GENERAL CONTRACT CONDITIONS OF THE CONTRACT FOR ORGANISING ACCESS TO TREATMENT IN PRIVATE MEDICAL INSTITUTIONS LOCATED IN THE REPUBLIC OF POLAND AND FOR EXECUTING TREATMENT COST REFUNDING IN THE CUSTOMER COUNTRY OF RESIDENCE

§1

General contract conditions (hereafter called “OWU”) constitute a sample contract for organising access to treatment in private medical institutions located in the Republic of Poland and for executing treatment cost refunding in the Customer country of residence by Med4EU sp z o.o. as regulated in the Civil Code art 384.1.

§2
DEFINTIONS

Wherever the following terms are used, they carry the meaning as explained below, and for terms not mentioned – their meaning is regulated in the content of OWU:

a) Med4EU – the company under the name Med4EU sp. z o.o. domiciled in Wroclaw, at the address ul. Warsztatowa 11, 53-014 Wroclaw, registered in the Business Register KRS kept by District Court for Wroclaw Fabryczna in Wroclaw, Business Department 6 of the National Court Register at the number 0000469197; Med4EU administrates and operates the Website;

b) Med4EU – business name (brand) owned by Med4EU, under which Med4EU runs its business activities connected with organising access to medical treatment in private medical institutions in the Republic of Poland and with carrying out refunding of the treatment costs in the Customer’s country of residence;

c) The Website – the web site with the address www.med4eu.co.uk, with all its tabs and sections, administered and operated by Med4EU;

d) The User – each person who uses the Website, regardless of whether he/she acts on his/her own behalf or in the name and on behalf of third parties;

e) The Contract – the contract for organising access to treatment in private medical institutions located in the Republic of Poland and/or carrying out refunding of the treatment cost in the Customer’s country of residence, concluded in the electronic form between the User and Med4EU – online via the Website, following the rules specified in the Regulations and in this OWU;

f) The Customer – the User who concluded the Contract with Med4EU or acts in order to conclude the contract;

g) The Customer Panel – a tool to manage the Website services and the contact with Med4EU, available after logging in on the site https://med4eu.co.uk;

h) the Regulations – the Regulations of online services rendering available on the Website;

i) Treatment – a series of medical actions, with the use of appropriate medications and equipment, intended to correct imbalance (restore homeostasis) of the system afflicted with a disease or disability; actions of physician/surgeon aimed at restoring health of a sick person or improve his/her quality of life.

j) Treatment Stage or the Stage of Treatment – a part of treatment, such as medical consultation and / or diagnostics, conservative treatment, surgery, physical therapy.

k) Medical Episode – treatment process consisting of one or several Treatment Stages within one specialty; it may consist of physician’s and/or surgeon’s consultation and diagnostics in several specialties, that result in a diagnosis and a treatment within one specialty.

§3
SUBJECT OF THE CONTRACT

1. The Customer orders and Med4EU accepts to execute the order to organise access to medical treatment in private institutions located in the Republic of Poland and to carry out cost refund in the Customer’s country of residence, consisting of:

A. assistance to choose a medical institution that will undertake the medical services for the Customer and preparation of the medical treatment cost refund according to the procedures and regulations in the Customer Country of Residence, or

B. undertaking the administrative actions indispensable for the correct Contract execution, especially, on the basis of entitlements received, to obtain from the chosen Medical Institution, as mentioned in Par. 4.2, the medical documents necessary prepare medical treatment cost refund application for a Stage of Treatment or a Medical Episode (hereafter called the “Application”), to prepare, on behalf of the Customer, the Application according to the procedures and regulations in the Customer Country of Residence, to collect the documents necessary to prepare the Application, to translate the Application with its attachments to the Customer country of residence language, and to submit the Application apply in the name of the Customer, or

C. assistance to obtain the medical treatment cost refund that – to the level of refunding – is due [for] the medical institution that performed the treatment.

§4
THE CUSTOMER STATEMENTS

1. The Customer hereby confirms that he/she has the status of an insured person in his country of residence and will retain this status for period necessary to finalise the cost refund process for the medical services as specified in Attachment no. 1

2. The Customer declares that all information and data given to Med4EU via Registration Form and Customer Panel are true and correct.

3. The Customer confirms that he/she is fully aware that Med4EU is not an institution rendering medical services or benefits and that to receive medical services the Customer must conclude a separate contract for medical services between the Customer and the chosen medical institution; therefore the Customer declares that he/she is aware that Med4EU is not liable for any possible negative effects of improper performance of medical services by the above-mentioned medical institution.

