Updated May 3, 2006
PRE-EXISTING MEDICAL CONDITION EXCLUSION WAIVER
|
Coverage: |
|
|
Trip Cancellation and Interruption |
Vacation Package Cost |
|
Travel Delay ($100 per day) |
$500 Maximum |
|
Baggage and personal effects |
$1,000 |
|
Baggage Delay |
$100 |
|
Missed Connection |
$500 |
|
Medical Expense |
$25,000 |
|
Emergency Medical Transportation |
$100,000 |
|
Accidental Death and Dismemberment |
$25,000 |
|
Travel Guard Assistance |
Included |
|
Live Travel support |
Included |
If insurance is purchased within 24 hours of
initial Trip payment, the Pre-Existing Medical Condition Exclusion will be
waived. This is applicable to all coverages contained in the policy. The Insured
must be medically able to travel when you pay your premium. In the event a claim
is filed, the Injury or illness must be substantiated to our Claims Department.
IMPORTANT: Exclusions apply to certain medical conditions.
For coverage questions or to request a claim form, call
toll-free 1.866.385.4839. For emergency help while on your Trip, see the
information and phone numbers mentioned above.
Blanket Travel Accident Insurance
This document describes the benefits and basic
provisions of the policy. You should read it with care so you will understand
the coverage. The policy is the only contract under which benefits are paid.
Insurance Coverage
Underwritten by the National Union Fire Insurance
Company of Pittsburgh, PA, a member of the AIG Companies ®, with its principal
place of business at 70 Pine Street, New York, New York 10270. It is currently
authorized to transact business in all states and the District of Columbia. NAIC
No. 19445.
This is only a brief description of the insurance
coverage(s) available under policy series T30253NUFIC. The Policy contains
reductions, limitations, exclusions, and termination provisions. Full details of
the coverage are contained in the Policy. If there are any conflicts between
this document and the Policy, the Policy shall govern.
Coverage is valid only if premium has been paid -
PRODUCT NUMBER: 007715-P1 2/05 - In the event of a claim, please refer to the
above Product Number.
Individual Eligibility, Effective & Termination Dates
Persons eligible for insurance under the policy are any
travelers who purchase
coverage through the Travel Supplier, accepts, enrolls and pays the premium for
coverage providing they have not already departed on their Trip.
Effective Date:
Trip Cancellation benefit will be effective at 12:01
a.m. on the
day after the premium is paid to the Travel Agent. All other coverages will
begin on the later of: (a) the date and time the Insured starts his/her Trip, or
(b) the scheduled Contracted Departure Date shown on the enrollment form.
Termination Date:
All coverage ends on the earliest of: (a) the date the
Trip is
completed; (b) the scheduled Contracted Return Date; (c) the Insured’s arrival
at the Return Destination on a round Trip, or the Destination on a one-way Trip;
or (d) cancellation of the Trip covered by the policy. The policy covers Trips
up to 180 days in length.
Extension of Coverage:
All coverage under the policy will be extended, if: (a)
the
Insured’s entire Trip is covered by the policy; and (b) the Insured’s return is
delayed by unforeseeable circumstances beyond his/her control. If coverage is
extended for the above reasons, coverage will end on the earlier of: (a) the
date the Insured reaches his/her Return Destination; or (b) seven (7) days after
the date the Trip was scheduled to be completed.
General Exclusions
These exclusions apply to all benefits. In addition to
any exclusions which apply to a particular benefit (called “Additional
Exclusions”), the policy does not cover loss caused by: (a) suicide, or
attempted suicide, or intentionally self-inflicted Injury or any attempt at
intentionally self-inflicted Injury by the Insured, Immediate Family
Member, Traveling Companion or Business Partner (while sane, in Colorado and
Missouri); (b) pregnancy or childbirth, or elective abortion, other than
Complications of Pregnancy; (c) professional athletic events, motor sport, or
motor racing, including training or practice for the same; (d) mountain
climbing; (e) war or act of war, whether declared or not, civil commotion,
insurrection or riot; (f) military duty or service; (g) operating or learning to
operate any aircraft, as student, pilot or crew; (h) air travel on any
air-supported device, other than a regularly scheduled airline or air charter
company; (i) loss or damage caused by detention, confiscation, or destruction by
customs; (j) any unlawful acts, committed by the Insured, a Traveling Companion,
or an Immediate Family Member, whether insured or not; (k) mental,
psychological, or nervous
disorders including, but not limited to, anxiety, depression, neurosis, or
psychosis; (l) if the Insured’s tickets do not contain specific travel dates
(open tickets); (m) alcohol or substance abuse or treatment for same; (n)
medical treatment during or arising from a Trip undertaken for the purpose or
intent of securing medical treatment or traveling expressly for the purpose of
obtaining medical treatment; (o) elective or non-emergency treatment or surgery,
except for any necessary treatment or surgery due to covered Injury; (p)
Experimental or Investigative treatment or procedures; or (q) an Injury or
Sickness which occurs at a time when this coverage is not in effect.
