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ProtectAssist: Description
of Coverage
SCHEDULE
OF BENEFITS
All coverages are per person.
| Trip
Cancellation....................................................................................................... |
Trip
Cost |
| Trip Interruption......................................................................................................... |
Trip Cost |
| Travel Delay.............................................................................................................. |
$ 750 |
| (Maximum of $150
per day) |
|
| Missed Connection................................................................................................... |
$ 250 |
| Baggage & Personal
Effects Loss........................................... |
$ 200 |
| (Includes lost, stolen,
or damaged luggage or travel documents) |
|
| Baggage Delay......................................................................................................... |
$ 750 |
| Medical Expense...................................................................................................... |
$ 25,000 |
| Emergency Medical
Transportation ............................................................................ |
$ 500,000 |
| Travel Guard® Assist................................................................................................. |
Included |
| LiveTravel Assistance
............................................................................................... |
Included |
| Concierge Services.................................................................................................... |
Included |
| |
|
| Additional
Coverages |
|
| Flight Guard (Maximum
of $ 500,000)......................................................................... |
Amount Selected |
| Collision Damage
Waiver........................................................................................... |
$ 25,000 |
| Additional Optional
Coverage |
|
| (for which appropriate
additional premium has been paid) |
|
| Medical Expense...................................................................................................... |
$ 25,000 |
Blanket
Travel Accident Insurance
This
document describes the benefits and basic provisions of the
Policy. Read it with care. The Policy is the only contract
under which benefits are paid.
PLEASE
READ THIS DOCUMENT CAREFULLY!
Insurance
Coverage
Underwritten
by the American Home Assurance Company, a New York insurance
company, 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. 19380. Collision Damage Waiver underwritten by the National
Union Fire Insurance Company of Pittsburgh, PA, 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 T30253AHAC. 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.
PRE-EXISTING
MEDICAL CONDITION EXCLUSION WAIVER:
The Pre-Existing Medical Condition Exclusion will be waived
if the insurance is purchased within fifteen calendar days
of the “initial trip payment.” (Day one is the
date the “initial trip payment” is received.)
This exclusion applies to all coverages. It applies to the
Insured, all the Immediate Family Members, and Traveling Companions,
whether or not they are traveling with the Insured. Please
read it carefully.
24-Hour
Emergency Assistance Telephone Numbers
Continental USA………1.800.549.9037
International.………1.715.345.0505
LiveTravel 24-Hour Assistance.………1.800.826.8597
Be
sure to use the appropriate country and city codes when
calling.
KEEP THESE NUMBERS WITH YOU WHEN YOU TRAVEL
PRE-EXISTING MEDICAL
CONDITION EXCLUSION:
The Insurer will not pay for loss or expense incurred as the
result of Injury or Sickness of an Insured or Immediate Family
Member which manifests itself, worsened, became acute, or
had symptoms, which would prompt a reasonable person to seek
diagnosis, care, or treatment, or request treatment by a physician
or treatment had been recommended during the 180 days immediately
preceding and including the Insured's coverage effective
date, unless the condition is controlled through the taking
of prescription drugs or medication and remains controlled
throughout the 180-day period. A Sickness has manifested itself
when medical care, treatment,
or diagnosis has been given. The Insurer
will waive this exclusion if the Insured meets the following
conditions:
1. The Insured purchases the plan within 15 days of making
his/her “initial trip payment”;
2. The amount of Trip Cancellation coverage purchased must
equal the full cost of all pre-paid non-refundable Trip arrangements;
3. The booking for this Trip must be the first and only booking
for this travel period and Destination;
4. The Insured must be medically able to travel when he/she
pays his/her premium.
DEFINITIONS
“Actual Cash Value”
means purchase price less depreciation.
“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 whose 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 classifiable distinct
Complication of Pregnancy.
“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, as shown
on the Enrollment Form.
“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: (1) resides with the Insured; (2) shares financial
assets and obligations with the Insured; the Insurer may require
proof of the Domestic Partner relationship in the form of
a signed and completed Affidavit of Domestic Partnership.
