Terms and
Conditions.
The services you will receive
We will only provide you with information about our plans so that you can make an informed choice. We will not provide
you with any advice or personal recommendation about the plan or range of options available from Westeld Health.
You will need to make your own decision as to the suitability of the product for your own circumstances.
Who are we?
This plan is sold, underwritten and managed by Westeld Health. Westeld Health is a trading name of Westeld
Contributory Health Scheme Ltd and is registered in England and Wales, company number 303523. We are authorised
by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation
Authority, our registration number is 202609. Our registered address is Westeld House, 60 Charter Row, Sheeld, S1
3FZ.
Commission
For direct sales, our Health and Wellbeing Consultants receive a salary and a monthly bonus which is calculated as a
percentage of sales.
If you are introduced, to us by an Introducer Appointed Representative (IAR) we pay them a percentage commission.
For sales via an Intermediary/Broker, we pay them a percentage commission.
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Cooling O Period
If you are not completely satised with the plan, simply notify us within 14 days of the date that we accept your
application and we will cancel it. Provided a claim has not been paid, we will refund any premium collected. Please
refer to full terms and conditions in your plan guide.
Complaints
You can contact us with your concerns by phone, email or post. If you’re not satised with our response, you may be able
to refer your complaint to the Financial Ombudsman Service (FOS). You will have 6 months from the date of our
response letter to do this, or you may lose your right to have the complaint investigated. More information is available on
the FOS website www.nancial-ombudsman.org.uk.
The Financial Services Compensation Scheme
Westeld Health are covered by the Financial Services Compensation Scheme (FSCS). If we are unable to meet our
obligations, you may be entitled to compensation from the scheme. For more information please visit www.fscs.org.uk
Multiple policies
If you have multiple plans with Westeld Health, or from any other source, you are not entitled to receive more than the
total amount that you have paid for treatment. If you are claiming from another insurer we will pay our proportionate
share of the cost, subject to the benet being available and the terms and conditions of your plan.
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Benet Rules
So you’ll know that we’ve given them
a special meaning, we’ve put some
words or phrases in ‘bold type’ like
this in the Benet Rules and General
Terms and Conditions. Our
denitions of these words and
phrases are on pages 31 to 33.
Don’t forget to check the benet
tables on pages 8 to 11 to see what
you’re covered for.
For each money back or receipted benet, the tables tell you the length of the benet period, the percentage of each receipt
that you’ll be paid and the maximum that you can claim during each benet period (benet limit).
For each xed cash payout, the tables tell you the benet period, the set benet amount and where applicable how many days/
nights are covered.
Benets are listed in alphabetical order except for Personal Accident as it appears last..
24 Hour Advice and
Information Line
including access to the Wisdom app
Policyholder: For you
The 24 Hour Advice and Information
Line and the Wisdom progressive app
are provided by Health Assured Ltd.
The telephone service can be used
by you, your partner and dependent
children who are 16 to 24 years old,
in full-time education and living with
you, this includes children living away
from home during term time. There
is a scheme number in your welcome
pack that you and your family must
use when you call the 24 Hour Advice
and Information Line. The scheme
number doesn’t identify individual
users and any usage statistics given
to an employer don’t include any
personal information.
To access the 24 Hour Advice and
Information Line:
Phone 0800 092 0987
Available 24 hours a day, 365 days
a year. Call charges may apply. Calls
are not recorded. This is a condential
service; the only time Health Assured
would breach condentiality is if you
or someone else is at risk of serious
harm.
Please have your scheme number
ready when you call.
Wisdom app
You, the policyholder has access to
online tools including a progressive
app – Wisdom. With the Wisdom app
you are able to specify preferences
and topics to populate a personalised
newsfeed and account with tailored
resources, tools and learning
materials. These include weekly mood
trackers, four week plans that can
be worked through by you using the
app, mini health checks and webinars.
In addition, you are also able to dial
through to the helpline, request a
call back or Live Agent instant chat
function with one of the team.
To access Wisdom: Only the
policyholder can register to use this
service. It is available as a progressive
app, which means as well as a mobile
app you are able to login on your
mobile phone app, tablet or computer
using an internet browser. There
is a unique code that you will need
when registering. Please use WHVOL.
You create your own username and
password. Once registered you can
access Wisdom through an app or
through an internet browser using
the same username and password.
Download: Wisdom available on
Apple App Store for iOS and Google
Play Store for Android. You can
also access on the website https://
wisdom.healthassured.org/login
What’s covered…
• Unlimited access to our 24/7/365
condential telephone service,
giving you and your family
support from a team of qualied
counsellors and legal advisors.
• Telephone support from a qualied
counsellor on a wide range of
issues e.g., stress; anxiety; family
problems; bereavement; money
management; depression;
relationships; problems at work;
substance misuse.
• Free telephone legal information
from an qualied legal professional
on a wide range of issues e.g.,
consumer disputes; property;
motoring; landlord/tenancy; debt;
welfare benets; matrimonial;
family; wills and probate.
• Access to medical information
provided by Health Assured’s
Occupational Health nurses,
available Monday to Friday 9am to
5pm. Health Assured's qualied
23
nurses can provide easy to
understand expert information,
guidance and signposting on
a wide range of health and
lifestyle issues including: medical
symptoms and conditions, medical
and surgical treatments; hospital
tests and procedures; childhood
illnesses; caring for the elderly;
diet and exercise; reducing alcohol
consumption; stopping smoking.
Please note, this is not a diagnostic
service.
• For you, the policyholder access
to online resources via Wisdom
to help overcome life’s mental
and nancial wellbeing challenges
with a large library of wellbeing
resources, giving you access
to podcasts, videos, guides,
webinars, factsheets, self-help
programmes, interactive tools and
educational resources and articles.
Wisdom users are able to specify
preferences and topics to populate
a personalised newsfeed and
account with tailored resources,
tools and learning materials.
The features of Wisdom include
weekly mood trackers, four week
plans that can be worked through
by the user using the app, mini
health checks, webinars. Track your
activity, steps, sleep and mood.
Guided breathing exercises and
meditation sessions.
What’s not covered…
• Structured Counselling Sessions
and CBT programmes.
• Crisis care: this is not an
emergency service. At busy times,
it may be necessary to take your
details and arrange a convenient
time for the most appropriate
counsellor, legal advisor or health
professional to call you back
• Access for your family to the online
tools: only the policyholder can
use Wisdom
• Diagnosis of a medical condition or
issuing a prescription: the service
gives general guidance only and
isn’t intended to replace your
normal personal medical care.
• Legal information about
employment disputes
• Exclusions (see section 6, General
Terms and Conditions
Care after Hospital
18 hours of home care services
following an overnight stay in
hospital.
Phone 0114 303 1060
Available 8.30am-5.30pm, Monday to
Friday except public holidays.
Please have your Westeld Health
policy number ready when you call.
Our Care After Hospital benet is
arranged and administered by Grace
Consulting. Eligibility will be veried
with Westeld Health.
You must contact the Westeld
Health care advisory team at Grace
Consulting so that they can nd the
Home Care for you.
The allowance of 18 hours Home Care
is available for you to share with one
relative aged 65 or over who must be
either your Partner or your Parent.
The rst home visit must occur within
14 days of discharge from Hospital
or Hospice, and Home Care must be
delivered within 28 days of that rst
home visit.
What’s covered…
• Unlimited telephone care advice
from the Westeld Health
care advisory team at Grace
Consulting.
• Rapid research into appropriate
care providers, and a written
report for you to make an
informed choice.
• Up to 18 hours of Home Care
services in any 12 consecutive
months for you. The allowance of
18 hours Home Care is available
for you to share with one relative
aged 65 or over who must be
either your Partner or your
Parent. The 65 year old age limit
does not apply to you as the
policyholder.
• Payments for the rst 18 hours
of Home Care, at the money back
rate that applies to your level of
cover, will be paid on your behalf.
Please see the table of benets
for the money back rate.
What’s not covered…
• Any Home Care that hasn’t been
arranged in conjunction with and
with the approval of the Westeld
Health care advisory team at
Grace Consulting.
• Home Care for your partner or
parent if they are aged under 65,
or for anyone else other than you.
• Home Care that does not follow a
Hospital In-patient admission.
• Home Care that commenced
more than 14 days after
discharge from hospital, or Home
Care delivered more than 28 days
after the rst home visit.
• Home Care that follows a
Hospital In-patient admission
due to a pre-existing medical
condition.
• Home Care that follows a
Hospital In-patient admission
during your qualifying period.
• Home Care that exceeds 18
hours in any consecutive 12
month period.
• Home Care provided by a care
provider who is not registered
with the Care Quality Commission
or an equivalent national body.
• Care that is not domestic or
personal care. For example,
nursing or medical care are
excluded. If only cleaning is
required, this isn’t classed as
personal care.
• Discharge expenses such as
medical equipment, assisted
living aids, medicines, and
transport from Hospital to home.
• Exclusions (see section 6, General
Terms and Conditions)
How do I access
Care After Hospital?
Care After Hospital is not a cash
benet: you must follow these simple
steps so that the care advisory team
can nd the Home Care for you.
Step 1
Ring the care advisory helpline. You’ll
need your Westeld Health policy
number. The care advisory team will
explain how the service works. The
care advisory team will verify your
entitlement with Westeld Health
before arranging care.
Step 2
Before they can arrange a Home
Care package the care advisory
team will discuss your, or (with their
permission) your partner’s or your
parent’s needs with you. Our Home
Care package is not intended to
replace any discharge arrangements
such as Intermediate Care made by
the Hospital, NHS community team,
or Local Authority, but to complement
them. Our care advisory
24
team will provide advice about your
statutory entitlements and carry out
rapid research into appropriate care
providers, and provide a written report
for you to make the nal choice.
Step 3
The care provider that you select will
visit you, or your partner or parent, to
agree a package of care with you and
carry out an assessment.
Step 4
You will advise the care advisory
team of the agreed Home Care to be
delivered, the commencement date,
and home visit timings. The care
advisory team will conrm this with
the care provider.
Step 5
The care advisory team will pay the
care provider for the rst 18 hours of
Home Care, at the money back rate
that applies to your level of cover. If
your cover level means you are liable
for part of the cost, then the care
provider will invoice you direct for this
part. Let the care advisory team know
if you, or your partner or parent, need
any further help.
Chiropody
Policyholder: Your maximum benet
allowance is available over a one year
benet period.
When…
• you receive and pay for treatment
from a registered Chiropodist/
Podiatrist, who must be a fully
qualied practitioner who is
registered with the Health and
Care Professions Council (HCPC)
and
• you submit your claim in
accordance with section 8,
General Terms and Conditions
We will cover…
• 75% of the cost, up to the
maximum for your plan level, see
table of benets on pages 8-9
Fo r…
• chiropody and podiatry
consultations, assessments and
treatment
We will not cover…
• any treatment that is not
chiropody or podiatry
• pedicures or cosmetic treatments
• surgical footwear or appliances
(e.g. corrective footwear)
• exclusions (see section 6, General
Terms and Conditions)
Dental
Policyholder: Your maximum benet
allowance is available over a one year
benet period.
Dependent children: You have
a separate allowance for your
dependent children - the maximum
benet is available over a one year
benet period and is shared between
all your dependent children.