PRE-EXISTING MEDICAL CONDITION - EXCLUSION APPLICABLE
TO ALL COVERAGES
The Insurer will not pay for loss or expense incurred as
the result of an Injury, Sickness or other condition of the Insured, a Traveling
Companion, or an Immediate Family Member of the Insured or Traveling Companion
which, within the 60 day period before the Insured's coverage began: (a) first
manifested itself, worsened, became acute, or had symptoms which would have
prompted a reasonable person to seek diagnosis, care or treatment; (b) required
taking prescribed drugs or medicine, unless the condition for which the
prescribed drug or medicine is taken remains controlled without any change in
the required prescription; or (c) required treatment by a Physician or treatment
had been recommended by a Physician.
MAXIMUM LIMIT OF LIABILITY:
All limits are applied per Trip. The Insurer’s maximum
limit of liability resulting from the same occurrence will be $10,000,000 under
the Travel Guard Policies Underwritten by National Union. If loss for all
Insureds from such an occurrence exceeds $10,000,000, the Insurer will pay each
Insured that proportion of the Benefits stated which $10,000,000 bears to the
total loss of all persons the Insurer insures under all travel and flight
insurance in force, under the Travel Guard Policies Underwritten by National
Union. The Insurer will pay no more than $250,000 per occurrence, under the
Travel Guard Policies Underwritten by National Union, to or on account of any
person insured under the Travel Guard Policies Underwritten by National Union.
Trip Cancellation and Interruption
The Insurer will pay this benefit up to the Maximum
Limit shown on the Schedule of Benefits if a Trip is canceled or interrupted due
to any of the following unforeseen reasons: (a) Sickness, Injury, or death of an
Insured, Immediate Family Member, Traveling Companion, or Business Partner.
Injury or Sickness must be so disabling as to reasonably cause a Trip to be
delayed, canceled, or interrupted; (b) Inclement Weather conditions causing
delay or cancellation of travel; (c) the Insured’s principal residence being
made uninhabitable by fire, flood, or similar Natural Disaster, vandalism, or
burglary; (d) the Insured being subpoenaed, required to serve on jury duty,
hijacked, or quarantined; (e) being involved in or delayed due to an automobile
accident en route to departure; (f) Strike, resulting in the complete cessation
of travel services
at the point of departure or Destination. This coverage does not cover loss
caused by: (i) carrier-caused delays including an announced, organized,
sanctioned labor union Strike that affects public transportation, unless the
Insured’s coverage effective date is prior to when the Strike is foreseeable. A
Strike is foreseeable on the date labor union members vote to approve a Strike;
(ii) travel arrangements canceled or changed by an airline, cruise line, or tour
operator, unless the cancellation is the result of a Natural Disaster; (iii)
changes in plans by the Insured, an Immediate Family Member, or Traveling
Companion, for any reason; (iv) financial circumstances of the Insured, an
Immediate Family Member, or a Traveling Companion; (v) any business or
contractual obligations of the Insured, an Immediate Family Member or a
Traveling Companion;
(vi) Default by the person, agency, or tour operator from whom the Insured
bought his/her coverage or purchased his/her travel arrangements; (vii) any
government regulation or prohibition; (viii) an event or circumstance which
occurs prior to the Insured’s coverage effective date.
Trip Cancellation Benefits:
The Insurer will pay this benefit up to the Maximum
Limit shown on the Schedule of Benefits for Trips that are delayed or canceled
before the scheduled Contracted Departure Date. The Insurer will pay forfeited,
non-refundable, unused prepaid payments or deposits if the Insured’s Trip is
canceled due to the reasons shown at the beginning of this section.
The Insurer will pay the Insured’s additional cost as a result of a change in
the per-person occupancy rate for prepaid travel arrangements if a Traveling
Companion’s Trip is canceled due to reasons shown at the beginning of this
section, and the Insured’s Trip is not canceled.
