What is Medical Evacuation & Repatriation travel insurance?

If you become critically ill or injured while traveling and local hospitals are unable to provide adequate treatment, the Medical Evacuation benefit can provide coverage for emergency medical evacuation services.

Most insurance plans with Medical Evacuation coverage will transport you, or an insured member of your party, to the nearest adequate medical facility. If the treating physician determines you should return to your home country to receive further medical attention, this benefit can also cover those transportation expenses.

What Does Medical Evacuation Insurance Cover?

Medical Evacuation is a benefit included in most travel insurance policies that provides coverage in the event of a medical emergency that requires an evacuation. Most Medical Evacuation policies can include coverage for the following:

  • Transportation to the nearest adequate medical facility: If the facility you arrive at is unable to treat your condition, this benefit may cover the cost to transport you to another facility to receive medical services.
  • Transportation back home: If the treating physician or medical professional believes it is in your best interest to return home for treatment, this benefit may cover the cost emergency transportation to back home.
  • Hospital companion: If you are traveling alone, some Medical Evacuation policies can cover the cost of a round trip ticket for a close friend or family member to visit you in the hospital if your stay reaches the minimum length outlined in your policy, usually 7 days.
  • Traveling companion: If you are traveling with a companion, this benefit may reimburse their hotel stay, meals, and transportation expenses so they can remain nearby while you receive treatment.
  • Return of children: If you are traveling with children at the time of your hospitalization, this benefit may cover the cost to transport your children back home so they can be in the care of a close friend or relative while you are treated.
  • Repatriation of remains: If you die during your trip, this benefit may cover the cost to return your remains to the city of the burial site, as well as cremation, embalming, and other necessary expenses.

Common Medical Evacuation Exclusions

Even the best travel insurance plans have limitations. While the Medical Evacuation benefit can be used in a wide-range of scenarios, below are some common exclusions you may find when comparing travel medical insurance.

  • Pre-Existing Conditions: Most plans won’t cover claims relating to a pre-existing medical condition unless stated otherwise.
  • Drug & Alcohol Abuse: Claims stemming from drug or alcohol abuse, including overdoses, will likely not be covered.
  • Pregnancy: Routine pregnancy checkups and childbirth are typically not covered by travel protection.
  • Medical Tourism: Traveling for the purpose of having an elective cosmetic or plastic surgery procedure may not be covered by your plan.

Be sure to check the policy details of your specific medical plan for a more detailed list of exclusions and limitations prior to departing for your trip.

How Much Medical Evacuation Insurance Do I Need?

Travel insurance companies offer a wide-range of Medical Evacuation coverage limits. On Squaremouth.com, plans offer anywhere between $50,000 to $2,000,000 in coverage per traveler.

For most international trips, we recommend at least $100,000 in emergency Medical Evacuation coverage. This is due to the potentially high cost of transporting you during an emergency situation, as well as the cost of receiving treatment abroad for medical emergencies. For more cruises or remote trips, we recommend a policy with at least $250,000 in Medical Evacuation coverage.

Will My Health Insurance Cover Medical Evacuations?

Most primary health insurance plans, such as Medicare or an employer sponsored plan, do not provide coverage outside the the United States. While your medical transport may be covered in the USA, it is not likely to be covered if you are planning international travel.

If you are planning travel overseas, consider purchasing a comprehensive travel insurance policy. These plans not only provide peace of mind, but also includes coverage for out of pocket medical expenses, cancellations, delays, and personal belongings.

Do Credit Cards Provide Coverage for Medical Evacuations?

No, credit cards do not typically provide insurance coverage for medical treatment or transportation while traveling. The cards that do offer coverage for medical care typically offer coverage limits that fall short of Squaremouth’s coverage recommendations.

Many travel credit cards do, however, include other valuable benefits, such as Trip Cancellation, Trip Interruption, and various travel assistance services.

What is a Medical Evacuation Membership?

A Medical Evacuation Membership is a type of service offered by various organizations, typically insurance companies or specialized assistance companies, that provides coverage and assistance for emergency medical evacuations. These memberships are designed to assist individuals who encounter medical emergencies while traveling or living abroad, particularly in remote or underdeveloped areas where access to adequate medical care may be limited.

Medical evacuation memberships typically cover the cost of transporting the individual to the nearest appropriate medical facility capable of providing the necessary treatment. This usually involves ground ambulance transportation and air ambulance services.

Unlike a travel insurance plan that covers you for the duration of your trip, a Medical Evacuation Membership involves an annual or short-term fee. One of the more well-known Medical Evacuation Membership programs is MedJet.

Please be aware that coverage and eligibility requirements for this benefit differ by policy. The tables below show the providers that offer Medical Evacuation & Repatriation coverage.

Looking for a policy with Medical Evacuation & Repatriation coverage?

Enter your trip information on our custom quote form. Once you receive your results, select the Medical Evacuation & Repatriation filter to find the best policy for your trip with the coverage that you need.

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Medical Evacuation & Repatriation by Provider

Last Updated: 07/17/2024
Aegis Aegis
Policy Name and Summary of Coverage
1

Go Ready Trip Cancellation

No coverage

There is no Medical Evacuation & Repatriation coverage with this plan.

2

Go Ready Choice

$250,000 per person

B. EMERGENCY EVACUATION AND REPATRIATION PLAN

1. EMERGENCY EVACUATION AND REPATRIATION BENEFIT

Subject to SECTION II – EFFECTIVE AND TERMINATION DATES OF INSURANCE, A. EFFECTIVE DATE, the Insured’s coverage under the Emergency Evacuation And Repatriation Benefit will take effect on the Scheduled Date of Departure.

We will pay the Insured an Emergency Evacuation And Repatriation Benefit, for the following Covered Expenses incurred by the Insured, up to the corresponding Maximum Covered Amount per Insured shown in the Schedule, subject to the following: (i) health care related Covered Expenses will only be payable at the Usual and Customary level of payment; Covered Expenses not related to health care will only be payable at the reasonable and customary level of payment; (ii) benefits will be payable only for Covered Expenses resulting from a Sickness that first manifests itself or a Covered Injury that occurs while on a Covered Trip;

(iii) the Insured must first receive treatment during his/her Covered Trip; and (iv) benefits payable as a result of incurred Covered Expenses will only be paid after benefits have been paid under any Other Valid and Collectible Insurance in effect for the Insured or in accordance with a Coordination of Benefits provision in jurisdictions where excess coverage provisions are not permitted.

The following are Covered Expenses under this Emergency Evacuation and Repatriation Benefit:

a. expenses incurred by the Insured for Physician-ordered emergency medical evacuation, including medically appropriate transportation and necessary medical care en route, to the nearest suitable Hospital if the onsite attending Physician certifies that the Insured is medically able to travel when the Insured is critically Sick or Injured and no suitable local care is available, subject to Our or the Assistance Provider’s prior approval;

b. expenses incurred for non-emergency medical evacuation, including medically appropriate transportation and medical care en route, to a Hospital or to the Insured’s Home when deemed medically necessary by the attending Physician, subject to Our or the Assistance Provider’s prior approval;

c. expenses for transportation not to exceed the cost of one round-trip economy class air fare subject to a maximum of $3,000 to the place of Hospitalization for one person chosen by the Insured as well as lodging and meals not to exceed $300 per day for a maximum of 15 days, provided the Insured is traveling alone and is Hospitalized for more than 3 days. Coverage is also provided immediately (to up to 15 days) following the Insured being a victim of a Felonious Assault and needs the support of a Family Member;

d. expenses for transportation not to exceed the cost of one-way economy class air fare to the Insured’s Home, including escort expenses, if the Insured is 17 years of age or younger and left unattended due to the death or Hospitalization of an accompanying adult(s), subject to Our or the Assistance Provider’s prior approval;

e. expenses for one-way economy class air fare (or We will match the class of the original tickets) to the Insured’s Home, from a medical facility to which the Insured was previously evacuated, less any refund paid or payable from the Insured’s unused transportation tickets, if these expenses are not covered elsewhere in this Policy;

f. repatriation expenses for preparation and air transportation of the Insured’s remains to his/her Home, or up to an equivalent amount for a local burial in the country where death occurred, if the Insured dies while outside the United States of America. Covered Expenses under this benefit include the reasonable and customary expenses for: (i) embalming; (ii) cremation; (iii) the most economical coffins or receptacles adequate for transportation of the remains; and (iv) transportation of the remains, by the most direct and economical conveyance and route possible. The Assistance Provider must make all arrangements and authorize all expenses in advance for this benefit to be payable;

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3

Go Ready Pandemic Plus

$500,000 per person

EMERGENCY MEDICAL EVACUATION & MEDICALLY NECESSARY REPATRIATION

We will pay, subject to the limitations set out herein, for covered Emergency Medical Evacuation expenses reasonably incurred if You suffer an Accidental Injury or Emergency Sickness that warrants Your Emergency Medical Evacuation while You are on a Covered Trip. Benefits payable are subject to the Maximum Benefit per Insured shown on the Schedule of Benefits for all Emergency Medical Evacuations due to all injuries from the same Accident or all Emergency Sickness from the same or related causes.

A legally licensed Physician, in coordination with Our designated Assistance Company, must order the Emergency Medical Evacuation and must certify that the severity of Your Accidental Injury or Emergency Sickness warrants Your Emergency Medical Evacuation to the closest adequate medical facility. We or Our Assistance Company or We must review and approve the necessity of the Emergency Medical Evacuation based on the inadequacy of local medical facilities. The Emergency Medical Evacuation must be coordinated through the most direct and economical conveyance and route possible, such as air or land ambulance or commercial airline carrier.

Covered Emergency Medical Evacuation expenses are those for Medically Necessary Transportation, including Reasonable and Customary medical services and supplies incurred in connection with Your Emergency Medical Evacuation. Expenses for Transportation must be: a) recommended by the attending Physician; b) required by the standard regulations of the conveyance transporting You; and c) reviewed and pre-approved by Our designated Assistance Company.

We will also pay Reasonable and Customary expenses, for escort expenses required by You, if You are disabled during a Covered Trip and an escort is recommended in writing by an attending Physician and such expenses are pre-approved by Our designated Assistance Company.

If You are hospitalized for more than the number of days shown on the Schedule of Benefits following a covered Emergency Medical Evacuation, We will pay, subject to the limitations set out herein, for expenses:

a) to return You to your residence in the United States, with an attendant if necessary, any of Your Dependent Children who were accompanying You when the Accidental Injury or Emergency Sickness occurred and were left alone as a result of same. Our payment will not exceed the cost of a single one-way economy airfare ticket, less the value of applied credit from any unused return travel tickets per person; and

b) to bring 1 person chosen by You to and from the Hospital or other medical facility where You are confined if You are alone, but not to exceed the cost of 1 round-trip economy airfare ticket.

In addition to the above Covered Expenses, if We have previously evacuated You to a medical facility, We will pay Your airfare costs from that facility to Your primary residence, within 1 year from Your original Scheduled Return Date, less refunds from Your unused Transportation tickets. Airfare costs will be economy or first class if Your original tickets are first class. This benefit is available only if it is not provided under another coverage in the Policy.

Transportation of Spouse or Domestic Partner: If You are confined to the Hospital for more than the number of days shown on the Schedule of Benefits or if the attending Physician certifies that due to Your Accidental Injury or Emergency Sickness, You will be required to stay in the Hospital for more than the number of consecutive days shown on the Schedule of Benefits or if You die on the Covered Trip and require Repatriation of Remains, We will return Your spouse or Domestic Partner to Your primary residence. Our payment will not exceed the cost of a single one-way economy airfare ticket, less the value of applied credit from any unused return travel ticket.

Escort Service: We will pay to return any of Your children who were accompanying You at the time of Your Accidental Injury or Emergency Sickness back to Your primary residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way economy airfare ticket, less the value of any applied credit from any unused return travel tickets for each person. The escort service must be arranged and approved by Us or Our designated Assistance Company.

REPATRIATION OF REMAINS

We will pay the reasonable Covered Expenses incurred to return Your body to Your place of permanent residence if You die due to Accidental Injury or a Covered Sickness during the Covered Trip. No payment will exceed the maximum shown on the Schedule of Benefits.

Covered Expenses include: a) The collection of the body of the deceased; b) the transfer of the body to a professional funeral home; c) embalming and preparation of the body or cremation if so desired; d) standard shipping casket; e) any required consular proceedings; f) the transfer of the casket to the airport and boarding of the casket onto the plane; g) any required permits and corresponding airfare; and h) the transfer of the deceased to their final destination. All Covered Expenses must be approved in advance by Our designated Assistance Company.

Escort Service: We will pay to return any of Your children who were accompanying You at the time of Your death back to Your primary residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way economy airfare ticket, less the value of any applied credit from any unused return travel tickets for each person. The escort service must be arranged and approved by Us or Our designated Assistance Company.

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Policy Name and Summary of Coverage
4

Pro

$250,000 per person

MEDICAL EVACUATION AND REPATRIATION OF REMAINS

Benefits will be paid, up to the Maximum Benefit Amount shown in the Schedule of Benefits, when You suffer a covered Sickness, Injury, or Loss of life, during Your Trip, for the following:

Emergency Medical Evacuation

We will pay the Usual and Customary level of charges for Transportation Expense for an emergency Medical Evacuation to the nearest Hospital or medical facility where suitable Medically Necessary treatment is available, provided: 1) Your local attending Physician and We or Our Program Assistance Provider determine that Your condition is acute, severe or life threatening; and 2) that adequate Medically Necessary treatment is not available in Your immediate area.

Medically Necessary Repatriation

We will pay for a Medical Evacuation to return You to Your point of origin, Your primary place of residence, or to a Hospital or medical facility closest to Your primary place of residence capable of providing continued treatment, if Your local attending Physician and We or Our Program Assistance Provider determine that it is Medically Necessary.

We will pay for one of the following methods of transportation, as pre-approved by Us or Our Program Assistance Provider:

1) commercial air upgrade to Business or First Class, less refunds from Your unused transportation tickets;

2) other Transportation Expense.

Transportation must be via the most direct and economical route.

Hospital of Choice: You may choose to be transported to a Hospital in a city within the United States of America other than the city of Your primary place of residence. The maximum amount payable is limited to the cost of transportation to Your primary place of residence.

Repatriation of Remains

Benefits will be paid for covered Repatriation Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, to return Your body to Your city of primary residence in the United States of America if You die during Your Trip. “Repatriation Expenses” means expenses for embalming, local cremation, minimally necessary casket for transport and air transportation of Your remains and any other expenses required to comply with local laws or regulations to arrange transport of Your remains.

All Repatriation Expenses must be approved in advance by Us or Our Program Assistance Provider.

Additional Medical Evacuation Benefits:

Transportation to Join You: If You are or will be hospitalized for more than 7 days, We will pay, up to the cost of a single round-trip Economy Transportation ticket and, up to $250 per day up to 5 days for expenses for hotel nights, meals and local transportation for one person chosen by You to visit Your bedside, provided You are traveling alone and emergency Medical Evacuation or non-emergency Medical Evacuation is not imminent.

Transportation of Dependent Children: If You die or are hospitalized for more than 7 days, We will pay, up to the cost of a single one-way Economy Transportation ticket (less the value of applied credit from any unused return travel tickets) per
person, to return Your Dependent children (and any accompanying minor persons under Your care) who are left unattended by Your death or hospitalization to their home (with an attendant, if considered necessary by Us or Our Program Assistance Provider.

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5

Pro Plus

$500,000 per person

MEDICAL EVACUATION AND REPATRIATION OF REMAINS

Benefits will be paid, up to the Maximum Benefit Amount shown in the Schedule of Benefits, when You suffer a covered Sickness, Injury, or Loss of life, during Your Trip, for the following:

Emergency Medical Evacuation

We will pay the Usual and Customary level of charges for Transportation Expense for an emergency Medical Evacuation to the nearest Hospital or medical facility where suitable Medically Necessary treatment is available, provided: 1) Your local attending Physician and We or Our Program Assistance Provider determine that Your condition is acute, severe or life threatening; and 2) that adequate Medically Necessary treatment is not available in Your immediate area.

Medically Necessary Repatriation

We will pay for a Medical Evacuation to return You to Your point of origin, Your primary place of residence, or to a Hospital or medical facility closest to Your primary place of residence capable of providing continued treatment, if Your local attending Physician and We or Our Program Assistance Provider determine that it is Medically Necessary.

We will pay for one of the following methods of transportation, as pre-approved by Us or Our Program Assistance Provider:

1) commercial air upgrade to Business or First Class, less refunds from Your unused transportation tickets;

2) other Transportation Expense.

Transportation must be via the most direct and economical route.

Hospital of Choice: You may choose to be transported to a Hospital in a city within the United States of America other than the city of Your primary place of residence. The maximum amount payable is limited to the cost of transportation to Your primary place of residence.

Repatriation of Remains

Benefits will be paid for covered Repatriation Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, to return Your body to Your city of primary residence in the United States of America if You die during Your Trip.

“Repatriation Expenses” means expenses for embalming, local cremation, minimally necessary casket for transport and air transportation of Your remains and any other expenses required to comply with local laws or regulations to arrange transport of Your remains.

All Repatriation Expenses must be approved in advance by Us or Our Program Assistance Provider.