When…
• you pay a Dentist, who must be a
fully qualied dental practitioner
holding current registration with
the General Dental Council, who
works in a general dental practice,
and
• you submit your claim in
accordance with section 8,
General Terms and Conditions
We will cover…
• 100% of the cost, up to the
maximum for your plan level, see
table of benets on pages 8-11
Fo r…
• dental treatment, full* or partial
dentures and dental check-ups
• hygienist
• x-rays
• braces and implants
We will not cover…
• insurance or dental care scheme
premiums/payments, registration
or administration fees
• dental treatment as a result of
an accident (see Dental Accident
benet)
• teeth whitening
• prescription charges
• non-prescribed gum shields
• exclusions (see section 6, General
Terms and Conditions)
*Full Dentures
If you need full dentures (either a full
upper set, full lower set or both) you
can claim up to double the maximum
Dental Benet, but this allowance
will be available over a two year
benet period. Your receipt must
conrm that full dentures have been
supplied. Once you have made a
claim for full dentures, all subsequent
dental or denture claims will then
also be assessed over a two year
benet period. If you do not claim the
maximum benet on the rst claim you
submit for dentures, any remaining
balance may be used, within the two
year benet period, for claims for
either dental treatment or dentures.
The dentures must be removable by
the wearer.
Dental Accident
Policyholder: Your maximum benet
is available over a one year benet
period.
Dependent children: You have a
separate allowance for dependent
children - the maximum benet is
available over a one year benet
period and is shared between all your
dependent children.
When…
• you pay a Dentist, who must be a
fully qualied dental practitioner
holding current registration
with the General Dental Council,
who works in a general dental
practice, for treatment carried
out as a result of accidental
injury to teeth, caused by direct
external impact to the head e.g.
sports injuries, falls, or other
accidents that cause injury by
external force and
• the dentist’s receipt specically
conrms treatment is a
consequence of an accidental
injury and
• if there has been a dental
emergency appointment within
30 days of the accident or injury
and
• you give us details of the
accident, which must have
occurred after you applied for the
plan
and
• you submit your claim in
accordance with section 8,
General Terms and Conditions
We will cover…
• 100% of the cost, up to the
maximum for your plan level, see
table of benets on pages 8-11
Fo r…
• dental treatment directly related
to the accidental injury
We will not cover…
• any accidental injury that has not
been caused by direct external
impact to the head e.g. we will
not cover injury caused by eating/
drinking
• any payment made more than
24 months after the date of the
accident
• any insurance or dental care
scheme premiums
• prescription charges
• exclusions (see section 6,
General Terms and Conditions)
DoctorLine
Policyholder: For you, your partner
and your dependent children under
the age of 18.
Round the clock advice from a GP.
Phone 0345 612 3861 or 0203 858
9094
24 hours a day, every day. Call
charges may apply.
The DoctorLine web app can be
used to book appointments. The
web address is https://doctorline.
onlinegp.co
Webcam appointments are available
between 8am-10pm UK time; 7 days
25
a week, except on Christmas Day. All
consultations are condential but calls
and any visual images will be recorded
for your protection.
Please have the Westeld Health
policy number ready when you call
to arrange a telephone or webcam
consultation or when using the app.
Our DoctorLine service is provided
by an experienced external provider.
DoctorLine is a registered trademark
of Westeld Health.
You and your partner can call
DoctorLine from anywhere in
the world, 24/7. An experienced
healthcare operator will take your
details and arrange a call back with
a GP at a time that suits you. During
surgery hours you can choose to have
a virtual consultation, if you’ve access
to a webcam and broadband. You
and your partner can call on behalf
of dependent children under the age
of 18.
It’s reassuring to know that your
consultation will be with a qualied
practising GP, who’ll give you advice
and in most cases a diagnosis. You
can discuss anything that you’d
usually ask your own GP about, from
common ailments to sensitive or
condential concerns. You might want
to talk about travel inoculations, side
eects from your medication, or a
health story you’ve seen in the news.
DoctorLine is the closest thing to a
surgery appointment, but without
the wait.
If you need to consult with a medical
professional regarding a long-term
medical condition including managing
your symptoms and medication, then
you have the option to speak to an
experienced Clinical Pharmacist. They
can support you with a wide range of
medication queries including:
• Reviewing your medication if
you have multiple prescriptions;
you may have been given
new medications separately
and require an expert Clinical
Pharmacist to ensure your
medications are working
eectively
• Reassuring you that you are
taking your medication correctly
• Side eects from existing
medication
• Over the counter medication
that works with your existing
medication
• Alternative medication options
Private Prescription service
If the DoctorLine GP thinks that
prescription medicine would be
appropriate, you may choose from the
following options:
• The DoctorLine GP may oer
to send a private prescription
electronically to a registered
online pharmacy service from
where the medication will be
sent directly to you. When the
prescription is issued before 4pm
during weekdays, it is usually
delivered the next working day.
They will not charge you for
processing your prescription, but
you will be charged for the cost
of the medication and delivery.
The online pharmacy service will
call you to take your payment
by credit card or debit card.
Simply conrm your payment
details and delivery address and
they’ll arrange delivery of the
medication to your home or place
of work
• You can also collect your
medication from a nominated
local pharmacy. The DoctorLine
GP will send your prescription
directly to the pharmacy and
you will be contacted when
your medication is ready to be
collected
• You may be oered a digitally
secure electronic prescription
to present at a nominated local
pharmacy. An email will be sent
to you with your prescription and
instructions on how to collect
your medication. You must
present this to your nominated
pharmacy at collection. This
service is unable to prescribe any
controlled medications outside of
the UK electronically
DoctorLine web app
You can save the website as an icon
on your mobile phones home page.
You can access the service through a
computer. After you have created an
account, booking future appointments
is easier as it uses the stored
information.
The web app also includes access to
articles on heath:
• Information on medicines,
treatments and conditions
• Health & Wellbeing articles ,
tips and information to help you
make the best choices for your
body and mind
• Search your local area for clinic
services including GPs, dentists,
pharmacies and more
What’s covered…
• Telephone consultations with a
qualied practising GP or Clinical
Pharmacist
• A call back at the time of your
appointment. You don’t pay for
the call whether you’re at home,
work, or travelling anywhere in
the world
• Virtual consultations using state
of the art webcam technology
so that you can show the GP
your symptoms to help with a
diagnosis.
• An electronic private prescription
service, that delivers the
medication that you buy to your
home or place of work, or a local
nominated pharmacy
• DoctorLine may oer to update
your own GP about your
consultation; this is particularly
important if you’ve been
prescribed medicine
What’s not covered…
• Emergencies or urgent
consultations; DoctorLine isn’t
intended to replace your own GP
or the emergency services
• Any charges for receiving a call
to your mobile e.g. while you’re
outside the UK
• Face to face consultations at a
doctor’s surgery
• Private prescriptions can’t be sent
directly to you via post
• Electronic prescriptions are not
available to send outside the UK
• DoctorLine can’t prescribe
controlled drugs
• You can’t use a recommendation
from a DoctorLine GP to claim any
other plan benets.
• Exclusions (see section 6, General
Terms and Conditions)
Gym Discounts
Just for you, the policyholder only
Helping you to get t and keep active,
for less.
Go to www.westeldhealth.com to log
onto your account, or to register for
My Westeld access; then choose Gym
Discounts from there you gain access
to the gym discount oers.
Your cover has been designed to help
keep you in the best possible shape.
We believe in well beings and are
therefore pleased to provide you with
access to discounted gym and digital
tness memberships, along with active
lifestyle discounts in order to support
your journey to your best health.
What’s covered…
You can save up to 30% on a
membership at your chosen health
club, closest to wherever you live or
work. Choose from a wide range of
options at over 3,700 gyms, leisure
centres, yoga or Pilates studios and
bootcamps across the UK.
If the gym isn’t for you – don’t
worry! There are also discounted
subscriptions to online workout
programmes so you can kickstart your
tness regime from the comfort of your
home.
Alternatively, if you enjoy getting out
and about then why not select a multi-
26
Please note: Health assessments must
be carried out:
• by a doctor registered with the
General Medical Council (GMC) or
• by a nurse registered with the
Nursing and Midwifery Council
(NMC) or
• by a pharmacist registered with
the General Pharmaceutical
Council (GPhC)
• and in each case at an
establishment registered with
the General Pharmaceutical
Council (GPhC) or Care Quality
Commission (CQC), or the
equivalent regulatory body where
the assessment is carried out.
These could include, for example,
a hospital, GP practice, pharmacy
or health screening unit.
We will not cover…
• any other screening check or test
not carried out as part of one of
those listed above
• exclusions (see section 6, General
Terms and Conditions)
Hospital Benet
Policyholder: Your benet is payable
for a maximum of 14 days/nights in a
one year benet period.
Dependent children: Each of your
dependent children has a maximum
allowance of 14 days/nights in a one
year benet period.
When…
• you are admitted as an in-patient
to an NHS or private hospital/
treatment centre or hospice and
• you submit your claim in
accordance with section 8,
General Terms and Conditions
Or on a day when…
• you are admitted to an NHS
or private hospital/treatment
centre as a day case patient and
• you are required to sign a consent
form and are allocated a bed – the
use of which is normally for a
period of supervised recovery and
• you submit your claim in
accordance with section 8,
General Terms and Conditions
We will cover…
• you at the day/night rate for your
plan level, see table of benets
on pages 8-11
Fo r…
• a surgical procedure involving
the use of theatre facilities
when you’re admitted as a day
patient, you sign a consent form
and you have a local, regional
or general anaesthetic. The
surgical procedure is one that
aims to treat disease, injury or
abnormality by operating directly
on or removing the aected body
part, or removing a foreign body.
When you submit your claim, we
need a copy of your discharge
letter as evidence of your
admission. If you do not have
your discharge letter, you will
need to get written conrmation
of your hospital stay (e.g. a
headed letter from the hospital)
• overnight in-patient admissions
for treatment, tests or
investigations
• maternity related in-patient
admissions, from the 11
th
night
that you have been an in-patient.
You must give us evidence of
the rst 10 nights that you have
spent in the hospital/treatment
centre (these nights do not have
to be consecutive)
• a dependent child required to
remain in the hospital/treatment
centre following its birth, from
the date that the mother is
discharged
• claims submitted when the
patient is discharged as an in-
patient. When you submit your
claim, we need a copy of your
discharge letter as evidence
of your admission. If you do
not have your discharge letter,
you will need to get written
conrmation of your hospital stay
(e.g. a headed letter from the
hospital).
We will not cover…
• out-patient attendances,
including procedures carried
out in an out-patient setting. An
out-patient is a person attending
a hospital/treatment centre
for advice, consultation and/
or treatment, but who does not
receive admitted patient care.
• tests or investigations e.g.
biopsies and endoscopies carried
out for investigative purposes as
a day patient
• treatment and/or pain relief
administered by injection as a
day patient
• cardioversion as a day patient
• out-patient visits for
chemotherapy, radiotherapy or
kidney dialysis
• admissions for rehabilitation,
domestic reasons or respite care
• attendances at a GP or Dental
surgery
• maternity related admissions for
the rst 10 nights
• any type of in-patient admission
where the hospital/treatment
centre could be regarded as your
permanent residence
• if you had a day surgery
procedure and are admitted as
an in-patient on the same day
this counts as one event not two
activity membership meaning you can
pick and choose from thousands of
activities and classes at your leisure.
