Terms and Conditions

1. Eligibility

To enrol in an OYSHIA health insurance plan, you must:

• Be at least 18 years old.
• Provide accurate and complete personal and medical information.
• Be a resident of the State that OYSHIA is situated in.

2. Enrolment Process

By enrolling, you:

• Agree to submit all required documentation and personal information.
• Understand that providing false or incomplete information may result in disqualification or denial of claims.
• Acknowledge that your coverage will begin only after full approval and payment of any necessary premiums.

Enrolment may be facilitated through digital channels and other authorised enrolment channels supported by OYSHIA and Plural Health.

3. Premium Payments

• Premiums must be paid on time and in full according to the applicable payment schedule.
• Late or missed payments may result in suspension or cancellation of coverage.
• Payment terms and methods are specified in your enrolment package.

4. Coverage

• Your health insurance coverage is subject to the Terms and Conditions outlined in the applicable insurance policy.
• Certain treatments, procedures and medications may not be covered or may require pre-authorisation.
• You are responsible for understanding the scope of your coverage and any applicable limitations.

5. Claims

• All claims must be submitted within an agreed number of days following the receipt of medical treatment or services.
• The insurance company may request additional documentation or information to process a claim.
• Fraudulent claims may result in termination of coverage and legal action.

6. Privacy and Data Protection

We respect your privacy and are committed to protecting your personal information.

Please refer to the Plural Health Privacy Policy for more details on how personal information submitted through its digital platforms is collected, used and stored.

By enrolling, you acknowledge that your information may be collected and processed for purposes related to the administration of your health insurance package, in accordance with applicable data protection laws.

7. Termination and Cancellation

• You may cancel your enrolment at any time by providing written notice.
• The insurance institution reserves the right to terminate your coverage for failure to comply with these Terms and Conditions, non-payment of premiums or fraudulent activities.

8. Amendments

The insurance institution reserves the right to modify these Terms and Conditions at any time.

Changes will be communicated through official channels, and your continued participation will constitute acceptance of any changes.

9. Dispute Resolution

Any disputes arising from your enrolment or participation in the health insurance package will be resolved in accordance with the laws of the State that OYSHIA is situated in.

10. Contact Information

For questions or concerns regarding these Terms and Conditions or your health insurance coverage, please contact OYSHIA through its official customer service channels.

For technical assistance relating to the digital enrolment platform, please contact Plural Health through its official support channels.

By enrolling, you acknowledge that you have read, understood and agreed to these Terms and Conditions.