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Discretionary payments
Sometimes, in certain situations, we may pay for treatment you have received which is outside the terms of your cover. This is called a discretionary or ex-gratia payment. Any payment that we may make on this basis will still count towards the maximum limits of your membership. If you receive a discretionary payment like this, it does not mean that we are required to pay similar costs in the future.
We are not required to pay for any treatment or condition that is not covered by your plan, even if we have paid an earlier claim for similar or identical treatments or conditions.