Trip Interruption Benefits:
The Insurer will pay this benefit up to the Maximum
Limit shown on the Schedule of Benefits for Trips that have been interrupted or
delayed, due to the reasons shown at the beginning of this section. The Insurer
will pay for the following: (a) unused prepaid payments or deposits for the
Insured’s Trip if the Insured’s Trip is interrupted; or (b) additional
transportation expenses incurred by the Insured, either (i) to the Return
Destination; or (ii) from the place that the Insured left the Trip to the place
that the Insured may rejoin the Trip; (c) additional transportation expenses
incurred by the
Insured to reach the original Trip Destination if the Insured is delayed, and
leaves after the Contracted Departure Date. However, the benefit payable under
(b) and (c) above will not exceed the cost of economy airfare (or first class if
the Insured’s original tickets were first class) by the most direct route, less
any
refunds paid or payable; (d) the Insured’s additional cost as a result of a
change
in the per-person occupancy rate for prepaid travel arrangements if a Traveling
Companion’s Trip is interrupted, and the Insured’s Trip is continued.
Travel Delay
The Insurer will reimburse up to $100 a day to the
Maximum Limit shown on the Schedule of Benefits if the Insured’s Trip is delayed
for 12 or more hours for Reasonable Additional Expenses until travel becomes
possible. Incurred expenses must be accompanied by receipts. This benefit is
payable for only one delay per Insured, per Trip. Travel Delay must be caused
by: (a) carrier delay; or (b) lost or stolen passport, travel documents, or
money; or (c) quarantine; or (d) Natural Disaster; or (e) Injury or Sickness of
the Insured or Traveling Companion.
LOSS OF BAGGAGE AND PERSONAL EFFECTS
The Insurer will reimburse up to the Maximum Limit shown
on the Schedule of Benefits. The Insurer will pay for loss, theft, or damage to
the Insured’s Baggage, passports, and visas during the Insured’s Trip. The
Insurer will also pay for loss due to unauthorized use of the Insured’s credit
cards, if the Insured has complied with all credit card conditions imposed by
the credit card companies.
Continuation of Coverage: If the covered Baggage,
passports, and visas are in the charge of a charter or Common Carrier, and
delivery is delayed, this coverage will continue until such property is
delivered to the Insured. This coverage does not include loss caused by the
delay.
Property Not Covered: The Insurer will not pay
for damage or loss of: (a) animals; (b) property used in trade, business, or for
the production of income; (c) motor vehicles, aircraft, and other conveyances;
(d) artificial limbs, false teeth, any type of eyeglasses, sunglasses, contact
lenses, or hearing aids; (e) tickets, except for administrative fees required to
reissue tickets; (f) money, stamps, stocks and bonds, postal or money orders;
(g) property shipped as freight, or shipped prior to the Contracted Departure
Date; (h) credit cards, except as noted above; (i) contraband.
Special Limitation: The Insurer will not pay more
than $500 for the first item and, thereafter, no more than $250 per item up to
the limit of coverage as shown in the Schedule of Benefits. Items over $150
should be accompanied by original receipts. If receipts are not provided,
benefits may be reduced.
Additional Exclusions: In addition to the General
Exclusions, the Insurer will not pay this benefit for loss due to: (a) defective
materials or craftsmanship; or (b) normal wear and tear; or (c) deterioration;
or (d) rodents, animals, or insects.
Payment of Loss: The Insurer will pay, the lesser
of, cash value (original cash value) less depreciation determined by the Insurer
or replacement. The Insurer will notify the Insured within 30 days after the
Insurer receives his/her proof of loss. The Insurer may take all or part of the
damaged Baggage at the appraised or agreed value. In the event of a loss to a
pair or set of items, the Insurer may at the Insurer’s option: (a) repair or
replace any part to restore the pair or set to its value before the loss; or (b)
pay the difference between the value of the property before and after the loss.
BAGGAGE DELAY
The Insurer will reimburse incurred expenses up to the
Maximum Limit shown on the Schedule of Benefits for Baggage which is delayed or
misdirected more than 24 hours for the cost of necessary personal effects.
Incurred expenses must be accompanied by receipts. This
does not apply if Baggage is delayed after the Insured reaches his/her Return
Destination.
MEDICAL EXPENSE BENEFIT
The Insurer will pay this benefit, up to the Maximum
Limit shown on the Schedule of Benefits. The Insurer will pay for medical
expenses incurred by the Insured within one year from the date of Injury or
Sickness provided initial treatment was received during the Trip. The Injury
must occur or Sickness must begin while the Insured is covered by the policy.