Frequently Asked Questions are within
My Westeld and within the gym
discount website
If you have any queries on the oers
you can call 0345 123 5327
Available 9am-5pm, Monday to Friday
except public holidays. Calls may be
recorded.
What’s not covered…
• Some deals aren’t available to
existing health club members.
• Whilst the gym network is hugely
extensive there are some gyms
who do not wish to participate,
you can however recommend
gyms for inclusion via the gym
discounts website
• Only available online through
My Westeld, no post copies of
vouchers
• Exclusions (see section 6, General
Terms and Conditions)
Health Screening/Assessment
This benet is to help towards the
costs of a detailed assessment of your
health.
Plan levels 4 and 5 ONLY.
Policyholder: Your maximum benet
allowance is available over a one year
benet period.
When…
• you pay for and receive a health
screening check and
• the screening check is carried out
by medically qualied sta and
• you submit your claim in
accordance with section 8,
General Terms and Conditions
We will cover…
• 50% of the cost if you have
cover on level 4 or 5, up to the
maximum for your plan level, see
table of benets on pages 8-9
Fo r…
• tests which you have to assess
your general health. The tests
must be carried out within one
appointment:
• by a registered doctor, nurse
or pharmacist at a registered
establishment
• as a minimum the health
assessment must include all
of the following:
- body composition
measurement including
height, weight (BMI) and
body fat percentage
- blood pressure
measurement cholesterol
or diabetes check
and
- kidney or liver function
test
27
so only one day/night can be
claimed.
• exclusions (see section 6, General
Terms and Conditions)
Maternity/Paternity/Adoption
Policyholder: Benet(s) are payable
once in a one year benet period.
When…
• you are named as mother or
father on the child’s full birth
certicate, or you are named as
the child’s adopter and
• you submit your claim in
accordance with section 8,
General Terms and Conditions
We will cover…
• you at the rate for your plan level,
see table of benets on pages
8-9
Fo r…
• single or multiple births, benet
is payable per child
• adoptions when the child is
placed with you before their 16
th
birthday
• stillbirths when you send us the
stillbirth certicate
We will not cover…
• exclusions (see section 6, General
Terms and Conditions)
Optical
Policyholder: Your maximum benet
is available over a two year benet
period.
Dependent children: You have a
separate allowance for dependent
children - the maximum benet is
available over a two year benet
period and is shared between all your
dependent children.
When…
• you pay an Optician who must
be a fully qualied Optical
practitioner holding current
registration with the General
Optical Council, who works in a
general optical practice and
• you submit your claim in
accordance with section 8,
General Terms and Conditions
We will cover…
• 100% of the cost, up to the
maximum for your plan level, see
table of benets on pages 8-11
Fo r…
• eyesight tests
• prescription spectacles,
sunglasses and/or contact lenses
• solutions for use with your
prescribed contact lenses
• prescription lenses to an existing
frame
• repairs to prescription spectacles
• prescription goggles/safety
goggles
• payments that you make for
prescription contact lenses
supplied under a monthly
scheme, when you obtain an
itemised receipt
We will not cover…
• frames purchased without
prescription lenses
• non-prescription spectacles or
sunglasses or contact lenses
• any insurance or peace of mind
guarantee
• exclusions (see section 6, General
Terms and Conditions)
Prescription Charges
Plan levels 3, 4 and 5 ONLY.
Policyholder: Your maximum benet
is available over a one year benet
period.
When…
• you are not exempt from paying
NHS prescription charges and
• you receive and pay a charge
for an NHS prescription item
or private prescription item, or
you provide us with evidence
that you have purchased an
NHS prescription pre-payment
certicate to pay for your
prescription charges and
• you submit your claim in
accordance with section 8,
General Terms and Conditions
We will cover…
• the maximum number of
prescription items for your plan
level, see table of benets on
pages 8-9
Fo r…
• The cost of NHS prescription
charges at the current standard
rate for an item in England.
This means if the claim is for a
private prescription the amount
reimbursed is the equivalent cost
of an NHS prescription item in
England and the number of items
for your plan level.
We will not cover…
• any prescription item if you are
exempt from paying prescription
charges or a prescription charge
does not apply
• exclusions (see section 6, General
Terms and Conditions)
Specialist Consultation and
Diagnostics
Policyholder: Your maximum benet
allowance is available over a one
year benet period. You can use
your benet allowance for yourself,
your partner and/or your dependent
children.
When…
• your Medical Professional
recommends referral to a
Consultant Physician or
Consultant Surgeon and
• you pay a registered Consultant
Physician or Consultant Surgeon,
who holds an appropriate
qualication, or a GP (see
Denitions section) and
• you submit your claim in
accordance with section 8,
General Terms and Conditions
We will cover…
• 75% of the cost, up to the
maximum for your plan level, see
table of benets on pages 8-9
Fo r…
• diagnostic consultations from
a Consultant Physician or
Consultant Surgeon on all levels
of the plan
• diagnostic and investigative
tests and scans carried out in
a hospital/treatment centre,
including but not limited to
x-rays, scans, endoscopies, tests
on body tissue samples, blood
tests, ECGs, required to aid the
diagnosis under the management
of a Consultant Physician or
Consultant Surgeon
• diagnostic and investigative
tests and scans carried out in
a hospital/treatment centre,
including but not limited to x-rays,
scans, endoscopy, test on body
tissue samples, blood tests, ECGs
required to aid the diagnosis
under the management of a GP
• payments you make to a
Consultant Physician or
Consultant Surgeon for treatment
on levels 3, 4 or 5 of the plan
We will not cover…
• treatment on levels 1 or 2 of the
plan
• room fees, nursing charges,
prescription items/charges or
sundry items
• exclusions (see section 6, General
Terms and Conditions
Surgical Appliance
Policyholder: Your maximum benet
allowance is available over a one year
benet period.
When…
• you pay for an appliance
prescribed by your GP, Consultant
Physician/Consultant Surgeon,
Chiropodist/Podiatrist,
Physiotherapist, Acupuncturist,
Chiropractor or Osteopath and
• If requested you provide us with
evidence that the appliance was
prescribed for your use and
• you submit your claim in
28
accordance with section 8, General
Terms and Conditions
We will cover…
• 75% of the cost, up to the
maximum for your plan level, see
table of benets on pages 8-9
Fo r…
• hearing aids (including repairs);
surgical supports that are worn;
surgical corsets; trusses; surgical
stockings; prosthetics; orthotic
shoes (custom-made for your
specic medical needs); orthotic
inserts/arch supports; wigs;
mastectomy bras/prosthesis/
swimwear
We will not cover…
• any item not specically listed
above
• hearing aid batteries
• tens machines
• wheelchairs/crutches/walking
frames
• exclusions (see section 6, General
Terms and Conditions)
Telephone Care Advisory
Service
Make informed care choices for
yourself and elderly relatives.
Phone 0114 303 1060
Available 8.30am-5.30pm, Monday to
Friday except public holidays.
Please have your Westeld Health
policy number ready when you call.
Our Telephone Care Advisory Service
benet is arranged and administered
by Grace Consulting. Eligibility will be
veried with Westeld Health.
You can use the Westeld Health care
advisory team to support you with
your own care, or the care of any of
you/your partner’s elderly relatives
dened as 65 or over (including your
partner if aged 65+).
The care advisory team can help you
with your role as a carer. They will also
discuss your own care needs, or those
of you/your partner’s elderly relatives,
and inform and help you to resolve all
care issues, including researching the
most appropriate care providers for
each personal situation.
What’s covered…
• Unlimited telephone care advice
from the Westeld Health
care advisory team at Grace
Consulting.
• Practical advice and emotional
support for your caring
responsibilities.
• Advice on how to resolve all care
issues including: navigating the
care system; appropriate care
options; how to nd ideal care
providers; state benets and
state funding of care; statutory
services; guarding against
potential future crises; relevant
assistive devices, or monitoring
devices that reassure about a
loved one’s wellbeing.
• An intensive research service to
identify the most appropriate
care providers for each personal
situation, whether it be for care
homes, home care agencies, day
centres, or lunch clubs.
• A written report on appropriate
care providers for you to make an
informed and nal choice.
• Continued help and assistance
until your care issue is resolved.
What’s not covered…
• Care advice relating to the
needs of anyone aged under 65,
with the exception of you the
Policyholder.
• Legal, nancial or medical advice,
although our team may signpost
you to appropriate advisors and
practitioners for these needs.
• Face to face advisory services
or site visits to potential care
providers.
• Exclusions (see section 6, General
Terms and Conditions)
Therapy Treatments
Physiotherapy, Acupuncture,
Chiropractic, Homeopathy and
Osteopathy
Policyholder: Your maximum benet
allowance is available over a one year
benet period and represents the
total for any one or combination of the
treatment types.
When…
• your GP or Consultant
Physician/Consultant Surgeon
recommends that you receive
treatment. If requested at
any time, you must provide us
with written evidence of this
recommendation at your own
expense and
• you receive and pay for
treatment from a registered
Physiotherapist, Chiropractor or
Osteopath, or an Acupuncturist
or Homeopath who is a member
of an approved professional
organisation. Registration/
membership must be relevant
to the treatment that they
are providing (see Denitions
section) and
• you submit your claim in
accordance with section 8,
General Terms and Conditions
We will cover…
• 75% of the cost, up to the
maximum for your plan level, see
table of benets on pages 8-9
Fo r…
• physiotherapy, acupuncture,
chiropractic, osteopathy,
homeopathy treatment
• homeopathic prescriptions
supplied by a Homeopath as part
of a consultation
We will not cover…
• any treatment that is not
physiotherapy, acupuncture,
chiropractic, osteopathy or
homeopathy
• group sessions or classes
• separate scans e.g. MRI,
ultrasound , x-rays unless they
are diagnostic scans or x-rays
when they are performed by the
therapist at the same time as
their therapeutic assessment
• herbs, herbal remedies,
supplements or vitamins even if
these have been recommended
or supplied by your
Physiotherapist, Acupuncturist,
Chiropractor, Homeopath or
Osteopath
• exclusions (see section 6, General
Terms and Conditions)
Westeld Rewards
Policyholder: Just for you.
Westeld Rewards is provided by
Reward Gateway.
Website www.westeldrewards.co.uk
to register for Westeld Rewards.
Helpdesk 0203 583 7020 Available
24 hours a day, 7 days a week, 365
days a year. Calls may be monitored
or recorded to conrm that your
instructions have been carried out
and to help improve the quality of the
service.
To activate your Westeld Rewards
registration, you’ll need your Westeld
Health policy number and your email
address.
Once you have registered you can
download the SmartSpending app
from the iOS App Store or Google Play
for Android. You cannot register for
Westeld Rewards on the app, you
must rst register via the website,
then use the same details to login to
the app.
You’ll get a discount when you buy
Reloadable Cards to spend in some
high street stores and supermarkets.
Please allow time for the card to be
sent to you and be activated if you
want to use it by a specic date. You
can top-up your card’s balance at any
time online, or by calling the helpdesk.
If you change your mind within 14
days you can ask Westeld Rewards
for a refund if you haven’t activated
the card. Top-ups aren’t refundable.
