Trip Cancellation Coverage: 100% of trip cost
Trip Interruption Coverage: 100% of trip cost
TRIP CANCELLATION AND/OR INTERRUPTION
Benefit will be provided for loss(es) incurred by You for a covered Trip cancelled up to the date and time of departure or interrupted or delayed after the time and date of departure. A maximum benefit of up to the amount indicated in the Schedule of Benefits to cover certain expenses as listed below which result in the cancellation or interruption of Your Trip due to any of the following Unforeseen events:
Medical / Health
(a) Any serious Injury, death, or Sickness;
(1) Occurring to You or a Traveling Companion, a Family Member traveling with You, that is so disabling as to cause a reasonable person to cancel or interrupt their Trip or which results in medically imposed restrictions as certified by a Physician at the time of Loss preventing your continued participation in the Trip;
(2) Occurring to a Family Member not traveling with You that is considered life-threatening, as certified by a Physician or they require Your immediate care. Such disability must be so disabling as to reasonably cause a Trip to be canceled or interrupted and must be certified by a Physician;
(3) Occurring to a Business Partner that is so disabling as to cause a reasonable person to cancel or interrupt their Trip to assume daily management of the business. Such disability must be certified by a Physician;
Transportation and Accommodation
(a) Financial Default of an airline, Cruise line, Common Carrier or tour operator provided that:
(1) The insurance was purchased with 15 days of Initial Trip Payment; and
(2) Financial Default occurs more than 14 days following an Insured's effective date for the Trip Cancellation or Trip Interruption Benefits.
The Company will not cover Losses resulting from a Financial Default of any person, organization, agency, or firm that solicited Your travel arrangements to you.
(b) You and/or a Traveling Companion are directly involved in or delayed due to a traffic accident, while en route to the Insured’s Destination. Traffic accident must be substantiated by a police report.
(c) Strike resulting in complete interruption of travel services at the point of departure or Destination;
Environment
(a) Inclement Weather, if it causes delay or cancellation of travel;
(b) You or a Traveling Companion’s Primary Residence being made Uninhabitable or Inaccessible by Natural Disaster, vandalism, or burglary;
Political / Violence
(a) You, or a Traveling Companion are hijacked, quarantined, subpoenaed, or required to serve on a jury;
(b) You or a Traveling Companion is called to active military service, or military leave is revoked or reassigned;
Work
(a) You or a Traveling Companion is involuntarily terminated or laid off through no fault of his or her own, provided that he or she has been an active employee for the same employer for at least 1 continuous year. Termination must occur following the effective date of coverage. This provision is not applicable to temporary employment, seasonal employment, independent contractors or self-employed persons.
(b) Cancel for Work Reasons coverage will be included for these additional Unforeseen events:
(a) You or a Traveling Companion are required to work during Your scheduled Trip. You must provide proof of requirement to work, such as a notarized statement signed by an officer of Your employer. In the situation of self-employment, proof of self-employment and a notarized statement confirming that the Insured is unable to travel due to his or her job obligations will be required.
(b) You or a Traveling Companion are directly involved in a merger, acquisition, government required product recall, or bankruptcy proceedings and must be currently employed by the company that is involved in said event;
(c) You or a Traveling Companion’s company is deemed to be unsuitable for business due to burglary, or Natural Disaster and the You or a Traveling Companion are directly involved as a Key Employee of the disaster recovery team.
This coverage applies only if insurance was purchased within 15 days of Initial Trip Payment.
SPECIAL NOTIFICATION OF CLAIM
You must notify the Travel Insurance Administrator within 72 hours or as soon as reasonably possible in the event of a Trip Cancellation or Interruption claim. If You are unable to provide cancellation notice within the required timeframe, You must provide proof of the circumstance that prevented timely notification.
Trip Cancellation Benefits: The Company will reimburse You for Forfeited, pre-paid Trip Costs up to the Maximum Limit shown in the Schedule for Trips that are canceled prior to the scheduled Departure due to any of the Unforeseen events shown above.
Trip Interruption Benefits: The Company will reimburse You up to the Maximum Limit shown in the Schedule for Trips that are interrupted due to the Unforeseen events shown above for:
(a) Unused portion of non-refundable pre-paid insured Trip Cost; and
(b) additional transportation expenses incurred by You, either to the Return Destination; or from the place that You left the Trip to the place that You may rejoin the Trip; or
(c) additional transportation expenses incurred by You to reach the original Trip Destination if the Insured is delayed and leaves after the Departure Date.
However, the benefit payable under (b) and (c) above will not exceed the cost of economy airfare or the same class as the Insured’s original ticket, less any refunds paid or payable, by the most direct route.
SINGLE OCCUPANCY BENEFIT
The Company will reimburse You, up to the Trip Cancellation and Trip Interruption Maximum Limit shown in the Schedule, for the additional cost incurred during the Trip as a result of a change in the per person occupancy rate for prepaid, non-refundable travel arrangements if a person booked to share accommodations with You has his/her Trip canceled or interrupted due to any of the Unforeseen events shown in the Trip Cancellation and Trip Interruption section and You do not cancel.
FREQUENT TRAVELER BENEFIT
The Company will reimburse You for the cost of re-depositing frequent traveler awards utilized for the Trip for which this plan is purchased into Your account up to the Maximum Limit shown in the Schedule, provided the Trip is canceled prior to the scheduled Departure Date due to any of the Unforeseen events shown at the beginning of the Trip Cancellation and Trip Interruption section.
Medical Evacuation: $100,000 per person
EMERGENCY EVACUATION AND REPATRIATION OF REMAINSThe Company will pay for Covered Emergency Evacuation Expenses incurred due to an Injury or Sickness that occurs to You while You are on a Trip. Benefits payable are subject to the Maximum Limit shown in the Schedule for all Emergency Evacuations due to all Injuries from the same accident or all Sicknesses from the same or related causes during an overnight Trip with a Destination of at least 100 miles from the Insured’s Primary Residence.
Covered Emergency Evacuation Expenses are the Reasonable and Customary Charges for necessary Transportation, related medical services and medical supplies incurred in connection with the Emergency Evacuation of the Insured. All Transportation arrangements made for evacuating the Insured must be by the most direct and economical route possible and required by the standard regulations of the conveyance transporting the Insured.
Expenses for Transportation must be:
(a) ordered by the onsite attending Physician who must certify that the severity of the Insured’s Injury or Sickness warrants his or her Emergency Evacuation and adequate medical treatment is not locally available; and
(b) authorized in advance by the Travel Insurance Administrator. In the event the Insured’s Injury or Sickness prevents prior authorization of the Emergency Evacuation, the Travel Insurance Administrator must be notified as soon as reasonably possible.
The Company will also pay a benefit for reasonable and customary expenses incurred for an escort’s transportation and accommodations subject to the Escort Maximum Limit shown in the Schedule if an onsite attending Physician recommends in writing that an escort accompany the Insured.
Special Limitation: In the event the Travel Insurance Administrator could not be contacted to arrange for Emergency Evacuation, benefits are limited to the amount the Company would have paid had the Company or its authorized representative been contacted.
Emergency Evacuation - means:
(a) Transportation from the place where You are Injured or sick to the nearest adequate licensed medical facility where appropriate medical treatment can be obtained; or
(b) Transportation from a local medical facility to the nearest adequate licensed medical facility to obtain appropriate medical treatment if the onsite attending Physician certifies that additional treatment is needed but not locally available; and You are medically able to travel; or
(c) Transportation to the adequate licensed medical facility nearest Your home to obtain further medical treatment or to recover, after being treated at a local licensed medical facility, and the onsite attending Physician determines that the Insured is medically able to be transported.
