Capsule Limited Flare Ambulance Membership Program
Ambulance Activation means the request by a Member in case of a Serious Medical Incident for an ambulance from the Flare Platform and which may include mobilisation of a ground ambulance and/or motorcycle ambulance with the appropriate first responders.
Ambulance Service Providers means the ambulance companies that may respond to an ambulance activation request from Capsule.
Flare Emergency Operations Centre means the operations centre staffed with medical and logistics personnel utilizing Capsule’s proprietary technologies to provide the Services.
Flare Platform means the hotline, web-based browser or smart phone application owned by Capsule and provided to Members.
Intervention means all activities related to a single event of a Serious Medical Incident which may include Ambulance Activation and communications with and activities undertaken by the Flare Emergency Operations Centre.
Member means the person or persons designated as Members on the Membership Submission.
Membership Fees means the fee for subscription to the Membership.
Memberships Submission means all information provided by the Member(s) during enrollment and renewal of the Membership.
Reimbursements means any and all payments due to Capsule including payments to third parties, and any other payments, deposits, advances or guarantees made by Capsule on behalf of the Member, not included as a part of this Membership including but not limited to any fees paid to the Ambulance Service Providers, with the exception of the Membership Fee.
Serious Medical Incident means a medical condition which in the opinion of Capsule requires ambulance transport to a health facility for admission to the accident and emergency department for treatment.
Services means the services provided under “Description of Services”.
Term means the term specified in the Membership Submission.
Description of Services
a) Access to Emergency Dispatch Specialists
Members have access to emergency specialists from the Flare Emergency Operations Centre to assist in medical assessments for the member, liaisons with Ambulance Service Providers or other specialists and resources which may be required during the provision of these Services.
b) Flare Emergency Platform
Members are provided with a centralized emergency hotline short-code, web-based browser platform and/or app to connect with Flare personnel, the Flare Emergency Operations Centre and Ambulance Service Providers.
c) Flare Emergency Preparedness, Educational Information and Updates
Every member will be provided information to prepare them in the event of an emergency. This may include, but not limited to, branded information about how to prepare and handle specific emergency situations including medical emergencies such as advice on first aid kits, poisonings advice, burns and other medical emergencies as well as contact numbers and other branded information including pamphlets and apparel.
d) Emergency Message Distribution
In case of a major medical incident or emergency situation, Capsule may distribute an emergency message transmission to the Members distributed via the Flare Emergency Platform.
e) Ambulance activation
At the request of an eligible Member, either via the Flare App, direct via hotline or other communication means and in response to a Serious Medical Incident, Capsule will arrange for the activation of the Ambulance Service Provider. The Ambulance Service Provider will provide ground ambulance services including, dispatch, retrieval and transfer to a receiving facility as long as the member is within Nairobi County.
f) Active Monitoring
During an ambulance activation, Capsule will actively monitor from the point of dispatch of an Ambulance Service Provider through to pick up of Member and until the admission of the Member at a receiving facility. Capsule will as and when required contact parties involved including the Member and facility to facilitate the provision of these Services.
g) Payment of Ambulance Service Providers
Capsule has negotiated agreements with Ambulance Service Providers and utilizes them during an activation Subject to the Exceptions and Program Limitations clause of the Agreement and the Member having paid the Membership Fee, no other charges or Reimbursements will be payable by the Member.
h) Access to all Updates and Continuous Development
All updates and developments of the Flare Platform which are made by Capsule and during the Term will be made available to the Members.
i) Assistance with Documentation
Capsule may assist Members in obtaining any necessary documentation from its Ambulance Service Providers as well as any information that Capsule may have relating to the Serious Medical Incident to assist for any future medical care as well as medical insurance claims. This will be performed on a reasonable commercial efforts basis in compliance with any legislation or regulation in force.
1. Only those persons designated as Members on the Membership Submission shall be eligible for services under the Program.
2. Membership continues only for the period for which the Membership Fee has been paid.
3. Newborn children may be provided Services of the Membership, subject to the newborn’s inclusion on the Membership Submission and the Membership Fee has been paid. If born during the Membership term, the Member should notify Capsule in writing for inclusion of the newborn on the Membership Submission and eligibility for Services.
Geographic Scope of Service
The Services provided by Capsule under these Terms and Conditions are provided within the county of Nairobi. Capsule shall be under no obligation to provide the services to Members, who in the sole opinion of Capsule are located in areas that represent conditions in which providing the services is impossible, reasonably impractical or unsafe, including without limitation geographical remoteness, war (whether declared or undeclared), civil or other hostilities or political unrest.
Payment of Membership Fee
1. The Membership Fee is due and payable on or before the commencement of services. Capsule shall have no obligation to render Services unless the Membership Fee has been paid in full.
2. For Interventions which fall under the Exceptions clause of this Agreement or when the Member has exhausted benefits, the Member agrees to pay Capsule all Reimbursements which are due under or pursuant to these Terms and Conditions, within seven (7) days of the date of the Capsule invoice.
3. The Membership Fee and Reimbursements are net of any applicable withholding taxes, customs, levies, excise taxes (including without limitation value added tax, goods and services tax, use tax and sales tax), deductions or other similar charges imposed by any jurisdiction or government on Capsule or on its services.
4. The Member’s obligation to pay the Membership Fee and Reimbursements shall not be contingent upon the outcome of any insurance or third party claim.
5. The Membership Fee is nonrefundable and no partial refunds are permitted. After the commencement of the Program, the fee is considered fully earned and nonrefundable.
6. Membership programs are not transferable.
The following limitations shall apply to the Services in this Program and do not purport to limit liability or alter the Members rights under any applicable law.