4. The Customer declares that s/he is aware that the level of medical treatment cost refund is regulated by the national institution financing medical benefits (hereafter called NIFMB) in the Customer’s country of residence.

5. The Customer confirms that s/he is aware of his obligation to cover the possible difference between the actual medical treatment cost and the level of final NIFMB cost refund.

§5
STATEMENTS OF THE CUSTOMER’S LEGAL REPRESENTATIVE

The Customer’s legal representative declares and guarantees the s/he is fully entitled to independently represent the Customer in actions such as registration of the Customer on the Customer Panel on www.med4eu.co.uk, as well as making statements and giving approvals in the name and on behalf of the Customer as required within the Regulations of Online Services Rendering and within the Contract for Organising Medical Treatment, especially to give and approve the processing of the Customer’s personal data, including the sensitive data as specified in the Personal Data Protection Law of 29.08.1997 (published in Journal of Laws of 2016, item 922 with later changes).

§6
Med4EU STATEMENT

Med4EU hereby states that it has the knowledge and skills necessary to prepare the Application with its Attachments, for the cross-border medical treatment cost settlement in the Customer country of residence and puts all effort to get the maximum possible cost refund for the Customer within the Contract.

§7
ORGANISATION OF TREATMENT

1. The general rules of the medical treatment organisation and of Application preparation are described on the Website.

2. The Customer may pay for the medical treatment costs with his own resources or use the loan for paying the cross-border medical treatment costs.

3. The conditions of the loan to cover the cost of cross-border medical treatment will be regulated by a separate contract.

4. The Customer chooses medical institution from the list of institutions given by Med4EU and informs Med4EU about his choice.

5. The date of visit / treatment procedure is set by the Customer with the chosen medical institution and, via the Customer Panel, the Customer informs Med4EU about this date and the dates of all following visits / tests / treatment procedures required by the diagnosis / treatment process as well as about the scope of further medical services.

6. If at any moment of the diagnosis / treatment process, the projected procedures require separate approval of the NIFMB in the Customer country of residence, then Med4EU shall inform the Customer. If the Customer starts such procedure before the NIFMB approval, he does that exclusively at his own risk.

7. Med4EU recommends that the Customer starting a cross-border health care process holds a valid European Health Insurance Card issued by his country of residence, a card that is valid for the period of cross-border health care procedures. Med4EU is not liable for any results of unexpected medical occurrence that happen during cross-border treatment.

8. After finalising a Treatment Stage, Med4EU, in co-operation with medical institution mentioned in § 7.4, prepares all medical and financial documents necessary to file the Application.

9. The Customer is obliged to submit, via the Customer Panel, the scans of documents confirming his residency and insurance, as specified in Attachment no. 1, before the visit / procedure / test initiating a Treatment Stage.

10. After each Treatment Stage or Medical Event is completed, The Customer is obliged to submit with no delay all the documents necessary to prepare Application in accordance with Attachment no. 1

11. If NIFMB in the Customer’s country of residence requires documents or information other than those specified in Attachment no. 1, at the request of Med4EU the Customer shall immediately submit all those information or documents which are demanded by NIFMB

12.If the Customer does not fulfill his obligations of § 7.9 and 10, Med4EU is not able to file the Application and carry our medical treatment cost refund in the Customer country of residence.

13. If the Customer does not comply with § 7.11, Med4EU may not able to carry our medical treatment cost refund in the Customer country of residence

14. If the Customer does not comply with § 7.9-11, Med4EU requests the Customer to submit the lacking documents within 7 days from the request date, by sending an e-mail to the Customer’s email address given in the Registration Form. If after the given 7-day period, the Customer does not submit the requested documents, which, as a result, makes filing the Application impossible, then the administrative fees or payment for the Application preparation paid by the Customer will not be returned.

§8
ENTITLEMENT FOR Med4EU

1. Under this contract, the Customer grants Med4EU the power of attorney that is exclusive and justified by the purpose and circumstances of this Contract, with the right to grant further powers of attorney, to:

–to represent the Customer in the NIFMB units to apply for the refund of the healthcare benefits cost to which the Customer is entitled due to cross-border medical treatment performed in Poland, especially to submit all applications and statements necessary to achieve the purpose of the power of attorney;

–to contact the medical institution specified in § 7.4 or any other medical institution that, at that time, renders for the Customer any medical services that are connected with the subject of this Entitlement, and to require Customer’s medical documents that are connected with the medical services, including both completed and planned treatment procedures for the Customer, as well to require medical information concerning those procedures, also those subject to medical confidentiality.