Additional Medical Evacuation Benefits:

Transportation to Join You: If You are or will be hospitalized for more than 7 days, We will pay, up to the cost of a single round-trip Economy Transportation ticket and, up to $250 per day up to 5 days for expenses for hotel nights, meals and local transportation for one person chosen by You to visit Your bedside, provided You are traveling alone and emergency Medical Evacuation or non-emergency Medical Evacuation is not imminent.

Transportation of Dependent Children: If You die or are hospitalized for more than 7 days, We will pay, up to the cost of a single one-way Economy Transportation ticket (less the value of applied credit from any unused return travel tickets) per person, to return Your Dependent children (and any accompanying minor persons under Your care) who are left unattended by Your death or hospitalization to their home (with an attendant, if considered necessary by Us or Our Program Assistance Provider.

Optional Benefits

Emergency Evacuation Upgrade – Additional $100,000

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AXA Assistance USA AXA Assistance USA
Policy Name and Summary of Coverage
6

Silver

$100,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;

b) after being treated at a local Hospital, Your medical condition warrants Transportation to Your Home where You reside, to obtain further medical treatment or to recover; or

c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;

b) required by the standard regulations of the conveyance transporting You; and

c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the Company’s authorized Travel Assistance Company.

Transportation of Minor Children: If You are expected to be in the Hospital for more than seven (7) days following a covered Emergency Evacuation, or pass away during the Trip, the Company will return Your unattended minor child(ren) (under the age of eighteen (18)) who is/are accompanying You on the scheduled Trip, to the domicile of a person nominated by You or Your next of kin with an attendant if necessary.

Hospital Companion:

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

REPATRIATION OF REMAINS

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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7

Gold

$500,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;
b) after being treated at a local Hospital, Your medical condition warrants Transportation to Your Home where You reside, to obtain further medical treatment or to recover; or
c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;
b) required by the standard regulations of the conveyance transporting You; and
c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the Company’s authorized Travel Assistance Company.

Transportation of Minor Children: If You are expected to be in the Hospital for more than seven (7) days following a covered Emergency Evacuation, or pass away during the Trip, the Company will return Your unattended minor child(ren) (under the age of eighteen (18)) who is/are accompanying You on the scheduled Trip, to the domicile of a person nominated by You or Your next of kin with an attendant if necessary.

Hospital Companion:
Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent. Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

REPATRIATION OF REMAINS

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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8

Platinum

$1,000,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;

b) after being treated at a local Hospital, Your medical condition warrants Transportation to Your Home where You reside, to obtain further medical treatment or to recover; or

c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;

b) required by the standard regulations of the conveyance transporting You; and

c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the Company’s authorized Travel Assistance Company.

Transportation of Minor Children: If You are expected to be in the Hospital for more than seven (7) days following a covered Emergency Evacuation, or pass away during the Trip, the Company will return Your unattended minor child(ren) (under the age of eighteen (18)) who is/are accompanying You on the scheduled Trip, to the domicile of a person
nominated by You or Your next of kin with an attendant if necessary.

Hospital Companion:

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

REPATRIATION OF REMAINS

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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Policy Name and Summary of Coverage
9

Discovery Plan

Optional coverage

EMERGENCY EVACUATION AND REPATRIATION OF REMAINS

We will reimburse you, up to the maximum amount shown in the schedule of benefits, for covered emergency evacuation expenses incurred due to your injury or sickness that occurs while on a covered trip.

Covered emergency evacuation expenses are the reasonable and customary charges for medically necessary transportation, related medical services, and medical supplies required by the standard regulations of the conveyance transporting you incurred during your Emergency Evacuation.

The transportation must be:

a. Ordered by the onsite attending physician, who must certify that the severity of your injury or sickness warrants the Emergency Evacuation;

b. Authorized in advance by us or our designated representative. In the event your injury or sickness prevents prior authorization of the Emergency Evacuation, we or our designated representative must be notified as soon as reasonably possible; and

c. By the most direct and economical route possible.

We will also pay a benefit for reasonable and customary charges incurred for an escort’s or contracted attendant’s services, and the escort’s or attendant’s transportation and accommodations, if an attending physician recommends that an escort or attendant accompany you. This coverage is inclusive of the maximum limit of the Emergency Evacuation benefit.

Transportation will be provided:

a. From the place where your injury or sickness occurs to the nearest adequate licensed medical facility where appropriate medical treatment can be obtained; and

b. 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 medically necessary treatment is needed but not locally available, and you are medically able to travel; and

c. To your primary residence, or an adequate licensed medical facility nearest your primary residence,

d. to obtain further medical treatment or to recover after being treated at a local licensed medical facility, if the onsite attending physician determines that you are medically able to be transported and that the transportation is medically appropriate.

Special Limitation: In the event we or our authorized representative could not be contacted to arrange for Covered Emergency Evacuation Expenses, benefits are limited to the amount we would have paid had we or our authorized representative been contacted.

REPATRIATION OF REMAINS COVERAGE

We will reimburse you for Repatriation Covered Expenses up to the maximum amount shown in the schedule to return your remains if you die while on the covered trip. Repatriation Covered Expenses are limited to the reasonable and customary charges for the expenses listed below. We or our authorized representative must make all arrangements and authorize all expenses in advance.

Repatriation Covered Expenses include the reasonable and customary charges for:

a. Embalming or cremation; and

b. Associated temporary storage costs for up to fifteen (15) days, or until local authorities will permit further transportation of the body, whichever is later; and

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, to:

1. The nearest location where the body can be embalmed or cremated, if not locally available; and

2. The receiving funeral home or morgue, the return destination, or a different place of burial within your country of residence; and

e. The cost for creation and transmission of necessary documentation to transport the body, such as a death certificate, autopsy or police report, up to five (5) copies per document.

Special Limitation:

In the event we or our authorized representative could not be contacted to arrange for Repatriation Covered Expenses, benefits are limited to the amount we would have paid had we or our authorized representative been contacted.

Advance Payment

We will pay a benefit, up to the maximum limit shown in the schedule, directly to the provider if, while on a covered trip, you suffer an injury or sickness which requires an emergency evacuation or repatriation of remains, and payment is required prior to transportation or repatriation. This amount will be deducted from the Emergency Evacuation and Repatriation of Remains benefit limit, shown in the schedule of benefits. You agree to reimburse this payment to us if: a) you do not file a claim for the expenses incurred as outlined in the Payment of Claims section; or b) it is determined that your emergency evacuation or repatriation of remains claim is not covered.

We will provide advance payment when required and requested by you. However:

a. We reserve the right to deny a request for advance payment, if we confirm that your claim is not covered under the policy; and

b. An advance payment made by us is not a guarantee of claim approval.
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Berkshire Hathaway Travel Protection Berkshire Hathaway Travel Protection
Policy Name and Summary of Coverage
10

ExactCare

$500,000 per person

EMERGENCY EVACUATION and REPATRIATION OF REMAINS

The 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 Your 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 Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible and required by the standard regulations of the conveyance transporting You.

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 Berkshire Hathaway Specialty Concierge. In the event the Insured’s Injury or Sickness prevents prior authorization of the Emergency Evacuation, by Berkshire Hathaway Specialty Concierge 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 by Berkshire Hathaway Specialty Concierge 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 Medically Necessary 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;

If the Emergency Evacuation Upgrade is selected and the appropriate cost has been paid, the following will also apply:

d) Transportation from an adequate licensed medical facility to an adequate licensed medical facility of Your choice for further Medically Necessary treatment if the onsite attending Physician certifies that the Insured is medically able to travel.

Advanced authorization by by Berkshire Hathaway Specialty Concierge 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 the Insured is confined if the Insured is alone. The payment will not exceed the cost of one round‐Trip economy airfare ticket. This additional benefit only applies if the Emergency Evacuation Upgrade is purchased.

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 You 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.

Berkshire Hathaway Specialty Concierge 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.

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11

ExactCare

$500,000 per person

EMERGENCY EVACUATION & REPATRIATION OF REMAINS

The Company will pay for Covered Emergency Evacuation Expenses incurred due to an Injury or Sickness that occurs to the Insured while on a Trip, up to the Maximum Limit shown in the Schedule. In the event of death, the Company will pay for Covered Repatriation Expenses up to the Maximum Limit shown in the Schedule to return the Insured’s body to the City of burial.

Special Limitation: In the event the Travel Insurance Administrator could not be contacted to arrange for Emergency Evacuation or Repatriation of Remains, benefits are limited to the amount the Company would have paid had the Company or its authorized representative been contacted.

Covered Emergency Evacuation Expenses are the Reasonable and Customary Charges for necessary transportation, related medical services and medical supplies incurred in connection with an Emergency Evacuation. All transportation arrangements made for evacuation must be by the most direct and economical route possible and required by the standard regulations of the transporting conveyance. If possible, the Insured’s Common Carrier tickets will be used.

Expenses for transportation must be:

a) Ordered by the onsite attending Physician who must certify that the severity of the Injury or Sickness warrants an Emergency Evacuation and adequate medical treatment is not locally available; and

b) Authorized in advance by the Travel Insurance Administrator. In the event the 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 an escort in writing.

Emergency Evacuation – means:

a) 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; 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 Medically Necessary treatment is needed but not locally available; and the Insured is medically able to travel; or

c) Transportation to the adequate licensed medical facility nearest to the Insured’s 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.

Advanced authorization by the Travel Insurance Administrator is needed for a), b) and c) above.

ADDITIONAL BENEFITS

In addition to the above covered expenses, if the Company has previously evacuated the Insured to a medical facility, the Company will reimburse for airfare costs, less refunds from Unused transportation tickets, from that facility to the Return Destination or home, within one year from the original Return Date. Airfare costs will be based on medical necessity or same class as the Insured’s original tickets.

If the Insured is hospitalized for more than 7 days following a covered Emergency Evacuation, the Company will reimburse, subject to the limitations set out herein, the expenses for:

a) Return of Children: Return of Children, who were accompanying the Insured when the Injury or Sickness occurred, to the Insured’s 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.

b) Bedside Traveling Companion: The Company will reimburse the Insured for reasonable expenses incurred for Lodging and meals shown in the Schedule for the Traveling Companion to remain near the Insured. For an insured Child, a bedside companion is available immediately upon Hospital admission. Receipts must be submitted. Coverage for this benefit ends on the discharge date from the hospital.

c) Bedside Visit: If the Insured is alone the Company will reimburse the Insured for the transportation costs to bring one person, chosen by the Insured, to and from the medical facility where the Insured is confined. The payment will not exceed the cost of one round-Trip economy airfare ticket.

Covered Repatriation Expenses are the reasonable and customary expenses for

a) The most economical coffins or receptacles adequate for transportation of the remains; and
b) Transportation of the remains, by the most direct and economical conveyance and route possible. This coverage ends when the body is returned to the City of burial.

The Travel Insurance Administrator must make all arrangements and authorize all expenses in advance.

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12

ExactCare Value

$150,000 per person

EMERGENCY EVACUATION and REPATRIATION OF REMAINS

The 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 Your 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 Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible and required by the standard regulations of the conveyance transporting You.

Expenses for Transportation must be:

a) ordered by the onsite attending Physician who must certify that the severity of Your Injury or Sickness warrants Your Emergency Evacuation and adequate medical treatment is not locally available; and

b) authorized in advance by Berkshire Hathaway Specialty Concierge. In the event Your Injury or Sickness prevents prior authorization of the Emergency Evacuation, Berkshire Hathaway Specialty Concierge 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 You.

Special Limitation: In the event Berkshire Hathaway Specialty Concierge 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 Medically Necessary 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 You are medically able to be transported; or If the Emergency Evacuation Upgrade is selected and the appropriate cost has been paid, the following will also apply:

d) Transportation from an adequate licensed medical facility to an adequate licensed medical facility of Your choice for further Medically Necessary treatment if the onsite attending Physician certifies that You are medically able to travel.

Advanced authorization by Berkshire Hathaway Specialty Concierge 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 the Insured is confined if the Insured is alone. The payment will not exceed the cost of one round-Trip economy airfare ticket. This additional benefit only applies if the Emergency Evacuation Upgrade is purchased.

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 You 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 , subject to the Cremation Maximum Limit shown in the Schedule;
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, subject to the Transportation Maximum Limit shown in the Schedule.

Berkshire Hathaway Specialty Concierge 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.

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13

ExactCare Value

$150,000 per person

EMERGENCY EVACUATION & REPATRIATION OF REMAINS

The Company will pay for Covered Emergency Evacuation Expenses incurred due to an Injury or Sickness that occurs to the Insured while on a Trip, up to the Maximum Limit shown in the Schedule. In the event of death, the Company will pay for Covered Repatriation Expenses up to the Maximum Limit shown in the Schedule to return the Insured’s body to the City of burial.

Special Limitation: In the event the Travel Insurance Administrator could not be contacted to arrange for Emergency Evacuation or Repatriation of Remains, benefits are limited to the amount the Company would have paid had the Company or its authorized representative been contacted.

Covered Emergency Evacuation Expenses are the Reasonable and Customary Charges for necessary transportation, related medical services and medical supplies incurred in connection with an Emergency Evacuation. All transportation arrangements made for evacuation must be by the most direct and economical route possible and required by the standard regulations of the transporting conveyance. If possible, the Insured’s Common Carrier tickets will be used.

Expenses for transportation must be:

(a) Ordered by the onsite attending Physician who must certify that the severity of the Injury or Sickness warrants an Emergency Evacuation and adequate medical treatment is not locally available; and

(b) Authorized in advance by the Travel Insurance Administrator. In the event the 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 an escort in writing.

Emergency Evacuation – means:

a) 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; 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 Medically Necessary treatment is needed but not locally available; and the Insured is medically able to travel; or

c) Transportation to the adequate licensed medical facility nearest to the Insured’s 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.

Advanced authorization by the Travel Insurance Administrator is needed for a), b) and c) above.

ADDITIONAL BENEFITS
In addition to the above covered expenses, if the Company has previously evacuated the Insured to a medical facility, the Company will reimburse for airfare costs, less refunds from Unused transportation tickets, from that facility to the Return Destination or home, within one year from the original Return Date. Airfare costs will be based on medical necessity or same class as the Insured’s original tickets.

If the Insured is hospitalized for more than 7 days following a covered Emergency Evacuation, the Company will reimburse, subject to the limitations set out herein, the expenses for:

a) Return of Children: Return of Children, who were accompanying the Insured when the Injury or Sickness occurred, to the Insured’s 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.

b) Bedside Traveling Companion: The Company will reimburse the Insured for reasonable expenses incurred for Lodging and meals shown in the Schedule for the Traveling Companion to remain near the Insured. For an insured Child, a bedside companion is available immediately upon Hospital admission. Receipts must be submitted. Coverage for this benefit ends on the discharge date from the hospital.

c) Bedside Visit: If the Insured is alone the Company will reimburse the Insured for the transportation costs to bring one person, chosen by the Insured, to and from the medical facility where the Insured is confined. The payment will not exceed the cost of one round-Trip economy airfare ticket.

Covered Repatriation Expenses are 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. This coverage ends when the body is returned to the City of burial.

The Travel Insurance Administrator must make all arrangements and authorize all expenses in advance.

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14

LuxuryCare

$1,000,000 per person

EMERGENCY EVACUATION and REPATRIATION OF REMAINS

The 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 Your 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 Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible and required by the standard regulations of the conveyance transporting You.

Expenses for Transportation must be:

a) ordered by the onsite attending Physician who must certify that the severity of Your Injury or Sickness warrants Your Emergency Evacuation and adequate medical treatment is not locally available; and

b) authorized in advance by the Travel Insurance Administrator. In the event Your 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 Medically Necessary 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 You are medically able to be transported; or

d) Transportation from an adequate licensed medical facility to an adequate licensed medical facility of Your choice for further Medically Necessary 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.

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15

LuxuryCare

$1,000,000 per person

EMERGENCY EVACUATION & REPATRIATION OF REMAINS

The Company will pay for Covered Emergency Evacuation Expenses incurred due to an Injury or Sickness that occurs to the Insured while on a Trip, up to the Maximum Limit shown in the Schedule. In the event of death, the Company will pay for Covered Repatriation Expenses up to the Maximum Limit shown in the Schedule to return the Insured’s body to the City of burial.

Special Limitation: In the event the Travel Insurance Administrator could not be contacted to arrange for Emergency Evacuation or Repatriation of Remains, benefits are limited to the amount the Company would have paid had theCompany or its authorized representative been contacted.

Covered Emergency Evacuation Expenses are the Reasonable and Customary Charges for necessary transportation, related medical services and medical supplies incurred in connection with an Emergency Evacuation. All transportation arrangements made for evacuation must be by the most direct and economical route possible and required by the standard regulations of the transporting conveyance. If possible, the Insured’s Common Carrier tickets will be used.

Expenses for transportation must be:

(a) Ordered by the onsite attending Physician who must certify that the severity of the Injury or Sickness warrants an Emergency Evacuation and adequate medical treatment is not locally available; and

(b) Authorized in advance by the Travel Insurance Administrator. In the event the 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 an escort in writing.

Emergency Evacuation – means:

a) 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; 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 Medically Necessary treatment is needed but not locally available; and the Insured is medically able to travel; or

c) Transportation to the adequate licensed medical facility nearest to the Insured’s 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.

Advanced authorization by the Travel Insurance Administrator is needed for a), b) and c) above.