“Exotic Vehicle” means
Alfa Romeo, Aston Martin, Auburn, Avanti, Bentley, Bertone,
BMC/Leyland, BMW M Series, Bradley, Bricklin, Cosworth, Citroen,
Clenet, De Lorean, Excalibre, Ferrari, Fiat, Iso, Jaguar,
Jensen, Jensen Healy, Lamborghini, Lancia, Lexus, Lotus, Maserati,
Mercedes, MG, Morgan, Pantera, Panther, Pininfarina, Porsche,
Rolls Royce, Stutz, Sterling, and Triumph. The Insured must
contact Travel Guard customer service at 1.800.549.9037 before
renting to confirm whether the vehicle is covered.
“Financial Default”
means either (i) the complete suspension of operations due
to financial circumstances, whether or not a bankruptcy petition
is filed; or (ii) a partial suspension of the operations following
a filing of a bankruptcy petition.
“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 the Insured's or Traveling Companion's spouse,
Domestic Partner, 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 the Policy. The injury must be verified
by a Physician.
“Insured” means the person named
on the individual Enrollment Form.
“Insurer” means American
Home Assurance Company on all coverages with the exception
of Collision Damage Waiver. For Collision Damage Waiver coverage,
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
government-licensed practitioner of the healing arts including
accredited Christian Science Practitioners, acting within
the scope of his/her license. The treating Physician may not
be the Insured, Immediate Family Member, or a Traveling Companion.
“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.
“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.
“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 are work slowdowns and sickouts.
“Terrorist Incident”
means an act of violence, 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, 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.
“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.
“Traveling Companion”
means a person or persons with whom you have coordinated travel
arrangements and intend to travel with during the Trip. A
group or tour leader is not considered a Traveling Companion,
unless you are 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 365 days; and the Insured's Destination
is not to another home; travel is primarily by Common Carrier
and only incidentally by private conveyance.
“Trip Completion 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.
“Trip Departure Date”
means the date on which the Insured is originally scheduled
to leave on his/her Trip.
INDIVIDUAL
ELIGIBILITY, EFFECTIVE & TERMINATION DATES
Persons eligible for insurance under the policy
are any traveler(s) who purchases his/her insurance through
or from a properly licensed agent/agency located in the U.S.,
who enrolls for coverage and pays the premium, providing he/she
has not already departed on his/her Trip.
Effective Date: After premium is paid by the Insured and the
Enrollment Form is completed and signed, TRIP CANCELLATION
BENEFIT will be effective: (a) at 12:01 a.m. on the date after
the Enrollment Form is postmarked to TRAVEL GUARD® if
coverage is purchased by mail; (b) at 12:01 a.m. on the day
after the Enrollment Form is phoned in to TRAVEL GUARD®
if coverage is purchased via phone; (c) at 12:01 a.m. on the
day after the Enrollment Form is faxed to TRAVEL GUARD®
if coverage is purchased by facsimile; or (d) at 12:01 a.m.
on the day after the online purchase confirmation date. All
other coverages will begin on the later of: (a) the date and
time the Insured starts his/her Trip, or (b) the scheduled
Trip Departure Date shown on the Enrollment Form.
Termination Date: All coverage ends on the earlier of: (a)
the date the Trip is completed; (b) the scheduled Trip Completion
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.
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 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) intentionally self-inflicted Injury, suicide, or attempted
suicide while sane or insane;
(b) pregnancy or childbirth, or elective abortion, other than
the Complications of Pregnancy;
(c) participation in 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 disturbance,
riot, or insurrection;
(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, Immediate
Family Member, or a Traveling Companion, whether insured or
not;
(k) civil disorder;
(l) if the Insured's tickets do not contain specific
travel dates (open tickets);
(m) use of drugs, narcotics, or alcohol, unless administered
upon the advice of a Physician; or
(n) mental, psychological, or nervous disorders including,
but not limited to, anxiety, depression, neurosis, or psychosis.