Covered Expenses: The Insurer will pay the
Insured’s Reasonable and Customary Charges for medical and surgical expenses.
The Insurer will pay emergency dental treatment only during a Trip. Dental
coverage does not apply if treatment or expenses are incurred after the Insured
has reached his or her Destination, in the case of a one-way ticket, or Return
Destination regardless of the reason. The
treatment must be given by a Physician or dentist. The Insurer will pay for
professional nursing, Hospital charges, X-ray, ambulance services, and
prosthetic devices. If the Insured is covered by any other group, blanket
health, accident insurance, or assistance plan, and would, as a result, receive
total benefits in excess of the
expenses actually incurred, the benefits will be reduced by such excess.
Additional Exclusions: In addition to the General
Exclusions, coverage is not provided for: (a) routine physical examinations; (b)
replacement of hearing aids, eye glasses, contact lenses, sunglasses, and
artificial teeth; (c) routine dental care; (d) any service provided by the
Insured, an Immediate Family Member or
Traveling Companion.
Payment of Loss: The Insured must provide the
Insurer with: (a) all medical bills and reports for medical expenses claimed;
and (b) a signed patient authorization to release medical information to the
Insurer. Make sure you call Travel Guard (1.866.385.4839 or 1.715.295.5452)
before you seek medical care while traveling. Where available, we can arrange
direct payment to a member of our Preferred medical network, saving you the time
and paperwork associated with reimbursement of medical expenses. Our assistance
coordinators also can help you locate the nearest and most appropriate medical
provider, monitor your care, and provide updates to your family and/or employer.
EMERGENCY MEDICAL TRANSPORTATION
The Insurer will pay this benefit up to the Maximum
Limit shown on the Schedule of Benefits. Travel Guard Assist will arrange for
emergency medical transportation services required by the Insured as the result
of an Injury or emergency Sickness during a Trip.
Covered Expenses: The Insurer will pay: (a)
Reasonable and Customary Charges for medical services required for evacuation to
the nearest adequate medical facility or home if medically required. This
service will be arranged only if the Insured’s Physician determines that
adequate medical treatment is not locally
available; (b) up to $5,000 for reasonable and necessary charges for escort
expenses required by Insured, if the Insured is disabled during a Trip, and an
escort is recommended, in writing, by the attending Physician; (c) reasonable
and necessary charges for services for transportation of the Insured’s remains
to his/her place of residence if he/she dies during a Trip. Services must be
provided by a provider designated by Travel Guard Assist.
Additional Benefit: In addition to the above
Covered Expenses, if the Insurer has previously evacuated an Insured to a
medical facility, the Insurer will pay his/her airfare costs from that facility
to the Insured’s Return Destination, within one year from the Insured’s original
Contracted Return Date, less refunds from the Insured’s unused transportation
tickets. Airfare costs will be economy, or first class if the Insured’s original
tickets are first class. This benefit is available only if it is not provided
under another coverage in the policy.
Additional Exclusions: In addition to the General
Exclusions, the Insurer also will not pay for services arranged without the
Insurer’s prior consent or approval. Timely notification by the Insured to the
Insurer’s designated provider is required, with regard to Emergency Evacuation.
ACCIDENTAL DEATH AND DISMEMBERMENT
The Insurer will pay this benefit up to the Maximum
Limit shown on the Schedule of Benefits if: (a) the Insured is Injured in an
accident which happens while he or she is on a Trip and covered under the
Policy; and (b) he or she suffers one of the losses listed below, within 180
days of the accident. The Principal Sum is shown on the Schedule of Benefits.
|
Loss:
Percentage of Principal Sum Payable |
| Life |
100% |
| Both hands or feet, or sight of both eyes |
100% |
| One hand and one foot |
100% |
| One hand or one foot and sight of one eye |
100% |
| Speech and Hearing in Both Ears |
100% |
| One hand |
50% |
| One foot |
50% |
| Sight of One Eye |
50% |
If the Insured suffers more than one loss from an
accident, the Insurer will pay only for the loss with the larger benefit. The
Insurer will not pay more than 100% of the principal sum for all losses due to
the same accident.
Loss of a hand or foot means complete severance at or
above the wrist or ankle joint. Loss of sight of an eye means complete and
irrecoverable loss of sight.
Speech or hearing means entire and irrecoverable loss of
speech or hearing in both ears.
Disappearance: If the Insured’s body is not found
within one year of the disappearance, forced landing, stranding, wrecking, or
sinking of a conveyance in which he/she was an occupant, he/she will be presumed
dead.