ADDITIONAL BENEFITS
In addition to the above covered expenses, if the Company has previously evacuated the Insured to a medical facility, the Company will reimburse for airfare costs, less refunds from Unused transportation tickets, from that facility to the Return Destination or home, within one year from the original Return Date. Airfare costs will be based on medical necessity or same class as the Insured’s original tickets.

If the Insured is hospitalized for more than 7 days following a covered Emergency Evacuation, the Company will reimburse, subject to the limitations set out herein, the expenses for:

a) Return of Children: Return of Children, who were accompanying the Insured when the Injury or Sickness occurred, to the Insured’s 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.

b) Bedside Traveling Companion: The Company will reimburse the Insured for reasonable expenses incurred forLodging and meals shown in the Schedule for the Traveling Companion to remain near the Insured. For an insured Child, a bedside companion is available immediately upon Hospital admission. Receipts must be submitted.Coverage for this benefit ends on the discharge date from the hospital.

c) Bedside Visit: If the Insured is alone the Company will reimburse the Insured for the transportation costs to bring one person, chosen by the Insured, to and from the medical facility where the Insured is confined. The payment will not exceed the cost of one round-Trip economy airfare ticket.

Covered Repatriation Expenses are the reasonable and customary expenses for

(a) The most economical coffins or receptacles adequate for transportation of the remains; and

(b) Transportation of the remains, by the most direct and economical conveyance and route possible. This coverage ends when the body is returned to the City of burial.

The Travel Insurance Administrator must make all arrangements and authorize all expenses in advance.

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16

ExactCare Lite

$100,000 per person

EMERGENCY EVACUATION and REPATRIATION OF REMAINS

The 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 Your Emergency Evacuation. All Transportation arrangements made for evacuating You 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 Berkshire Hathaway Specialty Insurance. In the event the Insured’s Injury or Sickness prevents prior authorization of the Emergency Evacuation, Berkshire Hathaway Specialty Insurance 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 Berkshire Hathaway Specialty Insurance 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 Medically Necessary 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; or

Advanced authorization by Berkshire Hathaway Specialty Insurance is needed for

a), b), and c) 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.

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.

Berkshire Hathaway Specialty Insurance 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.

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17

ExactCare Lite

$100,000 per person

EMERGENCY EVACUATION & REPATRIATION OF REMAINS

The Company will pay for Covered Emergency Evacuation Expenses incurred due to an Injury or Sickness that occurs to the Insured while on a Trip, up to the Maximum Limit shown in the Schedule. In the event of death, the Company will pay for Covered Repatriation Expenses up to the Maximum Limit shown in the Schedule to return the Insured’s body to the City of burial.

Special Limitation: In the event the Travel Insurance Administrator could not be contacted to arrange for Emergency Evacuation or Repatriation of Remains, benefits are limited to the amount the Company would have paid had the Company or its authorized representative been contacted.

Covered Emergency Evacuation Expenses are the Reasonable and Customary Charges for necessary transportation, related medical services and medical supplies incurred in connection with an Emergency Evacuation. All Transportation arrangements made for evacuation must be by the most direct and economical route possible and required by the standard regulations of the transporting conveyance. If possible, the Insured’s Common Carrier tickets will be used.

Expenses for Transportation must be:

(a) Ordered by the onsite attending Physician who must certify that the severity of the Injury or Sickness warrants an Emergency Evacuation and adequate medical treatment is not locally available; and

(b) Authorized in advance by the Travel Insurance Administrator. In the event the 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 an escort in writing.

Emergency Evacuation – means:

a) 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; 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 Medically Necessary treatment is needed but not locally available; and the Insured is medically able to travel; or

c) Transportation to the adequate licensed medical facility nearest to the Insured’s 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.

Advanced authorization by the Travel Insurance Administrator is needed for a), b) and c) above

ADDITIONAL BENEFITS
In addition to the above covered expenses, if the Company has previously evacuated the Insured to a medical facility, the Company will reimburse for airfare costs, less refunds from Unused transportation tickets, from that facility to the Return Destination or home, within one year from the original Return Date. Airfare costs will be based on medical necessity or same class as the Insured’s original tickets.

If the Insured is hospitalized for more than 7 days following a covered Emergency Evacuation, the Company will reimburse, subject to the limitations set out herein, the expenses for:

(a) Return of Children: Return of Children, who were accompanying the Insured when the Injury or Sickness occurred, to the Insured’s 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.

(b) Bedside Traveling Companion: The Company will reimburse the Insured for reasonable expenses incurred for Lodging and meals shown in the Schedule for the Traveling Companion to remain near the Insured. For an insured Child, a bedside companion is available immediately upon Hospital admission. Receipts must be submitted. Coverage for this benefit ends on the discharge date from the hospital.

Covered Repatriation Expenses are 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. This coverage ends when the body is returned to the City of burial.

The Travel Insurance Administrator must make all arrangements and authorize all expenses in advance.

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Cat 70 Cat 70
Policy Name and Summary of Coverage
18

Travel Plan

$500,000 per person

EMERGENCY MEDICAL EVACUATION & MEDICALLY NECESSARY REPATRIATION

We will pay, subject to the limitations set out herein, for covered Emergency Medical Evacuation expenses reasonably incurred if You suffer an Accidental Injury or Emergency Sickness that warrants Your Emergency Medical Evacuation while You are on a Covered Trip. Benefits payable are subject to the Maximum Benefit per Insured shown on the Schedule of Benefits for all Emergency Medical Evacuations due to all injuries from the same Accident or all Emergency Sickness from the same or related causes.

A legally licensed Physician, in coordination with Our designated Assistance Company, must order the Emergency Medical Evacuation and must certify that the severity of Your Accidental Injury or Emergency Sickness warrants Your Emergency Medical Evacuation to the closest adequate medical facility. We or Our Assistance Company or We must review and approve the necessity of the Emergency Medical Evacuation based on the inadequacy of local medical facilities. The Emergency Medical Evacuation must be coordinated through the most direct and economical conveyance and route possible, such as air or land ambulance or commercial airline carrier.

Covered Emergency Medical Evacuation expenses are those for Medically Necessary Transportation, including Reasonable and Customary medical services and supplies incurred in connection with Your Emergency Medical Evacuation. Expenses for Transportation must be: a) recommended by the attending Physician; b) required by the standard regulations of the conveyance transporting You; and c) reviewed and pre-approved by Our designated Assistance Company.

We will also pay Reasonable and Customary expenses, for escort expenses required by You, if You are disabled during a Covered Trip and an escort is recommended in writing by an attending Physician and such expenses are pre-approved by Our designated Assistance Company.

If You are hospitalized for more than the number of days shown on the Schedule of Benefits following a covered Emergency Medical Evacuation, We will pay, subject to the limitations set out herein, for expenses:

a) to return You to your residence in the United States, with an attendant if necessary, any of Your Dependent Children who were accompanying You when the Accidental Injury or Emergency Sickness occurred and were left alone as a result of same. Our payment will not exceed the cost of a single one-way economy airfare ticket, less the value of applied credit from any unused return travel tickets per person; and

b) to bring 1 person chosen by You to and from the Hospital or other medical facility where You are confined if You are alone, but not to exceed the cost of 1 round-trip economy airfare ticket.

In addition to the above Covered Expenses, if We have previously evacuated You to a medical facility, We will pay Your airfare costs from that facility to Your primary residence, within 1 year from Your original Scheduled Return Date, less refunds from Your unused Transportation tickets. Airfare costs will be economy or first class if Your original tickets are first class. This benefit is available only if it is not provided under another coverage in the Policy.

Transportation of Spouse or Domestic Partner: If You are confined to the Hospital for more than the number of days shown on the Schedule of Benefits or if the attending Physician certifies that due to Your Accidental Injury or Emergency Sickness, You will be required to stay in the Hospital for more than the number of consecutive days shown on the Schedule of Benefits or if You die on the Covered Trip and require Repatriation of Remains, We will return Your spouse or Domestic Partner to Your primary residence. Our payment will not exceed the cost of a single one-way economy airfare ticket, less the value of applied credit from any unused return travel ticket.

Escort Service: We will pay to return any of Your children who were accompanying You at the time of Your Accidental Injury or Emergency Sickness back to Your primary residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way economy airfare ticket, less the value of any applied credit from any unused return travel tickets for each person. The escort service must be arranged and approved by Us or Our designated Assistance Company.

REPATRIATION OF REMAINS

We will pay the reasonable Covered Expenses incurred to return Your body to Your place of permanent residence if You die due to Accidental Injury or a Covered Sickness during the Covered Trip. No payment will exceed the maximum shown on the Schedule of Benefits.

Covered Expenses include: a) The collection of the body of the deceased; b) the transfer of the body to a professional funeral home; c) embalming and preparation of the body or cremation if so desired; d) standard shipping casket; e) any required consular proceedings; f) the transfer of the casket to the airport and boarding of the casket onto the plane; g) any required permits and corresponding airfare; and h) the transfer of the deceased to their final destination. All Covered Expenses must be approved in advance by Our designated Assistance Company.

Escort Service: We will pay to return any of Your children who were accompanying You at the time of Your death back to Your primary residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way economy airfare ticket, less the value of any applied credit from any unused return travel tickets for each person. The escort service must be arranged and approved by Us or Our designated Assistance Company.

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Detour Insurance Detour Insurance
Policy Name and Summary of Coverage
19

@the edge

$1,000,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured
or sick to the nearest Hospital where appropriate medical treatment can be obtained. If elected, Transportation to Your Hospital of choice will begin when You are determined to be stable enough for Transportation. Once You arrive at the Hospital of choice, this coverage ends;

b) after being treated at a local Hospital, Your medical condition warrants Transportation to Your Home where You reside, to obtain further medical treatment or to recover; or

c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;

b) required by the standard regulations of the conveyance transporting You; and

c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the
Company’s authorized Travel Assistance Company.

Not with standing the forgoing, in the event the Emergency Evacuation services are not arranged by the Company’s authorized Travel Assistance Company, the Company, in its sole discretion, may elect to evaluate the need for the Emergency Evacuation and provide limited reimbursement for the portion of the expenses related to such Emergency Evacuation as would have been authorized by Company’s authorized Travel Assistance Company.

Transportation of Minor Children: If You are expected to be in the Hospital for more than seven (7) days following a covered Emergency Evacuation, or pass away during the Trip, the Company will return Your unattended minor child(ren) (under the age of eighteen (18)) who is/are accompanying You on the scheduled Trip, to the domicile of a person nominated by You or Your next of kin with an attendant if necessary.

Hospital Companion:

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

REPATRIATION OF REMAINS

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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20

@the edge plus

$1,000,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured
or sick to the nearest Hospital where appropriate medical treatment can be obtained. If elected, Transportation to Your Hospital of choice will begin when You are determined to be stable enough for Transportation. Once You arrive at the Hospital of choice, this coverage ends;

b) after being treated at a local Hospital, Your medical condition warrants Transportation to Your Home where You reside, to obtain further medical treatment or to recover; or

c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;

b) required by the standard regulations of the conveyance transporting You; and

c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the
Company’s authorized Travel Assistance Company.

Notwithstanding the forgoing, in the event the Emergency Evacuation services are not arranged by the Company’s authorized Travel Assistance Company, the Company, in its sole discretion, may elect to evaluate the need for the Emergency Evacuation and provide limited reimbursement for the portion of the expenses related to such Emergency Evacuation as would have been authorized by Company’s authorized Travel Assistance Company.

Transportation of Minor Children: If You are expected to be in the Hospital for more than seven (7) days following a covered Emergency Evacuation, or pass away during the Trip, the Company will return Your unattended minor child(ren) (under the age of eighteen (18)) who is/are accompanying You on the scheduled Trip, to the domicile of a person nominated by You or Your next of kin with an attendant if necessary.

Hospital Companion:

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

REPATRIATION OF REMAINS

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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GeoBlue GeoBlue
Policy Name and Summary of Coverage
21

Voyager Choice excl US

$500,000 per person

Emergency Medical Evacuation Benefit

If a Covered Person suffers a sudden accident or unforeseen illness, resulting in a life-threatening/limb-threatening medical condition, and We, or Our designee’s medical director, determines that adequate medical facilities are not available locally, We, or Our designee, will arrange for an emergency evacuation to the nearest or most appropriate provider capable of providing adequate care, without which there would be a significant risk of death or serious impairment. You must contact Us at the phone number indicated on Your identification card to begin this process.

In making our determinations, We, and/or Our designee, will consider the nature of the emergency, Your condition and ability to travel, as well as other relevant circumstances including airport availability, weather conditions, and distance to be covered.

Repatriation

Following any covered emergency evacuation, or if deemed appropriate by Our or Our designee’s medical director in consultation with the attending physician, We will pay for one of the following:

1. A return to the Covered Person’s permanent residence, or if appropriate, to a health care facility nearer to their permanent residence. Transportation will be provided by medically equipped specialty aircraft, commercial airline, train or ambulance depending upon the medical needs and available transportation specific to each case. Transportation must be by the most direct and economical route.

2. You will be transferred back to your original location or the location from which you were evacuated via a one-way economy airfare.

If Your transportation needs to be medically supervised a qualified medical attendant will escort you. Additionally, if We and/or Our designee, determines a mode of transport other than economy class seating on a commercial aircraft is required, We or Our designee will arrange accordingly and such will be covered by Us. Transportation shall not be considered Medically Necessary if We or Our designee’s medical director determines that the Covered Person can continue his/her trip or can use the original transportation arrangements that he/she purchased.

Return of Dependent Children: If the Covered Person has minor children who are left unattended as a result of their injury, illness or medical evacuation, We or Our designee will arrange and pay for the cost of economy class one-way airfares, and an escort as may be reasonably required, for the transportation of such minor children to their Home Country or Country of Assignment.

General Limitations/ Exclusions for Emergency Medical Evacuation and Repatriation after an Emergency Medical Evacuation Benefits

In addition to any of the general exclusions listed in Section VI. of this certificate, the following exclusions also apply to the Emergency Medical Transportation benefit:

1. Transportation shall not be considered Medically Necessary if We or Our designee’s medical director determines that the Covered Person is receiving adequate care in their current location.

2. Transportation shall not be considered Medically Necessary if We or Our designee’s medical director determines that the Covered Person can continue his/her trip or can use the original transportation arrangements that he/she purchased.

3. No more than one Emergency Medical Evacuation and/or Repatriation is allowed for any single medical condition of a Covered Member while covered under this Certificate.

4. No payment will be made for charges for:

a) services rendered without the authorization or intervention of Us or Our designee;

b) non-emergency, routine or minor medical problems, tests and exams where there is no clear or significant risk of death or imminent serious Injury or harm to You;

c) a condition which would allow for treatment at a future date convenient to You and which does not require emergency evacuation or repatriation;

d) expenses incurred if the original or ancillary purpose of Your trip is to obtain medical treatment;

e) Any expense for medical evacuation or repatriation if the Covered Member is not suffering from a Serious Medical Condition, and/or in the opinion of Our designee’s medical director, the Covered Member can be adequately treated locally, or treatment can be reasonably delayed until the Covered Member returns to his/her Home Country or Country of Assignment.

5. Medical transport services will not be provided to a Covered Person who has a diagnosis of, or is suspected of having, a Biosafety Class Level 3 (and above) pathogen as classified by either the Centers for Disease Control and Prevention (CDC) or the National Institutes of Health (NIH).

Emergency Family Travel Arrangements

If a Covered Person is Hospital Confined due to an Injury or Sickness for more than 7 days, is likely to be hospitalized for more than 7 days or is in critical condition, while traveling outside of his/her home country, the Insurer will pay up to the maximum benefit as listed in Benefit Overview Matrix for the cost of one economy round trip air fare ticket to, and the hotel accommodations in, the place of the Hospital Confinement for one person designated by the Covered Person. Payment for meals, ground transportation and other incidentals are the responsibility of the family member or friend.

With respect to any one trip, this benefit is payable only once for that trip, regardless of the number of Covered Persons on that trip. The determination of whether the Covered Person will be hospitalized for more than 7 days or is in critical condition shall be made by the Administrator after consultation with the attending physician. No benefits are payable unless the trip is approved in advance by the Plan Administrator.

This benefit is available only to Covered Persons who are traveling outside of their Home Country while covered under this Certificate of Coverage.

The benefit for all Bedside Visits is listed in the Benefit Overview Matrix.

Repatriation of Mortal Remains Benefit

If a Covered Person dies, while traveling outside of his/her home country, the Insurer will pay the necessary expenses actually incurred, up to the Maximum Limit shown in the Benefit Overview Matrix, for the preparation of the body for burial, or the cremation, and for the transportation of the remains to his/her Home Country. This benefit covers the legal minimum requirements for the transportation of the remains. It does not include the transportation of anyone accompanying the body, urns, caskets, coffins, visitation, burial or funeral expenses. Any expense for repatriation of remains requires approval in advance by the Plan Administrator.

The Insurer will not pay any claims under this provision unless the expense has been approved by the Administrator before the body is prepared for transportation.

This benefit is available only to Covered Persons who are traveling outside of their Home Country

The benefit maximum for all necessary repatriation of mortal remains services is listed in the Benefit Overview Matrix.

No benefit is payable if the death occurs after the Termination Date of this Certificate of Coverage. However, if the Covered Person dies while coverage is in effect, eligibility for this benefit continues until the earlier of the Termination Date of this Certificate of Coverage or 7 days after the Termination Date.

