• A life threatening or accidental injury or a sudden and unexpected onset of a condition or illness which at the time of the occurrence reasonably appears to have the potential of causing immediate disability or death, or which requires the immediate action or alleviation of pain or discomfort. These illnesses or injuries require urgent medical or surgical care and attention which the Member secures immediately after the onset or as soon as the care may be made available but in any case not later than twenty four (24) hours after the onset. Heart attacks, cardiovascular accidents, poisonings, loss of consciousness or respiration and convulsions are some examples of emergency conditions.
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Are any device, medical treatment, supply or procedure which is not established or unproven, whose safety and efficacy is considered investigational. These tests/procedures shall be classified under the category of Experimental Medical Procedures in the Maxicare Service Agreement, Benefits and Coverage.