4. General records4. General records

4. General records

For each fund conducted by an insurer, the insurer must keep records that contain the following details about each policy of the fund:

1. the name, date of birth, age and principal place of residence of each person covered by the policy; and
2. which of the following the policy covers:
   1. hospital treatment;
   2. hospital-substitute treatment;
   3. chronic disease management programs;
   4. ambulance service;
   5. other general treatment; and
3. whether the policy includes any excesses or co‑payments payable; and
4. the category of policy by reference to the number of adults and dependents covered; and

Note: Subrule 3 (2) deals with the identification of ‘categories of policies’.

1. for each benefit that is paid to or on behalf of an insured person:
   1. the name of the insured person to whom the benefit relates; and
   2. the medical or health speciality for which the benefit was paid; and
   3. whether the benefit was paid for:
      1. hospital treatment; or
      2. hospital-substitute treatment; or
      3. chronic disease management program treatment; or
      4. ambulance services; or
      5. other general treatment; and
   4. if the treatment was provided in accordance with a chronic disease management program, the type of disease for which the program was provided and whether the treatment was provided as hospital treatment or general treatment; and
   5. the gross benefits paid; and
   6. the date of treatment; and
   7. the date of payment.