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22

Voyager Essential excl US

$500,000 per person

Emergency Medical Evacuation Benefit

If a Covered Person suffers a sudden accident or unforeseen illness, resulting in a life-threatening/limb-threatening medical condition, and We, or Our designee’s medical director, determines that adequate medical facilities are not available locally, We, or Our designee, will arrange for an emergency evacuation to the nearest or most appropriate provider capable of providing adequate care, without which there would be a significant risk of death or serious impairment. You must contact Us at the phone number indicated on Your identification card to begin this process.

In making our determinations, We, and/or Our designee, will consider the nature of the emergency, Your condition and ability to travel, as well as other relevant circumstances including airport availability, weather conditions, and distance to be covered.

Repatriation

Following any covered emergency evacuation, or if deemed appropriate by Our or Our designee’s medical director in consultation with the attending physician, We will pay for one of the following:

1. A return to the Covered Person’s permanent residence, or if appropriate, to a health care facility nearer to their permanent residence. Transportation will be provided by medically equipped specialty aircraft, commercial airline, train or ambulance depending upon the medical needs and available transportation specific to each case. Transportation must be by the most direct and economical route.

2. You will be transferred back to your original location or the location from which you were evacuated via a one-way economy airfare.

If Your transportation needs to be medically supervised a qualified medical attendant will escort you. Additionally, if We and/or Our designee, determines a mode of transport other than economy class seating on a commercial aircraft is required, We or Our designee will arrange accordingly and such will be covered by Us. Transportation shall not be considered Medically Necessary if We or Our designee’s medical director determines that the Covered Person can continue his/her trip or can use the original transportation arrangements that he/she purchased.

Return of Dependent Children: If the Covered Person has minor children who are left unattended as a result of their injury, illness or medical evacuation, We or Our designee will arrange and pay for the cost of economy class one-way airfares, and an escort as may be reasonably required, for the transportation of such minor children to their Home Country or Country of Assignment.

General Limitations/ Exclusions for Emergency Medical Evacuation and Repatriation after an Emergency Medical Evacuation Benefits

In addition to any of the general exclusions listed in Section VI. of this certificate, the following exclusions also apply to the Emergency Medical Transportation benefit:

1. Transportation shall not be considered Medically Necessary if We or Our designee’s medical director determines that the Covered Person is receiving adequate care in their current location.

2. Transportation shall not be considered Medically Necessary if We or Our designee’s medical director determines that the Covered Person can continue his/her trip or can use the original transportation arrangements that he/she purchased.

3. No more than one Emergency Medical Evacuation and/or Repatriation is allowed for any single medical condition of a Covered Member while covered under this Certificate.

4. No payment will be made for charges for:

a) services rendered without the authorization or intervention of Us or Our designee;

b) non-emergency, routine or minor medical problems, tests and exams where there is no clear or significant risk of death or imminent serious Injury or harm to You;

c) a condition which would allow for treatment at a future date convenient to You and which does not require emergency evacuation or repatriation;

d) expenses incurred if the original or ancillary purpose of Your trip is to obtain medical treatment;

e) Any expense for medical evacuation or repatriation if the Covered Member is not suffering from a Serious Medical Condition, and/or in the opinion of Our designee’s medical director, the Covered Member can be adequately treated locally, or treatment can be reasonably delayed until the Covered Member returns to his/her Home Country or Country of Assignment.

5. Medical transport services will not be provided to a Covered Person who has a diagnosis of, or is suspected of having, a Biosafety Class Level 3 (and above) pathogen as classified by either the Centers for Disease Control and Prevention (CDC) or the National Institutes of Health (NIH).

Emergency Family Travel Arrangements

If a Covered Person is Hospital Confined due to an Injury or Sickness for more than 7 days, is likely to be hospitalized for more than 7 days or is in critical condition, while traveling outside of his/her home country, the Insurer will pay up to the maximum benefit as listed in Benefit Overview Matrix for the cost of one economy round trip air fare ticket to, and the hotel accommodations in, the place of the Hospital Confinement for one person designated by the Covered Person. Payment for meals, ground transportation and other incidentals are the responsibility of the family member or friend.

With respect to any one trip, this benefit is payable only once for that trip, regardless of the number of Covered Persons on that trip. The determination of whether the Covered Person will be hospitalized for more than 7 days or is in critical condition shall be made by the Administrator after consultation with the attending physician. No benefits are payable unless the trip is approved in advance by the Plan Administrator.

This benefit is available only to Covered Persons who are traveling outside of their Home Country while covered under this Certificate of Coverage.

The benefit for all Bedside Visits is listed in the Benefit Overview Matrix.

Repatriation of Mortal Remains Benefit

If a Covered Person dies, while traveling outside of his/her home country, the Insurer will pay the necessary expenses actually incurred, up to the Maximum Limit shown in the Benefit Overview Matrix, for the preparation of the body for burial, or the cremation, and for the transportation of the remains to his/her Home Country. This benefit covers the legal minimum requirements for the transportation of the remains. It does not include the transportation of anyone accompanying the body, urns, caskets, coffins, visitation, burial or funeral expenses. Any expense for repatriation of remains requires approval in advance by the Plan Administrator.

The Insurer will not pay any claims under this provision unless the expense has been approved by the Administrator before the body is prepared for transportation.

This benefit is available only to Covered Persons who are traveling outside of their Home Country

The benefit maximum for all necessary repatriation of mortal remains services is listed in the Benefit Overview Matrix.

No benefit is payable if the death occurs after the Termination Date of this Certificate of Coverage. However, if the Covered Person dies while coverage is in effect, eligibility for this benefit continues until the earlier of the Termination Date of this Certificate of Coverage or 7 days after the Termination Date.

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23

Trekker Choice excl US

$500,000 per person

Emergency Medical Transportation Benefit

If a Covered Person suffers a sudden accident or unforeseen illness, resulting in a life-threatening/limb-threatening medical condition, and We, or Our designee’s medical director, determines that adequate medical facilities are not available locally, We, or Our designee, will arrange for an emergency evacuation to the nearest or most appropriate provider capable of providing adequate care, without which there would be a significant risk of death or serious impairment. You must contact Us at the phone number indicated on Your identification card to begin this process.

In making our determinations, We, and/or Our designee, will consider the nature of the emergency, Your condition and ability to travel, as well as other relevant circumstances including airport availability, weather conditions, and distance to be covered.

Repatriation

Following any covered emergency evacuation, or if deemed appropriate by Our or Our designee’s medical director in consultation with the attending physician, We will pay for one of the following:

1. A return to the Covered Person’s permanent residence, or if appropriate, to a health care facility nearer to their permanent residence. Transportation will be provided by medically equipped specialty aircraft, commercial airline, train or ambulance depending upon the medical needs and available transportation specific to each case. Transportation must be by the most direct and economical route.

2. You will be transferred back to your original location or the location from which you were evacuated via a one-way economy airfare.

If Your transportation needs to be medically supervised a qualified medical attendant will escort you. Additionally, if We and/or Our designee, determines a mode of transport other than economy class seating on a commercial aircraft is required, We or Our designee will arrange accordingly and such will be covered by Us. Transportation shall not be considered Medically Necessary if We or Our designee’s medical director determines that the Covered Person can continue his/her trip or can use the original transportation arrangements that he/she purchased.

Return of Dependent Children: If the Covered Person has minor children who are left unattended as a result of their injury, illness or medical evacuation, We or Our designee will arrange and pay for the cost of economy class one-way airfares, and an escort as may be reasonably required, for the transportation of such minor children to their Home Country or Country of Assignment.

General Limitations/ Exclusions for Emergency Medical Evacuation and Repatriation after an Emergency Medical Evacuation Benefits

In addition to any of the general exclusions listed in Section VI. of this certificate, the following exclusions also apply to the Emergency Medical Transportation benefit:

1. Transportation shall not be considered Medically Necessary if We or Our designee’s medical director determines that the Covered Person is receiving adequate care in their current location.

2. Transportation shall not be considered Medically Necessary if We or Our designee’s medical director determines that the Covered Person can continue his/her trip or can use the original transportation arrangements that he/she purchased.

3. No more than one Emergency Medical Evacuation and/or Repatriation is allowed for any single medical condition of a Covered Member while covered under this Certificate.

4. No payment will be made for charges for:

a) services rendered without the authorization or intervention of Us or Our designee;

b) non-emergency, routine or minor medical problems, tests and exams where there is no clear or significant risk of death or imminent serious Injury or harm to You;

c) a condition which would allow for treatment at a future date convenient to You and which does not require emergency evacuation or repatriation;

d) expenses incurred if the original or ancillary purpose of Your trip is to obtain medical treatment;

e) Any expense for medical evacuation or repatriation if the Covered Member is not suffering from a Serious Medical Condition, and/or in the opinion of Our designee’s medical director, the Covered Member can be adequately treated locally, or treatment can be reasonably delayed until the Covered Member returns to his/her Home Country or Country of Assignment.

5. Medical transport services will not be provided to a Covered Person who has a diagnosis of, or is suspected of having, a Biosafety Class Level 3 (and above) pathogen as classified by either the Centers for Disease Control and Prevention (CDC) or the National Institutes of Health (NIH).

Emergency Family Travel Arrangements

If a Covered Person is Hospital Confined due to an Injury or Sickness for more than 7 days, is likely to be hospitalized for more than 7 days or is in critical condition, while traveling outside of his/her home country, the Insurer will pay up to the maximum benefit as listed in Benefit Overview Matrix for the cost of one economy round trip air fare ticket to, and the hotel accommodations in, the place of the Hospital Confinement for one person designated by the Covered Person. Payment for meals, ground transportation and other incidentals are the responsibility of the family member or friend.

With respect to any one trip, this benefit is payable only once for that trip, regardless of the number of Covered Persons on that trip. The determination of whether the Covered Person will be hospitalized for more than 7 days or is in critical condition shall be made by the Administrator after consultation with the attending physician. No benefits are payable unless the trip is approved in advance by the Plan Administrator.

This benefit is available only to Covered Persons who are traveling outside of their Home Country while covered under this Certificate of Coverage.

The benefit for all Bedside Visits is listed in the Benefit Overview Matrix.

Repatriation of Mortal Remains Benefit

If a Covered Person dies, while traveling outside of his/her home country, the Insurer will pay the necessary expenses actually incurred, up to the Maximum Limit shown in the Benefit Overview Matrix, for the preparation of the body for burial, or the cremation, and for the transportation of the remains to his/her Home Country. This benefit covers the legal minimum requirements for the transportation of the remains. It does not include the transportation of anyone accompanying the body, urns, caskets, coffins, visitation, burial or funeral expenses. Any expense for repatriation of remains requires approval in advance by the Plan Administrator.

The Insurer will not pay any claims under this provision unless the expense has been approved by the Administrator before the body is prepared for transportation.

This benefit is available only to Covered Persons who are traveling outside of their Home Country

The benefit maximum for all necessary repatriation of mortal remains services is listed in the Benefit Overview Matrix.

No benefit is payable if the death occurs after the Termination Date of this Certificate of Coverage. However, if the Covered Person dies while coverage is in effect, eligibility for this benefit continues until the earlier of the Termination Date of this Certificate of Coverage or 7 days after the Termination Date.

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24

Trekker Essential excl US

$250,000 per person

Emergency Medical Transportation Benefit

If a Covered Person suffers a sudden accident or unforeseen illness, resulting in a life-threatening/limb-threatening medical condition, and We, or Our designee’s medical director, determines that adequate medical facilities are not available locally, We, or Our designee, will arrange for an emergency evacuation to the nearest or most appropriate provider capable of providing adequate care, without which there would be a significant risk of death or serious impairment. You must contact Us at the phone number indicated on Your identification card to begin this process.

In making our determinations, We, and/or Our designee, will consider the nature of the emergency, Your condition and ability to travel, as well as other relevant circumstances including airport availability, weather conditions, and distance to be covered.

Repatriation

Following any covered emergency evacuation, or if deemed appropriate by Our or Our designee’s medical director in consultation with the attending physician, We will pay for one of the following:

1. A return to the Covered Person’s permanent residence, or if appropriate, to a health care facility nearer to their permanent residence. Transportation will be provided by medically equipped specialty aircraft, commercial airline, train or ambulance depending upon the medical needs and available transportation specific to each case. Transportation must be by the most direct and economical route.

2. You will be transferred back to your original location or the location from which you were evacuated via a one-way economy airfare. If Your transportation needs to be medically supervised a qualified medical attendant will escort you. Additionally, if We and/or Our designee, determines a mode of transport other than economy class seating on a commercial aircraft is required, We or Our designee will arrange accordingly and such will be covered by Us. Transportation shall not be considered Medically Necessary if We or Our designee’s medical director determines that the Covered Person can continue his/her trip or can use the original transportation arrangements that he/she purchased.

Return of Dependent Children: If the Covered Person has minor children who are left unattended as a result of their injury, illness or medical evacuation, We or Our designee will arrange and pay for the cost of economy class one-way airfares, and an escort as may be reasonably required, for the transportation of such minor children to their Home Country or Country of Assignment.

General Limitations/ Exclusions for Emergency Medical Evacuation and Repatriation after an Emergency Medical Evacuation Benefits

In addition to any of the general exclusions listed in Section VI. of this certificate, the following exclusions also apply to the Emergency Medical Transportation benefit:

1. Transportation shall not be considered Medically Necessary if We or Our designee’s medical director determines that the Covered Person is receiving adequate care in their current location.

2. Transportation shall not be considered Medically Necessary if We or Our designee’s medical director determines that the Covered Person can continue his/her trip or can use the original transportation arrangements that he/she purchased.

3. No more than one Emergency Medical Evacuation and/or Repatriation is allowed for any single medical condition of a Covered Member while covered under this Certificate.

4. No payment will be made for charges for:

a) services rendered without the authorization or intervention of Us or Our designee;

b) non-emergency, routine or minor medical problems, tests and exams where there is no clear or significant risk of death or imminent serious Injury or harm to You;

c) a condition which would allow for treatment at a future date convenient to You and which does not require emergency evacuation or repatriation;

d) expenses incurred if the original or ancillary purpose of Your trip is to obtain medical treatment;

e) Any expense for medical evacuation or repatriation if the Covered Member is not suffering from a Serious Medical Condition, and/or in the opinion of Our designee’s medical director, the Covered Member can be adequately treated locally, or treatment can be reasonably delayed until the Covered Member returns to his/her Home Country or Country of Assignment.

5. Medical transport services will not be provided to a Covered Person who has a diagnosis of, or is suspected of having, a Biosafety Class Level 3 (and above) pathogen as classified by either the Centers for Disease Control and Prevention (CDC) or the National Institutes of Health (NIH).

Emergency Family Travel Arrangements

If a Covered Person is Hospital Confined due to an Injury or Sickness for more than 7 days, is likely to be hospitalized for more than 7 days or is in critical condition, while traveling outside of his/her home country, the Insurer will pay up to the maximum benefit as listed in Benefit Overview Matrix for the cost of one economy round trip air fare ticket to, and the hotel accommodations in, the place of the Hospital Confinement for one person designated by the Covered Person. Payment for meals, ground transportation and other incidentals are the responsibility of the family member or friend.

With respect to any one trip, this benefit is payable only once for that trip, regardless of the number of Covered Persons on that trip. The determination of whether the Covered Person will be hospitalized for more than 7 days or is in critical condition shall be made by the Administrator after consultation with the attending physician. No benefits are payable unless the trip is approved in advance by the Plan Administrator.

This benefit is available only to Covered Persons who are traveling outside of their Home Country while covered under this Certificate of Coverage.

The benefit for all Bedside Visits is listed in the Benefit Overview Matrix.

Repatriation of Mortal Remains Benefit

If a Covered Person dies, while traveling outside of his/her home country, the Insurer will pay the necessary expenses actually incurred, up to the Maximum Limit shown in the Benefit Overview Matrix, for the preparation of the body for burial, or the cremation, and for the transportation of the remains to his/her Home Country. This benefit covers the legal minimum requirements for the transportation of the remains. It does not include the transportation of anyone accompanying the body, urns, caskets, coffins, visitation, burial or funeral expenses. Any expense for repatriation of remains requires approval in advance by the Plan Administrator.

The Insurer will not pay any claims under this provision unless the expense has been approved by the Administrator before the body is prepared for transportation.

This benefit is available only to Covered Persons who are traveling outside of their Home Country

The benefit maximum for all necessary repatriation of mortal remains services is listed in the Benefit Overview Matrix.

No benefit is payable if the death occurs after the Termination Date of this Certificate of Coverage. However, if the Covered Person dies while coverage is in effect, eligibility for this benefit continues until the earlier of the Termination Date of this Certificate of Coverage or 7 days after the Termination Date.

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Global Underwriters Global Underwriters
Policy Name and Summary of Coverage
25

Diplomat International

$100,000 per person

Emergency Medical Evacuation, Emergency Medical Repatriation And Return Of Mortal Remains Expense Benefit

When You suffer loss of life for any reason or incur a Sickness or Injury during the course of Your Trip, the following benefits are payable, up to the Maximum Benefit Amount shown in the Schedule of Benefits subject to pre-approval from the authorized travel assistance company.

1) Emergency Medical Evacuation: If the local attending Legally Qualified Physician and the authorized travel assistance company determine that transportation to a Hospital or medical facility is Medically Necessary to treat an unforeseen Sickness or Injury which is acute or life threatening and adequate Medical Treatment is not available in the immediate area, the Transportation Expense incurred will be paid for the Usual and Customary Charges for transportation to the closest Hospital or medical facility capable of providing that treatment.