(d) Transportation from an adequate licensed medical facility to an adequate licensed medical facility of Your choice for further treatment if the onsite attending Physician certifies that You are medically able to travel.
Advanced authorization by the Travel Insurance Administrator is needed for (a), (b), (c) and (d) above.
ADDITIONAL BENEFITS
In addition to the above covered expenses, if the Company has previously evacuated You to a medical facility, the Company will reimburse You Your airfare costs, less refunds from Your Unused transportation tickets, from that facility to Your Return Destination or home, within one year from Your original Return Date. Airfare costs will be based on medical necessity or same class as the Insured’s original tickets.
If You are hospitalized for more than 7 days following a covered Emergency Evacuation, the Company will reimburse You, subject to the limitations set out herein, the expenses for:
1. Return of Children: Return of Your Children, who were accompanying You when the Injury or Sickness occurred, to Your residence in the United States, including the cost of an attendant, if necessary. Such expenses shall not exceed the cost of a one-way economy airfare
ticket, or same class as the original ticket, less the value of any applied credit from any Unused return travel tickets for each person.
2. Bedside Visit: To bring one person chosen by You to and from the medical facility where You are confined if You are alone. The payment will not exceed the cost of one round-Trip economy airfare ticket.
3. Bedside Traveling Companion: The Company will reimburse You for reasonable expenses incurred for Hotel and meals shown in the Schedule for the Traveling Companion to remain near You. For an insured Child, a bedside companion is available immediately upon Hospital admission. Receipts must be submitted. Coverage for this benefit ends on the day You are discharged from the hospital. For purposes of this benefit, Traveling Companion means the person is Insured under this plan and accompanies the Insured on the Trip.
If you or a Traveling Companion are Hospitalized due to an Accidental Injury or Sickness that first occurred during the course of Your Trip beyond the date Your coverage ends, coverage under this benefit will be extended until You or Your Traveling Companion are released from the Hospital or until the Maximum Benefit as listed in the Schedule is paid.
REPATRIATION OF REMAINS
The Company will pay Repatriation Covered Expenses up to the Maximum Limit shown in the Schedule of Benefits to return Your body to the City of burial if You die during the Trip.
Repatriation Covered Expenses. include, but are not limited to, the reasonable and customary expenses for:
(a) embalming;
(b) Cremation;
(c) the most economical coffins or receptacles adequate for transportation of the remains; and
(d) transportation of the remains, by the most direct and economical conveyance and route possible.
The Travel Insurance Administrator must make all arrangements and authorize all expenses in advance.
Special Limitation: In the event the Company or the Company’s authorized representative could not be contacted to arrange for Repatriation Covered Expenses, benefits are limited to the amount the Company would have paid had the Company or its authorized representative been contacted.
Medical Protection: $15,000 per person ($0 deductible)
ACCIDENT SICKNESS MEDICAL EXPENSE BENEFITIf, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre-existing medical conditions will be covered if the Pre-existing Medical Condition Waiver is in effect.
Covered Expenses:
The Company will reimburse the Insured for:
Baggage Loss: $500 per person
BAGGAGE AND PERSONAL EFFECTSIf Your Baggage, personal effects, passports, travel documents and visas are lost, damaged, or stolen during Your Trip, the Company will pay the lesser of: (a) the cash value (original cash value less depreciation) as determined by the Company or, (b) the cost of replacement, up to the Maximum Limit shown in the Schedule subject to the special limitations shown below.
Special Limitations
Notwithstanding the foregoing, the Company will cover up to the maximum amount indicated for the following:
• $500 for the first item
• $250 per each additional item
• $500 aggregate on all Losses to: jewelry, watches, furs, cameras and camera equipment, camcorders, computers, electronic devices, including but not limited to: lap top computers, cell phones, electronic organizers and portable CD players.
Items over $150 must be accompanied by original receipts. If receipts are not provided, no benefits are payable.
The Company 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 Company may choose to:
(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 cash value of the Baggage before and after the Loss.
Accidental Death: $10,000 per person
ACCIDENTAL DEATH AND DISMEMBERMENT
The Company will reimburse the Insured for this benefit for one of the Losses shown in the Table of Losses below if the Insured is Injured other than while riding as a passenger in or boarding or alighting from or struck or run down by a certified passenger aircraft provided by a regularly scheduled airline or charter and operated by a properly certified pilot. The Loss must occur within 365 days of the date of the accident which caused Injury. The Company will pay the percentage shown below of the Maximum Limit shown in the Schedule or Declarations Page. The accident must occur while the Insured is on the Trip and is covered under the Policy.
If more than one Loss is sustained by an Insured as a result of the same accident, only one amount, the largest applicable to the Losses incurred, will be paid. The Company will not pay more than 100% of the Maximum Limit for all Losses due to the same accident.
Table of Losses:
Trip Interruption Coverage: 100% of trip cost
TRIP CANCELLATION AND/OR INTERRUPTION
Benefit will be provided for loss(es) incurred by You for a covered Trip cancelled up to the date and time of departure or interrupted or delayed after the time and date of departure. A maximum benefit of up to the amount indicated in the Schedule of Benefits to cover certain expenses as listed below which result in the cancellation or interruption of Your Trip due to any of the following Unforeseen events:
Medical / Health
(a) Any serious Injury, death, or Sickness;
(1) Occurring to You or a Traveling Companion, a Family Member traveling with You, that is so disabling as to cause a reasonable person to cancel or interrupt their Trip or which results in medically imposed restrictions as certified by a Physician at the time of Loss preventing your continued participation in the Trip;
(2) Occurring to a Family Member not traveling with You that is considered life-threatening, as certified by a Physician or they require Your immediate care. Such disability must be so disabling as to reasonably cause a Trip to be canceled or interrupted and must be certified by a Physician;
(3) Occurring to a Business Partner that is so disabling as to cause a reasonable person to cancel or interrupt their Trip to assume daily management of the business. Such disability must be certified by a Physician;
Transportation and Accommodation
(a) Financial Default of an airline, Cruise line, Common Carrier or tour operator provided that:
(1) The insurance was purchased with 15 days of Initial Trip Payment; and
(2) Financial Default occurs more than 14 days following an Insured's effective date for the Trip Cancellation or Trip Interruption Benefits.
The Company will not cover Losses resulting from a Financial Default of any person, organization, agency, or firm that solicited Your travel arrangements to you.
(b) You and/or a Traveling Companion are directly involved in or delayed due to a traffic accident, while en route to the Insured’s Destination. Traffic accident must be substantiated by a police report.
(c) Strike resulting in complete interruption of travel services at the point of departure or Destination;
Environment
(a) Inclement Weather, if it causes delay or cancellation of travel;
(b) You or a Traveling Companion’s Primary Residence being made Uninhabitable or Inaccessible by Natural Disaster, vandalism, or burglary;
Political / Violence
(a) You, or a Traveling Companion are hijacked, quarantined, subpoenaed, or required to serve on a jury;
(b) You or a Traveling Companion is called to active military service, or military leave is revoked or reassigned;
Work
(a) You or a Traveling Companion is involuntarily terminated or laid off through no fault of his or her own, provided that he or she has been an active employee for the same employer for at least 1 continuous year. Termination must occur following the effective date of coverage. This provision is not applicable to temporary employment, seasonal employment, independent contractors or self-employed persons.
(b) Cancel for Work Reasons coverage will be included for these additional Unforeseen events:
(a) You or a Traveling Companion are required to work during Your scheduled Trip. You must provide proof of requirement to work, such as a notarized statement signed by an officer of Your employer. In the situation of self-employment, proof of self-employment and a notarized statement confirming that the Insured is unable to travel due to his or her job obligations will be required.