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 Program Policies (TGP Policies). 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 TGP policies. The Insurer will pay no
more than $250,000 per occurrence, under the TGP policies,
to or on account of any person insured under the TGP policies.
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 for the Insured due to any of the following unforeseen
circumstances:
(a) Sickness (see
definition), 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. If the Insured must
cancel or interrupt his/her Trip due to Injury or Sickness
of an Immediate Family Member, it must be because their condition
is life-threatening, and because the Immediate Family Member
requires the Insured's care. Cancellations due to the
death of an Immediate Family Member or Traveling Companion
are covered;
(b) Financial Default of an airline, cruise line, or tour
operator resulting in the complete cessation of services.
Excluded is the organization from which the Insured purchased
his/her Trip and this coverage. Financial Default occurring
on or before the Insured's coverage effective date or
less than fourteen days after the Insured's coverage
effective date will not be covered. This coverage
applies only if insurance was purchased within fifteen calendar
days of “initial trip payment.” “Initial
trip payment” means the date the first
deposit is made to the Insured's Travel Agent toward
the cost of his/her Trip;
(c) Inclement Weather causing delay or cancellation of travel;
(d) Strike resulting in complete cessation of travel services
at the point of departure and Destination;
(e) the Insured's principal residence or Destination
being made uninhabitable by fire, flood, vandalism, or Natural
Disaster;
(f) the Insured, or a Traveling Companion being subpoenaed,
required to serve on a jury, hijacked, or quarantined; or
(g) a Terrorist Incident in a City listed on the Insured's
itinerary within 30 days of the Insured's scheduled
arrival. “City” means
an incorporated municipality having defined borders and does
not include the high seas, uninhabited areas, or airspace.
Trip
Cancellation Benefits: The Insurer will reimburse
this benefit up to the Maximum Limit shown on the Schedule
of Benefits for Trips that are canceled before the scheduled
Trip Departure Date due to the reasons shown at the beginning
of this section. The Insurer will reimburse for the following:
(a) forfeited, non-refundable prepaid deposits or payments,
or unused prepaid payments or deposits;
(b) the charge for a single supplement if the Insured's
Traveling Companion or traveling Immediate Family Member's
Trip is canceled but the Insured's is not.
Trip Interruption Benefits: The
Insurer will reimburse 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 reimburse for the following:
(a) forfeited, non-refundable, unused prepaid payments, made
prior to your Trip Departure Date or travel arrangements 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; or
(c) additional transportation expenses incurred by the Insured
to reach the original Trip Destination if the Insured is delayed,
and
leaves after the Trip 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.
The Insured Must: Contact LiveTravel (1.800.826.8597)
as soon as he/she knows the Trip is going to be canceled or
interrupted. Failure to do so may affect coverage.
In
addition to the General Exclusions, coverage is not provided
for losses caused by or as a result of:
(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,
except as provided elsewhere in the policy; (ii) travel arrangements
canceled by an airline, cruise line, or tour operator, except
as provided else- where in the policy; (iii) changes 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 Traveling Companion; (vi) Default
by the person, agency, or tour operator from whom the Insured
bought his/her coverage and purchased his/her travel arrangements;
(vii) any government regulation or prohibition; (viii) an
event which occurs prior to the Insured's coverage Effective
Date, whether known to the Insured or not; (ix) failure of
any tour operator, Common Carrier, person, or agency to provide
the bargained-for travel arrangements.
The Insured's Duties in the Event of Loss:
The Insured must provide the Insurer documentation of the
cancellation, interruption, or delay and proof of the expenses
incurred. The Insured must provide proof of payment for the
Trip such as canceled check or credit card statements, proof
of refunds received, copies of applicable tour operator or
Common Carrier cancellation policies, and any other information
reasonably required to prove the loss. Claims involving loss
due to Sickness, Injury, or death require signed patient (or
next of kin) authorization to release medical information
and an attending physician's statement. The Insured
must provide the Insurer with all unused air, rail, cruise,
or other tickets if he/she is claiming the value of those
unused tickets.