2) Emergency Medical Repatriation: If the local attending Legally Qualified Physician and the authorized travel assistance company determine that it is Medically Necessary for You to return to Your primary place of residence because of an unforeseen Sickness or Injury which is acute or life-threatening, the Transportation Expense incurred within 90 days from the date of the Covered Loss, will be paid for Your return to Your primary place of residence or to a Hospital or medical facility closest to Your primary place of place of residence capable of providing continued treatment via one of the following methods of transportation, as approved, in writing, by the authorized travel assistance company:

a) one-way Economy Transportation;

b) commercial air upgrade (to Business or First Class), based on Your condition as recommended by the local attending Legally Qualified Physician and verified in writing and considered necessary by the authorized travel assistance company; or

c) other covered land or air transportation including, but not limited to, commercial stretcher, medical escort, or the Usual and Customary Charges for air ambulance, provided such transportation has been pre-approved and arranged by the authorized travel assistance company. Transportation must be via the most direct and economical route.

3) Return of Mortal Remains: In the event of Your death during a Trip, the expense incurred within 30 days from the date of the Covered Loss will be paid for minimally necessary casket or air tray, preparation and transportation of Your remains to Your primary place of residence in the United States of America or to the place of burial.

Return Of Minor Child Benefit:

Should the Plan Participant be traveling alone with a Minor Child(ren) and is hospitalized because of a covered Sickness or Injury and the Minor Child(ren) are left unattended, The Company will arrange and pay for one way economy fares to their current Home Country. These arrangements will be made at no cost to the Plan Participant. Meals and lodging are the responsibility of the Plan Participant. If an attendant/escort is necessary to insure the safety and welfare of Minor Child(ren), The Company will arrange and pay for these services as stated in the Schedule of Benefits. All transportation in connection with a Return of Minor Child(ren) must be pre-approved and arranged by an assistance company representative appointed by the Company.

Emergency Medical Reunion Benefit:

When a Plan Participant is traveling alone and is hospitalized for more than 5 days, the Company will arrange and pay for round-trip economy-class transportation for one individual selected by the Plan Participant from the Plan Participant’s Home Country to the location where the Plan Participant is hospitalized and return to the current Home Country. The benefits payable will include: If the Plan Participant is eligible for a covered Emergency Medical Evacuation or Repatriation under this Plan Document and the assistance company representative, appointed by the Company, and the attending Physician determines that Medical Emergency Evacuation or Repatriation is necessary and prudent for the Plan Participant, the Company will arrange and pay for round trip economy-class transportation for one individual selected by the Plan Participant, from the Plan Participant’s current Home Country to the location where the Plan Participant is hospitalized and return to the current Home Country. The benefits payable will include: 1. The cost of a round trip economy air fare up to the maximum stated in the Schedule of Benefits; 2. Reasonable travel and accommodation expenses incurred in relation to the Emergency Medical Reunion up to the maximum stated in the Schedule of Benefits; The period of Emergency Medical Reunion is not to exceed 10 days, including travel.

All transportation in connection with an Emergency Medical Reunion must be pre-approved and arranged by the assistance company representative appointed by the Company.

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HTH Travel Insurance HTH Travel Insurance
Policy Name and Summary of Coverage
26

TravelGap Voyager excl US

$500,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;

b) after being treated at a local Hospital, Your medical condition warrants Transportation to the United States of America where You reside, to obtain further medical treatment or to recover; or

c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;

b) required by the standard regulations of the conveyance transporting You; and

c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the Company’s authorized Travel Assistance Company.

Notwithstanding the forgoing, in the event the Emergency Evacuation services are not arranged by the Company’s authorized Travel Assistance Company, the Company, in its sole discretion, may elect to evaluate the need for the Emergency Evacuation and provide limited reimbursement for the portion of the expenses related to such Emergency Evacuation as would have been authorized by Company’s authorized Travel Assistance Company.

Hospital Companion:

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

REPATRIATION OF REMAINS – $25,000

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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27

TripProtector Preferred

$1,000,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;

b) after being treated at a local Hospital, Your medical condition warrants Transportation to Your Home where You reside, to obtain further medical treatment or to recover; or

c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;

b) required by the standard regulations of the conveyance transporting You; and

c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the Company’s authorized Travel Assistance Company.

Transportation of Minor Children: If You are expected to be in the Hospital for more than seven (7) days following a covered Emergency Evacuation, or pass away during the Trip, the Company will return Your unattended minor child(ren) (under the age of eighteen (18)) who is/are accompanying You on the scheduled Trip, to the domicile of a person nominated by You or Your next of kin with an attendant if necessary.

Hospital Companion:

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

REPATRIATION OF REMAINS

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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28

TravelGap Excursion excl US

$500,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;

b) after being treated at a local Hospital, Your medical condition warrants Transportation to the United States of America where You reside, to obtain further medical treatment or to recover; or

c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;

b) required by the standard regulations of the conveyance transporting You; and

c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the Company’s authorized Travel Assistance Company.

Notwithstanding the forgoing, in the event the Emergency Evacuation services are not arranged by the Company’s authorized Travel Assistance Company, the Company, in its sole discretion, may elect to evaluate the need for the Emergency Evacuation and provide limited reimbursement for the portion of the expenses related to such Emergency Evacuation as would have been authorized by Company’s authorized Travel Assistance Company.

Hospital Companion:

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

REPATRIATION OF REMAINS – $25,000

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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29

TripProtector Economy

$500,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;

b) after being treated at a local Hospital, Your medical condition warrants Transportation to Your Home where You reside, to obtain further medical treatment or to recover; or

c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;

b) required by the standard regulations of the conveyance transporting You; and

c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the Company’s authorized Travel Assistance Company.

Transportation of Minor Children: If You are expected to be in the Hospital for more than seven (7) days following a covered Emergency Evacuation, or pass away during the Trip, the Company will return Your unattended minor child(ren) (under the age of eighteen (18)) who is/are accompanying You on the scheduled Trip, to the domicile of a person nominated by You or Your next of kin with an attendant if necessary.

Hospital Companion:

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

REPATRIATION OF REMAINS

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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30

TripProtector Classic

$1,000,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;
b) after being treated at a local Hospital, Your medical condition warrants Transportation to Your Home where You reside, to obtain further medical treatment or to recover; or
c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;
b) required by the standard regulations of the conveyance transporting You; and
c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the Company’s authorized Travel Assistance Company.

Transportation of Minor Children: If You are expected to be in the Hospital for more than seven (7) days following a covered Emergency Evacuation, or pass away during the Trip, the Company will return Your unattended minor child(ren) (under the age of eighteen (18)) who is/are accompanying You on the scheduled Trip, to the domicile of a person nominated by You or Your next of kin with an attendant if necessary.

Hospital Companion:

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

REPATRIATION OF REMAINS

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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IMG IMG
Policy Name and Summary of Coverage
31

iTravelInsured Travel Lite

$500,000 per person

MEDICAL EVACUATION AND REPATRIATION OF REMAINS

Benefits will be paid, up to the Maximum Benefit Amount shown in the Schedule of Benefits, when You suffer a Sickness, Injury, or loss of life, during Your Trip, for the following:

Emergency Medical Evacuation

We will pay for the Usual and Customary transportation expenses for an Emergency Medical Evacuation, to the nearest suitable Hospital or medical facility where Medically Necessary treatment is available to treat an Unforeseen Sickness or Injury provided:

1. the local attending Physician and Our designated Travel Assistance Services Provider determine that Your condition is acute, severe or life threating; and
2. that adequate Medically Necessary treatment is not available in Your immediate area.

Medical Repatriation

Following an Emergency Medical Evacuation or a covered Injury or Sickness, We will pay for Medical Evacuation expenses to return You to Your point of origin, Your Primary Residence, or to a Hospital or medical facility closest to Your Primary Residence capable of providing continued treatment, if Your local attending Physician and Our designated Travel Assistance Services Provider determine that it is Medically Necessary.

We will pay for one of the following methods of transportation, as pre-approved (prior to the evacuation) and arranged by Us or Our designated Travel Assistance Services Provider:

a) one-way economy transportation;
b) commercial air upgrade to business or first class, less refunds from Your unused transportation tickets;
c) other covered land or air transportation including, but not limited to, commercial stretcher, Medical Escort, or the contracted charges for air ambulance.

Transportation must be via the most direct, efficient and economical method of conveyance. In all cases, where practical, economy fare will be utilized. If possible, Your Common Carrier tickets will be used.

We will also pay a benefit for Usual and Customary expenses incurred for a Medical Escort’s transportation and accommodations if an onsite attending Physician recommends in writing that a Medical Escort accompany You.

Medical Escort means a medically trained professional who is approved by Us or Our designated Travel Assistance Services Provider, and is contracted to accompany and provide medical care to a sick or injured person while they are being transported.

Advance Payment: We will pay covered expenses directly to the service provider if You require an Emergency Medical Evacuation while on Your Trip, and the provider requires payment prior to service. This amount will be deducted from the benefit limit shown in the Schedule of Benefits. You agree to reimburse this payment to Us if: (a) You do not complete the claims process as outlined in the Payment of Claims section; or (b) it is determined that Your Emergency Medical Evacuation claim is not covered.

Medical Evacuation expenses will only be payable at the Usual and Customary level or payment for necessary transportation, related medical services and medical supplies.

Repatriation of Remains

Benefits will be paid for covered Repatriation Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, to return Your body to Your city of Primary Residence or Your origination point or to the place of burial in the United States of America if You die during Your Trip.

Repatriation Expenses means:
a) embalming or local cremation; and
b) associated temporary storage costs for up to fourteen (14) days, or until local authorities of the country/state in which the death occurred, will permit further transportation of the body, whichever is later; and the most economical coffin or receptacle adequate to transport the remains;
c) the cost of transportation of the remains, by the most direct and economical conveyance and route possible, to: 1) the nearest location where the body can be embalmed or cremated, if not locally available; and/or 2) the receiving funeral home or morgue, at the Return Destination, or a different place of burial within United States or country where You are stationed or Your Family Member is stationed; and
d) the cost for the creation and transmission of necessary documentation required to transport the body, such as a death certificate, autopsy or police report.

All Repatriation Expenses must be authorized and arranged in advance by Us or Our designated Travel Assistance Services Provider. Once Your remains are claimed by the receiving funeral home or morgue, or in the event of local cremation, coverage under this benefit ends.

Dispatch of a Physician: If the local attending Physician and Our designated Travel Assistance Services Provider cannot adequately assess Your need for Emergency Medical Evacuation or transportation, and a Physician is dispatched by the Travel Assistance Services Provider to make such assessment, benefits will be paid for the travel expenses incurred and medical services provided by the dispatched Physician.

Transportation expenses for the Emergency Medical Evacuation and Medical Repatriation must be authorized and arranged in advance by Us or Our designated Travel Assistance Services Provider.

In the event that Your Injury or Sickness prevents for You to obtain prior authorization of the Emergency Medical Evacuation, Medical Repatriation or Repatriation of Remains, You must make all efforts to notify Us or Our designated Travel Assistance Services Provider as soon as reasonably possible.

In the event You have not contacted Us or Our designated Travel Assistance Services Provider to arrange for Emergency Medical Evacuation, Medical Repatriation or Repatriation of Remains, benefits will be limited to the amount We would have paid had We or Our designated Travel Assistance Services Provider been contacted and related services pre-approved.

Return Transportation: If We have previously evacuated You to a medical facility, We will reimburse Your airfare costs, less refunds from Your unused transportation tickets, from that facility to Your Return Destination or Primary Residence, within one hundred eighty (180) days from Your original Scheduled Return Date. Airfare costs will be based on medical necessity or same class as Your original tickets.

Transportation of Children/Child: If You die or are Hospitalized for more than three (3) consecutive days following or unable to travel due to an Emergency Medical Evacuation or Injury and Sickness that occurred during Your Trip, We will pay up to the cost of a single one-way economy transportation ticket, or same class as the original transportation ticket, less the value of any applied credit from any unused return travel tickets for each person, to return Your Children/Child who were accompanying You on Your Trip (and any accompanying minor persons under Your care) who are left unattended by Your death or Hospitalization to their Primary Residence or to Your residence in the United States, including the cost of an attendant, if considered necessary by Us or Our designated Travel Assistance Services Provider.

Bedside Visit Transportation to Join You: If You are or will be Hospitalized for more than three (3) consecutive days following an Emergency Medical Evacuation or Injury and Sickness that occurred during Your Trip, We will pay, up to the cost of a single round-trip economy transportation ticket, up to the Maximum Benefit Amount shown in the Schedule of Benefits, for Reasonable Additional Expenses for one person chosen by You to visit Your bedside, provided You are traveling alone and Emergency Medical Evacuation or Medically Necessary Repatriation is not imminent.

You must provide all receipts for all covered expenses incurred during the stay.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

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32

iTravelInsured Travel SE

$500,000 per person

MEDICAL EVACUATION AND REPATRIATION OF REMAINS

Benefits will be paid, up to the Maximum Benefit Amount shown in the Schedule of Benefits, when You suffer a Sickness, Injury, or loss of life, during Your Trip, for the following:

Emergency Medical Evacuation

We will pay for the Usual and Customary transportation expenses for an Emergency Medical Evacuation, to the nearest suitable Hospital or medical facility where Medically Necessary treatment is available to treat an Unforeseen Sickness or Injury provided:

1. the local attending Physician and Our designated Travel Assistance Services Provider determine that Your condition is acute, severe or life threatening; and

2. that adequate Medically Necessary treatment is not available in Your immediate area.

Medical Repatriation

Following an Emergency Medical Evacuation or a covered Injury or Sickness, We will pay for Medical Evacuation expenses to return You to Your point of origin, Your Primary Residence, or to a Hospital or medical facility closest to Your Primary Residence capable of providing continued treatment, if Your local attending Physician and Our designated Travel Assistance Services Provider determine that it is Medically Necessary.

We will pay for one of the following methods of transportation, as pre-approved (prior to the evacuation) and arranged by Us or Our designated Travel Assistance Services Provider:

a) one-way economy transportation;
b) commercial air upgrade to business or first class, less refunds from Your unused transportation tickets;
c) other covered land or air transportation including, but not limited to, commercial stretcher, Medical Escort, or the contracted charges for air ambulance.

Transportation must be via the most direct, efficient and economical method of conveyance. In all cases, where practical, economy fare will be utilized. If possible, Your Common Carrier tickets will be used.

We will also pay a benefit for Usual and Customary expenses incurred for a Medical Escort’s transportation and accommodations if an onsite attending Physician recommends in writing that a Medical Escort accompany You. Medical Escort means a medically trained professional who is approved by Us or Our designated Travel Assistance Services Provider, and is contracted to accompany and provide medical care to a sick or injured person while they are being transported.

Advance Payment: We will pay covered expenses directly to the service provider if You require an Emergency Medical Evacuation while on Your Trip, and the provider requires payment prior to service. This amount will be deducted from the benefit limit shown in the Schedule of Benefits. You agree to reimburse this payment to Us if: (a) You do not complete the claims process as outlined in the Payment of Claims section; or (b) it is determined that Your Emergency Medical Evacuation claim is not covered. Medical Evacuation expenses will only be payable at the Usual and Customary level or payment for necessary transportation, related medical services and medical supplies.

Repatriation of Remains

Benefits will be paid for covered Repatriation Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, to return Your body to Your city of Primary Residence or Your origination point or to the place of burial in the United States of America if You die during Your Trip.

Repatriation Expenses means:

a) embalming or local cremation; and

b) associated temporary storage costs for up to fourteen (14) days, or until local authorities of the country/state in which the death occurred, will permit further transportation of the body, whichever is later; and the most economical coffin or receptacle adequate to transport the remains;

c) the cost of transportation of the remains, by the most direct and economical conveyance and route possible, to: 1) the nearest location where the body can be embalmed or cremated, if not locally available; and/or 2) the receiving funeral home or morgue, at the Return Destination, or a different place of burial within United States or country where You are stationed or Your Family Member is stationed; and

d) the cost for the creation and transmission of necessary documentation required to transport the body, such as a death certificate, autopsy or police report.

All Repatriation Expenses must be authorized and arranged in advance by Us or Our designated Travel Assistance Services Provider. Once Your remains are claimed by the receiving funeral home or morgue, or in the event of local cremation, coverage under this benefit ends.

Dispatch of a Physician: If the local attending Physician and Our designated Travel Assistance Services Provider cannot adequately assess Your need for Emergency Medical Evacuation or transportation, and a Physician is dispatched by the Travel Assistance Services Provider to make such assessment, benefits will be paid for the travel expenses incurred and medical services provided by the dispatched Physician. Transportation expenses for the Emergency Medical Evacuation and Medical Repatriation must be authorized and arranged in advance in advance by Us or Our designated Travel Assistance Services Provider.

In the event that Your Injury or Sickness prevents for You to obtain prior authorization of the Emergency Medical Evacuation, Medical Repatriation or Repatriation of Remains, You must make all efforts to notify Us or Our designated Travel Assistance Services Provider as soon as reasonably possible.

In the event You have not contacted Us or Our designated Travel Assistance Services Provider to arrange for Emergency Medical Evacuation, Medical Repatriation or Repatriation of Remains, benefits will be limited to the amount We would have paid had We or Our designated Travel Assistance Services Provider been contacted and related services pre-approved.

