Ex-Gratia Applications for Additional Benefits - Added Value Benefits | Namibia Health Plan

Ex-Gratia Applications for Additional Benefits

You are advised that, should a need for an Ex-Gratia request for financial assistance arise, you should contact the Fund in which case you will be assisted in completing and submitting the relevant forms.

The Board of Trustees will not authorise payment for services other than those prescribed in the Rules of the Fund but can at its absolute discretion, increase the amount payable in terms of the Rules as an Ex-Gratia award, provided that the Board of Trustees is satisfied that the member would otherwise suffer undue financial hardship.

Please note:  The Board of Trustees decision in such cases shall always be final.

In order to realise the overall objective, the following criteria are applicable:

  • Each application is evaluated objectively and consistently.
  • Each application is evaluated and rated to determine the level of financial hardship of the member.The identity and nature of the request shall always be treated with the utmost discretion and confidentiality.
  • The identity and nature of the request shall always be treated with the utmost discretion and confidentiality.

The following relates to the application and appeal process:

  • Only applications that contain all the required information will be tabled for review.
  • All applications that are incomplete will be rejected outright and the applicant notified as such.
  • The final decision, with regards to the actual amount approved or rejected, remains entirely up to the discretion of the Ex-Gratia Committee.
  • Any member may appeal the decision of the Ex-Gratia Committee.
  • Such an appeal must be brought to the attention of the Ex-Gratia Committee. The appeal must be directed to the Principal Officer of the Fund and should be submitted within 30 days of the date of the notification by the administrator.
  • The Ex-Gratia Committee will review the merits of the appeal application as well as its decision and forward the appeal to the Board of Trustees. The member concerned shall be informed of the ruling of the Board of Trustees. The ruling of the Board of Trustees remains final and binding on the member.

Please note: Members are reminded that if any Ex-Gratia allocations made in a specific benefit year i.e. 1 January to 31 December are not used by the member, these cannot be transferred to the next benefit year.

It is therefore in the members own interest to ensure that they ensure that their treatment is completed as soon as possible after they have been informed of the outcome of their Ex-Gratia application.

Forms

Select and download all application, registration and request forms as well as information on NHP’s designated service providers, tariffs and travel insurance.

See all forms

Information and Services

Benefit suggestions

These life stages aim to illustrate the thoughtful consideration given to the evolving healthcare needs of individuals at different points in their lives. By aligning medical aid benefits with these life stages, we ensure that our members receive targeted and effective healthcare support throughout their journey.

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