Reloadable Cards are just like cash, so
keep them safe and if your card is lost
or stolen tell the Westeld Rewards
29
helpdesk straightaway.
Cashback is another easy way to
save you money. Simply check out
the Cashback rate for a participating
retailer and then connect to their
online store via the Westeld Rewards
link. Cashback is credited to your
Cashback account when your purchase
has been conrmed. Cashback isn’t
payable if you cancel, return the goods,
or don’t use the Westeld Rewards
link. When you want to withdraw
your Cashback just follow the online
instructions. If your Westeld Health
cover ends you must claim your
Cashback within 30 days.
You simply manage your Westeld
Rewards account online. Full terms
of use are on the Westeld Rewards
website. Reward Gateway are
always happy to help if you have any
questions.
What’s covered…
• Oers on a wide range of goods
and services.
• Cashback when you buy online
through a link on the Westeld
Rewards website.
• Discounts when you buy
Reloadable Cards to spend in
participating high street stores
and supermarkets.
• Instant vouchers are a quick
and easy way to save. Order
the amount you want and then
download the voucher from your
account to use in store or online
for an instant discount. Instant
vouchers can be downloaded to
the SmartSpending app whilst in a
shop.
What’s not covered…
• Cashback won’t be paid if you get
a refund for anything that you’ve
bought.
• Cashback won’t be paid if you
don’t complete your purchase
online through the link on the
Westeld Rewards website.
• Any money spent on a Reloadable
Card that’s been lost or stolen:
report your loss to Westeld
Rewards as soon as possible so
that they can cancel the card.
• Exclusions (see section 6, General
Terms and Conditions)
Personal Accident Cover
Just for you, the policyholder
We underwrite and administer the
Personal Accident cover provided by
your plan.
Conditions of your cover
Please read this summary together
with the full terms and conditions of
your personal accident cover.
• If you suer bodily injury as a
direct result of an accident which
within 24 months of the accident
results in death or disablement,
benet will be paid in accordance
with the Scale of Benets outlined
on page 30
• The maximum amount of benet
that will be paid for one accident
is equivalent to the amount for
permanent total disablement,
item 2 in the Scale of Benets on
page 30
• If we pay the benet for loss of
limb we won’t also pay for parts of
that limb
• If you already had a disability or
condition before your accident
we will take this into account
and it may reduce the amount of
permanent disability benet that
you get
• Please submit your personal
accident claim within 60 days, or
as soon as reasonably possible,
after the time of the accident
What’s covered...
• Accidental bodily injury that
causes your death within 24
months of the time of your
accident
• Accidental bodily injury that
causes your permanent total
disablement within 24 months of
the time of your accident
• Accidental bodily injury that
causes your permanent disability
within 24 months of the time of
your accident
What’s not covered...
• Any accident that happened
before your personal accident
cover started or after your
personal accident cover ended
• Permanent total disablement
benet if you are 75 or older at the
date of accident: we will assess
your claim based on the degree of
your permanent disability instead
• Bodily injury caused or contributed
to in any way
• by you committing an illegal act
• while you were under the
inuence of drugs or excessive
alcohol
• by a deliberate or reckless
exposure to danger
• by participation in dangerous
activities and sports – this
includes but is not limited to
canyoning, gorge walking, high
diving, horse jumping, micro-
lighting, mountain boarding,
parasailing, rock climbing or
riding/driving in any kind of race
• by you engaging in any form of
air sports or taking part in air
travel, unless travelling as a fare
paying passenger in an aircraft
which is provided and operated
by an airline or air charter
company that is licensed for this
• by war: except when war is
declared in the country that you
are travelling to after you’ve
already left the country where
you live
• because you are: a full time
member of the armed forces
of any nation or international
authority; you are on active
service as a member of any
reserved forces
• by your suicide, attempted
suicide or deliberate self-
inicted injury, regardless of the
state of your mental health
• Illness or disease not directly
caused by bodily injury, including
but not limited to a medical or
surgical procedure or childbirth
• Repetitive stress (strain) injury
or syndrome, or any gradually
operating cause
• Post-traumatic stress disorder
or related syndromes, or any
psychological or psychiatric
condition
• Bacterial or viral infection, except
where it is the direct result of
accidental bodily injury
• This benet does not provide cover
in the event of death caused by
illness or disease
30
When will my personal accident cover
start?
Your personal accident cover always
starts on the date we receive the
application for your cover. This is
regardless of your plan’s registration
date.
We won’t pay any benet if the time of
the accident was before we received
your application for a policy.
If your plan level changes your level
of personal accident cover changes
on the date that we receive the
application, not on the registration
date for your new plan level.
When will my personal accident cover
end?
Your personal accident cover will
end on the date that your plan cover
nishes.
How do I make a claim?
We understand that it’s likely to be a
dicult time if you’ve had an accident.
You, or someone acting on your behalf,
should contact the Westeld Health
Customer Care Team within 60 days or
as soon as reasonably possible after
the accident. We’ll send out a personal
accident claim form for you to ll in
and return to us. We’ll then contact
you to explain what happens next.
If there’s any delay in you notifying a
claim to us it could be detrimental to
us investigating and assessing the
claim: this may impact the claim being
paid at all, or the amount of the claim
that’s paid.
Sometimes it may be necessary to
wait up to 24 months to establish the
full extent of your injury and whether
a permanent total disablement or
permanent disability claim is payable.
We cannot carry out a medical
assessment while you are still having
treatment for that injury.
Personal Accident Percentage of Accidental Death
amount in table of benets on pages 8-9
1 Death as a result of an accident 100%
2 Permanent total disablement 100%
Permanent disability benets
3 Loss of sight - both eyes 100%
4 Loss of speech 100%
5 Loss of sight - one eye 50%
6 Loss of hearing - both ears 50%
7 Loss of hearing - one ear 15%
8 Loss or loss of use of:
a foot below the level of the ankle 50%
a hip, knee, or ankle 20%
one or more limbs 100%
a thumb 20%
a forenger or big toe 15%
any other nger 10%
any other toe 5%
9 Permanent and total loss of use of:
the back or spine below the neck, with no damage to the spinal cord 40%
the back neck or cervical spine, with no damage to the spinal cord 30%
a shoulder elbow or wrist 25%
10 To ensure you are provided with a payment for a permanent disability that is not listed above, we will assess
medical evidence to calculate the degree of disablement relative to this scale. No account shall be taken of your
occupation. For example if bodily injury results in 25% of the loss of sight in one of your eyes, we will pay you 25%
of the loss of sight – one eye, item 5 on this scale.
31
Personal Accident
Denitions
Accident/Accidental
A sudden, identiable violent external
event that happens by chance and
which could not be expected; or
unavoidable exposure to severe
weather.
Air sports
Airborne leisure activities, for example:
• ballooning
• bungee-jumping
• gliding
• hang-gliding
• micro lighting
• parachuting
• paragliding
• parascending
Bodily injury
• Injury to you which happens whilst
the personal accident cover is in
force
and
• which is caused only by an
accident
and
• on its own, within 24 months of
the accident leads to permanent
disability or death and results in a
claim covered under this policy.
Loss of hearing
Permanent profound deafness, which
means the quietest sound you can hear
is louder than 90 decibels when you’re
tested by a qualied audiologist.
Loss or loss of use
Amputation or permanent loss of all
functional use.
Loss of sight - both eyes
Permanent blindness, which based on
medical evidence you will never recover
from, and which results in your name
being added (on the authority of a
qualied ophthalmic specialist) to the
Register of Blind Persons maintained by
the government.
Loss of sight - one eye
Permanent blindness, which based on
medical evidence you will never recover
from, in an eye to the degree that, after
correction using spectacles, lenses or
surgery, objects that should be clear
from 60 feet away can only be seen
from 3 feet away or less.
Loss of speech
Permanent and total loss of speech
as conrmed by a GP or Consultant
Physician.
Permanent disability
Any form of functional disability which
has lasted for at least 12 months
and from which, based on medical
evidence, you will never recover.
Permanent total disablement
If you were in gainful employment at
the date of the accident:
A permanent disability which
stops you from carrying out gainful
employment for which you are tted
by way of training, education or
experience.
Or
If you were not in gainful employment
at the date of the accident:
A form of permanent disability
calculated on a medical assessment by
us or an independent medical expert
appointed by us, which results in your
inability to perform, without assistance
from another person, at least two of
the following activities of daily living:
• eating
• getting in and out of bed
• dressing and undressing
• toileting
• walking 200 metres on level
ground
Time
The Standard Local Time where you
permanently live.
War
Armed conict between nations,
invasion, act of foreign enemy, civil war
or taking power by organised military
force.
We’ve put some words or phrases in ‘bold type’ like this, so that you’ll know we have given them these special meanings
for your personal accident cover. The denitions of other words and phrases in ‘bold type’ are in the General Terms and
Conditions section on pages 32 to 33.
32
Denitions.
Acupuncturist
A fully qualied Acupuncturist who is a:
• Member of the British Acupuncture
Council (BAcC)
• Fully Accredited Member of the
British Medical Acupuncture Society
(BMAS)
• Fully Accredited Member of
an association under British
Acupuncture Federation (BAF)
Agreement
The contract between Westeld Health
and you for the provision of the plan
governed by the terms and conditions
set out in this guide.
Benet Period
The period of time over which each
separate benet is available to claim.
See section 7, General Terms and
Conditions.
Chiropodist/Podiatrist
A fully qualied practitioner who is
registered with the Health and Care
Professions Council (HCPC).
Chiropractor
A fully qualied practitioner who
is registered with the General
Chiropractic Council.
Consultant Physician/
Consultant Surgeon
A registered Consultant Physician or
Consultant Surgeon, including any
individual holding an appropriate
Consultant Physician or Consultant
Surgeon position within a private
or registered hospital/treatment
centre.
Day patient
A patient that:
• Is admitted to a hospital/
treatment centre as a day case
and
• Is allocated a bed, or similar
facility e.g. a reclining chair
that the treatment provider
classes as a bed – the use of
which is normally for a period of
supervised recovery
and
• Doesn’t stay overnight.
Dependent Child
A child who is:
• your child, your partner’s child, a
child that you/your partner have
legally adopted or have legal
guardianship of and
• under 18 years old and
• not married/not in a civil
partnership and
• living with you or is nancially
dependent on you and lives in the
UK, Channel Islands or Isle of Man.
We may ask you for proof of your
relationship with the child. A
dependent child that’s included on
your policy won’t be covered for
dependent child benets once they’re
18.
Elderly Relative
Any relative aged 65 or over, including
your Partner, Parents, aunts,
uncles, etc, but excludes friends and
neighbours.
GP
A General Practitioner who’s registered
with the General Medical Council and
who works in general practice.
Hearing Aid
An electronic device usually worn in or
behind the ear of a hearing-impaired
person for amplifying sound
Home Care
Domestic and personal care such as
help with dressing, washing, bathing
or shaving, toileting, getting in or
out of bed, eating, drinking, taking
medication, communicating, preparing
meals, cleaning, laundry and ironing,
shopping, and companionship.
Homeopath
A fully qualied Homeopath who is
a member of one of the following
professional bodies:
• Member of the Faculty of
Homeopathy
• Licensed or Registered Member of
the Society of Homeopaths
• Registered Member of the UKHMA
• Member of the Alliance of
Registered Homeopaths
Hospice
A facility that provides in-patient
palliative care for patients with a life
limiting or terminal illness.