Return Transportation: If We have previously evacuated You to a medical facility, We will reimburse Your airfare costs, less refunds from Your unused transportation tickets, from that facility to Your Return Destination or Primary Residence, within one hundred eighty (180) days from Your original Scheduled Return Date. Airfare costs will be based on medical necessity or same class as Your original tickets.

Transportation of Children/Child: If You die or are Hospitalized for more than three (3) consecutive days following or unable to travel due to an Emergency Medical Evacuation or Injury and Sickness that occurred during Your Trip, We will pay up to the cost of a single one-way economy transportation ticket, or same class as the original transportation ticket, less the value of any applied credit from any unused return travel tickets for each person, to return Your Children/Child who were accompanying You on Your Trip (and any accompanying minor persons under Your care) who are left unattended by Your death or Hospitalization to their Primary Residence or to Your residence in the United States, including the cost of an attendant, if considered necessary by Us or Our designated Travel Assistance Services Provider.

Bedside Visit Transportation to Join You: If You are or will be Hospitalized for more than three (3) consecutive days following an Emergency Medical Evacuation or Injury and Sickness that occurred during Your Trip, We will pay, up to the cost of a single round-trip economy transportation ticket, up to the Maximum Benefit Amount shown in the Schedule of Benefits, for Reasonable Additional Expenses for one person chosen by You to visit Your bedside, provided You are traveling alone and Emergency Medical Evacuation or Medically Necessary Repatriation is not imminent.

You must provide all receipts for all covered expenses incurred during the stay.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

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33

Patriot America Plus

$1,000,000 policy limit
Pre-Existing Condition limit $25,000 per policy

L. EMERGENCY MEDICAL EVACUATION:

(1) Subject to the applicable Maximum Limit set forth in the BENEFIT SUMMARY, and the other Terms of this insurance, including the EXCLUSIONS provision and the CONDITIONS AND RESTRICTIONS subparagraph below, the Company will reimburse the Insured Person for the following transportation costs, when the Company or Plan Administrator arranges such transportation, and expenses incurred by the Insured Person arising out of or in connection with an Emergency Medical

Evacuation occurring while this Certificate is in effect and during the Period of Coverage:

a) Emergency air transportation to a suitable airport nearest to the Hospital where the Insured Person will receive Treatment

b) Emergency ground transportation necessarily preceding Emergency air transportation and from the destination airport to the Hospital where the Insured Person will receive Treatment

c) Return ground and air transportation, upon medical release by the attending Physician, to the country where the evacuation initially occurred or to the Insured Person’s Country of Residence, at the Insured Person’s option.

J. BEDSIDE VISIT: Maximum Limit: $1,500

Subject to the applicable Maximum Limit set forth in the BENEFIT SUMMARY, and the other Terms of this insurance, including the EXCLUSIONS provision and if the Insured Person is Hospitalized as an Inpatient in the Intensive Care unit of a Hospital for a covered life-threatening Injury or Illness during the Period of Coverage, the Company will reimburse the cost of a round-trip economy commercial airline ticket for one (1) Relative from the airport nearest to the location of the Relative at the time of the Insured Person’s Inpatient Intensive Care Hospitalization to the airport serving the area where the Insured Person is Hospitalized.

M. EMERGENCY REUNION: Maximum Limit: $100,000

(1) Subject to the Terms of this insurance, including without limitation the CONDITIONS AND RESTRICTIONS subparagraph below, Emergency Reunion expenses will be reimbursed to an Insured Person as outlined in the BENEFIT SUMMARY, in cases where there has been an Emergency Medical Evacuation covered under the Terms of this insurance. Subject to the applicable Deductible and Coinsurance and other limits and sub-limits as specified in the BENEFIT SUMMARY, and subject to the CONDITIONS AND RESTRICTIONS subparagraph below, the following costs and expenses incurred in respect of travel by a Relative or friend of the Insured Person will be reimbursable to the Insured Person upon the recommendation and prior approval of the Company:

a) the cost of a round-trip economy commercial airline ticket for one (1) Relative or friend from the airport nearest to the location of the Relative or friend at the time of the Emergency to the airport serving the area where the Insured Person is Hospitalized as a result of the Emergency or is to be Hospitalized as a result of the Emergency Medical Evacuation (to be determined pursuant to the Terms of the CONDITIONS AND RESTRICTIONS subparagraph, below), and return from whichever of such locations is actually selected to the point of the original departure

b) reasonable and necessary travel costs, meals (up to the amount shown in the BENEFIT SUMMARY), transportation and accommodation expenses incurred in relation to the Emergency Reunion (but excluding entertainment).

Y. RETURN OF MINOR CHILDREN: Maximum Limit: $100,000

Subject to the Terms of this insurance, in the event the Insured Person is Hospitalized for a covered Injury or Illness as an Inpatient or dies during the Period of Coverage and at the time of such Hospitalization the Insured Person was traveling alone with a Child, the Company will reimburse the Insured Person up to the amount shown in the BENEFIT SUMMARY for the cost of a one-way economy commercial airline ticket to return the Child to their Country of Residence, including such economy commercial airline ticket cost for a chaperone if necessary and required by the airline for the safety of the Child, subject to the following conditions and limitations:

(1) the Insured Person must be outside the Country of Residence at the time of the Hospitalization as an Inpatient

(2) the return of the Child must occur during the Insured Person’s Hospitalization

(3) reimbursable costs are only for a one-way economy commercial airline ticket from the airport nearest to the Child at the time of the Insured Person’s Hospitalization to the airport within the Child’s Country of Residence

(4) all travel and transportation arrangements for the Child must be approved in advance by the Company in order to be eligible for coverage under this insurance

(5) the Company will deduct from the return transportation benefits payable hereunder the value, if any, of the unused commercial airline return ticket(s) possessed by or for the benefit of the Child at the time of the Insured Person’s Hospitalization. The Insured Person and/or the Child must first attempt to receive credit for or deduct toward the costs of the return trip.

The Company will not provide any benefits, reimbursements or coverages for any costs or expenses incurred by the Insured Person and/or by the Child for a return trip, if any, to the original location of the Child at the time of the Hospitalization.

Z. RETURN OF MORTAL REMAINS: Up to the Period of Coverage limit

In the event of the death of the Insured Person during the Period of Coverage as a result of an Illness or Injury covered under this insurance while the Insured Person is outside of their Country of Residence, the Company will reimburse the authorized personal representative or the estate of the Insured Person up to the amount shown in the BENEFIT SUMMARY for the costs and expenses incurred to return the Insured Person’s Mortal Remains to their Country of Residence and thereafter to the place of burial or other final disposition (but not including any costs of burial
or other disposition); provided, however, that the Company must approve all costs and expenses related to the return of the Insured Person’s Mortal Remains in advance as a condition to the availability of this benefit; or up to the amount shown in the BENEFIT SUMMARY for preparation, local burial or cremation of the Insured Person’s Mortal Remains at the place of death in accordance with the commonly accepted cultural and religious beliefs practiced by the Insured Person. Coverage is not provided for burial and cremation costs incurred for religious practitioners, flowers, music, food or beverages.

Acute Onset of Pre-existing Conditions

Emergency Medical Evacuation: Maximum Limit: $25,000

-Arises or results directly from a covered Acute Onset of a Pre-existing Condition
-Insured Person must be under 70 years of age

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34

iTravelInsured Travel LX Basic

$1,000,000 per person

MEDICAL EVACUATION AND REPATRIATION OF REMAINS

Benefits will be paid, up to the Maximum Benefit Amount shown in the Schedule of Benefits, when You suffer a Sickness, Injury, or loss of life, during Your Trip, for the following:

Emergency Medical Evacuation

We will pay for the Usual and Customary transportation expenses for an Emergency Medical Evacuation, to the nearest suitable Hospital or medical facility where Medically Necessary treatment is available to treat an Unforeseen Sickness orInjury provided:

1. the local attending Physician and Our designated Travel Assistance Services Provider determine that Your condition is acute, severe or life threatening; and

2. that adequate Medically Necessary treatment is not available in Your immediate area.

Medical Repatriation

Following an Emergency Medical Evacuation or a covered Injury or Sickness, We will pay for Medical Evacuation expenses to return You to Your point of origin, Your Primary Residence, or to a Hospital of Choice or medical facility closest to Your Primary Residence capable of providing continued treatment, if Your local attending Physician and Our designated Travel Assistance Services Provider determine that it is Medically Necessary.

We will pay for one of the following methods of transportation, as pre-approved (prior to the evacuation) and arranged by Us or Our designated Travel Assistance Services Provider:

a) one-way economy transportation;

b) commercial air upgrade to business or first class, less refunds from Your unused transportation tickets;

c) other covered land or air transportation including, but not limited to, commercial stretcher, Medical Escort, or the contracted charges for air ambulance.

Transportation must be via the most direct, efficient and economical method of conveyance. In all cases, where practical, economy fare will be utilized. If possible, Your Common Carrier tickets will be used.

We will also pay a benefit for Usual and Customary expenses incurred for a Medical Escort’s transportation and accommodations if an onsite attending Physician recommends in writing that a Medical Escort accompany You.

Medical Escort means a medically trained professional who is approved by Us or Our designated Travel Assistance Services Provider, and is contracted to accompany and provide medical care to a sick or injured person while they are being transported.

Hospital of Choice: You may choose to be transported to a Hospital in a city within the United States of America other than the city of Your Primary Residence. If You are located outside of the United States because of Your or Your Family Member’s service in the armed forces or government of the United States of America, You may choose a Hospital in any city within the United States of America. The maximum amount payable is limited to the cost of transportation to Your Primary Residence.

Advance Payment: We will pay covered expenses directly to the service provider if You require an Emergency MedicalEvacuation while on Your Trip, and the provider requires payment prior to service. This amount will be deducted from the benefit limit shown in the Schedule of Benefits. You agree to reimburse this payment to Us if:

(a) You do not complete the claims process as outlined in the Payment of Claims section; or

(b) it is determined that Your Emergency Medical Evacuation claim is not covered.

Medical Evacuation expenses will only be payable at the Usual and Customary level or payment for necessary transportation, related medical services and medical supplies.

Repatriation of Remains Benefits will be paid for covered Repatriation Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, to return Your body to Your city of Primary Residence or Your origination point or to the place of burial in the United States of America if You die during Your Trip.

Repatriation Expenses means:

a) embalming or local cremation; and

b) associated temporary storage costs for up to fourteen (14) days, or until local authorities of the country/state in which the death occurred, will permit further transportation of the body, whichever is later; and the most economical coffin or receptacle adequate to transport the remains;

c) the cost of transportation of the remains, by the most direct and economical conveyance and route possible, to:

1) the nearest location where the body can be embalmed or cremated, if not locally available; and/or

2) the receiving funeral home or morgue, at the Return Destination, or a different place of burial within United States or country where You are stationed or Your Family Member is stationed; and

(d) the cost for the creation and transmission of necessary documentation required to transport the body, such as a death certificate, autopsy or police report.

All Repatriation Expenses must be authorized and arranged in advance by Us or Our designated Travel Assistance Services Provider. Once Your remains are claimed by the receiving funeral home or morgue, or in the event of local cremation, coverage under this benefit ends.

Dispatch of a Physician: If the local attending Physician and Our designated Travel Assistance Services Provider cannot adequately assess Your need for Emergency Medical Evacuation or transportation, and a Physician is dispatched by the Travel Assistance Services Provider to make such assessment, benefits will be paid for the travel expenses incurred and medical services provided by the dispatched Physician.

Transportation expenses for the Emergency Medical Evacuation and Medical Repatriation must be authorized and arranged in advance by Us or Our designated Travel Assistance Services Provider.

In the event that Your Injury or Sickness prevents for You to obtain prior authorization of the Emergency Medical Evacuation, Medical Repatriation or Repatriation of Remains, You must make all efforts to notify Us or Our designated Travel Assistance Services Provider as soon as reasonably possible. In the event You have not contacted Us or Our designated Travel Assistance Services Provider to arrange for Emergency Medical Evacuation, Medical Repatriation or Repatriation of Remains, benefits will be limited to the amount We would have paid had We or Our designated Travel Assistance Services Provider been contacted and related services pre-approved.

Return Transportation: If We have previously evacuated You to a medical facility, We will reimburse Your airfare costs, less refunds from Your unused transportation tickets, from that facility to Your Return Destination or Primary Residence, within one hundred eighty (180) days from Your original Scheduled Return Date. Airfare costs will be based on medical necessity or same class as Your original tickets.

Transportation of Children/Child: If You die or are Hospitalized for more than three (3) consecutive days following or unable to travel due to an Emergency Medical Evacuation or Injury and Sickness that occurred during Your Trip, We will pay up to the cost of a single one-way economy transportation ticket, or same class as the original transportation ticket, less the value of any applied credit from any unused return travel tickets for each person, to return Your Children/Child who were accompanying You on Your Trip (and any accompanying minor persons under Your care) who are left unattended by Your death or Hospitalization to their Primary Residence or to Your residence in the United States, including the cost of an attendant, if considered necessary by Us or Our designated Travel Assistance Services Provider.

Bedside Visit Transportation to Join You: If You are or will be Hospitalized for more than three (3) consecutive days following an Emergency Medical Evacuation or Injury and Sickness that occurred during Your Trip, We will pay, up to the cost of a single round-trip economy transportation ticket, up to the Maximum Benefit Amount shown in the Schedule of Benefits, for Reasonable Additional Expenses for one person chosen by You to visit Your bedside, provided You are traveling alone and Emergency Medical Evacuation or Medically Necessary Repatriation is not imminent.You must provide all receipts for all covered expenses incurred during the stay.These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

TRAVELING COMPANION BEDSIDE COMPANION DAILY – Up to $200 per day to a maximum of $1,000 per person

We will reimburse You, up to the Maximum Benefit Amount shown in the Schedule of Benefits, if Your Traveling Companion is Hospitalized for at least three (3) days during Your Trip, for Reasonable Additional Expenses incurred by You to remain near Your Traveling Companion. If the patient is an insured Child, a Traveling Companion bedside companion is available immediately upon Hospital admission. For purposes of this benefit, the Traveling Companion must accompany You on the Trip. You must provide all receipts for all covered expenses incurred during the stay.

Traveling Companion Bedside Companion Daily Benefits are supplemental to benefits provided under Trip Interruption and Your total Interruption coverage may not exceed the amount shown in the Schedule of Benefits. These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

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35

iTravelInsured Travel Sport

$1,000,000 per person

MEDICAL EVACUATION

We will pay this benefit, up to the Maximum Benefit Amount shown in the Schedule of Benefits, for the covered expenses listed below, incurred by You, subject to the following:
(1) Covered Expenses will only be payable at the Usual and Customary level of payment; and
(2) Benefits will be payable only for Covered Expenses listed below resulting from a Sickness or an Injury that occurs while on Your Trip.

For this benefit, Covered Expenses shall mean:

(a) expenses incurred by You for Physician-ordered emergency medical evacuation, including medically appropriate transportation and necessary medical care en route, to the nearest suitable Hospital, when You are critically ill or injured, and no suitable local care is available, subject to Our prior approval or that of Our Plan Assistance Provider.

(b) expenses incurred for non-emergency repatriation, including medically appropriate transportation and medical care en route, to a Hospital or to Your Home, when deemed medically necessary by the attending physician, subject to Our prior approval or that of Our Plan Assistance Provider. In lieu of returning to Your Home, You may opt to be returned to a different city in Your Home Country if proper care for Your condition is not available in Your Home city.

c) expenses for transportation (not to exceed the cost of one round-trip economy-class air fare, to the place of hospitalization), and expenses for reasonable hotel accommodations, meals, telephone calls and local transportation for one (1) person chosen by You, up to the sub-limit in the Schedule of Benefits, provided that You are traveling alone, with a minor, or with a person incapable of providing support, and are Hospitalized, or if Your Physician expects You to be Hospitalized, for seven (7) days or longer.

(d) expenses for transportation (not to exceed the cost of a one-way economy-class air fare) to Your Home, including escort expenses, if You are under the age of eighteen (18) and are left unattended due to the death or hospitalization of Your accompanying adult(s), subject to Our prior approval or that of Our Plan Assistance Provider.

(e) expenses for Transportation (not to exceed the cost of one round-trip economy-class air fare, to return Your Traveling Companion to their Home if You are Hospitalized, or if Your Physician expects You to be Hospitalized, for seven (7) days or longer.

Transportation expenses for items (a) and (b) above include, but are not limited to, Usual and Customary charges for land transportation, air transportation, commercial stretcher, medical escort, non-medical escort, air ambulance, and helicopter transfer provided such transportation has been pre-approved and arranged by Us or Our Plan Assistance Provider. In the event the Medical Evacuation services are not arranged by the Plan Assistance Provider, We may elect to evaluate the need for the Medical Evacuation and provide limited reimbursement for the portion of the expenses that would have been authorized by the Plan Assistance Provider had they initiated the Medical Evacuation.

REPATRIATION OF REMAINS

We will pay benefits for covered Repatriation Expenses incurred, up to the Maximum Benefit Amount in the Schedule of Benefits, to return Your body to Your Home city if You die during Your Trip.