(b) You or a Traveling Companion are directly involved in a merger, acquisition, government required product recall, or bankruptcy proceedings and must be currently employed by the company that is involved in said event;
(c) You or a Traveling Companion’s company is deemed to be unsuitable for business due to burglary, or Natural Disaster and the You or a Traveling Companion are directly involved as a Key Employee of the disaster recovery team.
This coverage applies only if insurance was purchased within 15 days of Initial Trip Payment.
SPECIAL NOTIFICATION OF CLAIM
You must notify the Travel Insurance Administrator within 72 hours or as soon as reasonably possible in the event of a Trip Cancellation or Interruption claim. If You are unable to provide cancellation notice within the required timeframe, You must provide proof of the circumstance that prevented timely notification.
Trip Cancellation Benefits: The Company will reimburse You for Forfeited, pre-paid Trip Costs up to the Maximum Limit shown in the Schedule for Trips that are canceled prior to the scheduled Departure due to any of the Unforeseen events shown above.
Trip Interruption Benefits: The Company will reimburse You up to the Maximum Limit shown in the Schedule for Trips that are interrupted due to the Unforeseen events shown above for:
(a) Unused portion of non-refundable pre-paid insured Trip Cost; and
(b) additional transportation expenses incurred by You, either to the Return Destination; or from the place that You left the Trip to the place that You may rejoin the Trip; or
(c) additional transportation expenses incurred by You to reach the original Trip Destination if the Insured is delayed and leaves after the Departure Date.
However, the benefit payable under (b) and (c) above will not exceed the cost of economy airfare or the same class as the Insured’s original ticket, less any refunds paid or payable, by the most direct route.
SINGLE OCCUPANCY BENEFIT
The Company will reimburse You, up to the Trip Cancellation and Trip Interruption Maximum Limit shown in the Schedule, for the additional cost incurred during the Trip as a result of a change in the per person occupancy rate for prepaid, non-refundable travel arrangements if a person booked to share accommodations with You has his/her Trip canceled or interrupted due to any of the Unforeseen events shown in the Trip Cancellation and Trip Interruption section and You do not cancel.
FREQUENT TRAVELER BENEFIT
The Company will reimburse You for the cost of re-depositing frequent traveler awards utilized for the Trip for which this plan is purchased into Your account up to the Maximum Limit shown in the Schedule, provided the Trip is canceled prior to the scheduled Departure Date due to any of the Unforeseen events shown at the beginning of the Trip Cancellation and Trip Interruption section.
Medical Evacuation: $100,000 per person
EMERGENCY EVACUATION AND REPATRIATION OF REMAINSThe Company will pay for Covered Emergency Evacuation Expenses incurred due to an Injury or Sickness that occurs to You while You are on a Trip. Benefits payable are subject to the Maximum Limit shown in the Schedule for all Emergency Evacuations due to all Injuries from the same accident or all Sicknesses from the same or related causes during an overnight Trip with a Destination of at least 100 miles from the Insured’s Primary Residence.
Covered Emergency Evacuation Expenses are the Reasonable and Customary Charges for necessary Transportation, related medical services and medical supplies incurred in connection with the Emergency Evacuation of the Insured. All Transportation arrangements made for evacuating the Insured must be by the most direct and economical route possible and required by the standard regulations of the conveyance transporting the Insured.
Expenses for Transportation must be:
(a) ordered by the onsite attending Physician who must certify that the severity of the Insured’s Injury or Sickness warrants his or her Emergency Evacuation and adequate medical treatment is not locally available; and
(b) authorized in advance by the Travel Insurance Administrator. In the event the Insured’s Injury or Sickness prevents prior authorization of the Emergency Evacuation, the Travel Insurance Administrator must be notified as soon as reasonably possible.
The Company will also pay a benefit for reasonable and customary expenses incurred for an escort’s transportation and accommodations subject to the Escort Maximum Limit shown in the Schedule if an onsite attending Physician recommends in writing that an escort accompany the Insured.
Special Limitation: In the event the Travel Insurance Administrator could not be contacted to arrange for Emergency Evacuation, benefits are limited to the amount the Company would have paid had the Company or its authorized representative been contacted.
Emergency Evacuation - means:
(a) Transportation from the place where You are Injured or sick to the nearest adequate licensed medical facility where appropriate medical treatment can be obtained; or
(b) Transportation from a local medical facility to the nearest adequate licensed medical facility to obtain appropriate medical treatment if the onsite attending Physician certifies that additional treatment is needed but not locally available; and You are medically able to travel; or
(c) Transportation to the adequate licensed medical facility nearest Your home to obtain further medical treatment or to recover, after being treated at a local licensed medical facility, and the onsite attending Physician determines that the Insured is medically able to be transported.
(d) Transportation from an adequate licensed medical facility to an adequate licensed medical facility of Your choice for further treatment if the onsite attending Physician certifies that You are medically able to travel.
Advanced authorization by the Travel Insurance Administrator is needed for (a), (b), (c) and (d) above.
ADDITIONAL BENEFITS
In addition to the above covered expenses, if the Company has previously evacuated You to a medical facility, the Company will reimburse You Your airfare costs, less refunds from Your Unused transportation tickets, from that facility to Your Return Destination or home, within one year from Your original Return Date. Airfare costs will be based on medical necessity or same class as the Insured’s original tickets.
If You are hospitalized for more than 7 days following a covered Emergency Evacuation, the Company will reimburse You, subject to the limitations set out herein, the expenses for:
1. Return of Children: Return of Your Children, who were accompanying You when the Injury or Sickness occurred, to Your residence in the United States, including the cost of an attendant, if necessary. Such expenses shall not exceed the cost of a one-way economy airfare
ticket, or same class as the original ticket, less the value of any applied credit from any Unused return travel tickets for each person.
2. Bedside Visit: To bring one person chosen by You to and from the medical facility where You are confined if You are alone. The payment will not exceed the cost of one round-Trip economy airfare ticket.
3. Bedside Traveling Companion: The Company will reimburse You for reasonable expenses incurred for Hotel and meals shown in the Schedule for the Traveling Companion to remain near You. For an insured Child, a bedside companion is available immediately upon Hospital admission. Receipts must be submitted. Coverage for this benefit ends on the day You are discharged from the hospital. For purposes of this benefit, Traveling Companion means the person is Insured under this plan and accompanies the Insured on the Trip.
If you or a Traveling Companion are Hospitalized due to an Accidental Injury or Sickness that first occurred during the course of Your Trip beyond the date Your coverage ends, coverage under this benefit will be extended until You or Your Traveling Companion are released from the Hospital or until the Maximum Benefit as listed in the Schedule is paid.
REPATRIATION OF REMAINS
The Company will pay Repatriation Covered Expenses up to the Maximum Limit shown in the Schedule of Benefits to return Your body to the City of burial if You die during the Trip.
Repatriation Covered Expenses. include, but are not limited to, the reasonable and customary expenses for:
(a) embalming;
(b) Cremation;
(c) the most economical coffins or receptacles adequate for transportation of the remains; and
(d) transportation of the remains, by the most direct and economical conveyance and route possible.
The Travel Insurance Administrator must make all arrangements and authorize all expenses in advance.
Special Limitation: In the event the Company or the Company’s authorized representative could not be contacted to arrange for Repatriation Covered Expenses, benefits are limited to the amount the Company would have paid had the Company or its authorized representative been contacted.
Medical Protection: $15,000 per person ($0 deductible)
ACCIDENT SICKNESS MEDICAL EXPENSE BENEFITIf, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre-existing medical conditions will be covered if the Pre-existing Medical Condition Waiver is in effect.
