Pays for the cost of treatment associated with a medical emergency incurred while traveling.
Pays for the cost of treatment associated with a medical emergency incurred while traveling.
The Insurer will reimburse or pay this Primary benefit the Reasonable and Customary Charges for Medically Necessary Covered Expenses incurred by the Insured due to an Injury or Sickness within one year from the date of Injury or Sickness provided initial treatment was received during the Trip up to the Maximum Limit shown in the Schedule of Benefits.
Covered Expenses: Means charges incurred for any of the following services, supplies or treatments:
1) Emergency dental treatment received during a Trip limited to a maximum of $500;
2) Services of a Physician or Registered Nurse (R.N.);
3) Hospital charges;
5) local ambulance services to or from the Hospital;
6) artificial limbs, eyes, teeth or other prosthetic appliances;
7) Physical therapy will be covered up to 90 days after the Insured reaches his/her Return Destination..
Additional Exclusions: In addition to the General Exclusions, coverage is not provided for:
a) routine physical examinations;
b) mental, psychological or nervous disorders including but not limited to: anxiety, depression, neurosis or psychosis, panic attacks and post-traumatic stress disorder;
c) replacement of hearing aids, eye glasses, contact lenses, sunglasses, for the correction of vision or fitting of glasses;
d) routine dental care, dentures, false teeth;
e) alcohol or substance abuse or treatment for same;
f) any service provided by the Insured, an Immediate Family Member, or Traveling Companion.
1) “Accident” means a sudden, unexpected, unusual, specific event which occurs at an identifiable time and place, but shall also include exposure resulting from a mishap to a conveyance in which You are traveling.
2) “Accidental Injury” means Bodily Injury caused by an Accident (of external origin) being the direct and independent cause in the loss.
3) “Actual Cash Value” means purchase price less depreciation.
4) “Bankruptcy” means the filing of a petition for voluntary or involuntary Bankruptcy in a court of competent jurisdiction under Chapter 7 or Chapter 11 of the United States Bankruptcy Code 11 L.S.C. Subsection 101 et seq.
5) “Bodily Injury” means identifiable physical injury which:
a) is caused by an Accident, and
b) solely and independently of any other cause, except illness resulting from, or medical or surgical treatment rendered necessary by such injury, is the direct cause of death or dismemberment of You within twelve months from the date of the Accident.
6) “Business Partner” means an individual who:
a) is involved in a legal partnership; and
b) is actively involved in the day-today management of the business.
7) “Common Carrier” means any land, sea, and/or air conveyance operating under a license for the transportation of passengers for hire.
8) “Complications of Pregnancy” means:
(1) conditions requiring hospital stays (when the pregnancy is not terminated) whose diagnoses are distinct from pregnancy but are adversely affected by pregnancy or are caused by pregnancy, such as acute nephritis, nephrosis, cardiac decompensation, missed abortion, and similar medical and surgical conditions of comparable severity, and shall 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; and
(2) nonelective caesarean 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.
9) “Cruise” means any prepaid sea arrangements.
10) “Default” means a material failure or inability to provide contracted services due to financial insolvency.
11) “Domestic Partner” means a person who has registered as a Domestic Partner in a municipality that requires such registration or has provided the Insurer with a signed and notarized Affidavit of Partnership in a municipality that does not require such registration. The Affidavit will attest to the following:
a) Each person is 18 years of age or older and is mentally competent to consent to contract,
b) Neither one is married to or legally separated from anyone else,
c) They are not related by blood in a manner that would bar marriage under the laws of the state of New York,
d) They have been living together on a continuous basis prior to the date of application, and
e) Neither individual has been registered as a member of another domestic partnership within the last six months.
12) “Effective Date” means the date and time an Insured’s coverage begins, as outlined in the General Provisions section of this coverage.
13) “Exotic Vehicles” includes Bentley; Ferrari; Lamborghini; Lancia; Lotus; Maserati; Pininfarina; and Rolls Royce. The Insured must contact Travel Guard’s customer service at 1.800.826.1300 before renting to confirm whether the vehicle is covered.
14) “Family Member” means Your or Your Traveling Companion’s legal or common law spouse, Domestic Partner, parent, legal guardian, step-parent, grandparent, parents-in-law, grandchild, natural or adopted child, foster child, ward, step-child, childrenin- law, brother, sister, step-brother, step-sister, brother-in-law, sister-in-law, aunt, uncle, niece, or nephew.
15) “Hospital” means a facility that:
a) holds a valid license if it is required by the law;
b) operates primarily 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 professional nurse on duty or call;
e) has organized diagnostic and surgical facilities, either on the premises or in facilities available to the Hospital on a pre-arranged basis; and
f) is not, except incidentally, a clinic, nursing home, rest home, or convalescent home for the aged, or similar institution.