For this benefit, covered Repatriation Expenses means: embalming, local cremation, minimally necessary casket for transport and air transportation of Your remains, and other expenses required to comply with local laws or regulations to arrange transport of Your remains. All Repatriation Expenses must be approved in advance by Us or Our Plan Assistance Provider. In the event the Repatriation of Remains services are not arranged by the Plan Assistance Provider, We may elect to provide limited reimbursement for the portion of the expenses that would have been authorized by the Plan Assistance Provider had they initiated the repatriation.

Alternatively, if chosen by Your estate in lieu of covered Repatriation Expenses, We will reimburse benefits for an equivalent amount paid for a local burial in the country where the death occurred if You die while outside of Your Home Country.

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36

iTravelInsured Travel Essential

No coverage

There is no Medical Evacuation & Repatriation coverage with this plan.

37

Patriot America Platinum

Included in Emergency Medical
$2,000,000 policy limit

L. EMERGENCY MEDICAL EVACUATION:

(1) Subject to the applicable Maximum Limit set forth in the BENEFIT SUMMARY, and the other Terms of this insurance, including the EXCLUSIONS provision and the CONDITIONS AND RESTRICTIONS subparagraph below, the Company will reimburse the Insured Person for the following transportation costs, when the Company or Plan Administrator arranges such transportation, and expenses incurred by the Insured Person arising out of or in connection with an Emergency Medical Evacuation occurring while this Certificate is in effect and during the Period of Coverage:

a) Emergency air transportation to a suitable airport nearest to the Hospital where the Insured Person will receive Treatment

b) Emergency ground transportation necessarily preceding Emergency air transportation and from the destination airport to the Hospital where the Insured Person will receive Treatment

c) Return ground and air transportation, upon medical release by the attending Physician, to the country where the evacuation initially occurred or to the Insured Person’s Country of Residence, at the Insured Person’s option.

(2) CONDITIONS AND RESTRICTIONS:

To be eligible for coverage for Emergency Medical Evacuation benefits, the Insured Person must be in compliance with all Terms of this insurance. The Company will provide Emergency Medical Evacuation benefits only when the condition, Illness, Injury or occurrence giving rise to the Emergency Medical Evacuation is covered under the Terms of this insurance. The Company will provide Emergency Medical Evacuation benefits only when all of the following conditions and restrictions are met:

a) Medically Necessary Treatment cannot be provided locally

b) transportation by any other means or methods would result in loss of the Insured Person’s life or limb within twentyfour (24) hours, based upon a reasonable medical certainty

c) Emergency Medical Evacuation is recommended by the attending Physician who certifies to the matters in subparagraphs a) and b), above

d) Emergency Medical Evacuation is agreed to by the Insured Person or a Relative of the Insured Person

e) Emergency Medical Evacuation is provided by designated, licensed, qualified, professional emergency personnel acting within the scope of such license and approved in advance and all arrangements are coordinated by the Company

f) the condition, Illness, Injury or occurrence giving rise to the need for the Emergency Medical Evacuation:

i) occurred outside the Insured Person’s Country of Residence suddenly, Unexpectedly, and spontaneously, and without: (1) advance warning, or (2) advance Treatment, diagnosis or recommendation for Treatment by a Physician, or (3) prior manifestation of symptoms or conditions that would have caused a reasonably prudent person to seek medical attention prior to the onset of the Emergency

ii) was not a Pre-existing Condition unless otherwise expressly provided for under the ACUTE ONSET OF PREEXISTING CONDITIONS provision

g) The Company will cover reimbursement for the above-described costs and expenses and will arrange Emergency Medical Evacuation only to the nearest Hospital that is qualified to provide the Medically Necessary Treatment toprevent the Insured Person’s loss of life or limb.

The Insured Person may select a different Hospital in their Country of Residence at their option, but in such event the Insured Person shall be solely responsible for all costs and expenses in excess of the amounts that would have been incurred had the Insured Person used the nearest qualified Hospital. If a Hospital other than the nearest qualified Hospital is selected by the Insured Person, then the attending Physician, Insured Person or a Relative of the Insured Person shall certify to the Company the Insured Person’s understanding and acknowledgement of such responsibility
for excess costs and expenses in addition to the matters set forth in the CONDITIONS AND RESTRICTIONS subparagraph, above. In all cases the Company will make the necessary arrangements for the Emergency Medical Evacuation and will use its best efforts to arrange with independent, third-party contractors any Emergency Medical Evacuation within the least amount of time reasonably possible.

By acceptance of this Certificate and request for Emergency Medical Evacuation benefits hereunder, the Insured Person understands, acknowledges and agrees that the timeliness, duration, occurrences during and outcome of an Emergency Medical Evacuation can be directly and indirectly affected by events and/or circumstances that are not within the supervision or control of the Company, including but not limited to: the availability, limitations, physical condition, reliability, maintenance and training schedules and procedures and performance or non-performance of competent transportation equipment, supplies and/or staff of such third-party contractors; delays or restrictions on flights or other modes or means of transportation caused by mechanical problems, government officials, telecommunications problems, non-availability of routes, and/or other travel, geographical or weather conditions; and other acts of God and unforeseeable and/or uncontrollable occurrences.

The Insured Person agrees to release and to hold the Company, the Plan Administrator and their agents and representatives harmless from, and agrees that the Company, the Plan Administrator and their agents and representatives shall not be held liable or responsible for, any delays, losses, damages, further Injuries or Illnesses, or any other claims that arise from or are caused in whole or in part by the acts or omissions of such independent third party contractors or their agents, employees or representatives, or that arise from or are caused in whole or in part by any acts, omissions, events or circumstances that are not within the direct and immediate supervision and control of the Company, the Plan Administrator and/or their authorized agents and representatives, including without limitation the events and circumstances set forth above.

The Insured Person further agrees that upon seeking an Emergency Medical Evacuation, he or she will cooperate fully as required by the CONDITIONS AND GENERAL PROVISIONS, COOPERATION provision. Failure to so cooperate and/or failure to use or accept Emergency Medical Evacuation once it has been arranged by the Company or Plan Administrator will require the Insured Person to reimburse the Company for costs incurred for any Emergency Medical Evacuation that was arranged, but not used, by the Insured Person. Furthermore, the Insured Person may be required to arrange for payment of any subsequent Emergency Medical Evacuation and seek reimbursement thereafter for eligible costs associated with that subsequent Emergency Medical Evacuation.

M. EMERGENCY REUNION: Maximum Limit: $100,000

(1) Subject to the Terms of this insurance, including without limitation the CONDITIONS AND RESTRICTIONS subparagraph below, Emergency Reunion expenses will be reimbursed to an Insured Person as outlined in the BENEFIT SUMMARY, in cases where there has been an Emergency Medical Evacuation covered under the Terms of this insurance. Subject to the applicable Deductible and Coinsurance and other limits and sub-limits as specified in the BENEFIT SUMMARY, and subject to the CONDITIONS AND RESTRICTIONS subparagraph below, the following costs and expenses incurred in respect of travel by a Relative or friend of the Insured Person will be reimbursable to the Insured Person upon the recommendation and prior approval of the Company:

a) the cost of a round-trip economy commercial airline ticket for one (1) Relative or friend from the airport nearest to the location of the Relative or friend at the time of the Emergency to the airport serving the area where the Insured Person is Hospitalized as a result of the Emergency or is to be Hospitalized as a result of the Emergency Medical Evacuation (to be determined pursuant to the Terms of the CONDITIONS AND RESTRICTIONS subparagraph, below), and return from whichever of such locations is actually selected to the point of the original departure

b) reasonable and necessary travel costs, meals (up to the amount shown in the BENEFIT SUMMARY), transportation and accommodation expenses incurred in relation to the Emergency Reunion (but excluding entertainment).

(2) CONDITIONS AND RESTRICTIONS:

a) the allowable maximum coverage for the Emergency Reunion shall not exceed fifteen (15) days, including travel days, and all costs and expenses incurred beyond fifteen (15) days shall be retained for the sole account and responsibility of the Insured Person, Relative or friend

b) the Emergency Reunion must be due to an Emergency Medical Evacuation covered under the Terms of this insurance

c) the Insured Person must be so seriously ill that the attending Physician deems it necessary and recommends the presence of a Relative or friend at either the location where the Insured Person is being evacuated from or the destination of the Emergency Medical Evacuation, whichever is considered by the attending Physician and the Company to be the more reasonable

d) all Emergency Reunion travel, transportation and accommodation arrangements and benefits must be approved in advance by the Company in order to be eligible for coverage under this insurance

e) the Insured Person, Relative and/or friend must submit to the Company upon completion of the Emergency Reunion travel legible and verifiable copies of all paid receipts for the travel and transportation costs and expenses so incurred for which reimbursement is sought.

Z. RETURN OF MINOR CHILDREN: Maximum Limit: $100,000

Subject to the Terms of this insurance, in the event the Insured Person is Hospitalized for a covered Injury or Illness as an Inpatient or dies during the Period of Coverage and at the time of such Hospitalization the Insured Person was traveling alone with a Child, the Company will reimburse the Insured Person up to the amount shown in the BENEFIT SUMMARY for the cost of a one-way economy commercial airline ticket to return the Child to their Country of Residence, including such economy commercial airline ticket cost for a chaperone if necessary and required by the airline for the safety of the Child, subject to the following conditions and limitations:

(1) the Insured Person must be outside the Country of Residence at the time of the Hospitalization as an Inpatient

(2) the return of the Child must occur during the Insured Person’s Hospitalization

(3) reimbursable costs are only for a one-way economy commercial airline ticket from the airport nearest to the Child at the time of the Insured Person’s Hospitalization to the airport within the Child’s Country of Residence

(4) all travel and transportation arrangements for the Child must be approved in advance by the Company in order to be eligible for coverage under this insurance

(5) the Company will deduct from the return transportation benefits payable hereunder the value, if any, of the unused commercial airline return ticket(s) possessed by or for the benefit of the Child at the time of the Insured Person’s Hospitalization. The Insured Person and/or the Child must first attempt to receive credit for or deduct toward the costs of the return trip.

The Company will not provide any benefits, reimbursements or coverages for any costs or expenses incurred by the Insured Person and/or by the Child for a return trip, if any, to the original location of the Child at the time of the Hospitalization.

AA. RETURN OF MORTAL REMAINS: Maximum Limit

In the event of the death of the Insured Person during the Period of Coverage as a result of an Illness or Injury covered under this insurance while the Insured Person is outside of their Country of Residence, the Company will reimburse the authorized personal representative or the estate of the Insured Person up to the amount shown in the BENEFIT SUMMARY for the costs and expenses incurred to return the Insured Person’s Mortal Remains to their Country of Residence and thereafter to the place of burial or other final disposition (but not including any costs of burial or other disposition); provided, however, that the Company must approve all costs and expenses related to the return of the Insured Person’s Mortal Remains in advance as a condition to the availability of this benefit; or up to the amount shown in the BENEFIT SUMMARY for preparation, local burial or cremation of the Insured Person’s Mortal Remains at the place of death in accordance with the commonly accepted cultural and religious beliefs practiced by the Insured Person. Coverage is not provided for burial and cremation costs incurred for religious practitioners, flowers, music, food or beverages.

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38

Patriot America Lite

$1,000,000 policy limit

K. EMERGENCY MEDICAL EVACUATION:

(1) Subject to the applicable Maximum Limit set forth in the BENEFIT SUMMARY, and the other Terms of this insurance, including the EXCLUSIONS provision and the CONDITIONS AND RESTRICTIONS subparagraph below, the Company will reimburse the Insured Person for the following transportation costs, when the Company or Plan Administrator arranges such transportation, and expenses incurred by the Insured Person arising out of or in connection with an Emergency Medical Evacuation occurring while this Certificate is in effect and during the Period of Coverage:

a) Emergency air transportation to a suitable airport nearest to the Hospital where the Insured Person will receive Treatment

b) Emergency ground transportation necessarily preceding Emergency air transportation and from the destination airport to the Hospital where the Insured Person will receive Treatment

c) Return ground and air transportation, upon medical release by the attending Physician, to the country where the evacuation initially occurred or to the Insured Person’s Country of Residence, at the Insured Person’s option.

L. EMERGENCY REUNION: Maximum Limit $100,000

(1) Subject to the Terms of this insurance, including without limitation the CONDITIONS AND RESTRICTIONS subparagraph below, Emergency Reunion expenses will be reimbursed to an Insured Person as outlined in the BENEFIT SUMMARY, in cases where there has been an Emergency Medical Evacuation covered under the Terms of this insurance. Subject to the applicable Deductible and Coinsurance and other limits and sub-limits as specified in the BENEFIT SUMMARY, and subject to the CONDITIONS AND RESTRICTIONS subparagraph below, the following costs and expenses incurred in respect of travel by a Relative or friend of the Insured Person will be reimbursable to the Insured Person upon the recommendation and prior approval of the Company:

a) the cost of a round-trip economy commercial airline ticket for one (1) Relative or friend from the airport nearest to the location of the Relative or friend at the time of the Emergency to the airport serving the area where the Insured Person is Hospitalized as a result of the Emergency or is to be Hospitalized as a result of the Emergency Medical Evacuation (to be determined pursuant to the Terms of the CONDITIONS AND RESTRICTIONS subparagraph, below), and return from whichever of such locations is actually selected to the point of the original departure

b) reasonable and necessary travel costs, meals (up to the amount shown in the BENEFIT SUMMARY), transportation and accommodation expenses incurred in relation to the Emergency Reunion (but excluding entertainment).

X. RETURN OF MINOR CHILDREN: Maximum Limit $100,000

Subject to the Terms of this insurance, in the event the Insured Person is Hospitalized for a covered Injury or Illness as an Inpatient or dies during the Period of Coverage and at the time of such Hospitalization the Insured Person was traveling alone with a Child, the Company will reimburse the Insured Person up to the amount shown in the BENEFIT SUMMARY for the cost of a one-way economy commercial airline ticket to return the Child to their Country of Residence, including such economy commercial airline ticket cost for a chaperone if necessary and required by the airline for the safety of the Child, subject to the following conditions and limitations:

(1) the Insured Person must be outside the Country of Residence at the time of the Hospitalization as an Inpatient

(2) the return of the Child must occur during the Insured Person’s Hospitalization

(3) reimbursable costs are only for a one-way economy commercial airline ticket from the airport nearest to the Child at the time of the Insured Person’s Hospitalization to the airport within the Child’s Country of Residence

(4) all travel and transportation arrangements for the Child must be approved in advance by the Company in order to be eligible for coverage under this insurance

(5) the Company will deduct from the return transportation benefits payable hereunder the value, if any, of the unused commercial airline return ticket(s) possessed by or for the benefit of the Child at the time of the Insured Person’s Hospitalization. The Insured Person and/or the Child must first attempt to receive credit for or deduct toward the costs of the return trip.

The Company will not provide any benefits, reimbursements or coverages for any costs or expenses incurred by the Insured Person and/or by the Child for a return trip, if any, to the original location of the Child at the time of the Hospitalization.

Y. RETURN OF MORTAL REMAINS: Local Burial / Cremation Maximum Limit $5,000

In the event of the death of the Insured Person during the Period of Coverage as a result of an Illness or Injury covered under this insurance while the Insured Person is outside of their Country of Residence, the Company will reimburse the authorized personal representative or the estate of the Insured Person up to the amount shown in the BENEFIT SUMMARY for the costs and expenses incurred to return the Insured Person’s Mortal Remains to their Country of Residence and thereafter to the place of burial or other final disposition (but not including any costs of burial or other disposition); provided, however, that the Company must approve all costs and expenses related to the return of the Insured Person’s Mortal Remains in advance as a condition to the availability of this benefit; or up to the amount shown in the BENEFIT SUMMARY for preparation, local burial or cremation of the Insured Person’s Mortal Remains at the place of death in accordance with the commonly accepted cultural and religious beliefs practiced by the Insured Person. Coverage is not provided for burial and cremation costs incurred for religious practitioners, flowers, music, food or beverages.

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39

Patriot International Lite

$1,000,000 policy limit

L. EMERGENCY MEDICAL EVACUATION:

(1) Subject to the applicable Maximum Limit set forth in the BENEFIT SUMMARY, and the other Terms of this insurance, including the EXCLUSIONS provision and the CONDITIONS AND RESTRICTIONS subparagraph below, the Company will reimburse the Insured Person for the following transportation costs, when the Company or Plan Administrator arranges such transportation, and expenses incurred by the Insured Person arising out of or in connection with an Emergency Medical Evacuation occurring while this Certificate is in effect and during the Period of Coverage:

a) Emergency air transportation to a suitable airport nearest to the Hospital where the Insured Person will receive Treatment

b) Emergency ground transportation necessarily preceding Emergency air transportation and from the destination airport to the Hospital where the Insured Person will receive Treatment

c) Return ground and air transportation, upon medical release by the attending Physician, to the country where the evacuation initially occurred or to the Insured Person’s Country of Residence, at the Insured Person’s option.