Covered Expenses:
The Company will reimburse the Insured for:
- services of a Physician or registered nurse (R.N.);
- Hospital charges;
- X-rays;
- local ambulance services to or from a Hospital;
- artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
- the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.
Baggage Loss: $500 per person
BAGGAGE AND PERSONAL EFFECTSIf Your Baggage, personal effects, passports, travel documents and visas are lost, damaged, or stolen during Your Trip, the Company will pay the lesser of: (a) the cash value (original cash value less depreciation) as determined by the Company or, (b) the cost of replacement, up to the Maximum Limit shown in the Schedule subject to the special limitations shown below.
Special Limitations
Notwithstanding the foregoing, the Company will cover up to the maximum amount indicated for the following:
• $500 for the first item
• $250 per each additional item
• $500 aggregate on all Losses to: jewelry, watches, furs, cameras and camera equipment, camcorders, computers, electronic devices, including but not limited to: lap top computers, cell phones, electronic organizers and portable CD players.
Items over $150 must be accompanied by original receipts. If receipts are not provided, no benefits are payable.
The Company 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 Company may choose to:
(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 cash value of the Baggage before and after the Loss.
Accidental Death: $10,000 per person
ACCIDENTAL DEATH AND DISMEMBERMENT
The Company will reimburse the Insured for this benefit for one of the Losses shown in the Table of Losses below if the Insured is Injured other than while riding as a passenger in or boarding or alighting from or struck or run down by a certified passenger aircraft provided by a regularly scheduled airline or charter and operated by a properly certified pilot. The Loss must occur within 365 days of the date of the accident which caused Injury. The Company will pay the percentage shown below of the Maximum Limit shown in the Schedule or Declarations Page. The accident must occur while the Insured is on the Trip and is covered under the Policy.
If more than one Loss is sustained by an Insured as a result of the same accident, only one amount, the largest applicable to the Losses incurred, will be paid. The Company will not pay more than 100% of the Maximum Limit for all Losses due to the same accident.
Table of Losses:
LOSS OF: |
% OF MAXIMUM LIMIT |
Life |
100% |
Both Hands or Both Feet |
100% |
Sight of Both Eyes |
100% |
One Hand and One Foot |
100% |
Either Hand or Foot and Sight of One Eye |
100% |
Either Hand or Foot |
50% |
Sight of One Eye |
50% |
"Loss" with regard to:
(a) hand or foot means actual severance through or above the wrist or ankle joints; or
(b) eye means entire and irrecoverable Loss of sight in that eye.
(a) hand or foot means actual severance through or above the wrist or ankle joints; or
(b) eye means entire and irrecoverable Loss of sight in that eye.
EXPOSURE
The Company will pay a benefit for covered Losses as specified above which result from an Insured being unavoidably exposed to the elements due to an accidental Injury during the Trip. The Loss must occur within 365 days after the event which caused the exposure.
DISAPPEARANCE
The Company will pay a benefit for Loss of life as specified above if the Insured’s body cannot be located one year after a disappearance due to an accident during the Trip.
DEFINITIONS
(Capitalized terms within this Certificate of Insurance are defined herein)
“Actual Cash Value” means purchase price less depreciation.
“Baggage” means luggage, travel documents, and personal possessions; whether owned, borrowed or rented, taken by the Insured on the Trip.
“Business Partner” means a person who: (1) is involved with the Insured or the Insured’s Traveling Companion in a legal partnership; and (2) is actively involved in the daily management of the business.
“Caregiver” means an individual employed for the purpose of providing assistance with activities of daily living to the Insured or to the Insured’s Family Member who has a physical or mental impairment. The Caregiver must be employed by the Insured or the Insured’s Family Member. A Caregiver is not a babysitter; childcare service, facility or provider; or persons employed by any service, provider or facility to supply assisted living.
“Children” “Child” means with respect to Emergency Evacuation Benefit and as shown on the enrollment form unmarried children or grandchildren of the Insured, including natural children from the moment of birth, children from a civil union and step, foster or adopted children from the moment of placement in the Insured’s home, under age 25 and primarily dependent on the Insured for support and maintenance. However, the age limit does not apply to a child who: (1) otherwise meets the definition of children; and (2) is incapable of self-sustaining employment by reason of mental or physical incapacity. As otherwise used in this plan it means the Insured’s natural, step, foster, adopted children or grandchildren of any age.
“City” means an incorporated municipality having defined borders and does not include the high seas, uninhabited areas or airspace.
“Common Carrier” means an air, land or sea conveyance operated under a license for the transportation of passengers for hire and for which the Insured’s ticket was purchased through the Travel Supplier.
“Company” means National Union Fire Insurance Company of Pittsburgh, Pa.
“Complications of Pregnancy” means conditions whose diagnoses are distinct from pregnancy but are adversely affected by pregnancy or are caused by pregnancy. These conditions include acute nephritis, nephrosis, cardiac decompensation, missed abortion and similar medical and surgical conditions of comparable severity. Complications of pregnancy also include non-elective cesarean section, ectopic pregnancy which is terminated and spontaneous termination of pregnancy, which occurs during a period of gestation in which a viable birth is not possible.
Complications of pregnancy do not include false labor, occasional spotting, Physician-prescribed rest during the period of pregnancy, morning sickness, hyperemesis gravidarum, preeclampsia and similar conditions associated with the management of a difficult pregnancy not constituting a nosologically distinct complication of pregnancy.
“Cruise” means a vacation on a cruise ship.
“Declarations Page” means the document showing the Insured’s travel arrangements and insurance benefits.
“Deductible” means the amount of charges that must be incurred by an Insured before benefits become payable. The amount of the deductible is shown in the Schedule or Declarations Page for each benefit to which a deductible applies.
“Departure Date” means the date on which the Insured is originally scheduled to leave on his/her Trip. This date is specified in the travel documents.
“Destination” means any place where the Insured expects to travel to on his/her Trip as shown on the travel documents.
“Domestic Partner” means an opposite or a same-sex partner who is at least 18 years of age and has met all of the following requirements for at least 6 months:
(a) resides with the Insured or Family Member; and
(b) shares financial assets and obligations with the Insured or Family Member.
The Company may require proof of the domestic partner relationship in the form of a signed and completed Affidavit of Domestic Partnership.
“Eligible Person” means a person who is a member of an eligible class of persons as described in the Description of Eligible Persons section of the Master Application.
“Exotic Vehicle” means antique cars that are over 20 years old or have not been manufactured for 10 or more years or any vehicle with an original manufacturer’s suggested retail price greater than $50,000.
“Experimental or Investigative” means treatments, devices or prescription medications which are recommended by a Physician, but are not considered by the medical community as a whole to be safe and effective for the condition for which the treatments, devices or prescription medications are being used. This includes any treatments, procedures, facilities, equipments, 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.
“Family Member” means the Insured’s or Traveling Companion’s spouse, civil union partner, Domestic Partner, Child, daughter-in-law, son-in-law, brother, sister, mother, father, grandparent, step-grandparent, grandchild, step-grandchild, step-child, step-brother, step-sister, step-parent, parent-in-law, brother-in-law, sister-in-law, aunt, step-aunt, uncle, step-uncle, niece, nephew, legal guardian, Caregiver, foster Child, ward, or legal ward; spouse, civil union partner or Domestic Partner of any of the above. Family Member also includes these relations to the Insured’s or Traveling Companion’s spouse, civil union partner or Domestic Partner.