Additional Exclusion: In addition to the General
Exclusions, the Insurer will not pay for loss caused by or resulting from
Sickness or disease of any kind.
OPTIONAL RENTER'S COLLISION INSURANCE
The Insurer will pay this benefit up to the Maximum
Limit shown on the Schedule of Benefits subject to a $250 deductible. Coverage
does not apply in countries or states where the sale of this insurance is
prohibited by law. If the Insured rents a car while on his/her Trip, and
the car is damaged due to collision, vandalism, windstorm, fire, hail or flood,
while in his/her possession, the Insurer will pay the lesser of: (a) the cost of
repairs and rental charges imposed by the rental company while the car is being
repaired; or (b) the Actual Cash Value of the car.
Coverage is provided to the Insured and Traveling
Companion, providing the Insured and Traveling Companion are licensed drivers,
and are listed on the rental agreement. This coverage is primary to other forms
of insurance or indemnity.
In addition to the General Exclusions, coverage is not
provided for loss due to: (a) any loss which occurs if the Insured or his/her
Traveling Companion is in violation of the rental agreement; (b) rentals of
trucks, campers, trailers, off-road vehicles, motor bikes, motorcycles,
recreational vehicles, or Exotic Vehicles; (c) any obligation the Insured or his
or her Traveling Companion assumes under any agreement except insurance
collision deductible; (d) failure to report the loss to the proper local
authorities and the rental car company; (e) damage to any other vehicle,
structure, or person as a result of a covered loss; (f) participation in
contests of speed, motor sport or motor racing including training or practice
for the same; (g) driving under the influence of alcohol; (h) being under the
influence of drugs or intoxicants, unless prescribed by a Physician; (i) war or
act of war, whether declared or not, civil commotion, insurrection or riot; (j)
any unlawful acts, committed by the Insured, Immediate Family Member, or a
Traveling Companion, whether insured or not; (k) Injury sustained while
committing or attempting to commit a crime.
The Insured’s Duties in the Event of Loss: The
Insured must: take all reasonable, necessary steps to protect the vehicle and
prevent further damage to it; report the loss to the appropriate local
authorities and the rental company as soon as possible; obtain all information
on any other party involved in an accident, such as name, address, insurance
information, and driver’s license number; and provide the Insurer all
documentation such as rental agreement, police report, and damage estimate.
PAYMENT OF CLAIMS
Claim Procedures: Notice of Claim: The Insured
must call Travel Guard as soon as reasonably possible, and be prepared with what
coverage the loss was under (i.e., Medical Expense), the name of the company
that arranged the Trip (i.e., tour operator, cruise line, or charter operator),
the Trip dates and the amount that the Insured paid. Travel Guard will complete
the claim form and send it to the Insured for his/her review/signature. The
completed form should be returned to Travel Guard Group, Inc., 1145 Clark
Street, Stevens Point, Wisconsin. 54481 (Telephone: 1.715.295.5452 or
1.866.385.4839). All claims of California residents will be administered by
Mercury Claims Administrator Services, LLC. All accident, health, and life
claims will be administered by Mercury Claims & Assistance of WI, LLC, in those
states where it is licensed.
Claim Procedures: Proof of Loss: The claim forms
must be sent back to Travel Guard no more than 90 days after a covered loss
occurs or ends, or as soon after that as is reasonably possible. All claims
under the coverage must be submitted to Travel Guard no later than one year
after the date of loss or insured occurrence or as soon as reasonably possible.
If Travel Guard has not provided claim forms within 15 days after the Notice of
Claim, other proofs of loss should be sent to the Insurer by the date claims
forms would be due. The proof of loss should include written proof of the
occurrence, type and amount of loss, the Insured’s name, the participating
organization name, and the policy number.
Payment of Claims: When Paid: Claims will
be paid as soon as Travel Guard receives complete proof of loss and verification
of age.
Payment of Claims: To Whom Paid: Benefits paid on
account of an Insured’s death will be paid to: 1) his/her spouse, if living; 2)
if not, in equal shares to his/her living children; 3) if there are none, in
equal shares to his/her living parents; 4) if there are none, in equal shares to
his/her living brothers and sisters; 5) if there are none, to his/her estate.
If a benefit is payable to the Insured’s estate, or to a
minor or other person who is incapable of giving a valid release, the Insurer
may pay up to $1,000 to a relative by blood or connection by marriage who has
assumed care or custody of the minor or responsibility for the incompetent
person’s affairs. Any payment the Insurer makes in good faith fully discharges
the Insurer to the extent of that payment. All other benefits will be payable to
the Insured.