16) “Host at Destination” means a person with whom the Insured is sharing pre-arranged overnight accommodations at the host’s usual principal place of residence.
17) “Inclement Weather” means any severe weather condition which delays the scheduled arrival or departure of a Common Carrier.
18) “The Insurer” means National Union Fire Insurance Company of Pittsburgh, PA.
19) “Land/Sea Arrangements” means land and/or sea arrangements booked by the Travel Supplier.
20) “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; and
(3) is ordered by a Physician and performed under his or her care, supervision, or order.
21) “Natural Disaster” means flood, hurricane, tornado, earthquake, or blizzard that is due to natural causes.
22) “Physician” means a licensed practitioner of medical, surgical, or dental services acting within the scope of his/her license. The treating Physician may not be Yourself, a Traveling Companion, or a Family Member.
23) “Scheduled Departure Date” means the date on which You are originally scheduled to leave on the Trip.
24) “Scheduled Return Date” means the date on which You are originally scheduled to return to the point of origin or to a different final destination.
25) “Sickness” means illness or disease which is diagnosed or treated by a Physician after the effective date of this plan and while You are covered under this plan.
26) “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. This includes work slowdowns and sick-outs
27) “Terrorist Attack” means an incident deemed an act of terrorism by the U.S. government.
28) “Travel Supplier” means tour operator, cruise line, hotel, etc., who has made the land and/or sea arrangements.
29) “Traveling Companion” means a person who is sharing travel arrangements with You. Note: A group or tour leader is not considered a Traveling Companion unless You are sharing room accommodations with the group or tour leader.
30) “Trip” means prepaid Land/Sea Arrangements and shall include flight connections to join and depart such Land/Sea Arrangements, provided such flight connections are scheduled to commence within one (1) day of the Land/Sea Arrangements. Maximum Trip duration is 365 days.
31) “Unforeseen” means not anticipated or expected and occurring after the Effective Date of the coverage.
32) “You,” “Your,” or “the Insured” means a person who has purchased a Trip and who has paid the required plan cost for this plan provided herein.
The following exclusions apply to Parts A, B, D, and E. This plan does not cover any loss caused by or resulting from:
1) Pre-Existing Conditions (This exclusion does not apply if coverage was purchased within 15 days of initial Trip deposit and You are not disabled at the time You pay Your cost.);
2) Suicide or attempted suicide or intentionally self-inflicted injuries;
3) War, invasion, acts of foreign enemies, hostilities between nations (whether declared or not), civil war;
4) Participation in any military maneuver or training exercise;
5) Piloting or learning to pilot or acting as a member of the crew of any aircraft;
6) Mental or emotional disorders;
7) Dental treatment except as a result of Accidental Injury to sound, natural teeth within twelve (12) months of the Accidental Injury;
8) Any non-emergency treatment or surgery (does not apply to Part B), routine physical examinations, hearing aids, eyeglasses, or contact lenses;
9) Pregnancy and childbirth (except for Complication of Pregnancy)
10) Riot or insurrection;
11) A loss that results from an illness, disease, or other condition, event, or circumstance which occurs at a time when the coverage is not in effect for You;
12) Traveling for the purpose of securing medical treatment (applies to Part A only);
13) Participation as a professional in athletics (applies to Part A
14) Participating in bodily contact sports; skydiving; hanggliding; parachuting; mountaineering; any race; bungee cord jumping; and speed contests (applies to Part A only).
The following exclusions apply to Baggage/Personal Effects Loss coverage only in Part C: ANY LOSS OR DAMAGE TO: animals; automobiles and their equipment; boats; trailers, motors; motorcycles; other conveyances and their equipment (except bicycles while checked as baggage with a Common Carrier); eyeglasses, sunglasses, and contact lenses; artificial teeth and dental bridges; hearing aids; prosthetic limbs; keys, money, securities, and documents; tickets.
ANY LOSS CAUSED BY OR RESULTING FROM: Wear and tear, gradual deterioration; insects or vermin; inherent vice or damage; confiscation or expropriation by order of any government; radioactive contamination; war or any act of war whether declared or not; and property shipped as freight or shipped prior to the Scheduled Departure Date.
The following exclusions apply to Car Rental Collision Coverage coverage only in Part E:
1) Any obligation You assume under any agreement (except insurance collision deductible);
2) Rentals of trucks, campers, trailers, off-road vehicles, motor bikes, motorcycles, recreational vehicles, or Exotic Vehicles;
3) Any loss which occurs if You are in violation of the rental agreement;
4) Failure to report the loss to the proper local authorities and the rental car company;
5) Damage to any other vehicle, structure, or person as a result
of a covered loss.