“Financial Default” means the total cessation or partial suspension of operations due to insolvency, with or without the filing of a bankruptcy petition by a tour operator, cruise line or airline.
“Forfeited” means the Insured’s financial Loss of any whole or prorated prepaid, nonrefundable components of a Trip.
“Hospital” means a facility that:
(a) is operated according to law for the care and treatment of sick or Injured people;
(b) has organized facilities for diagnosis and surgery on its premises or in facilities available to it on a prearranged basis;
(c) has 24 hour nursing service by registered nurses (R.N.’s); and
(d) is supervised by one or more Physicians available at all times.
A hospital does not include:
(a) a nursing, convalescent or geriatric unit of a hospital when a patient is confined mainly to receive nursing care;
(b) a facility that is, other than incidentally, a clinic, a rest home, nursing home, convalescent home, home health care, 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
(c) 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 for which no charge is normally made.
"Host At Destination" means the person with whom the Insured is sharing prearranged overnight accommodations in the host's home.
“Hotel” means any establishment used for the purpose of temporary, overnight lodging for which a fee is paid and reservations are required.
“Inaccessible” means an Insured cannot reach his/her Destination by the original mode of transportation.
“Inclement Weather” means any severe weather condition which delays the scheduled arrival or departure of a Common Carrier or prevents the Insured from reaching his/her Destination when traveling by a rented or owned vehicle.
“Initial Trip Payment” means the first payment made to the Insured’s Travel Supplier toward the cost of the Insured’s Trip. “Injury/Injured” means a bodily injury caused by an accident occurring while the Insured’s coverage under the Policy is in force and resulting directly and independently of all other causes of Loss covered by the Policy. The injury must be verified by a Physician.
“Insured” means an Eligible Person:
(a) for whom any required enrollment form has been completed;
(b) for whom any required plan cost has been paid;
(c) for whom a Trip is scheduled; and
(d) who is covered under the Policy.
“Key Employee” means an employee of an employer who is responsible for policy and decision making.
“Loss” means Injury or damage sustained by the Insured as a consequence of one or more of the events against which the Company has undertaken to compensate the Insured.
“Medically Necessary” means that a treatment, service, or supply:
(a) is essential for diagnosis, treatment, or care of the Injury or Sickness for which it is prescribed or performed;
(b) meets generally accepted standards of medical practice;
(c) is ordered by a Physician and performed under his or her care, supervision, or order; and
(d) is not primarily for the convenience of the Insured, Physician, other providers or any other person.
“Mental, Nervous or Psychological Disorder” means a mental or nervous health condition including, but not limited to: anxiety, depression, neurosis, phobia, psychosis or any related physical manifestation.
“Natural Disaster” means a flood, hurricane, tornado, earthquake, volcanic eruption, fire, wildfire or blizzard that is due to natural causes.
“Necessary Personal Effects” means items, such as clothing and toiletry items, which are included in the Insured’s Baggage and are required for the Insured’s Trip.
“Normal Pregnancy or Childbirth” means a pregnancy or childbirth that is free of complications or problems.
“Physician” means a licensed practitioner of medical, surgical, dental, services or the healing arts including accredited Christian Science Practitioner, acting within the scope of his/her license. The treating physician cannot be the Insured, a Traveling Companion, a Family Member, a Business Partner or retained by the Policyholder.
“Primary” means the Company will pay first but reserves the right to recover from any other insurance carrier with which the Insured may be enrolled.
“Primary Residence” means an Insured’s fixed, permanent and main home for legal and tax purposes.
“Reasonable Additional Expenses” means expenses for meals, taxi fares, essential telephone calls and lodging which are necessarily incurred as the result of a Trip Delay and which are not provided by the Common Carrier or any other party free of charge.
“Reasonable and Customary Charges” means expenses which:
(a) are charged for treatment, supplies, or medical services Medically Necessary to treat the Insured’s condition;
(b) do not exceed the usual level of charges for similar treatment, supplies or medical services in the locality where the expenses are incurred; and
(c) do 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.
“Rental Return Date” means the return date listed on the car rental agreement.
“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. This date is specified in the travel documents.
“Return Destination” means the place to which the Insured expects to return from his/her Trip as shown in the enrollment form.
“Schedule” means the Schedule of Benefits which is shown at the beginning of the Certificate.
“Sickness” means an illness or disease diagnosed or treated by a Physician.
“Strike” means a stoppage of work which:
(a) is announced, organized, and sanctioned by a labor union; and
(b) interferes with the normal departure and arrival of a Common Carrier.
This includes work slowdowns and sickouts. The Insured’s Trip Cancellation coverage must be effective prior to when the strike is foreseeable. A strike is foreseeable on the date labor union members vote to approve a strike.
“Terrorist Incident” means an act of violence by any person acting on behalf of or in connection with any organization which is generally recognized as having the intent to overthrow or influence the control of any government, that is deemed terrorism by the United States Government other than civil disorder or riot, that is not an act of war, declared or undeclared, that results in Loss of life or major damage to property.
“Transportation” means any land, sea or air conveyance required to transport the Insured during an Emergency Evacuation. Transportation includes, but is not limited to, air ambulances, land ambulances and private motor vehicles.
“Travel Supplier” means the tour operator, Hotel, rental company, Cruise line or airline that provides prepaid travel arrangements for the Insured’s Trip.
“Traveling Companion” means a person or persons with whom the Insured has coordinated travel arrangements and intends 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 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 364 days; travel is primarily by Common Carrier and only incidentally by private conveyance.
“Trip Cost” means the dollar amount of Trip payments or deposits paid by the Insured prior the Insured’s Trip Departure Date and shown on any required enrollment form which is subject to cancellation penalties or restrictions. Trip cost will also include the cost of any subsequent prepaid payments or deposits paid by the Insured for the same Trip, after enrollment for coverage under this plan provided the Insured amends the enrollment form to add such subsequent payments or deposits and pays any required additional plan cost prior to the Insured’s Departure Date.
“Unforeseen” means not anticipated or expected and occurring after the effective date of coverage.
“Uninhabitable” means (1) the building structure itself is unstable and there is a risk of collapse in whole or in part; (2) there is exterior or structural damage allowing elemental intrusion, such as rain, wind, hail or flood; (3) immediate safety hazards have yet to be cleared, such as debris or downed electrical lines; (4) the rental property is without electricity, gas, sewer service or water; or (5) the Destination is Inaccessible.
“Unused” means the Insured’s financial Loss of any whole, partial or prorated prepaid, nonrefundable components of a Trip that are not depleted or exhausted.
EXCLUSIONS AND LIMITATIONS
GENERAL EXCLUSIONS
This plan does not cover any loss caused by or resulting from:
(a) intentionally self-inflicted Injury, suicide, or attempted suicide of the Insured, Family Member, Traveling Companion or Business Partner while sane or insane;
(b) Normal Pregnancy or Childbirth, other than Unforeseen Complications of Pregnancy, or elective abortion of the Insured, a Traveling Companion or a Family Member;
(c) participation in professional athletic events, motor sport or motor racing, including training or practice for the same;
(d) mountaineering where ropes or guides are normally used. The ascent or descent of a mountain requiring the use of specialized equipment, including but not limited to pick-axes, anchors, bolts, crampons, carabineers and lead or top-rope anchoring equipment;
(e) war or act of war, whether declared or not, participation in a civil disorder, riot or insurrection;
(f) operating or learning to operate any aircraft, as student, pilot or crew;
(g) air travel on any air-supported device, other than a regularly scheduled airline or air charter company;
(h) commission of or attempt to commit a felony by the Insured; (i) Mental, Nervous or Psychological Disorder;
(j) if the Insured’s tickets do not contain specific travel dates (open tickets);
(k) being under the influence of drugs or narcotics, unless administered upon the advice of a Physician or intoxication above the legal limit;
(l) any loss that occurs at a time when this coverage is not in effect;
(m) traveling for the purpose of securing medical treatment; (n) any Trip taken outside the advice of a Physician;
(o) PRE-EXISTING MEDICAL CONDITION EXCLUSION: The Company will not pay for any loss or expense incurred as the result of an Injury, Sickness or other condition (excluding any condition from which death ensues) of an Insured, Traveling Companion, Business Partner or Family Member which, within the 180 day period immediately preceding and including the Insured’s coverage effective date: (a) first manifested itself, worsened, became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment; (b) for which care or treatment was given or recommended by a Physician; (c) required taking prescription drugs or medicines, unless the condition for which the drugs or medicines are taken remains controlled without any change in the required prescription drugs or medicines.