Benefits for Medical Expense/Emergency Medical
Transportation Services may be payable directly to the provider of the
services. However, the provider: a) must comply with the statutory provision for
direct payment, and b) must not have been paid from any other sources.
Problems with your insurance? If so, do not
hesitate to contact Travel Guard to resolve your problem at 1145 Clark Street,
Stevens Point, WI 54481, or call 1.866.385.4839.
General Provisions
Acts of Agents – No agent or any person or entity
has authority to accept service of the required proof of loss or demand
arbitration on the Insurer’s behalf nor to alter, modify, or waive any of the
provisions of the policy.
Autopsy – The Insurer at its own expense, may
require an autopsy where permitted by law.
Concealment or Fraud – The Insurer does not
provide coverage for the Insured if the Insured has intentionally concealed or
misrepresented any material fact or circumstance relating to the policy or
claim.
Insurer’s Recovery Rights – In the event of a
payment under the policy, the Insurer is entitled to all rights of recovery that
the Insured, or the person to whom payment was made, has against another. The
Insured must sign and deliver to the Insurer any legal papers relating to that
recovery, do whatever is necessary to help the Insurer exercise those rights,
and do nothing after the loss to harm the Insurer’s rights. When an Insured has
been paid benefits under the policy but also recovers from another policy, the
amount recovered from the other policy shall be held in trust for the Insurer by
the Insured and reimbursed to the Insurer the extent of the Insurer’s payment.
The provision does not apply in North Carolina.
Legal Actions – No one may sue for benefits less
than 60 days after due proof of loss is submitted, nor more than 3 years (or the
minimum period of time permitted by state law, if greater) after the date claim
forms are due.
Payment of Premium – Coverage is not effective
unless all premium due has been paid to Travel Guard prior to a date of loss or
insured occurrence.
Termination of the Policy – Termination of the
policy will not affect a claim for loss which occurs while the policy is in
force.
Transfer of Coverage - Coverage under the policy
cannot be transferred by the Insured to anyone else.
Notice to California residents: The plan contains
disability insurance benefits or health insurance benefits, or both, that only
apply during your covered Trip. You may have coverage from other sources that
already provides you with these benefits. You should review your existing
policies. If you have any questions about your current coverage, call your
insurer or health plan.
Notice to Florida residents: The benefits
of the Policy providing your coverage are governed primarily by the law of a
state other than Florida.
Notice: Your homeowners policy, if any, may provide
coverage for loss of personal effects provided by any Baggage/Personal Effects
coverage provided by this policy. This insurance is not required in connection
with the Insured's purchase of travel tickets.
The definition of “Hospital” applicable to residents of
Florida is as follows: Hospital means a facility that: (1) is operated
according to law for the care and treatment of injured people; (2) has organized
facilities for diagnosis and surgery on its premises or in facilities available
to it on a prearranged basis or is accredited by the Joint Commission on the
Accreditation of Hospitals, the American Osteopathic Association, or the
Commission on the Accreditation of Rehabilitative Facilities; (3) has 24 hour
nursing service by registered nurses (R.N.'s); and (4) is supervised by one or
more Physicians. A Hospital does not include: (1) a nursing,
convalescent or geriatric unit of a hospital when a patient is confined mainly
to receive nursing care; (2) a facility that is, other than incidentally, a rest
home, nursing home, convalescent home or home for the aged; nor does it include
any ward, room, wing, or other section of the hospital that is used for such
purposes; or (3) any military or veterans hospital or soldiers home or any
hospital contracted for or operated by any national government or government
agency for the treatment of members or ex-members of the armed forces.
The Legal Actions provision applicable to residents of
Florida is as follows: No action at law or in equity may be brought to recover
on this Policy prior to the expiration of 60 days after written proof of loss
has been furnished in accordance with the requirements of this Policy. No
such action may be brought after the expiration of 5 years after the time
written proof of loss is required to be furnished.
Exclusion (j) does not apply to residents of Florida.
For inquiries, information about coverage or for
assistance in resolving complaints call: 1.866.385.4839.
Notice to North Carolina residents: In
North Carolina, insurance is underwritten by National Union Fire Insurance
Company of Pittsburgh, PA, on Policy series 52735MO.
Notice to Texas residents: The policy may
provide a duplication of coverage already provided by your personal auto
insurance, homeowner’s, personal liability policy, or other source of coverage.
