Emergency Evacuation arranges to medically transport a patient to an appropriate medical facility. Medical Repatriation arranges for a patient to return home to receive care. Repatriation of Remains arranges for return of deceased remains back to the place of residence.
EMERGENCY EVACUATION & REPATRIATION OF REMAINS
The Company will pay for Covered Emergency Evacuation Expenses incurred if an Insured suffers an Injury or Sickness while he or she is on a Trip that warrants his or her Emergency Evacuation. Benefits payable are subject to the Maximum Limit shown on the Schedule of Benefits or Declarations Page for all Emergency Evacuations due to all Injuries from the same accident or all Sicknesses from the same or related causes.
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.
Expenses for Transportation must be:
a) ordered by the 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;
b) required by the standard regulations of the conveyance transporting the Insured; and
c) authorized in advance by Travel Guard. In the event theInsured’s Injury or Sickness prevents prior authorization of the Emergency Evacuation, Travel Guard must be notified as soon as reasonably possible. Special Limitation: In the event Travel Guard could not be contacted to arrange for emergency Transportation, benefits are limited to the amount the Company would have paid had the Company or their authorized representative been contacted. The Company will also pay a benefit for Reasonable and Customary Charges incurred for an escort’s transportation and accommodations if an attending Physician recommends in writing that an escort accompany the Insured.
Emergency Evacuation means:
a) the Insured’s medical condition warrants immediate transportation from the place where the Insured is injured or sick to the nearest adequate licensed medical facility where appropriate medical treatment can be obtained;
b) after being treated at a local licensed medical facility, the Insured’s medical condition warrants transportation to the Insured’s home or adequate licensed medical facility nearest the Insured’s home to obtain further medical treatment or to recover; or
c) both a) and b) above.
LIMITATIONS:
1) Benefits are only available under Emergency Evacuation if they are not provided under another coverage in this Policy.
2) The Maximum Limit payable for both Emergency Evacuation and Repatriation of Remains is shown in the Schedule of Benefits or Declarations Page.
ADDITIONAL BENEFITS
In addition to the above covered expenses, if the Company has previously evacuated an Insured to a medical facility, the Company will pay his/her airfare costs from that facility to the Insured’s Return Destination, within one year from the Insured’s original Return Date, less refunds from the Insured’s unused transportation tickets. Airfare costs will be economy, or same class as the Insured’s original tickets.
REPATRIATION OF REMAINS
The Company will pay Repatriation Covered Expenses up to the Maximum Limit shown on the Schedule of Benefits to return the Insured’s body to city of burial if he/she dies during the Trip. Repatriation Covered Expenses include, but are not limited to, the Reasonable and Customary Charges for: transportation, according to airline tariffs, of the remains by the most direct and economical conveyance and route possible. Travel Guard must make all arrangements and authorize all expenses in advance for this benefit to be payable. 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 his or her authorized representative been
contacted.
(Capitalized terms within this Policy 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.
“Children” or “Child” means, with respect to Medical Expense and Emergency Evacuation, unmarried children of the Insured, including natural children from the moment of birth, and step, foster or adopted children from the moment of placement in the Insured’s home, under age 25. 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.
“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, 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.
“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.
“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 of Benefits or Declarations Page for each coverage 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: (1) resides with the Insured; and (2) shares financial assets and obligations with the Insured. The Company may require proof of the Domestic Partner relationship in the form of a signed and completed Affidavit of Domestic Partnership
“Exotic Vehicle” means antique cars and any vehicle with an original manufacturer’s suggested retail price greater than $50,000. Antique cars means cars that are over 20 years old or have not been manufactured for 10 or more years.
“Experimental or Investigative” means treatment, a device or prescription medication which is recommended by a Physician, but is not considered by the medical community as a whole to be safe and effective for the condition for which the treatment, device or prescription medication is being used. This includes any treatment, procedure, facility, equipment, drugs, drug usage, devices, or supplies not recognized as accepted medical practice, and any of those items requiring federal or other governmental agency approval not received at the time services are rendered.
“Family Member” means the Insured’s, or Traveling Companion’s spouse, Domestic Partner, Child, daughter-in- law, son-in-law, brother, sister, mother, father, grandparents, grandchild, step-child, step-brother, step-sister, step- parents, parents-in-law, brother-in-law, sister-in-law, aunt, uncle, niece, nephew, legal guardian, Caregiver, foster Child, ward, or legal ward, spouse, or Domestic Partner of any of the above.
“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.
“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 or the armed forces.
“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 an Owned or Rented 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 this Policy is in force, and resulting directly and independently of all other causes of Loss covered by this Policy. The injury must be verified by a Physician.
“Insured, You or Your” means a person: a) for whom any required Enrollment Form has been completed; and b) for whom any required plan cost has been paid.
“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, or blizzard that is due to natural causes.
“Necessary Personal Effects” means items such as clothing and toiletry items, which were included in the Insured’s Baggage and are required for the Insured’s Trip.