–to receive bills or invoices issued for the Customer by the medical institution specified in § 7.4 or any other medical institution that renders any medical services for the Customer, also treatment and hospital stay documents.

2. The Customer accepts that the power of attorney mentioned in § 7.1 is indispensible to perform the Contract and its withdrawal may make the Contract performance impossible.

3. Med4EU may require the Customer to confirm the Entitlement as of § 7.1 also in the form of a separate document on paper. In such case, the Customer has no right to refuse to submit such document.

§9
PAYMENT AND CONTRACT FEES

1. The Customer is obliged to pay Med4EU the Contract fees at the level of and as specified in the Price List on the Website.

2. Contract performance for the Customer starts immediately after the following fees are paid:

a. administrative fee, or

b. Application preparation fee:
i. in case the Customer was treated in a medical institution outside of the network of institutions offered by Med4eu, or
ii. in case the treatment was performed by an institution within Med4eu network, but was not coordinated by Med4eu,

at the level specified in the Price List.

3. The Customer who chose cost settlement for a Medical Episode is obliged to:

a. pay administrative fee before starting each Treatment Stage if the Customer chooses a medical institution from Med4EU network

b. pay the total of fees for preparing the Application that depend on the amount and type of Treatment Stages within the Medical Episode:
i. in case the Customer was treated in a medical institution outside of the network of institutions offered by Med4eu, or;
ii. in case the treatment was performed by an institution within Med4eu network, but was not coordinated by Med4eu.

4. The Customer is obliged to pay success fee at the level specified in the Price List, minus administrative or Application preparation fees already paid, as specified in § 9.2 and 3, within 7 days from the day of receiving an e-mail notification from Med4EU that the cost refund has been granted by NIFMB.

5. The Customer is obliged to pay the medical institution mentioned in §7.5, the difference between the medical treatment cost and the expected NIFMB cost refund level, in the form and amount specified by the medical institution. The Customer’s refusal to make such payment means s/he withdraws from the Contract.

6. The final cost settlement for possible additional payments due will be completed within seven business days from the day Med4EU receives notification on the actual cost refund for each of the medical services.

7. The forms of payment are specified in § 4.5 of the Regulations.

8. With the exception of cases specified in the Contract contents, the payment, as specified in § 9, covers all the Contract costs and Application cost, especially the cost of preparing and submitting the Application and cost translating the Attachments to the Application.

§10
LIABILITY

1. Med4EU is responsible to exercise due diligence and care for the Customer’s interests while rendering the services within that contract, at the same time maintaining high professional standards.

2. Within this Contract, Med4EU is liable exclusively for the compliance with the formal requirements, especially exclusively for the formal aspects connected with processing the Application by the competent NIFMB. Med4EU is especially not in any way liable for not granting the cost refund to the Customer for reasons other than formal and due to Med4EU.

3. Med4EU is not liable for any consequence of non-performance or improper performance of the Contract, if it was connected with occurrences due to the Customer, especially refusal or not performing of the Customer’s actions by that are indispensible to perform the Contract, especially as specified in §7.

4. If cooperation between the parties is necessary to perform a Contract clause, Med4EU is not liable for any consequences of the lack of such cooperation from the Customer.

5. Apart from other provisions of this §10, Med4EU is not in any case liable for any lost benefits on the part of the Customer.

6. Med4EU is liable for non performance or improper performance of the contract on the general basis, regulated in the Civil Code, subject to provisions of this General Contract Conditions.

7. The Customer is aware that Med4EU is not liable for the process and outcome of the Customer’s disease medical treatment in the scope in which the Customer’s loss was caused by action or lack of action of medical institution performing the Customer’s treatment or the loss is a result of giving incomplete or untrue information on the Customer’s disease. In such case, the Customer may claim damages directly from the medical institution.

§11
CLAIMS / COMPLAINTS

1. The customer may file a complaint if the services rendered within organizing by Med4EU an access to medical treatment in private medical institutions located in the Republic of Poland and carrying out cost refunding in the Customer’s country of residence, are not realised in compliance with the Regulations or the General Contract Conditions.