AIG COMPANIES
Travel Guard Assist
All benefits provided are non-insurance services, not
insurance benefits. Any costs associated with benefits not purchased will be
paid by the named Insured.
24-HOUR MEDICAL ASSISTANCE
24-Hour Medical Monitoring: Physicians monitor
the Insured’s condition by maintaining close contact with the attending
Physicians, his/her family Physician, and Immediate Family Members.
Medical Evacuation: Arrangements for any and all
means necessary to transport the Insured back home when Medically Necessary.
Emergency Medical Payments: If a Hospital demands
a cash deposit or settlement prior to leaving, Travel Guard will assist in
arranging the advancement of funds to cover on-site medical expenses.
Prescription Assistance: Replacement of lost or
stolen medication, through a local pharmacy or special courier.
Transportation of Dependents: In the event of
hospitalization, arrangements will be made for unattended minors traveling with
the Insured to be flown home.
Family Visit: If the Insured is hospitalized for
ten or more days, Travel Guard will arrange transportation for an Immediate
Family Member or close friend to visit him/her.
Transportation of Mortal Remains: In the event of
death while traveling, arrangements for the return of remains to the place of
burial.
24-HOUR LEGAL ASSISTANCE
In a legal emergency, referral to a local legal advisor,
and advance of funds for bail and legal fees.
24-HOUR TRAVEL ASSISTANCE
Travel Documents Assistance: Travel Guard will
help retrieve, report, and reissue lost or stolen travel documents.
Emergency Cash Transfer: Travel Guard will,
whenever possible, coordinate with the Insured and a wire agency, in obtaining
funds in local currency for medical or travel emergencies.
Emergency Message Center: Transmission of
emergency messages to family and business associates.
Interpretation Services: Travel Guard provides
emergency language support or referral to the appropriate local services.
24-HOUR LIVETRAVEL ASSISTANCE
Provides 24-hour assistance for emergency travel needs.
Allows you to make emergency travel changes such as rebooking flights, making
hotel reservations, tracking lost luggage, and replacing lost credit cards. Call
1.800.826.8597 for assistance.
LIVE MESSAGING
Relay of e-mail or phone message to family, friends, or
business associates.
EMERGENCY CASH TRANSFER
Assistance in coordinating an emergency cash advance.
PRE-TRIP TRAVEL ADVICE
Around-the-clock access to passport, visa, inoculation,
and vaccine requirements; travel advisories; embassy and consulate contacts;
travel health advisories; weather and currency information all for the Insured’s
planned Destination.
*Non-insurance services through Travel Guard
Assist are provided by Travel Guard
Program fees are non-refundable.
INSURE AMERICA ® a division of Travel Guard
International
When calling from the U.S., 1.866.385.4839.
When calling from abroad, call collect 1.715.295.5452.
LiveTravel 24-Hour Assistance, Pre-Trip Advice, Live
Messaging: 1.800.826.8597
We will coordinate your assistance needs with the
appropriate TGA Center.
Benefits are payable up to the amount of coverage in the
insurance policy provided through TRAVEL GUARD ® and/or INSURE AMERICA ®.
Failure to call TRAVEL GUARD ® Assist may invalidate any payments applicable on
your claim. TGA shall not be responsible for the availability, quality, or
results of any medical treatment or the failure of the insured person to obtain
medical treatment. 007715-CT P1 2/05 ©TRAVEL GUARD ®
International 3/05
Notice to State of Washington Residents:
This is not your insurance policy. To obtain your
state-specific insurance policy, visit
www.insureamerica.com, or call 1.715.346.0860.
Definitions
“Baggage” means luggage and personal possessions,
whether owned, borrowed,
or rented, taken by the Insured on the Trip.
“Business Partner” means an individual who a) is
involved with the Insured or the Insured’s Traveling Companion in a legal
partnership; and b) is actively involved in the daily management of the
business.
“Common Carrier” means any conveyance operated under a
license for the transportation of passengers for hire.
“Complication of Pregnancy” means a condition in which
the diagnosis is distinct from pregnancy but adversely affected or caused by
pregnancy. It does not include any condition associated with the management of a
difficult pregnancy not consisting of a classifiably distinct Complication of
Pregnancy.
“Contracted Departure Date” means the date on which the
Insured is originally scheduled to leave on his/her Trip.
“Contracted Return Date” means the date on which the
Insured is scheduled to return to the point where the Trip started, or to a
different specified Return Destination.
“Default” means any failure of a provider of
travel-related services (including any tour operator) to provide the
bargained-for travel services or to refund money due the Insured.