PRE-EXISTING MEDICAL CONDITION EXCLUSION WAIVER
The Company will waive the pre-existing medical condition exclusion if the following conditions are met:
(1) This plan is purchased within 15 days of Initial Trip Payment;
(2) The amount of coverage purchased equals all prepaid nonrefundable payments or deposits applicable to the Trip at the time of purchase and the costs of any subsequent arrangements added to the same Trip are insured within 15 days of the date of payment or deposit for any subsequent Trip arrangements;
(3) All Insured’s are medically able to travel when this plan cost is paid;
(4) The Trip Cost does not exceed $100,000 per person (only applicable to Trip Cancellation/ Interruption).
This coverage will be terminated and no benefits will be paid under this Pre-existing Medical Condition Exclusion Waiver coverage if the full costs of all prepaid, nonrefundable Trip arrangements are not insured.
The following exclusions also apply to Trip Cancellation and Trip Interruption:
Unless otherwise provided by this plan Benefits will not be provided for any loss resulting (in whole or in part) from:
(a) travel arrangements canceled by an airline, Cruise line or tour operator, except as provided elsewhere in the plan;
(b) changes in plans by the Insured, a Family Member or Traveling Companion for any reason, unless Cancel for Any Reason was purchased;
(c) financial circumstances of the Insured, a Family Member or a Traveling Companion;
(d) any government regulation or prohibition;
(e) an event which occurs prior to the Insured’s coverage Effective Date;
(f) failure of any tour operator, Common Carrier, person or agency to provide the bargained-for travel arrangements or to refund money due the Insured.
The following exclusions apply to Baggage/Personal Effects and Baggage Delay:
Benefits will not be provided for any Loss, or damage to, caused by, or resulting in whole or in part from:
(a) animals, rodents, insects or vermin;
(b) bicycles (except when checked with a Common Carrier);
(c) motor vehicles, aircraft, boats, boat motors, ATV’s and other conveyances;
(d) artificial prosthetic devices, false teeth, any type of eyeglasses, sunglasses, contact lenses or hearing aids;
(e) keys, notes, securities, accounts, currency, deeds, food stamps, bills, credit cards or other evidences of debt, or tickets;
(f) money, stamps, stocks and bonds, postal or money orders;
(g) property shipped as freight, or shipped prior to the Departure Date;
(h) contraband, illegal transportation or trade;
(i) items seized by any government, government official or customs official;
(j) defective materials or craftsmanship;
(k) normal wear and tear;
(l) deterioration.
The following limitations and exclusions apply to Car Rental Collision Coverage:
Coverage is not provided in whole or in part for any loss to, or due to:
(a) the Insured or his/her Traveling Companion violating the rental agreement;
(b) rentals of trucks, (not including jeeps or SUV’s) 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, the Insured’s participation in a civil disorder, riot or insurrection.
The following exclusions also apply to the Accident Sickness Medical Expense Benefit:
Unless otherwise provided by this plan Benefits will not be provided for the following:
(a) routine physical examinations;
(b) mental health care;
(c) replacement of hearing aids, eye glasses, contact lenses and sunglasses;
(d) routine dental care;
(e) any service provided by the Insured, a Family Member or Traveling Companion;
(f) alcohol or substance abuse or treatment for the same;
(g) Experimental or Investigative treatment procedures;
(h) care or treatment which is not Medically Necessary, except for related reconstructive surgery resulting from trauma, infection or disease;
(i) coverage for Trips less than 100 miles from the Insured’s Primary Residence.
The following exclusion also applies to the Emergency Evacuation Benefit:
(a) coverage for Trips less than 100 miles from the Insured’s Primary Residence.
The following exclusions also apply to Accidental Death and Dismemberment and Flight Guard:
Benefits will not be provided for the following:
(a) loss caused by or resulting directly or indirectly from Sickness or disease of any kind;
(b) stroke or cerebrovascular accident or event, cardiovascular accident or event, myocardial infarction or heart attack, coronary thrombosis or aneurysm.
EXCESS INSURANCE LIMITATION
The insurance provided by the Policy for all coverages except Trip Cancellation, Trip Interruption and Car Rental Collision Coverage shall be in excess of all other valid and collectible insurance or indemnity. If at the time of the occurrence of any Loss payable under the Policy there is other valid and collectible insurance or indemnity in place, the Company shall be liable only for the excess of the amount of Loss, over the amount of such other insurance or indemnity and applicable deductible. Accident Sickness. Medical Expense will become Primary if the plan is purchased within 15 days of Initial Trip Payment.
(Capitalized terms within this Certificate of Insurance are defined herein)
“Actual Cash Value” means purchase price less depreciation.
“Baggage” means luggage, travel documents, and personal possessions; whether owned, borrowed or rented, taken by the Insured on the Trip.
“Business Partner” means a person who: (1) is involved with the Insured or the Insured’s Traveling Companion in a legal partnership; and (2) is actively involved in the daily management of the business.
“Caregiver” means an individual employed for the purpose of providing assistance with activities of daily living to the Insured or to the Insured’s Family Member who has a physical or mental impairment. The Caregiver must be employed by the Insured or the Insured’s Family Member. A Caregiver is not a babysitter; childcare service, facility or provider; or persons employed by any service, provider or facility to supply assisted living.
“Children” “Child” means with respect to Emergency Evacuation Benefit and as shown on the enrollment form unmarried children or grandchildren of the Insured, including natural children from the moment of birth, children from a civil union and step, foster or adopted children from the moment of placement in the Insured’s home, under age 25 and primarily dependent on the Insured for support and maintenance. However, the age limit does not apply to a child who: (1) otherwise meets the definition of children; and (2) is incapable of self-sustaining employment by reason of mental or physical incapacity. As otherwise used in this plan it means the Insured’s natural, step, foster, adopted children or grandchildren of any age.
“City” means an incorporated municipality having defined borders and does not include the high seas, uninhabited areas or airspace.
“Common Carrier” means an air, land or sea conveyance operated under a license for the transportation of passengers for hire and for which the Insured’s ticket was purchased through the Travel Supplier.
“Company” means National Union Fire Insurance Company of Pittsburgh, Pa.
“Complications of Pregnancy” means conditions whose diagnoses are distinct from pregnancy but are adversely affected by pregnancy or are caused by pregnancy. These conditions include acute nephritis, nephrosis, cardiac decompensation, missed abortion and similar medical and surgical conditions of comparable severity. Complications of pregnancy also include non-elective cesarean section, ectopic pregnancy which is terminated and spontaneous termination of pregnancy, which occurs during a period of gestation in which a viable birth is not possible.
Complications of pregnancy do not include false labor, occasional spotting, Physician-prescribed rest during the period of pregnancy, morning sickness, hyperemesis gravidarum, preeclampsia and similar conditions associated with the management of a difficult pregnancy not constituting a nosologically distinct complication of pregnancy.