Hospital/Treatment Centre
A medical facility that:
• has permanent facilities for caring
for patients as an in-patient and/
or a day patient and
• has facilities for medical
practitioners to diagnose and
treat injured or sick people and
• provides nursing services from
qualied nurses/midwives who
are on the Nursing and Midwifery
Council (NMC) register (or an
equivalent register if the hospital/
treatment centre is outside the
UK, Channel Islands or Isle of
Man) and
• is not a nursing home; hospice,
convalescent home; residential
care home; prison; health spa/
hydro.
In-patient
Admission to a hospital/treatment
centre or hospice for a full night stay,
or longer. To qualify as a full night you
must be admitted before midnight.
Medical Professional
This could be your GP or could be an
Optician, Dentist, Physiotherapist,
Chiropractor, Osteopath, Chiropodist,
whose qualications are already
General Terms
and Conditions.
So that you’ll know that we’ve given them these special meanings we’ve put some words or phrases in ‘bold type’ like this in
the Benet Rules and General Terms and Conditions.
33
dened in the applicable benet rules
or within denitions section.
Osteopath
A fully qualied practitioner who
is registered with the General
Osteopathic Council.
Outpatient
A patient that attends a hospital/
treatment centre, consulting room or
outpatient clinic but is not admitted as
an in-patient or day patient.
Parents
Your natural or lawful father or mother,
including adoptive parents. A step
parent married to your natural parent
is also covered. We may ask you for
proof of your relationship with that
person.
Partner
A person who:
• you live with that you’re married
to/in a civil partnership with or
• you permanently live with as if
you’re married to them/in a civil
partnership.
We may ask you for proof of your
relationship with that person.
Physiotherapist
A fully qualied practitioner who is
registered with the Health and Care
Professions Council (HCPC).
Placed/Placement
When a child comes to live with you
permanently so that you can formally
adopt the child in the future.
Plan
The Good4you Health Cash Plan.
Policyholder
The person in whose name the
plan is held (sometimes called the
lead name on a policy). We send all
communications to the policyholder.
Pre-existing medical condition
This plan is only intended to cover new
medical conditions.
You, your partner and your dependent
children will not be entitled to claim the
following benets for any pre-existing
medical conditions:
Care After Hospital; Chiropody;
Specialist Consultation and
Diagnostics; Dental Accident; Health
Screening /Assessment; Hospital
Benet; Prescription Charges; Surgical
Appliance; Therapy Treatments.
When you submit a claim we may ask
you to give details of the condition/
symptoms; dates; GP’s name, address
and telephone number if you, your
partner or your dependent child:
• Were taking any prescribed
medication, or had taken
prescribed medication in the last
12 months before the application;
• Had consulted a GP or Consultant
Physician/Consultant Surgeon
during the 12 months before the
application;
• Had received advice or treatment
from a qualied practitioner or
therapist i.e. Physiotherapist,
Acupuncturist, Chiropractor,
Homeopath, Osteopath,
Chiropodist, Podiatrist or any
other complementary medicine
practitioner, during the 12 months
before the application;
• Had attended a hospital/
treatment centre during the 12
months before the application;
• At point of application were
awaiting any medical tests,
investigations or treatment, or
were awaiting the results of any
medical tests or investigations,
whether or not the condition has
been diagnosed;
• Attended your GP, Consultant
Physician/Consultant Surgeon or
hospital for monitoring or check-
ups;
• Have an illness, injury or condition
that is permanent, or has ever
previously recurred or that is likely
to recur.
If you are not sure whether a fact
needs to be declared you should tell
us so that we can decide whether it is
relevant or not.
Qualifying period
The period of time that you, or your
dependants, have to wait before you
can use a benet. You can read a full
explanation of how qualifying periods
work on page 35.
Registration
The rst day of the current month if we
accept your application on the 1st of
the month. Cover will start that month.
The rst day of the next month if we
accept your application after the 1st of
the month. Cover will start the 1st of
the following month.
UK/United Kingdom
The United Kingdom of Great Britain
and Northern Ireland i.e. England,
Scotland, Wales and Northern Ireland.
We/us/our
Westeld Contributory Health Scheme
Limited.
You/your/yourself
The Westeld Health policyholder.
34
1. Who can have cover
You must reside in the United
Kingdom, Jersey or Isle of Man for a
minimum of 180 days each year to be a
Good4you Plan policyholder.
You must be at least 16 years old and
younger than 66 years of age to apply
for the plan. Existing policyholders
applying to transfer to a higher level
of cover must be under 66 years of
age. However, policyholders are not
required to leave the plan once they
become 66 and can transfer to a lower
plan level at any age.
Professional sports people are not
eligible for the plan.
You must satisfy yourself that this
plan and the level of cover you decide
to apply for are right for you. We
will not provide any advice in this
regard but you are of course free to
seek information or advice from a
professional advisor.
We, like any responsible insurer, and to
the extent permitted by all applicable
laws, reserve the right to decline an
application for a policy or a request to
upgrade your cover. If your application
is not accepted we will refund any
premium that you have paid for the
cover that we have declined to oer
(providing that we have not paid a
claim under that cover).
Cooling O Period - If you
change your mind
Your policy contains a 14-day cooling
o period from the date we accept
your application. If you change your
mind during this cooling o period you
should contact us. Providing that you
have not made or intend to make a
claim, we will refund the full premium
paid by you.
2. Pre-existing medical
conditions
This plan is only intended to cover new
medical conditions.
You, your partner and your dependent
children will not be entitled to claim
or use the following benets and
services for any pre-existing medical
conditions:
Care After Hospital; Chiropody;
Specialist Consultation and
Diagnostics; Dental Accident; Health
Screening/Assessment; Hospital
Benet; Prescription Charges; Surgical
Appliance; Therapy Treatments.
For Personal Accident cover we will take
into account any disability or condition
that you already had when we assess
the amount of disablement benet we
will pay as a result of a subsequent
accident.
Please read the denition of a pre-
existing medical condition on page 33
carefully. We may ask for information
from your GP to conrm any details
regarding pre-existing medical
conditions. The application form,
together with any information that
you give, forms part of the contract of
insurance.
If we discover that we have paid
any claims relating to a pre-existing
medical condition, we will seek to
recover any monies from you that have
been paid to you that you were not
due to under the terms and conditions
of the plan. We may terminate your
policy and we may seek to recover from
you any costs that we have incurred.
It may be necessary for us to request
a medical report from your GP,
Consultant Physician or Consultant
Surgeon. We will only request a report
when it is reasonably necessary and
under the Access to Medical Reports
Act 1988 and Personal Files and
Medical Reports (Northern Ireland)
Order 1991, if a medical report is
required we will write to you rst to tell
you why. If you, or where applicable
another person covered on your policy,
do not give us your consent we may
terminate your policy.
We will usually agree to continue
your policy on condition that any
pre-existing medical conditions are
not covered on your policy: if you are
applying to increase your level of cover
you will not be entitled to claim for pre-
existing medical conditions from the
date that you qualify for benet at the
higher level of the plan.
When you apply for a new policy, or ask
us to increase your level of cover any
pre-existing medical conditions are
not covered.
3. The contract between
Westeld Health and you
This health cash plan policy operates
on the basis that each calendar month
a new contract is formed between
Westeld Health and you. We do not
issue monthly reminder notices. Your
policy will be automatically renewed
each month providing you pay your
premium and abide by the terms and
conditions of the plan, unless we
receive notice from you that you do not
wish to continue your cover, or we give
you notice that we are not willing to
accept your monthly renewal.
Your Cancellation Rights
You have the right to cancel your policy.
If we receive notice that you wish to
cancel before the 15th day in any
month we will cancel your monthly
contract for that month and refund the
premium paid by you for that month. If
we receive notice of cancellation on or
after the 15th day of the month, then
we will not refund your premium for
that month but any further premiums
will not be payable. Any premium that
you have paid, in advance or that is
not due following cancellation will be
refunded to you. We will not pay a
claim for any benet beyond the date
that you have paid up to.
To cancel your policy please contact
our Customer Care Team on 0114
250 2000, email enquiries@
westeldhealth.com or write to us
at Westeld Health, PO Box 340,
Sheeld S98 1XB.
Re-applying for cover after you
have cancelled
If you cancel your policy and then
decide to re-apply for cover with us
you will be subject to the qualifying
periods for a new applicant to the
plan you apply for. You will also need
to sign a new declaration on the
application form. Previous claims may
be taken into account when we assess
your entitlement to benet on your
new policy.
Terminating your cover
We reserve the right to cancel your
cover at any time, (with retrospective
eect where appropriate), if:
• Under the terms and conditions
of the plan you are not eligible
for cover
• You provided false information
and/or failed to disclose all the
relevant required information
when you applied for cover,
applied to increase your plan
level, or submitted a claim
• You, or anyone covered on your
policy, fails to comply with our
request for information relating
to a claim or an application for
cover
• You submit a claim that is
fraudulent or that we reasonably
believe to be intentionally
false and/or misleading and/or
exaggerated
• You (or anyone covered on your
policy) act in a threatening or
abusive manner, e.g. violent
behaviour; verbal abuse; sexual
or racial harassment, towards a
member of our organisation, or
one of our suppliers
• You fail to abide by any of the
terms and conditions of this plan
Should we cancel your cover you will
not have any right to make any further
claim on the plan. In addition, we may
35
Continued overleaf
also seek to recover any monies from
you that have been paid to you that
you were not due to under the Terms
and Conditions of this plan.
If premiums for your cover have
been paid in advance we may refund
premiums paid beyond the date for
which you have had the benet of
cover. However, we retain the right to
withhold such premiums if you owe
us money.
We will notify you in writing our reason
for cancelling your cover and you have
the right to appeal to us through our
published Complaints Procedure,
which is available on request.
If your policy is terminated we will not
accept you for cover with us again on
any plan.
4. Premiums
Premiums are payable by monthly
Direct Debit to Westeld Health. When
you take out a policy, or upgrade your
cover, we will notify you when your
rst payment will be collected. To
bring your premiums up to date, it
may be necessary to take payment for
2 or more months’ premiums at the
rst collection. We will not process
any claims until we have received
a payment that covers the date for
which you are claiming. For more
information please refer to Section 7,
How to Claim.
Your policy will lapse if you do not
keep your premiums up to date. If you
owe more than one month’s premium
on levels 3, 4 or 5 or three month’s
premiums on levels 1 or 2 you will not
be entitled to remain in the plan.
You will not be entitled to use any of
the services included in the plan and
we will not pay your claim if premiums
have not been paid to cover the
date(s) for which you are claiming.
If when we receive your claim your
premiums are not paid up to date for
any reason, we will not process your
claim at that time. If you remain in
the plan, claims will be held until you
have made a payment that covers the
date(s) for which you are claiming.
If you do not continue to pay your
premiums all benet under the plan
will cease on the date that you have
paid up to.
We will not accept payment for more
than 13 months cover in advance.
Premiums include Insurance Premium
Tax at the current rate and are subject
to review in respect of any changes in
taxation.
Where a benet included in the plan
is underwritten by another insurer,
our agency agreements with insurers
allow us to hold the premiums you pay
in respect of these elements of the
product as agent of the insurer and
therefore payment to us means the
same as if you have paid that insurer
direct. This does not aect elements
that we underwrite.