“Destination” means the place where the Insured expects
to travel on his/her Trip.
“Experimental or Investigative“ means treatment, a
device or prescription medication which is recommended by a Physician, but is
not considered by the medical community as a whole to be safe and effective for
the condition for which the treatment, device or prescription medication is
being used, including any treatment, procedure, facility, equipment, drugs, drug
usage, devices,
or supplies not recognized as accepted medical practice, and any of those items
requiring federal or other governmental agency approval not received at the time
services are rendered.
“Hospital” means a place that: (a) holds a valid
license; (b) is run mainly for the care and treatment of sick or injured persons
as inpatients; (c) has a staff of one or more Physicians available at all times;
(d) provides 24-hour nursing service and has at least one registered nurse on
duty at all times; (e) has organized diagnostic and surgical facilities, either
on the premises or on a contract
basis with another Hospital; and (f) is not mainly a clinic, or facility for
nursing, rest or convalescence, or a place for the aged.
“Immediate Family Member” means a person’s spouse,
child, spouse’s child,daughter-in-law, son-in-law, brother, sister, mother,
father, grandparents, grandchild, step-brother, step-sister, step-parents,
parents-in-law, brother-in-law, sister-in-law, aunt, uncle, niece, nephew, legal
guardian, or legal ward.
“Inclement Weather” means any severe weather condition
which delays the scheduled arrival or departure of a Common Carrier.
“Injury” means a bodily Injury caused by an accident
occurring while this Policy is in force as to the Insured whose Injury is the
basis of a claim, and resulting directly and independently of all other causes
of loss covered by this Policy. The Injury must be verified by a Physician.
“Insured” means the person named on the individual
Enrollment Form.
“Insurer” means National Union Fire Insurance Company of
Pittsburgh, PA.
“Medically Necessary” means that a treatment, service or
supply: (1) is essential for diagnosis, treatment, or care of the Injury or
Sickness for which it is prescribed or performed; (2) meets generally accepted
standards of medical practice; (3) is ordered by a Physician and performed under
his or her care, supervision, or order; and (4) is not primarily for the
convenience of the Insured, Physician, other providers, or any other person.
“Natural Disaster” means a flood, hurricane, tornado,
earthquake, or blizzard that is due to natural causes.
“Physician” means a licensed practitioner of the healing
arts, acting within the scope of his/her license. The treating Physician may not
be the Insured, Immediate Family Member of the Insured or the Insured’s spouse
or a Traveling Companion, Traveling Companion, or Business Partner.
“Reasonable Additional Expenses” means any expenses for
meals and lodging which were necessarily incurred as the result of a Trip
Interruption or Travel Delay and which are not provided by the Common Carrier or
any other party free of charge.
“Reasonable and Customary Charges” means an expense
which: (a) is charged for treatment, supplies or medical services Medically
Necessary to treat the Insured’s condition; (b) does not exceed the usual level
of charges for similar treatment, supplies, or medical services in the locality
where the expense is incurred; and (c) does not include charges that would not
have been made if no insurance existed. In no event will the Reasonable and
Customary Charges
exceed the actual amount charged.
“Return Destination” means the place to which the
Insured expects to return from his/her Trip.
“Sickness” means an illness or disease which requires
treatment by a
Physician.
“Strike” means a stoppage of work (a) announced,
organized, and sanctioned by a labor union and (b) which interferes with the
normal departure and arrival of a Common Carrier. Included in the definition of
Strike is work slowdowns and sickouts.
“Travel Agent” means the Travel Agent, tour operator, or
other entity from which the Insured purchases his/her coverage or travel
arrangements, and includes all officers, employees, and affiliates of the Travel
Agent or tour operator.
“Travel Supplier” means the tour operator, hotel, cruise
line, and/or airline that: (1) provides pre-paid travel arrangements for the
Insured's Trip; and (2) is named in the master application.
“Traveling Companion” means a person or persons with
whom the Insured has coordinated travel arrangements and intend to travel with
during the Trip. A group or tour leader is not considered a Traveling Companion,
unless the Insured is sharing room accommodations with the group or tour leader.
“Trip” means a period of round-Trip travel away from
home to a Destination outside the Insured’s city of residence; the purpose of
the Trip is business or pleasure and is not to obtain health care or treatment
of any kind; the Trip has defined departure and return dates specified when the
Insured applies; the Trip does not exceed 180 days; and the Insured’s
Destination is not to another home; travel is primarily by Common Carrier and
only incidentally by private
conveyance.
Full description of coverage for travel protection