Rules

  1. Application for membership of the scheme is open to former and serving police officers and police staff, their spouses/partners and dependent children up to the age of 21 (or 24 if in full time education) and any other person that the Management Committee may, in their absolute discretion, admit.
  2. The admission of any person to the scheme is in the absolute discretion of the Management Committee.
  3. Membership of the scheme does not create an entitlement to benefits, which remain at the absolute discretion of the Management Committee.
  4. The benefit paid shall be limited to admissible expenses, for pre-authorised procedures, after allowing for claims or refunds receivable from any other organisation or under any insurance policy or recoverable as damages.
  5. Payment of benefit is normally made direct to the provider of treatment. Invoices must be submitted within 28 days of receipt by member.
  6. Members and/or their dependants are required to notify the Fund Managers on behalf of the Management Committee of any expenses which relate to a claim upon the Fund which may be recoverable from third parties. In the event that such action is successful and the monies paid to the claimant, the claimant will be required to reimburse the Fund for any admissible expenses paid by the Fund.
  7. Contribution rates for Fund membership shall be prescribed from time to time by the Management committee and shall be paid by members of the Fund by instalments and in such manner as the Management Committee shall require.
  8. Changes to rates for Fund membership will be notified to fund members.
  9. Failure to pay any instalment of the contribution due within 30 days of the due date, shall render membership null and void and any entitlement to benefit shall be forfeit.
  10. Terminology used by TriCare is defined as set out under Definitions.
  11. What is Covered by the Scheme, and What is Not Covered by the Scheme are set out on separate pages.
  12. Should the Fund be terminated, then any surplus monies remaining in the Fund after due regard for settlement of all outstanding claims will be distributed to the membership as defined on the date of termination in such shares and proportion as shall be decided upon by the Management Committee.
  13. The right is reserved to alter these rules of membership and the accompanying Benefit Schedule at any time. Any such alterations shall not affect benefit for an eligible, notified claim where the claim has been admitted by the Fund Managers prior to the date of the said alterations.
  14. Members wishing to leave the scheme must give one month’s notice in writing to the Tricare Office.
  15. Existing members of the scheme who make their home in another EU country may remain in the scheme and obtain treatment in their country of residence providing that it costs the scheme no more than it would have cost at the preferred provider facility in the UK. Members will be responsible for any additional expense. Claims made by members living abroad will be subject to an administration fee of £100.