2. The Customer should file complaints concerning the way and quality of performing services specified in §11.1 either in writing to Med4EU mailing address: Med4EU Sp. z o.o., ul Przasnyska 11A/294, 01-756 Warszawa, or by e-mail to the address reklamacje@med4eu.com. Properly filed complaint should contain at least: the Customer’s personal data such as name, surname and address, and should point out faults and irregularities in the process of rendering services.

3. An entitled representative or an employee of Med4EU makes the assessment of the object of complaint and its validity, with 30 days from the receipt by Med4EU of a complaint that meets the requirements specified in the preceding articles.

4. If the complaint is justified, after consulting the Customer, Med4EU will decide upon the remedy to improve functioning of the Website to the status consistent with the Regulations.

§12
ONLINE SERVICES RENDERING

1. The Customer agrees to conclude the contract online in accordance with the Online Services Rendering Law of 18.07.2002 published in Journal of Law no. 2002 Item 144.1204.

2. The Customer declares that s/he has read the Regulations of Online Services Rendering and accepted its content. The Regulations of Online Services Rendering are available on www.med4eu.co.uk.

§13
CONTRACT VALIDITY

1. Making the payment specified in § 9.2 and 3 is the condition to start services rendering by Med4EU for the benefit of the Customer within this Contract. When the payment is made, Med4EU will, with no delay, forward to the Customer the confirmation of concluding the Contract for organising medical treatment. If the payment is not made by the Customer, the Contract is suspended till the payment is made.

2. The Contract is signed for an unspecified period of time.

3. Each of the Parties may terminate the Contract online with one month’s notice, under the condition that the Contract is still in effect for the Stage of Treatment that is in progress and has not been completed.

4. The Customer may terminate the Contract online by sending notice to e-mail address biuro@med4eu.com, with immediate effect, in case of non-performance or improper performance of the Contract obligations by Med4EU that has not been amended in spite of two notices sent to Med4EU requiring Med4EU to stop violating the Contract.

5. Med4EU may terminate the Contract online by sending notice via e-mail to the address given by the Customer in the Registration Form, with immediate effect, in case of non-performance or improper performance by the Customer of any of the obligations of this Contract that is not amended in spite of requesting the Customer to stop violating the Contract.

6. In cases specified in § 13.5 above, Med4EU may, at its free discretion, instead of terminating the Contract, suspend the performance of Med4EU Contract obligations until the time the Customer fulfils his obligations. Med4EU is not liable for any delays resulting from the Contract suspension per the § 13.6 of the Contract.

7. If the above-mentioned contract termination results from occurrence due to the Customer:
a. payment specified in § 9.2 or 3 is not refundable,
b. payment specified in § 9.4 will payable to Med4EU in full as regulated in §9 in spite of the Contract termination.

8. The Contract may be terminated solely in the cases regulated by applicable law, by the General Contract Conditions or due to compelling reasons.

§14
FINAL PROVISIONS

1. Any dispute arising from and connected with concluding, binding and performing of the Contract for organising medical treatment will be resolved by the court of competent jurisdiction for the seat of Med4EU.

2. In matters not regulated [by this Contract] applicable legal regulations are at force, especially the Civil Code.

Attachment no. 1
GENERAL CONTRACT CONDINTIONS OF THE CONTRACT FOR ORGANISING ACCESS TO TREATMENT IN PRIVATE MEDICAL INSTITUTIONS LOCATED IN THE REPUBLIC OF POLAND AND FOR EXECUTING TREATMENT COST REFUNDING IN THE CUSTOMER COUNTRY OF RESIDENCE

Documents confirming residency and insurance:

I. Documents confirming insurance by NIFMB:

1. England
a) Scan of National Health Service number document sent by NHS
b) Scan of the insurance card

II. Documents confirming residency:
1. England

Documents confirming residency must cover the period before and after medical treatment, and at least one of them must be dated not less than three months before or after the treatment.
At the minimum two official documents with the Customer’s name and surname and his permanent address are required:
a) The first document is a bank account statement with dates of transactions made in England before and after the medical treatment period.
b) The second document:
– council tax bill
– water, gas or power bills
– A tax document (tax assessment, statement of account, notice of coding), with the exception of P45 i P60
– Official letter from the social benefits fund confirming the right to benefits or retirement / disability benefits.

If the Customer does not have access to his bank account statement, s/he must submit three documents: at least one of the list above and two of the following:
– Driving licence
– Landline bill
– Mobile phone bill
– Real estate contract
– Legal letter confirming a real estate purchase
– Compensation document if it contains the Customers current address
– A letter form NHS
– A letter from employer