TRAVEL DELAY
The Insurer will reimburse up to $150 a day to the
Maximum Limit shown on the Schedule of Benefits if the Insured's
Trip is delayed for more than 12 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) the Insured being delayed by a traffic accident
while en route to a departure; or (b) carrier-caused delay;
(c) lost or stolen passports, travel documents, or money;
or
(d) quarantine; (e) being
hijacked; (f) unannounced Strike; (g) Inclement Weather which
prohibits Common Carrier departure; or (h) Natural Disaster.
Payments for additional accommodation expenses will not exceed
$100 per day per individual, up to the Maximum Limit of Coverage
for Reasonable Additional Expenses.
The Insured Must: Contact LiveTravel (1.800.826.8597)
as soon as he/she knows his/her Trip is going to be delayed
more than 12 hours. Failure to do so may affect coverage.
MISSED CONNECTIONS
The Insurer will reimburse this benefit up to the
Maximum Limit shown on the Schedule of Benefits if Inclement
Weather or Carrier causes cancellation or a delay of all regularly
scheduled airline flights for three to less than twelve hours
to your point of departure. You can collect up to $250 for
additional transportation costs to join the Trip (must be
same class of original tickets purchased). Reasonable accommodations
and meals (up to $100 per day), and/or the non-refundable,
unused portion of the prepaid expenses as long as the expense
is supported by a proof of purchase and is not reimbursable
by another source. Common Carrier must certify the delay of
the regularly scheduled airline flight.
LOSS
OF BAGGAGE AND PERSONAL EFFECTS
The Insurer will reimburse this benefit, 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.
There is a maximum of $4,000 per traveling group.
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) bicycles (except when checked with a Common Carrier);
(c) motor vehicles and other conveyances;
(d) artificial limbs, false teeth, any type of eyeglasses,
sunglasses, contact lenses, or hearing aids;
(e) tickets, keys, money, notes, securities, accounts, bills,
currency, deeds, food stamps or other evidences of debt, credit
cards, and other travel documents (except passports and visas);
(f) money, stamps, stocks and bonds, postal or money orders;
(g) property shipped as freight, or shipped prior to the Trip
Departure Date; or
(h) 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
defined on the Schedule of Benefits. The Insurer will not
pay more than $500 aggregate on all losses to: jewelry, watches,
furs, cameras and camera equipment, camcorders, sporting equipment,
computers, and other electronic devices. Items over $150 must
be accompanied by original receipts. If receipts are not provided,
benefits will be reduced.
Additional Exclusions: In addition
to the General Exclusions, the Insurer will not pay this loss
due to: (a) defective materials or craftsmanship; (b) normal
wear and tear; (c) deterioration; or (d) rodents, animals,
or insects.
Payment of Loss: The Insured Must:
(a) Report theft losses to police or other local authorities
as soon as possible; (b) take reasonable steps to protect
his/her Baggage from further damage and make necessary and
reasonable temporary repairs. The Insurer will reimburse the
Insured for those expenses. The Insurer will not pay for further
damage if the Insured fails to protect his/her Baggage; (c)
allow the Insurer to examine the damaged baggage and/or the
Insurer may require the damaged item to be sent in the event
of payment; (d) send sworn proof of loss as soon as possible
from date of loss, providing amount of loss, date, time, and
cause of loss, and a complete list of damaged/lost items;
or (e) in the event of theft or unauthorized use of the Insured's
credit cards, the Insured must notify the credit card company
immediately to reduce his/her loss. Any items $150 or more
must be accompanied by the original receipt. Benefits for
Baggage and Personal Effects will be the excess of any amount
paid or payable by a Common Carrier or other third party responsible
for the loss.
BAGGAGE DELAY
The Insurer will reimburse up to the Maximum Limit
shown on the Schedule of Benefits for the cost of necessary
personal effects purchased by the Insured during the Trip,
if the Insured's Baggage is delayed or misdirected for
more than 24 hours. Incurred expenses must be accompanied
by receipts. This benefit does not apply if Baggage is delayed
after the Insured reaches his/her Return Destination. The
Insurer will also pay the reasonable cost to return the Insured's
Baggage to his/her home, up to his/her limit of coverage.