5. Qualifying Periods
New policyholders or those who
transfer to a higher level of cover will
have to wait the relevant qualifying
period before they are eligible for
most benets. The qualifying period
starts from your date of registration,
at that plan level. Following your
date of registration you must renew
your monthly contract with us for
the required minimum number of
consecutive months, detailed below,
to qualify for each benet.
Available from the date of
registration:
24 Hour Advice and Information Line;
DoctorLine; Gym Discounts; Personal
Accident cover; Telephone Care
Advisory Service; Westeld Rewards.
10 months qualifying period – all plan
levels:
Maternity/Paternity/Adoption benet
3 months qualifying period – levels
1 and 2:
All other benets
6 months qualifying period – levels 3,
4 and 5:
All other benets
Changes to your level of cover
If you transfer to a higher plan level
qualifying periods for benet at the
higher level are as shown above.
During the qualifying period we will
pay benet at the lower plan level, if
you have benet available.
If you transfer to a lower level of cover
we will pay benets at the lower plan
level from the registration date of the
transfer, providing you had already
completed the required qualifying
period during the time you were at
the higher plan level and you have
benet available. Benet periods
and benets paid at the higher plan
level will be taken into account when
assessing entitlement to benet at the
lower level.
Former Policyholders
In addition to the above, if you have
been a former policyholder with
Westeld Health and your policy
has lapsed, we will take into account
claims paid under your previous cover
when assessing entitlement to benet
on your new policy.
The date that each benet will be
available to claim will depend upon:
a) the Good4you Plan level that you
are applying for
b) the plan and plan level that you
were previously covered on
c) claims previously paid and the
benet periods relating to those
claims
Transferring Plans
For policyholders who transfer to the
Good4you Plan from another Westeld
Health plan previous claims that you
have made may be taken into account
when assessing your entitlement to
benet.
Our Customer Care Team can explain
the qualifying periods and benet
entitlement that will apply to you,
following a lapse in your cover or
transfer from another Westeld Health
plan.
6. Exclusions
The list of exclusions, below, should
be read in conjunction with the
Benet Rules section before receiving
treatment or paying for goods and
services for which you intend to claim.
We will not cover:
• any claim that is not submitted
in accordance with section 8,
General Terms and Conditions
• any claim that is submitted
where you, or anyone covered on
your policy, are in breach of the
plan and/or General Terms and
Conditions
• claims that arise as a result of a
pre-existing medical condition.
See section 2, General Terms
and Conditions for details of the
policies and the benets that
exclude cover for
pre-existing
medical conditions
• any charges that a hospital/
treatment centre, practitioner or
any other organisation makes for
lling in a claim form or providing
any information we ask for
relating to a claim
• benet for treatment, goods or
services within your qualifying
period. If you transfer to a higher
level of the plan a new qualifying
period will apply. Until you have
completed the new qualifying
period we will pay you benet at
your previous plan level, provided
that you have entitlement to that
benet
• any claim or expense of any kind
directly or indirectly arising as a
result of war, invasion, rebellion,
revolution or terrorism including
chemical or biological terrorism
• claims arising directly or indirectly
from, or as a consequence of,:
• professional sports
36
injuries – this is any injury
sustained whilst training
for, or participating in,
sport for which you receive
payment or non-charitable
sponsorship
• you participating in a
criminal act
• an accident while you were
under the inuence of
alcohol or drugs
• drug, alcohol or solvent
abuse, or taking drugs
(unless told to do by
a registered medical
practitioner)
• suicide or deliberate self-
inicted injury
• participation of dangerous
activities and sports - this
includes but is not limited to
canyoning, gorge walking,
hang-gliding, high diving,
horse jumping, micro-
lighting, mountain boarding,
parasailing, rock climbing or
riding/driving in any kind of
race.
• ying as a pilot or crew
member (that is, aircraft,
gliders, hang-gliders,
microlights, parachuting,
paragliding and ballooning)
• a pandemic illness
• any claim or expense of any
kind caused directly or indirectly
by ionising radiation or
contamination by any nuclear
fuel, or the radioactive, toxic
explosive or other dangerous
properties of any explosive
nuclear machinery or part of it
• any treatment or service that you
receive from a:
• member of your immediate
family – a parent, child,
brother or sister, or your
partner
• business that you own
We cannot pay benets for any claims
directly related to the following
• any health-screening checks,
medical examinations,
consultations or reports for
employment, emigration, legal or
insurance reasons
• contraceptives
• cosmetic reasons
• vasectomies or sterilisation
• GP fees for private treatment
This policy does not cover fees or
charges for:
• missing an appointment
• completing a claim form or
providing a medical report
• providing further information in
support of a claim
• administration or referral costs,
joining fees or registration fees
• postage and packing costs
7. Benet Period
A separate benet period applies to
each benet and these are detailed in
the Benet Rules section.
You must have benet available for
the date(s) on which you paid for
treatment, goods or services. For
Hospital Benet and Maternity/
Paternity/Adoption benets you must
have benet available, for the date(s)
that you are claiming.
When you have FULL BENEFIT
available the benet period will start
on the following dates:
• For Hospital Benet the benet
period begins on the rst day or
night that we pay benet for
• The Maternity/Paternity/Adoption
benet period begins on the
date of birth or the date a child is
placed with you for adoption
• For Care After Hospital the
benet period begins on the rst
day we pay benet for
• For all other benets the benet
period begins on the date that
you paid for the treatment, goods
or service
During each benet period you can
submit more than one claim under
each benet, however we will not pay
more than the maximum allowance for
your plan level.
The benet period that each claim
falls into is determined by:
• the date of birth/adoption
placement for Maternity/
Paternity/Adoption benet
• for Hospital Benet the date that
you are an in-patient or the date
that you attend for day surgery
• the date that home care was
provided for Care After Hospital
benet
• the date of your payment for
treatment goods or services
When a benet period ends full
benet will again become available
to claim. Any unused benet will not
be carried forward from one benet
period to the next. The new period
for that benet will not begin until you
submit the next claim and will start
according to the criteria set out above.
8. How to claim
For our fastest service, you can submit
claims for all benets on our My
Westeld mobile app (available on
Apple & Android), or online at www.
westeldhealth.com/my-Westeld.
Alternatively, you can use a Health
Cash Plan claim form, this is available
on your My Westeld account. The
claim form must be signed and dated
by the policyholder.
We won’t pay a claim until you or your
dependant has received and paid for
the treatment, goods or service.
To be entitled to claim, the premiums
for your cover must be paid up to and
including:
• the date on which you made each
payment for treatment, goods or
services
• the nights you were an in-patient
for Hospital Benet
• the date you attended for day
surgery for Hospital Benet
• the child’s date of birth/adoption
placement for Maternity/Paternity/
Adoption
• the date that home care was
provided for Care After Hospital
• the date of your accident, for
Personal Accident
For all benets where you (or a person
covered on your policy) have paid for
treatment, goods or services you must
get a full receipt detailing the payment
you have made. You must send us the
receipt if you are submitting your claim
on a paper claim form. We may ask
you to send the receipt to us within six
months if you submit a claim online.
The receipt must include:
• the name of the person who has
received the treatment, goods or
service
• the date and amount of each
payment
• the supplier or practitioner’s
name, address and daytime
contact details
• details of the qualications/
professional organisation that the
practitioner is registered with/a
member of (see Benet Rule or
Denitions section)
• details of the type of treatment/
service
• the date that you (or a person
eligible to claim on your policy)
received each separate treatment
or service
• separately itemised details of any
additional sundry items purchased
We do not accept the following:
• invoices without a supporting
receipt or credit/debit
card receipts without an
accompanying itemised receipt
• receipts where only a part
payment or deposit* has been
37
Continued overleaf
paid, including receipts showing a
balance outstanding for payment
• claims for payment(s) made in
advance for a course of treatment,
a service or goods: except when
the receipt also conrms that prior
to claiming you have received the
treatment, goods or service. The
receipt must detail the date(s) you
received the treatment, goods
or service and we must receive
your claim within 26 weeks of the
payment date – see below
* The only exception to this is
when you provide us with written
evidence that you have entered
into a payment arrangement/
credit agreement for treatment,
goods or services that you have
received. The date that you pay
the rst instalment determines
the benet period that your claim
falls into and we will pay you up
to the benet balance available
on that date ONLY towards the
full cost of the treatment, goods
or service purchased by the credit
agreement.
We do not cover administration/
interest charges. Dental insurance or
care scheme premiums/payments are
not covered on the plan.
For Maternity/Paternity benet we need
your baby’s full birth certicate with
your claim. To claim for Adoption you
must send us proof of the child’s name
and age, together with conrmation
from an adoption agency of the date
that the child was placed with you for
adoption.
To claim Hospital Benet your Westeld
Health claim form must be completed,
signed and stamped by the hospital/
treatment centre or hospice. We do
not accept photocopies of completed
claim forms.
We will not pay your claim unless it
is received within 26 weeks of the
following:
• the date that you tender each
payment (i.e. cash; credit/debit
card; cheque) to the practitioner/
supplier for treatment, goods or
services
• the date on which you were
discharged as an in-patient for
Hospital Benet
• the date of each attendance for
Day Surgery for Hospital Benet
• the child’s date of birth; the date
a child is placed with you for
adoption
• the date that home care was
provided for Care After Hospital
It is your responsibility to ensure
that you allow sucient time for the
claim to reach us within the 26 weeks
deadline. We will not accept any
responsibility for claims (or supporting
evidence) lost, delayed or damaged in
the post.
If you can claim part or all of your costs
under another Westeld Health plan,
or from any other source, you are not
entitled to receive more than the total
amount that you have paid. If you are
claiming from another insurer we will
pay our proportionate share of the
cost, subject to benet being available
and the terms and conditions of your
plan.
You should only submit a claim if
the person who has received the
treatment, goods or service is eligible
to claim under that specic benet.
If the claim is for your partner or
dependent child we may require proof
of your relationship with them. It is
your responsibility to provide complete
and accurate information with the
claim.
When you submit a claim, for audit
purposes we will carry out checks on
the information you and practitioners
provide to us and we will not process
that claim, or any further claims on
your policy, until we have successfully
completed our audit checks. If we
make a reasonable request for
additional information, this must be
provided at your own expense.
In order for us to verify a claim it
may be necessary for us to request
a medical report from your GP,
Consultant Physician or Consultant
Surgeon at any time. We will only
request a report when it is reasonably
necessary in accordance with the
Access to Medical Reports Act 1988
and Personal Files and Medical Reports
(Northern Ireland) Order 1991, if a
medical report is required we will write
to you rst to tell you why. If you,
or where applicable another person
covered on your policy, do not give us
your consent we will withhold payment
of all claims and may terminate your
policy.
Pre-existing medical conditions are
not covered on the plan for some
benets. When a claim is submitted
we will check if there is a pre-existing
medical condition. If we discover that
we have paid any claims relating to
a pre-existing medical condition we
will seek to recover any monies from
you that have been paid to you that
you were not due to under the terms
and conditions of the plan. We may
terminate your policy and we may seek
to recover from you any costs we have
incurred.
If you are providing information about
another person you should ensure that
you have their consent to do so.