“Cruise” means a vacation on a cruise ship.
“Declarations Page” means the document showing the Insured’s travel arrangements and insurance benefits.
“Deductible” means the amount of charges that must be incurred by an Insured before benefits become payable. The amount of the deductible is shown in the Schedule or Declarations Page for each benefit to which a deductible applies.
“Departure Date” means the date on which the Insured is originally scheduled to leave on his/her Trip. This date is specified in the travel documents.
“Destination” means any place where the Insured expects to travel to on his/her Trip as shown on the travel documents.
“Domestic Partner” means an opposite or a same-sex partner who is at least 18 years of age and has met all of the following requirements for at least 6 months:
(a) resides with the Insured or Family Member; and
(b) shares financial assets and obligations with the Insured or Family Member.
The Company may require proof of the domestic partner relationship in the form of a signed and completed Affidavit of Domestic Partnership.
“Eligible Person” means a person who is a member of an eligible class of persons as described in the Description of Eligible Persons section of the Master Application.
“Exotic Vehicle” means antique cars that are over 20 years old or have not been manufactured for 10 or more years or any vehicle with an original manufacturer’s suggested retail price greater than $50,000.
“Experimental or Investigative” means treatments, devices or prescription medications which are recommended by a Physician, but are not considered by the medical community as a whole to be safe and effective for the condition for which the treatments, devices or prescription medications are being used. This includes any treatments, procedures, facilities, equipments, 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.
“Family Member” means the Insured’s or Traveling Companion’s spouse, civil union partner, Domestic Partner, Child, daughter-in-law, son-in-law, brother, sister, mother, father, grandparent, step-grandparent, grandchild, step-grandchild, step-child, step-brother, step-sister, step-parent, parent-in-law, brother-in-law, sister-in-law, aunt, step-aunt, uncle, step-uncle, niece, nephew, legal guardian, Caregiver, foster Child, ward, or legal ward; spouse, civil union partner or Domestic Partner of any of the above. Family Member also includes these relations to the Insured’s or Traveling Companion’s spouse, civil union partner or Domestic Partner.
“Financial Default” means the total cessation or partial suspension of operations due to insolvency, with or without the filing of a bankruptcy petition by a tour operator, cruise line or airline.
“Forfeited” means the Insured’s financial Loss of any whole or prorated prepaid, nonrefundable components of a Trip.
“Hospital” means a facility that:
(a) is operated according to law for the care and treatment of sick or Injured people;
(b) has organized facilities for diagnosis and surgery on its premises or in facilities available to it on a prearranged basis;
(c) has 24 hour nursing service by registered nurses (R.N.’s); and
(d) is supervised by one or more Physicians available at all times.
A hospital does not include:
(a) a nursing, convalescent or geriatric unit of a hospital when a patient is confined mainly to receive nursing care;
(b) a facility that is, other than incidentally, a clinic, a rest home, nursing home, convalescent home, home health care, 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
(c) 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 for which no charge is normally made.
"Host At Destination" means the person with whom the Insured is sharing prearranged overnight accommodations in the host's home.
“Hotel” means any establishment used for the purpose of temporary, overnight lodging for which a fee is paid and reservations are required.
“Inaccessible” means an Insured cannot reach his/her Destination by the original mode of transportation.
“Inclement Weather” means any severe weather condition which delays the scheduled arrival or departure of a Common Carrier or prevents the Insured from reaching his/her Destination when traveling by a rented or owned vehicle.
“Initial Trip Payment” means the first payment made to the Insured’s Travel Supplier toward the cost of the Insured’s Trip. “Injury/Injured” means a bodily injury caused by an accident occurring while the Insured’s coverage under the Policy is in force and resulting directly and independently of all other causes of Loss covered by the Policy. The injury must be verified by a Physician.
“Insured” means an Eligible Person:
(a) for whom any required enrollment form has been completed;
(b) for whom any required plan cost has been paid;
(c) for whom a Trip is scheduled; and
(d) who is covered under the Policy.
“Key Employee” means an employee of an employer who is responsible for policy and decision making.
“Loss” means Injury or damage sustained by the Insured as a consequence of one or more of the events against which the Company has undertaken to compensate the Insured.
“Medically Necessary” means that a treatment, service, or supply:
(a) is essential for diagnosis, treatment, or care of the Injury or Sickness for which it is prescribed or performed;
(b) meets generally accepted standards of medical practice;
(c) is ordered by a Physician and performed under his or her care, supervision, or order; and
(d) is not primarily for the convenience of the Insured, Physician, other providers or any other person.
“Mental, Nervous or Psychological Disorder” means a mental or nervous health condition including, but not limited to: anxiety, depression, neurosis, phobia, psychosis or any related physical manifestation.
“Natural Disaster” means a flood, hurricane, tornado, earthquake, volcanic eruption, fire, wildfire or blizzard that is due to natural causes.
“Necessary Personal Effects” means items, such as clothing and toiletry items, which are included in the Insured’s Baggage and are required for the Insured’s Trip.
“Normal Pregnancy or Childbirth” means a pregnancy or childbirth that is free of complications or problems.
“Physician” means a licensed practitioner of medical, surgical, dental, services or the healing arts including accredited Christian Science Practitioner, acting within the scope of his/her license. The treating physician cannot be the Insured, a Traveling Companion, a Family Member, a Business Partner or retained by the Policyholder.
“Primary” means the Company will pay first but reserves the right to recover from any other insurance carrier with which the Insured may be enrolled.
“Primary Residence” means an Insured’s fixed, permanent and main home for legal and tax purposes.
“Reasonable Additional Expenses” means expenses for meals, taxi fares, essential telephone calls and lodging which are necessarily incurred as the result of a Trip Delay and which are not provided by the Common Carrier or any other party free of charge.
“Reasonable and Customary Charges” means expenses which:
(a) are charged for treatment, supplies, or medical services Medically Necessary to treat the Insured’s condition;
(b) do not exceed the usual level of charges for similar treatment, supplies or medical services in the locality where the expenses are incurred; and
(c) do 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.
“Rental Return Date” means the return date listed on the car rental agreement.
“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. This date is specified in the travel documents.
“Return Destination” means the place to which the Insured expects to return from his/her Trip as shown in the enrollment form.
“Schedule” means the Schedule of Benefits which is shown at the beginning of the Certificate.
“Sickness” means an illness or disease diagnosed or treated by a Physician.
“Strike” means a stoppage of work which:
(a) is announced, organized, and sanctioned by a labor union; and
(b) interferes with the normal departure and arrival of a Common Carrier.
This includes work slowdowns and sickouts. The Insured’s Trip Cancellation coverage must be effective prior to when the strike is foreseeable. A strike is foreseeable on the date labor union members vote to approve a strike.
“Terrorist Incident” means an act of violence by any person acting on behalf of or in connection with any organization which is generally recognized as having the intent to overthrow or influence the control of any government, that is deemed terrorism by the United States Government other than civil disorder or riot, that is not an act of war, declared or undeclared, that results in Loss of life or major damage to property.
“Transportation” means any land, sea or air conveyance required to transport the Insured during an Emergency Evacuation. Transportation includes, but is not limited to, air ambulances, land ambulances and private motor vehicles.
“Travel Supplier” means the tour operator, Hotel, rental company, Cruise line or airline that provides prepaid travel arrangements for the Insured’s Trip.
“Traveling Companion” means a person or persons with whom the Insured has coordinated travel arrangements and intends 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 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 364 days; travel is primarily by Common Carrier and only incidentally by private conveyance.