Payment of Loss: The Insured must
provide documentation of the delay or misdirection of baggage
by the Common Carrier and receipts for the emergency purchases.
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
Reasonable and Customary Charges for medical and surgical
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 emergency dental treatment only during a Trip. Payment
for dental expenses are limited to $500. Dental coverage 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. The Insurer will pay for professional nursing,
Hospital charges, X-ray, and ambulance services and prosthetic
devices. Physical therapy will be covered up to 90 days after
the Insured reaches his/her Return Destination. Benefits payable
will not exceed Reasonable and Customary Charges for similar
services in the geographic area in which the services were
rendered. 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 the Insurer will pay will
be reduced by such excess. The Insurer also will not pay for
amounts paid or awarded under any workers' compensation,
disability benefit, or similar law.
Additional Exclusions: In addition
to the General Exclusions, coverage is not provided for: (a)
routine physical examinations; (b) mental health care; (c)
hearing aids, eye glasses, contact lenses, sunglasses, and
artificial teeth; (d) routine dental care; (e) treatment arising
from alcohol or substance abuse; (f) cosmetic surgery, other
than reconstructive surgery when necessary due to an Injury
as a result of an accident which occurs while coverage is
in effect; (g) 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 (1.800.549.9037 or 1.715.345.0505) 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. By calling us first, we
can authorize a cash advance for medical providers that require
upfront payments. 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. The Insurer will
arrange for emergency medical transportation services required
by the Insured as the result of any Injury or emergency Sickness
during a Trip.
Covered Expenses: The Insurer will
arrange and pay: (a) Reasonable and Customary Charges 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 Customary Charges for escort expenses required
by the Insured, if the Insured is disabled during a Trip and
an escort is recommended, in writing, by a Physician; (c)
Reasonable and Customary Charges for services for transportation
of the Insured's remains to his/her place of residence
if he/she dies during a Trip.
Service must be provided by a provider designated by the Insurer.
Timely notification by the Insured to the Insurer's
designated provider is required, with regard to emergency
evacuation.
The insurance provided under this benefit shall be in excess
of all other valid and collectible insurance or indemnity
and shall apply only when such other benefits are exhausted.
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 Trip Completion 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 this
policy.
The Insured Must: Contact TRAVEL GUARD® (1.800.549.9037
or 1.715.345.0505) prior to arranging emergency medical transportation.
Failure to do so may affect coverage.
FLIGHT
GUARD – FLIGHT ACCIDENT BENEFIT
The Insurer will pay for the Insured's covered
accidental loss of life, hand, foot, or sight which occurred:
1) while he or she was riding as a passenger on or boarding
or alighting from a Scheduled Air Carrier, and 2) within 365
days of the accident.
The amount of this benefit is shown below.
Percentage
of Principal
Loss: 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%
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.
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. “Scheduled
Air Carrier” means any air carrier holding
a certificate, license, or similar authorization for civilian
scheduled air transport issued by the country of the aircraft's
registry, and which in accordance with that authorization
flies, maintains, and publishes schedules and tariffs for
regular passenger service between named cities at regular
and specified times, but only if the aircraft is then being
used for any regular or chartered flight operated by such
carrier.
The Insurer will not pay more than 100% of the Principal Sum
for all losses due to the same accident.