If you submit a claim that is false we
will terminate your policy and your
benets as a policyholder will end
immediately. We will not refund
premiums paid for the plan and always
take legal action for fraudulent claims.
How do we check claims and
prevent fraud?
We check all claims. We may need to
ask you for further proof before we
can process a claim; you must provide
this at your own expense. We may also
contact the practitioner for verication.
If the claim is for your dependant
we may ask you for proof of your
relationship with them. While we’re
waiting for information we won’t pay
any claims on your policy. We do these
routine checks to make sure that we’re
paying claims correctly; it doesn’t mean
that we think you’re being dishonest.
It’s your responsibility to make sure
that all the information that you
give us with a claim is truthful and
complete. We take fraud prevention
very seriously. False claims can
cause premiums to go up. To protect
our honest customers, we’ve many
systems and procedures that detect
false claims. We also share information
with other insurance companies, fraud
prevention agencies, the police and
other enforcement agencies.
You must always act honestly. For
example you, or anyone covered on
your policy, must not:
• Alter or forge a receipt/claim form.
• Send us any evidence with a claim
that you know is misleading or
untrue.
• Give dishonest answers to our
questions.
• Refuse to give us any information
that we need, or withdraw a claim
to avoid investigation.
• Refuse permission for us to
contact a healthcare provider.
• Deliberately claim for anything, or
anyone, that’s not covered.
• Claim reimbursement from
more than one policy with the
intention of getting back more
than you’ve paid out (this is called
betterment).
• Fail to tell us if the claim could be
covered on another policy.
• Claim for a pre-existing medical
condition that isn’t covered on
your policy, or a medical condition
that you should’ve told us about
when you made a claim.
If we reasonably believe that a claim is
false or fraudulent, even if we haven’t
proved that you’ve acted dishonestly,
we won’t pay that claim. We may
terminate your policy and all your
benets will stop immediately. We
38
won’t refund any premiums for a
terminated policy. We’ll charge you any
other costs that we’ve incurred.
Insurance fraud is a criminal oence.
We always pass details of suspected
fraudulent claims to the police or
Crown Prosecution Service for them
to investigate and prosecute through
the criminal courts. Anyone convicted
of fraud may have to declare it when
they apply for any type of insurance in
the future.
How we pay you
We will pay your claims directly into
your bank/building society account
and send you a remittance advice as
conrmation.
24 Hour Advice and Information
Line; Care After Hospital;
DoctorLine; Gym Discounts;
Telephone Care Advisory
Services; Westeld Rewards
For information on how to access these
services please refer to the Benet
Rules section.
How to claim Personal Accident
Once a claim has been submitted
by you we will contact you to explain
what happens next. Any document or
evidence reasonably required by us
to verify the claim shall be provided
by you or on your behalf at your own
expense. Any medical examination
required by us to verify the claim will be
at our expense. Any receipt which you
or anyone acting on your behalf may
give to us for benets payable shall be
deemed a nal and complete discharge
of all liability in respect of such benet.
9. Worldwide cover
If, as a result of an emergency, a claim
arises when you are temporarily
travelling away from home anywhere in
the World, on business or for pleasure,
you can still make a claim. You (and if
the claim relates to them your partner
or dependent child) must be resident
in the UK, Jersey or Isle of Man for a
minimum of 6 months each year to be
eligible for cover on this plan. When
you submit a receipt for money that
you have paid, we will use the currency
exchange sell rate, supplied by our
bank, on the date we process the claim.
If we request it, you must provide us
with evidence of your travel dates, these
must be for a period of less than 28
days. All documentation supporting
your claim should be in English. Entirely
at our discretion we may agree to accept
an English translation accompanying
the original documents, when you have
provided this at your own expense.
What benets are covered (if included
on your policy)
• Dental Accident
• Emergency Dental treatment
• Optical – replacement eyewear
(glasses or contact lenses)
• Emergency admissions for
Inpatient or Day Surgery
• DoctorLine
• 24 Hour Advice and Information
Line.
All other benets and services are not
available.
10. Making a complaint
We’re dedicated to making a healthy
dierence to the quality of life of our
customers and the communities in which
they live and work. We’re proud of the
service we provide but know we might not
get it right all the time. When something
goes wrong, we’d like to know so we can
try to put it right for you.
How to complain
You can contact us with your concerns by
Phone 0114 250 2000
Email enquiries@westeldhealth.com
Post Westeld Health, PO Box 340,
Sheeld S98 1XB.
Directly contact your sales consultant
We’ll try to resolve them straight away.
Sometimes we might need a little more
time, but we’ll keep you updated along
the way. When we receive your concerns
we’ll:
• Promptly acknowledge your complaint
• Assign your complaint to a case
handler to review and investigate
• Keep you updated throughout
• Provide you with a written response
within 8 weeks of receiving your
complaint
If you’re not satised with our response
If you’re not satised, you may be able
to refer your complaint to the Financial
Ombudsman Service. You will have 6
months from the date of our response
letter to refer your complaint to the
Ombudsman or you may lose your right
to have the complaint investigated.
The Financial Ombudsman Service may
not be able to consider a complaint if you
have not provided us with the opportunity
to resolve it rst.
We would point out that the Ombudsman
will only review complaints from ‘eligible
complainants’, for which specic
denitions apply. You should refer to the
FOS for further guidance on this subject.
What is the Financial Ombudsman
Service?
The Financial Ombudsman Service (FOS)
is an independent complaint resolution
scheme. The FOS website recommends
that you follow the process above before
referring your complaint on to them,
although you are able to ask them general
questions regarding complaints at any
time.
The FOS service is free of charge. The
Financial Ombudsman Service can be
contacted as follows:
Post: Financial Ombudsman Service
Exchange Tower, London, E14 9SR.
Telephone: 0800 023 4567 (free from a
UK landline) or 0300 123 9123 (calls to
this number cost no more than calls to 01
and 02 numbers). Please call +44 (0) 207
964 0500 if calling from outside the UK.
Email: complaint.info@nancial-
ombudsman.org.uk
Website: www.nancial-ombudsman.
org.uk
11. Compensation
Westeld Health is covered by the
Financial Services Compensation
Scheme.
In the unlikely event that we are
unable to meet our obligations, you
may be able to claim compensation.
Further information is available from
the Financial Services Compensation
Scheme, PO Box 300, Mitcheldean,
GL17 1DY and by visiting www.fscs.
org.uk.
12. General Conditions
Governing Law
Once your application to register for
the plan has been accepted by us, this
agreement shall be governed by and
construed in accordance with the laws
of England and the parties irrevocably
and unconditionally submit to the
exclusive jurisdiction of the courts of
England in respect of any dispute or
dierence between them arising out of
this agreement.
Changes to this Contract
From time to time upon renewal it may
be necessary for us to increase the
amount of the premium for the plan,
alter the benets payable under the
terms of the plan or amend the rules
relating to the plan. If we decide to
make any such changes we will give
you reasonable notice to enable you to
decide if you do not wish to continue
your policy, except when it is not
possible for us to do this, for example
changes required by law. Any revisions
will not extend the benet period
relating to each separate benet.
A person who is not a party to this
agreement shall not have any rights
under or in connection with it.
The Maternity/Paternity/Adoption
benet will remain in place if you
continue to be a Good4you Plan
39
policyholder unless we give you
12 months’ notice that it is to be
withdrawn.
We reserve the right to cancel the plan.
If we intend to completely withdraw
the plan, we shall provide you with
reasonable notice. Where possible,
we will try to oer you an alternative
Westeld Health plan.
Marketing Preferences
At Westeld Health, we help people to
lead healthier lives and feel their best. We
occasionally send out communications
with ideas and information on health and
wellbeing, plus special oers that we
think are of value to you, invitations to
take part in our research panel Westeld
Insiders, and on the products we’ve
designed to help keep you and your loved
ones healthy and happy.
We’ll never make your data available to
anyone outside Westeld Health for them
to use for their own marketing purposes,
we’ll treat your data with respect and will
keep your details safe and secure.
You can let us know what you want to
hear about and how you want to hear
about it using the attached application
form or by visiting westeldhealth.com
to register or log in to My Westeld where
you can also update your details.
We’d like to bring to your attention our
Privacy Policy which details how your
data is used and stored, and how to
exercise your privacy rights. Visit www.
westeldhealth.com/about-us/legal/
privacy-policy.
Westeld Contributory Health Scheme Ltd
(company number 0303523), Westeld
Health & Wellbeing Ltd (company number
9871093) are collectively referred to as
Westeld Health and are registered in
England & Wales.
Language
In accordance with regulatory guidance
we conrm the language we will use for
communication purposes. It is: English.
Additional Information
We are required to notify you that there
may also be other taxes or costs which
are not paid through, or imposed by,
the insurance underwriter.
The information contained within this
guide is eective from 1st June 2024
and replaces all previously published
information.
Our Privacy Policy
Who we are:
“Westeld Health” (referred to as “we”,
“us” or “our”) is a trading name of:
Westeld Contributory Health Scheme
Ltd, Westeld House, 60 Charter Row,
Sheeld, S1 3FZ. Company Registration
Number: 0303523. ICO registration
number: Z5678949.
We have a Data Protection Ocer
who can be contacted in the following
ways should you have any questions,
complaints or feedback about your
privacy. Please email:
dpo@westeldhealth.com or write to
them via the above address.
What information we collect:
In relation to your plan, you may provide
us with your personal details including:
• Your title, full name, postal and billing
addresses, email address, phone
number and date of birth;
• Your payment details;
• Information in relation to your health,
including any pre-existing medical
conditions;
• Details in relation to your partner,
friends or dependents for the
purposes of adding them to your plan/
policy or in order to create their own.
Where you have provided information
about another person you should
ensure that you have their approval
to do so.
How we use it:
Information provided to us or collected
in relation to your plan will be used by
Westeld Health, or selected third parties
to:
• Full your order;
• Provide the benets for which you
have applied;
• Manage and maintain your records;
• Manage the underwriting and/or
claims handling procedures (including
your dependants’ claims);
• Handle complaints and improve
customer service;
• Administer marketing on behalf of
Westeld Health. (You can change
your details and preferences at
anytime by logging into and using your
My Westeld account or by calling our
friendly Customer Helpline on 0114
250 2000);
• Prevent and detect fraud;
• Understand our customers
better in order to provide tailored
communications, a better experience
and to improve our services.
We will record, and monitor telephone
calls made to and from Westeld Health’s
sales and customer service teams. We
do this in order to continuously improve
our service to customers and for training
purposes. This will also include the
recording and monitoring of data relating
to health and medical conditions. We
do not record the element of telephone
calls where any form of payment is being
made.
We may share information, including your
health and medical information, with third
parties or individuals. These may include:
• Other insurance providers in order to
process your claims;
• For purposes of national security;
taxation; criminal investigations or
when we are obliged to do so by law;
• To prevent and detect fraud. This will
include the recording and monitoring
of Special Category data, such as
health and medical conditions for all
claims processed under your plan;
• Your employer (if they are paying
some or all of the premium for your
cover) where we have a reasonable
belief that the claims activity is in
serious breach of our terms and
conditions and/or may be fraudulent;
• Marketing agencies or mailing houses
acting on our behalf.
We’ll never make your personal data
available to anyone outside Westeld
Health for them to use for their own
marketing purposes without your prior
consent.