“Owned or Rented Vehicle” means a self-propelled private passenger motor vehicle with four or more wheels which is of a type both designed and required to be licensed for use on the highways of any state or country that is rented or owned by the Insured. Owned or Rented Vehicle includes, but is not limited to, a sedan, station wagon, jeep-type vehicle, pickup truck, van, camper or motor home type. Owned or Rented Vehicle does not include a mobile home or any motor vehicle which is used in mass or public transit.
“Physician” means a licensed practitioner of the healing arts including accredited Christian Science Practitioners, medical, surgical, or dental, services acting within the scope of his/her license. The treating Physician may not be the Insured, a Traveling Companion, a Family Member, or a Business Partner.
“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 a person’s fixed, permanent and principal home for legal and tax purposes.
“Reasonable and Customary Charges” means an expense which: (1) is charged for treatment, supplies, or medical services Medically Necessary to treat the Insured’s condition; (2) does not exceed the usual level of charges for similar treatment, supplies or medical services in the locality where the expense is incurred; and (3) does not include charges that would not have been made if no insurance existed. In no event will the Reasonable and Customary Charges exceed the actual amount charged.
“Return 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 Enrollment Form.
“Sickness” means an illness or disease diagnosed or treated by a Physician after the Insured’s effective date of coverage under this Policy.
“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 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, 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, 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.
“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, and/or airline that provides pre-paid 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) a period of round-Trip travel away from home to a Destination outside the Insured’s City of residence; b) the purpose of the Trip is business or pleasure and is not to obtain health care or treatment of any kind; c) the Trip has defined Departure and Return dates specified when the Insured applies; d) the Trip does not exceed 365 days; and e) travel is primarily by Common Carrier and only incidentally by private conveyance.
“Trip Cost” means the dollar amount of Trip payments or deposits reflected on any required enrollment form which are subject to cancellation penalties or restrictions paid by the Insured prior to the Insured’s Trip Departure Date. Trip Cost will also include the cost of any subsequent pre-paid payments or deposits paid by the Insured for the same Trip, after enrollment for coverage under this Policy provided the Insured amends his or her 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 this Policy.
“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 on roofs or downed electrical lines; or (4) the rental property is without electricity or water.
This Policy 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) pregnancy, childbirth, or elective abortion, other than Complications of Pregnancy;
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) loss or damage caused by detention, confiscation, or destruction by customs;
i) any felonies committed by the Insured;
j) Mental, Nervous or Psychological Disorder or rest cures;
k) if the Insured’s tickets do not contain specific travel dates (open tickets);
l) use of drugs, narcotics, or alcohol, unless administered upon the advice of a Physician; (not applicable to medical benefits)
m)any failure of a provider of travel related services (including any Travel Supplier) to provide the bargained-for travel services or to refund money due the Insured;
n) Experimental or Investigative treatment or procedures;
o) any loss that occurs at a time when this coverage is not in effect;
p) traveling for the purpose of securing medical treatment;
q) care or treatment which is not Medically Necessary, except for related reconstructive surgery resulting from trauma, infection, or disease; and
r) 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, a 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 or 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.
The following exclusions apply to Baggage, Personal Effects, Sportsman Equipment and Travel Documents and Baggage and Sportsman Equipment Delay:
Benefits will not be provided for any loss or damage to 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
e) tickets, keys, notes, securities, accounts, bills, currency, deeds, food stamps or other evidences of
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) inherent vice or damage; l) seizure or destruction under quarantine or custom regulation; m)transporting contraband or illegal trade;
n) mysterious disappearance;
o) normal wear and tear;
p) deterioration.
The following limitations and exclusions apply to Renter’s Collision Insurance:
Coverage is not provided (in whole or in part) for any loss due to:
a) any loss which occurs if the Insured or his/her
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, civil commotion, insurrection or riot;
j) Injury sustained while committing or attempting to commit a crime.
The following exclusions apply to Trip Cancellation and Trip Interruption:
Unless otherwise provided by this Policy, 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 this
b) changes 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 business (unless Cancel for Work Reasons was purchased) or contractual obligations of the Insured, a Family Member, or Traveling Companion, for any reason;
e) any government regulation or prohibition;
f) an event which occurs prior to the Insured’s coverage Effective Date;
g) failure of any tour operator, Common Carrier, person or agency to provide the bargained-for travel arrangements.
The following exclusions apply to the Medical Expense Benefit:
Benefits will not be provided for any loss resulting (in whole or in part) from:
a) routine physical examinations;
b) mental health care;
c) replacement of hearing aids, eye glasses, contact lenses;
d) routine dental care;
e) any service provided by the Insured, a Family Member,
f) alcoholism and drug addiction.
The following exclusion applies to Accidental Death and Dismemberment:
a) the Company will not pay for loss caused by or resulting from Sickness or disease of any kind.
The following exclusions apply to Flight Guard:
a) Sickness or disease whether the loss results directly or indirectly from any of these;
b) stroke or cerebrovascular accident or event; cardiovascular accident or event; myocardial infarction or heart attack; coronary thrombosis; aneurysm
EXCESS INSURANCE LIMITATION (Not applicable to medical benefits.) The insurance provided by the Policy for all coverages except Trip Cancellation and 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.