COLLISION
DAMAGE WAIVER
The Insurer will pay this benefit up to the Maximum Limit
shown on the Schedule of Benefits. Coverage does not apply
in countries or states where the sale of this insurance is
prohibited by law. If the Insured rents a car from a licensed
auto rental company while on his/her Trip, and the car is
damaged due to collision, theft, vandalism, windstorm, fire,
hail, flood, or any cause not within the Insured's control
while in his/her possession, or the car is stolen while rented
by the Insured and not recovered, 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
(c) the Actual Cash Value of the car. Coverage is provided
to the Insured and his/her Traveling Companion, providing
the Insured and his/her 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 obligation the Insured or his/her Traveling Companion
assume under any agreement (except insurance collision deductible);
(b) rentals of trucks, campers, trailers, off-road or four
wheel drive vehicles, motor bikes, motorcycles, recreational
vehicles, or Exotic Vehicles; (c) any loss which occurs if
the Insured or his/her Traveling Companion are in violation
of the rental agreement; (d) failure to report the loss to
the proper local authorities and the rental car company; or
(e) damage to any other vehicle, structure, or person as a
result of a covered loss.
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 Expenses), 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 fill in the claim form and forward it to the Insured
for his or her review and signature. The completed form should
be returned to Travel Guard Group, Inc., 1145 Clark Street,
Stevens Point, Wisconsin 54481 (telephone 1.715.345.0505 or
1.800.826.7791). All California claims will be administered
by Mercury Claims Administrator Services, LLC.
Claim Procedures: Proof of Loss:
The claim forms must be sent back to Insurer 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 policy
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 Insurer has not provided claim forms within 15
days after the notice of claim, other proofs of loss should
be sent to Insurer by the date claim 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: To Whom Paid:
Benefits paid on account of an Insured's death will
be paid to the beneficiary he/she has chosen. This choice
must be in writing and filed with the Insurer, or filed with
the Insurer or Insurer's administrator if Insurer has
agreed in advance. If the Insured has not chosen a beneficiary,
or if there is no beneficiary alive when he/she dies, Insurer
will pay this benefit:
(1) To his/her spouse, if living.
(2) If there are none, 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 Insurer makes in good faith fully discharges
Insurer to the extent of that payment. All other benefits
will be payable to the Insured. However, if he/she has assigned
his/her benefits, Insurer will honor the assignment, if Insurer
has a signed copy of the assignment. A payment made pursuant
to such an assignment shall discharge Insurer from further
liability under the policy to the extent of such payment.
Under no circumstances shall Insurer be responsible for the
validity or sufficiency of any such assignment.
Payment of Claims: When Paid: Claims
will be paid as soon as Insurer receives complete proof of
loss (and verification of age).
Payment of Claims: To Whom Paid:
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 the insurance? If so, do not hesitate to
contact the insurance provider or agent to resolve your problem
at 1145 Clark Street, Stevens Point, WI 54481, or call at
1.800.549.9037.
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.
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. This 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 without prior written consent.
Insurer's
Privacy Notice

TRAVEL
GUARD® ASSIST
All benefits provided are service benefits, not financial
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 and payment
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 will provide 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.
CONCIERGE
SERVICES
Restaurant Referrals and Reservations:
Travel Guard will supply a restaurant referral based on your
needs and desires. Additionally Travel Guard will arrange
for reservations at the recommended restaurant. Based on availability.
Ground Transportation: Travel Guard
will locate and arrange for a transportation service to pick
you up and deliver you to your desired destination.
Event Ticketing: Travel Guard will
assist with the purchase of tickets to such events as sporting
events, theatre, and concerts. Based on availability.
Tee Times and Course Recommendations:
Travel Guard will facilitate the reservation of tee times
at available courses and recommend alternatives in case of
a booked course. Based on availability.
Floral Services: Travel Guard will
facilitate the ordering of flowers for such events as birthdays,
anniversaries, holidays, and other special occasions.
Non-insurance services through Travel Guard®
Assist are provided by Travel Guard®
Satisfaction
Guaranteed: Travel Guard is committed
to providing products and services that will exceed expectations.
If You are not completely satisfied, You can receive a refund
of the premium, minus the service fee. Requests must be
submitted to Travel Guard in writing within 15 days of the
effective date of the Policy, provided it is not past the
original departure date.
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.
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 the Insured's coverage
is governed by the law of a state other than Florida.
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 the Insured's personal auto insurance, homeowner's,
personal liability policy, or other source of coverage.
106700-CT
10/04 ©TRAVEL GUARD® International 12/04
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