How we look after your data:
We have achieved ISO27001 certication
and we will protect the data that you
entrust to us at all times via appropriate
security measures and controls. We’ll also
ensure through the contracts we have in
place, that other businesses we work with
are just as careful with your data.
All the personal data we process is
processed by our sta in the UK and
stored on servers located inside the
European Economic Area (EEA).
How long we keep your data:
We will keep your personal data for a
number of purposes, as necessary to
allow us to carry out our business. Your
information will be kept securely for up
to 6 years following the date you cease
to remain an active customer, after
which time it will be archived, deleted
or anonymised. In some cases for the
purposes of processing your existing
or future claims and for underwriting
purposes, we may keep personal
information for longer. Where we, at
present, cannot technically erase the data
we will ensure this is securely archived
with restricted access.
Your Rights:
• Right to be Informed: We will always
be transparent in the way we use
your personal data. You will be fully
informed about the processing
through relevant privacy notices.
• Right to Access: You have a right to
request access to the personal data
that we hold about you and this
should be provided to you. If you
would like to request a copy of your
personal data, please contact our Data
40
Protection Ocer.
• Right to Rectication: We want to
make sure that the personal data
we hold about you is accurate and
up to date. If any of your details are
incorrect, please let us know and
we will amend them. You can also
visit the My Westeld section of the
website and update your details at
any time.
• Right to Erasure: You have the right
to have your data 'erased' in the
following situations:
• Where the personal data is no
longer necessary in relation to the
purpose for which it was originally
collected or processed.
• When you withdraw consent.
• When you object to the processing
and there is no overriding
legitimate interest for continuing
the processing.
• When the personal data was
unlawfully processed.
• When the personal data has to be
erased in order to comply with a
legal obligation.
If you would like to request erasure
of your personal data, please contact
our Data Protection Ocer. Please
note that each request will be
reviewed on a case by case basis and
where we have a lawful reason to
retain the data or where exceptions
exist within our retention policy, then
it may not be erased.
• Right to Restrict Processing: You
have the right to restrict processing in
certain situations such as:
• Where you contest the accuracy
of your personal data, we will
restrict the processing until you
have veried the accuracy of your
personal data.
• Where you have objected to
processing and we are considering
whether Westeld Health's
legitimate grounds override your
legitimate grounds.
• When processing is unlawful and
you oppose erasure and request
restriction instead.
• Where Westeld Health no longer
need the personal data but you
require the data to establish,
exercise or defend a legal claim.
• Right to Data Portability: You have
the right to data portability in certain
situations. You have the right to
obtain and reuse your personal data
for your own purposes via a machine-
readable format, such as a .CSV le.
If you would like to request portability
of your personal data, please contact
our Data Protection Ocer, this only
applies:
• To personal data that you have
provided to us;
• Where the processing is based
on your consent or for the
performance of a contract; and
• When processing is carried out by
automated means.
• Right to Object: You have the right
to object to the processing of your
personal data in the following
circumstances:
• Direct marketing (including
proling). Remember you can opt
out at any time from marketing
communications via our Marketing
Preferences, available in My
Westeld; and
• Where the processing is based on
legitimate interests.
• Rights in Relation to Automated
Decisions Making Including Proling:
You have the right to not be subject
to a decision when it is based on
automated processing. If you have
any questions in relation to how
your information is processed in this
way, then please contact our Data
Protection Ocer.
Not Happy?
If you feel that Westeld Health has
not upheld your rights, we ask that you
contact our Data Protection Ocer so
that we can try and help.
If you are not satised with how
Westeld Health processes your data,
or believe we are not processing your
data in accordance with the law you have
the right to lodge a complaint with the
Information Commissioner’s Oce (ICO).
Please visit: www.ico.org.uk.
41
Notes
42
Notes
43
Notes
44
Apply now
The following information will help you
complete this application form. Please
could we ask that you complete the
application form using block capitals
and a black pen.
Section A: Applicant 1
This section is for you to apply for cover, or to upgrade
existing cover. Please complete all the information in
this section.
Section B: Applicant 2
Your partner can ll in this section if they would like to
take out cover too. They will hold a separate policy.
Section C: Dependent Children Details
If you have dependent children, they are included for
key benets as part of your cover, at no additional cost.
Please provide their details on this form.
Section D: Declaration
Please read the declaration carefully before signing.
Pre-existing medical conditions
This policy covers new conditions only. Please read
carefully section 1 and 2, General Terms and Conditions
together with the denition of pre-existing medical
conditions on page 34 before completing the
application form.
Direct Debit instruction
Please don't forget to ll in the Direct Debit instruction.
We need the bank or building society details for each
applicant so that premiums can be paid by Direct Debit.
Payment of claims
We will reimburse your claims by crediting your bank or
building society account directly. It must be your own
bank or building society account. Once your claim has
been processed, conrmation of the payment will be
forwarded to you.
Important information
To apply for cover, applicants
must be aged 65 years or under
(i.e. not yet 66).
How to apply
To take out a policy, upgrade
existing cover, or apply for cover
for your partner – simply follow
the steps below:
Step 1
Choose a level of cover.
Step 2
Complete the application form
and Direct Debit instruction
attached to this guide.
Step 3
Return your completed application
form and Direct Debit instruction
to us at:
Westeld Health,
PO Box 340,
Sheeld S98 1XB
We will send you information
about your cover.
Good4you
Health Cash Plan:
Application Form
Application Form
Marketing preferences:
We’d love to keep you up to date with all things health and wellbeing.
Please tell us what you’d like to hear about:
Applicant 1 Health & Wellbeing Information Special Oers Westeld Insiders Products
Please tell us how you would like us to communicate with you for the above purposes:
Email Text Telephone Post Social Media Web
Applicant 2 Health & Wellbeing Information Special Oers Westeld Insiders Products
Please tell us how you would like us to communicate with you for the above purposes:
Email Text Telephone Post Social Media Web
You’re always in control. You can update your choices at any time. Simply visit westeldhealth.com and register or
log in to My Westeld.
We’d like to bring to your attention our Privacy Policy on pages 41 to 42 which details how your data is used, stored,
and how to exercise your privacy rights.
PLEASE CUT
<
GOD01V2
Good4you Health Cash Plan: Application Form
Section A – Applicant 1
Title (Mr/Mrs/Miss/Ms/Other)
Forename(s)
Surname
Date of birth (DD/MM/YY)
Address
Postcode
Tel work
Tel home
Email
Tel mobile
Westeld policy
number (if applicable)
Section B – Applicant 2
Title (Mr/Mrs/Miss/Ms/Other)
Forename(s)
Surname
Date of birth (DD/MM/YY)
Address
Postcode
Tel work
Tel home
Email
Tel mobile
Westeld policy
number (if applicable)
Applicant 1 signature Date Applicant 2 signature Date
Section E – Westeld oce use only
Policy number Promotion code
Event ID Media code
Section C – Dependent Children Details
Applicant 1 Applicant 2
Forename(s) Surname M/F
Date of birth
(DD/MM/YY)
Forename(s) Surname M/F
Date of birth
(DD/MM/YY)
Level Per Month Join Change to Remain on
L1 £8.09
L2 £16.58
L3 £24.33
L4 £33.26
L5 £49.39
Level Per Month Join Change to Remain on
L1 £8.09
L2 £16.58
L3 £24.33
L4 £33.26
L5 £49.39
Section D – Declaration: Please read carefully before signing – this part MUST be completed
I declare that the information I have given on this form
is true and complete and that I have received full details
of the policy, which I have read or have had read to me
and agree to be bound by the General Terms and
Conditions and Benet Rules of the plan.
I have carefully read section 1 and 2, General Terms and
Conditions and I understand that the Good4you Plan
covers new medical conditions only: Pre-existing
medical conditions are not covered.
I understand that all future benet claims will be
reimbursed to the bank/building society account as
detailed in the attached Direct Debit form, until
Westeld Health is notied to cancel the instruction.
I can conrm that I am one of the account holders.
(If you wish us to credit a dierent account please
contact us to request a Direct Credit Instruction Form
by emailing enquiries@westeldhealth.com or by
calling 0114 250 2000. Once your claim has been
processed a remittance advice will be forwarded to you
advising of the amount we will be crediting).
Please complete this form in block capitals using black ink . Please ensure you also complete the Direct Debit instruction and
return this to Westeld Health together with the application form.
Please complete as applicable Please complete as applicable
APPLICANT 1
APPLICANT 2
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INSTRUCTION TO YOUR BANK OR BUILDING SOCIETY TO PAY BY DIRECT DEBIT
Name(s) of account holder(s)
Reference
Service user number
Bank/Building Society account number
Branch sort code
Name and full postal address of your Bank or Building Society
To: The Manager
Address
Bank/Building Society
Postcode
Instruction to your Bank or Building Society
Please pay Westfield Health Direct Debits from the account
detailed in this Instruction subject to the safeguards assured
by the Direct Debit Guarantee. I understand that this
Instruction may remain with Westfield Health and if so, details
will be passed electronically to my Bank/Building Society.
For (Westeld Health) ocial use only:
This is not part of the instruction to your Bank or
Building Society
Originator’s Reference Number
Please indicate your chosen
payment collection date:
Banks and Building Societies may not accept Direct Debit Instructions for some types of account.
Please ll in the whole form including ocial use box and return to:
Westeld Health, PO Box 340, Sheeld S98 1XB
Signature(s):
Date:
INSTRUCTION TO YOUR BANK OR BUILDING SOCIETY TO PAY BY DIRECT DEBIT
Name(s) of account holder(s)
Reference
Service user number
Bank/Building Society account number
Branch sort code
Name and full postal address of your Bank or Building Society
To: The Manager
Address
Bank/Building Society
Postcode
Instruction to your Bank or Building Society
Please pay Westfield Health Direct Debits from the account
detailed in this Instruction subject to the safeguards assured
by the Direct Debit Guarantee. I understand that this
Instruction may remain with Westfield Health and if so, details
will be passed electronically to my Bank/Building Society.
For (Westeld Health) ocial use only:
This is not part of the instruction to your Bank or
Building Society
Originator’s Reference Number
Please indicate your chosen
payment collection date:
Banks and Building Societies may not accept Direct Debit Instructions for some types of account.
Please ll in the whole form including ocial use box and return to:
Westeld Health, PO Box 340, Sheeld S98 1XB
Signature(s):
Date:
9 4 1 1 1 0
9 4 1 1 1 0
Applicant 1Applicant 2
APPLICANT 1
APPLICANT 2
Remember, our
friendly Customer
Care Team is here
to help.
Online
westeldhealth.com
Email
enquiries@
westeldhealth.com
Phone
0114 250 2000
8:30am-5:30pm, Mon-Fri
(except public holidays)
Postal address
Westeld Health
PO Box 340
Sheeld
S98 1XB
Westeld Health is a trading name of Westeld Contributory Health Scheme and is registered in England & Wales
Company Number 303523. We are authorised by the Prudential Regulation Authority and regulated by the Financial
Conduct Authority and the Prudential Regulation Authority. Our nancial services registration number is 202609.
Registered Oce is Westeld House, 60 Charter Row, Sheeld, South Yorkshire S1 3FZ
Westeld Health is a registered trademark.
©Westeld Health 2024
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