“Trip Cost” means the dollar amount of Trip payments or deposits paid by the Insured prior the Insured’s Trip Departure Date and shown on any required enrollment form which is subject to cancellation penalties or restrictions. Trip cost will also include the cost of any subsequent prepaid payments or deposits paid by the Insured for the same Trip, after enrollment for coverage under this plan provided the Insured amends the enrollment form to add such subsequent payments or deposits and pays any required additional plan cost prior to the Insured’s Departure Date.
“Unforeseen” means not anticipated or expected and occurring after the effective date of coverage.
“Uninhabitable” means (1) the building structure itself is unstable and there is a risk of collapse in whole or in part; (2) there is exterior or structural damage allowing elemental intrusion, such as rain, wind, hail or flood; (3) immediate safety hazards have yet to be cleared, such as debris or downed electrical lines; (4) the rental property is without electricity, gas, sewer service or water; or (5) the Destination is Inaccessible.
“Unused” means the Insured’s financial Loss of any whole, partial or prorated prepaid, nonrefundable components of a Trip that are not depleted or exhausted.
EXCLUSIONS AND LIMITATIONS
GENERAL EXCLUSIONS
This plan does not cover any loss caused by or resulting from:
(a) intentionally self-inflicted Injury, suicide, or attempted suicide of the Insured, Family Member, Traveling Companion or Business Partner while sane or insane;
(b) Normal Pregnancy or Childbirth, other than Unforeseen Complications of Pregnancy, or elective abortion of the Insured, a Traveling Companion or a Family Member;
(c) participation in professional athletic events, motor sport or motor racing, including training or practice for the same;
(d) mountaineering where ropes or guides are normally used. The ascent or descent of a mountain requiring the use of specialized equipment, including but not limited to pick-axes, anchors, bolts, crampons, carabineers and lead or top-rope anchoring equipment;
(e) war or act of war, whether declared or not, participation in a civil disorder, riot or insurrection;
(f) operating or learning to operate any aircraft, as student, pilot or crew;
(g) air travel on any air-supported device, other than a regularly scheduled airline or air charter company;
(h) commission of or attempt to commit a felony by the Insured; (i) Mental, Nervous or Psychological Disorder;
(j) if the Insured’s tickets do not contain specific travel dates (open tickets);
(k) being under the influence of drugs or narcotics, unless administered upon the advice of a Physician or intoxication above the legal limit;
(l) any loss that occurs at a time when this coverage is not in effect;
(m) traveling for the purpose of securing medical treatment; (n) any Trip taken outside the advice of a Physician;
(o) PRE-EXISTING MEDICAL CONDITION EXCLUSION: The Company will not pay for any loss or expense incurred as the result of an Injury, Sickness or other condition (excluding any condition from which death ensues) of an Insured, Traveling Companion, Business Partner or Family Member which, within the 180 day period immediately preceding and including the Insured’s coverage effective date: (a) first manifested itself, worsened, became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment; (b) for which care or treatment was given or recommended by a Physician; (c) required taking prescription drugs or medicines, unless the condition for which the drugs or medicines are taken remains controlled without any change in the required prescription drugs or medicines.
PRE-EXISTING MEDICAL CONDITION EXCLUSION WAIVER
The Company will waive the pre-existing medical condition exclusion if the following conditions are met:
(1) This plan is purchased within 15 days of Initial Trip Payment;
(2) The amount of coverage purchased equals all prepaid nonrefundable payments or deposits applicable to the Trip at the time of purchase and the costs of any subsequent arrangements added to the same Trip are insured within 15 days of the date of payment or deposit for any subsequent Trip arrangements;
(3) All Insured’s are medically able to travel when this plan cost is paid;
(4) The Trip Cost does not exceed $100,000 per person (only applicable to Trip Cancellation/ Interruption).
This coverage will be terminated and no benefits will be paid under this Pre-existing Medical Condition Exclusion Waiver coverage if the full costs of all prepaid, nonrefundable Trip arrangements are not insured.
The following exclusions also apply to Trip Cancellation and Trip Interruption:
Unless otherwise provided by this plan Benefits will not be provided for any loss resulting (in whole or in part) from:
(a) travel arrangements canceled by an airline, Cruise line or tour operator, except as provided elsewhere in the plan;
(b) changes in plans by the Insured, a Family Member or Traveling Companion for any reason, unless Cancel for Any Reason was purchased;
(c) financial circumstances of the Insured, a Family Member or a Traveling Companion;
(d) any government regulation or prohibition;
(e) an event which occurs prior to the Insured’s coverage Effective Date;
(f) failure of any tour operator, Common Carrier, person or agency to provide the bargained-for travel arrangements or to refund money due the Insured.
The following exclusions apply to Baggage/Personal Effects and Baggage Delay:
Benefits will not be provided for any Loss, or damage to, caused by, or resulting in whole or in part from:
(a) animals, rodents, insects or vermin;
(b) bicycles (except when checked with a Common Carrier);
(c) motor vehicles, aircraft, boats, boat motors, ATV’s and other conveyances;
(d) artificial prosthetic devices, false teeth, any type of eyeglasses, sunglasses, contact lenses or hearing aids;
(e) keys, notes, securities, accounts, currency, deeds, food stamps, bills, credit cards or other evidences of debt, or tickets;
(f) money, stamps, stocks and bonds, postal or money orders;
(g) property shipped as freight, or shipped prior to the Departure Date;
(h) contraband, illegal transportation or trade;
(i) items seized by any government, government official or customs official;
(j) defective materials or craftsmanship;
(k) normal wear and tear;
(l) deterioration.
The following limitations and exclusions apply to Car Rental Collision Coverage:
Coverage is not provided in whole or in part for any loss to, or due to:
(a) the Insured or his/her Traveling Companion violating the rental agreement;
(b) rentals of trucks, (not including jeeps or SUV’s) 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, the Insured’s participation in a civil disorder, riot or insurrection.
The following exclusions also apply to the Accident Sickness Medical Expense Benefit:
Unless otherwise provided by this plan Benefits will not be provided for the following:
(a) routine physical examinations;
(b) mental health care;
(c) replacement of hearing aids, eye glasses, contact lenses and sunglasses;
(d) routine dental care;
(e) any service provided by the Insured, a Family Member or Traveling Companion;
(f) alcohol or substance abuse or treatment for the same;
(g) Experimental or Investigative treatment procedures;
(h) care or treatment which is not Medically Necessary, except for related reconstructive surgery resulting from trauma, infection or disease;
(i) coverage for Trips less than 100 miles from the Insured’s Primary Residence.
The following exclusion also applies to the Emergency Evacuation Benefit:
(a) coverage for Trips less than 100 miles from the Insured’s Primary Residence.
The following exclusions also apply to Accidental Death and Dismemberment and Flight Guard:
Benefits will not be provided for the following:
(a) loss caused by or resulting directly or indirectly from Sickness or disease of any kind;
(b) stroke or cerebrovascular accident or event, cardiovascular accident or event, myocardial infarction or heart attack, coronary thrombosis or aneurysm.
EXCESS INSURANCE LIMITATION
The insurance provided by the Policy for all coverages except Trip Cancellation, Trip Interruption and Car Rental Collision Coverage shall be in excess of all other valid and collectible insurance or indemnity. If at the time of the occurrence of any Loss payable under the Policy there is other valid and collectible insurance or indemnity in place, the Company shall be liable only for the excess of the amount of Loss, over the amount of such other insurance or indemnity and applicable deductible. Accident Sickness. Medical Expense will become Primary if the plan is purchased within 15 days of Initial Trip Payment.