1. Members are subject to a maximum cumulative limitation of KES20,000 per Member comprising a maximum of two (2) Interventions per Member per annum within the Geographic Scope of Service described in the Agreement. For the avoidance of doubt, an Intervention that occurs where the Member or other person receiving the Services has passed away will be counted as one of the Interventions under this clause.
2. Services provided under this Program come into effect 48hours after completion of the Membership Submission and payment of the Membership Fee.
The following treatment, items, conditions, activities and their related consequential expenses are excluded unless Capsule has given its prior written approval and the Member has paid the designated Fees:
1. Any services to an individual that cannot be verified as a Member or eligible to receive Members services.
2. More than two activations per Member per annum during the Term.
3. Any cost or expense not expressly covered by this Membership and not approved in advance and in writing by Capsule and/or not arranged by Capsule. This includes transport during a non-Serious Medical Incident or deceased Members and coordination of a hearse.
4. Any event occurring when the Member is outside the Geographic Scope of Service.
5. Any expense incurred for an intervention if the Member is not suffering from a Serious Medical Condition.
6. Any expense related to the Member engaging in the commission of, or the attempt to commit, an unlawful act.
7. Any expense related to a Member participating in civil unrest, terrorist or militia activity.
8. Any expense incurred as a result of the Member engaging in active service in the armed forces or police of any nation; active participation in war (whether declared or not), invasion, act of foreign enemy, hostilities, terrorist, counter-terrorist, civil war, rebellion, riot, revolution or insurrection.
Capsule, at its sole discretion, will assist Members on a fee-for-service basis for Interventions falling under the above Exceptions where the Member will pay Reimbursements to Capsule for provision of such services.
Cancellation or No-Show of Member
Where an Ambulance Activation occurs as part of an Intervention in providing the Services and either the Member or persons requesting the Services cancels the request or the ambulance arrives to the scene and the Member or person requiring the Services is not there, then the Member will be liable and this will be counted as an intervention.
The Member agrees to indemnify, defend and hold Capsule, its subsidiaries and affiliates, and their respective directors, officers and employees, harmless from and against any and all claims, suits, actions, proceedings, or liabilities of any kind, including reasonable attorney’s fees and expenses, arising out of its wrongful conduct, omission or fault.
Capsule shall not be liable for failure to provide services and/or delays caused by acts of God, strikes, or conditions beyond its control, including but not limited to, road conditions or situations where the rendering of services is prohibited or delayed by local laws, regulators or regulatory agencies. Capsule shall notify the Member of any circumstance likely to cause such failure or delay as soon as reasonably practicable.
Conduct of Others
The Member waives all claims against Capsule for any loss resulting from any advice given, services provided or any acts or omissions of any service provider including, without limitation, providers of medical services, information services and transportation and logistics services including the Ambulance Service Providers and any medical facilities who are referred by Capsule unless due to Capsule’ negligent acts or omissions, or willful misconduct.
In no event shall Capsule be liable for any incidental, special, consequential or indirect loss, damages, costs, charges, fees or expenses, including without limitation, loss of profits, loss of income, loss of business or loss of use.
Any and all legal actions and claims arising under this Program shall be barred unless written notice thereof is received by Capsule within one (1) year of the date of the event giving rise to such action or claim.
The services are compiled from sources that Capsule considers to be reliable or are expressions of opinion from its Ambulance Service Providers. Capsule has made reasonable commercial efforts to ensure the accuracy of information, however, the information is provided ‘as is’ and includes reasonable judgments in the circumstances prevailing at the time. These Terms and Conditions are entered into between the Member and Capsule, and are not intended by the parties, nor shall they be construed to, have the effect of creating or conferring any third-party beneficiary status or rights hereunder upon the Member or any other person who may be eligible for services provided under the Program.
Fraud, misstatement or concealment in the statements made by, for or on behalf of the Member prior to or when effecting the Program, or any fraudulent claim hereunder shall render the Program null and void and all benefits and services shall be forfeited.
Capsule may require Members and their immediate family to give Capsule written authorization and releases prior to rendering services under the Program.
Capsule shall be subrogated to any right or claim that the Members may have against a third party and which results in the rendering of services by Capsule under the Program.
Capsule reserves the right in its sole discretion to amend these Terms and Conditions. Any such amendment shall be effective as to the Member upon seven (7) days written notice.
The relationship shall be that of independent contractor. These terms and conditions shall not create any relationship of employment, partnership, or joint venture, between the Member and Capsule. Neither party shall have, nor represent that it has, any right or authority to bind the other to assume or create any obligation or responsibility expressed or implied on behalf of the other. The Program is not a contract of insurance nor is Capsule a fiduciary services provider or any other type of health plan, insurance administrator or financial services provider or agent of such.
The construction, validity and performance of this Agreement shall be governed in all respects by Kenyan law. Any dispute, controversy or claim arising out of or relating to this Agreement, or the breach, termination or invalidity thereof, if not settled mutually between the Parties, shall be referred to arbitration under the Rules of the Chartered Institute of Arbitrators of the United Kingdom, Kenya Branch.
It is expressly understood and agreed by the parties that the Application and Terms and Conditions are the final expression of the agreement between the parties. There are no promises, agreements, conditions or understandings, either oral or written, between them other than those that are set forth herein. It is further understood and agreed that, unless otherwise provided, no subsequent alteration, amendment, change or addition to the Program shall be binding upon Capsule unless reduced to writing and signed by an authorized representative of Capsule.
Any headings used in these Terms and Conditions are inserted solely for the convenience of reference and shall not constitute a part of these Terms and Conditions, nor shall they affect the meaning, construction or effect.
All notices hereunder shall be given to Capsule to the address set forth below and to the Member at the address set forth in the Application. Digital and soft copy notices and signatures are acceptable under these Terms and Conditions and shall be effective when received by the addressee.
PO Box 2087, Nairobi Kenya 00606