(2) CONDITIONS AND RESTRICTIONS:

To be eligible for coverage for Emergency Medical Evacuation benefits, the Insured Person must be in compliance with all Terms of this insurance. The Company will provide Emergency Medical Evacuation benefits only when the condition, Illness, Injury or occurrence giving rise to the Emergency Medical Evacuation is covered under the Terms of this insurance. The Company will provide Emergency Medical Evacuation benefits only when all of the following conditions and restrictions are met:

a) Medically Necessary Treatment cannot be provided locally

b) transportation by any other means or methods would result in loss of the Insured Person’s life or limb within twentyfour (24) hours, based upon a reasonable medical certainty

c) Emergency Medical Evacuation is recommended by the attending Physician who certifies to the matters in subparagraphs (a) and (b), above

d) Emergency Medical Evacuation is agreed to by the Insured Person or a Relative of the Insured Person

e) Emergency Medical Evacuation is provided by designated, licensed, qualified, professional emergency personnel acting within the scope of such license and approved in advance and all arrangements are coordinated by the Company

f) the condition, Illness, Injury or occurrence giving rise to the need for the Emergency Medical Evacuation:

(i) occurred outside the Insured Person’s Country of Residence suddenly, Unexpectedly, and spontaneously, and without:
(1) advance warning, or (2) advance Treatment, diagnosis or recommendation for Treatment by a Physician, or (3) prior manifestation of symptoms or conditions that would have caused a reasonably prudent person to seek medical attention prior to the onset of the Emergency

(ii) was not a Pre-existing Condition unless otherwise expressly provided for under the ACUTE ONSET OF PREEXISTING CONDITIONS provision

g) The Company will cover reimbursement for the above-described costs and expenses and will arrange Emergency Medical Evacuation only to the nearest Hospital that is qualified to provide the Medically Necessary Treatment to prevent the Insured Person’s loss of life or limb.

The Insured Person may select a different Hospital in their Country of Residence at their option, but in such event the Insured Person shall be solely responsible for all costs and expenses in excess of the amounts that would have been incurred had the Insured Person used the nearest qualified Hospital. If a Hospital other than the nearest qualified Hospital is selected by the Insured Person, then the attending Physician, Insured Person or a Relative of the Insured Person shall certify to the Company the Insured Person’s understanding and acknowledgement of such responsibility for excess costs and expenses in addition to the matters set forth in the CONDITIONS AND RESTRICTIONS subparagraph, above. In all cases the Company will make the necessary arrangements for the Emergency Medical
Evacuation and will use its best efforts to arrange with independent, third-party contractors any Emergency Medical Evacuation within the least amount of time reasonably possible.

By acceptance of this Certificate and request for Emergency Medical Evacuation benefits hereunder, the Insured Person understands, acknowledges and agrees that the timeliness, duration, occurrences during and outcome of an Emergency Medical Evacuation can be directly and indirectly affected by events and/or circumstances that are not within the supervision or control of the Company, including but not limited to: the availability, limitations, physical condition, reliability, maintenance and training schedules and procedures and performance or non-performance of competent transportation equipment, supplies and/or staff of such third-party contractors; delays or restrictions on flights or other modes or means of transportation caused by mechanical problems, government officials, telecommunications problems, non-availability of routes, and/or other travel, geographical or weather conditions; and other acts of God and unforeseeable and/or uncontrollable occurrences.

The Insured Person agrees to release and to hold the Company, the Plan Administrator and their agents and representatives harmless from, and agrees that the Company, the Plan Administrator and their agents and representatives shall not be held liable or responsible for, any delays, losses, damages, further Injuries or Illnesses, or any other claims that arise from or are caused in whole or in part by the acts or omissions of such independent third party contractors or their agents, employees or representatives, or that arise from or are caused in whole or in part by any acts, omissions, events or circumstances that are not within the direct and immediate supervision and control of the Company, the Plan Administrator and/or their authorized agents and representatives, including without limitation
the events and circumstances set forth above.

The Insured Person further agrees that upon seeking an Emergency Medical Evacuation, he or she will cooperate fully as required by the CONDITIONS AND GENERAL PROVISIONS, COOPERATION provision. Failure to so cooperate and/or failure to use or accept Emergency Medical Evacuation once it has been arranged by the Company or Plan Administrator will require the Insured Person to reimburse the Company for costs incurred for any Emergency Medical Evacuation that was arranged, but not used, by the Insured Person. Furthermore, the Insured Person may be required to arrange for payment of any subsequent Emergency Medical Evacuation and seek reimbursement thereafter for eligible costs associated with that subsequent Emergency Medical Evacuation.

M. EMERGENCY REUNION: Maximum Limit: $100,000

(1) Subject to the Terms of this insurance, including without limitation the CONDITIONS AND RESTRICTIONS subparagraph below, Emergency Reunion expenses will be reimbursed to an Insured Person as outlined in the BENEFIT SUMMARY, in cases where there has been an Emergency Medical Evacuation covered under the Terms of this insurance. Subject to the applicable Deductible and Coinsurance and other limits and sub-limits as specified in the BENEFIT SUMMARY, and subject to the CONDITIONS AND RESTRICTIONS subparagraph below, the following costs and expenses incurred in respect of travel by a Relative or friend of the Insured Person will be reimbursable to the Insured Person upon the recommendation and prior approval of the Company:

a) the cost of a round-trip economy commercial airline ticket for one (1) Relative or friend from the airport nearest to the location of the Relative or friend at the time of the Emergency to the airport serving the area where the Insured Person is Hospitalized as a result of the Emergency or is to be Hospitalized as a result of the Emergency Medical Evacuation (to be determined pursuant to the Terms of the CONDITIONS AND RESTRICTIONS subparagraph, below), and return from whichever of such locations is actually selected to the point of the original departure

b) reasonable and necessary travel costs, meals (up to the amount shown in the BENEFIT SUMMARY), transportation and accommodation expenses incurred in relation to the Emergency Reunion (but excluding entertainment).

(2) CONDITIONS AND RESTRICTIONS:

a) the allowable maximum coverage for the Emergency Reunion shall not exceed fifteen (15) days, including travel days, and all costs and expenses incurred beyond fifteen (15) days shall be retained for the sole account and responsibility of the Insured Person, Relative or friend

b) the Emergency Reunion must be due to an Emergency Medical Evacuation covered under the Terms of this insurance

c) the Insured Person must be so seriously ill that the attending Physician deems it necessary and recommends the presence of a Relative or friend at either the location where the Insured Person is being evacuated from or the destination of the Emergency Medical Evacuation, whichever is considered by the attending Physician and the Company to be the more reasonable

d) all Emergency Reunion travel, transportation and accommodation arrangements and benefits must be approved in advance by the Company in order to be eligible for coverage under this insurance

e) the Insured Person, Relative and/or friend must submit to the Company upon completion of the Emergency Reunion travel legible and verifiable copies of all paid receipts for the travel and transportation costs and expenses so incurred
for which reimbursement is sought.

AA. RETURN OF MINOR CHILDREN: Maximum Limit: $100,000

Subject to the Terms of this insurance, in the event the Insured Person is Hospitalized for a covered Injury or Illness as an Inpatient or dies during the Period of Coverage and at the time of such Hospitalization the Insured Person was traveling alone with a Child, the Company will reimburse the Insured Person up to the amount shown in the BENEFIT SUMMARY for the cost of a one-way economy commercial airline ticket to return the Child to their Country of Residence, including such economy commercial airline ticket cost for a chaperone if necessary and required by the airline for the safety of the Child, subject to the following conditions and limitations:

(1) the Insured Person must be outside the Country of Residence at the time of the Hospitalization as an Inpatient

(2) the return of the Child must occur during the Insured Person’s Hospitalization

(3) reimbursable costs are only for a one-way economy commercial airline ticket from the airport nearest to the Child at the time of the Insured Person’s Hospitalization to the airport within the Child’s Country of Residence

(4) all travel and transportation arrangements for the Child must be approved in advance by the Company in order to be eligible for coverage under this insurance

(5) the Company will deduct from the return transportation benefits payable hereunder the value, if any, of the unused commercial airline return ticket(s) possessed by or for the benefit of the Child at the time of the Insured Person’s
Hospitalization. The Insured Person and/or the Child must first attempt to receive credit for or deduct toward the costs of the return trip.

The Company will not provide any benefits, reimbursements or coverages for any costs or expenses incurred by the Insured Person and/or by the Child for a return trip, if any, to the original location of the Child at the time of the Hospitalization.

BB. RETURN OF MORTAL REMAINS: Up to the Period of Coverage limit

In the event of the death of the Insured Person during the Period of Coverage as a result of an Illness or Injury covered under this insurance while the Insured Person is outside of their Country of Residence, the Company will reimburse the authorized personal representative or the estate of the Insured Person up to the amount shown in the BENEFIT SUMMARY for the costs and expenses incurred to return the Insured Person’s Mortal Remains to
their Country of Residence and thereafter to the place of burial or other final disposition (but not including any costs of burial or other disposition); provided, however, that the Company must approve all costs and expenses related to the return of the Insured Person’s Mortal Remains in advance as a condition to the availability of this benefit; or up to the amount shown in the BENEFIT SUMMARY for preparation, local burial or cremation of the Insured Person’s Mortal Remains at the place of death in accordance with the commonly accepted cultural and religious beliefs practiced by the Insured Person. Coverage is not provided for burial and cremation costs incurred for religious practitioners, flowers, music, food or beverages.

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40

Patriot International Platinum

Included in Emergency Medical
$2,000,000 policy limit

L. EMERGENCY MEDICAL EVACUATION:

(1) Subject to the applicable Maximum Limit set forth in the BENEFIT SUMMARY, and the other Terms of this insurance, including the EXCLUSIONS provision and the CONDITIONS AND RESTRICTIONS subparagraph below, the Company will reimburse the Insured Person for the following transportation costs, when the Company or Plan Administrator arranges such transportation, and expenses incurred by the Insured Person arising out of or in connection with an Emergency Medical Evacuation occurring while this Certificate is in effect and during the Period of Coverage:

a) Emergency air transportation to a suitable airport nearest to the Hospital where the Insured Person will receive Treatment

b) Emergency ground transportation necessarily preceding Emergency air transportation and from the destination airport to the Hospital where the Insured Person will receive Treatment

c) Return ground and air transportation, upon medical release by the attending Physician, to the country where the evacuation initially occurred or to the Insured Person’s Country of Residence, at the Insured Person’s option.

(2) CONDITIONS AND RESTRICTIONS:

To be eligible for coverage for Emergency Medical Evacuation benefits, the Insured Person must be in compliance with all Terms of this insurance. The Company will provide Emergency Medical Evacuation benefits only when the condition, Illness, Injury or occurrence giving rise to the Emergency Medical Evacuation is covered under the Terms of this insurance. The Company will provide Emergency Medical Evacuation benefits only when all of the following conditions and restrictions are met:

a) Medically Necessary Treatment cannot be provided locally

b) transportation by any other means or methods would result in loss of the Insured Person’s life or limb within twentyfour (24) hours, based upon a reasonable medical certainty

c) Emergency Medical Evacuation is recommended by the attending Physician who certifies to the matters in subparagraphs a) and b), above

d) Emergency Medical Evacuation is agreed to by the Insured Person or a Relative of the Insured Person

e) Emergency Medical Evacuation is provided by designated, licensed, qualified, professional emergency personnel acting within the scope of such license and approved in advance and all arrangements are coordinated by the Company

f) the condition, Illness, Injury or occurrence giving rise to the need for the Emergency Medical Evacuation:

(i) occurred outside the Insured Person’s Country of Residence suddenly, Unexpectedly, and spontaneously, and without: (1) advance warning, or (2) advance Treatment, diagnosis or recommendation for Treatment by a Physician, or (3) prior manifestation of symptoms or conditions that would have caused a reasonably prudent person to seek medical attention prior to the onset of the Emergency

(ii) was not a Pre-existing Condition unless otherwise expressly provided for under the ACUTE ONSET OF A PREEXISTING CONDITIONS provision

g) The Company will cover reimbursement for the above-described costs and expenses and will arrange Emergency Medical Evacuation only to the nearest Hospital that is qualified to provide the Medically Necessary Treatment to prevent the Insured Person’s loss of life or limb.

The Insured Person may select a different Hospital in their Country of Residence at their option, but in such event the Insured Person shall be solely responsible for all costs and expenses in excess of the amounts that would have been incurred had the Insured Person used the nearest qualified Hospital. If a Hospital other than the nearest qualified Hospital is selected by the Insured Person, then the attending Physician, Insured Person or a Relative of the Insured Person shall certify to the Company the Insured Person’s understanding and acknowledgement of such responsibility\ for excess costs and expenses in addition to the matters set forth in the CONDITIONS AND RESTRICTIONS subparagraph, above. In all cases the Company will make the necessary arrangements for the Emergency Medical Evacuation and will use its best efforts to arrange with independent, third-party contractors any Emergency Medical Evacuation within the least amount of time reasonably possible.

By acceptance of this Certificate and request for Emergency Medical Evacuation benefits hereunder, the Insured Person understands, acknowledges and agrees that the timeliness, duration, occurrences during and outcome of an Emergency Medical Evacuation can be directly and indirectly affected by events and/or circumstances that are not within the supervision or control of the Company, including but not limited to: the availability, limitations, physical condition, reliability, maintenance and training schedules and procedures and performance or non-performance of competent transportation equipment, supplies and/or staff of such third-party contractors; delays or restrictions on flights or other modes or means of transportation caused by mechanical problems, government officials,
telecommunications problems, non-availability of routes, and/or other travel, geographical or weather conditions; and other acts of God and unforeseeable and/or uncontrollable occurrences.

The Insured Person agrees to release and to hold the Company, the Plan Administrator and their agents and representatives harmless from, and agrees that the Company, the Plan Administrator and their agents and representatives shall not be held liable or responsible for, any delays, losses, damages, further Injuries or Illnesses or any other claims that arise from or are caused in whole or in part by the acts or omissions of such independent thirdparty contractors or their agents, employees or representatives, or that arise from or are caused in whole or in part by any acts, omissions, events or circumstances that are not within the direct and immediate supervision and control of the Company, the Plan Administrator and/or their authorized agents and representatives, including without limitation the events and circumstances set forth above.

The Insured Person further agrees that upon seeking an Emergency Medical Evacuation, he or she will cooperate fully as required by the CONDITIONS AND GENERAL PROVISIONS, COOPERATION provision. Failure to so cooperate and/or failure to use or accept Emergency Medical Evacuation once it has been arranged by the Company or Plan Administrator will require the Insured Person to reimburse the Company for costs incurred for any Emergency Medical Evacuation that was arranged, but not used, by the Insured Person. Furthermore, the Insured Person may be required to arrange for payment of any subsequent Emergency Medical Evacuation and seek reimbursement thereafter for eligible costs associated with that subsequent Emergency Medical Evacuation.

I. BEDSIDE VISIT: Maximum Limit: $1,500

Subject to the applicable Maximum Limit set forth in the BENEFIT SUMMARY, and the other Terms of this insurance, including the EXCLUSIONS provision and if the Insured Person is Hospitalized as an Inpatient in the Intensive Care unit of a Hospital for a covered life-threatening Injury or Illness during the Period of Coverage, the Company will reimburse the cost of a round-trip economy commercial airline ticket for one (1) Relative from the airport nearest to the location of the Relative at the time of the Insured Person’s Inpatient Intensive Care Hospitalization to the airport serving the area where the Insured Person is Hospitalized.

M. EMERGENCY REUNION: Maximum Limit: $100,000

(1) Subject to the Terms of this insurance, including without limitation the CONDITIONS AND RESTRICTIONS subparagraph below, Emergency Reunion expenses will be reimbursed to an Insured Person as outlined in the BENEFIT SUMMARY, in cases where there has been an Emergency Medical Evacuation covered under the Terms of this insurance. Subject to the applicable Deductible and Coinsurance and other limits and sub-limits as specified in the BENEFIT SUMMARY, and subject to the CONDITIONS AND RESTRICTIONS subparagraph below, the following costs and expenses incurred in respect of travel by a Relative or friend of the Insured Person will be reimbursable to the Insured Person upon the recommendation and prior approval of the Company:

a) the cost of a round-trip economy commercial airline ticket for one (1) Relative or friend from the airport nearest to the location of the Relative or friend at the time of the Emergency to the airport serving the area where the Insured Person is Hospitalized as a result of the Emergency or is to be Hospitalized as a result of the Emergency Medical Evacuation (to be determined pursuant to the Terms of the CONDITIONS AND RESTRICTIONS subparagraph, below), and return from whichever of such locations is actually selected to the point of the original departure

b) reasonable and necessary travel costs, meals (up to the amount shown in the BENEFIT SUMMARY), transportation and accommodation expenses incurred in relation to the Emergency Reunion (but excluding entertainment).

(2) CONDITIONS AND RESTRICTIONS:

a) the allowable maximum coverage for the Emergency Reunion shall not exceed fifteen (15) days, including travel days, and all costs and expenses incurred beyond fifteen (15) days shall be retained for the sole account and responsibility of the Insured Person, Relative or friend

b) the Emergency Reunion must be due to an Emergency Medical Evacuation covered under the Terms of this insurance

c) the Insured Person must be so seriously ill that the attending Physician deems it necessary and recommends the presence of a Relative or friend at either the location where the Insured Person is being evacuated from or the destination of the Emergency Medical Evacuation, whichever is considered by the attending Physician and the Company to be the more reasonable

d) all Emergency Reunion travel, transportation and accommodation arrangements and benefits must be approved in advance by the Company in order to be eligible for coverage under this insurance

e) the Insured Person, Relative and/or friend must submit to the Company upon completion of the Emergency Reunion travel legible and verifiable copies of all paid receipts for the travel and transportation costs and expenses so incurred for which reimbursement is sought.

BB. RETURN OF MINOR CHILDREN: Maximum Limit: $100,000

Subject to the Terms of this insurance, in the event the Insured Person is Hospitalized for a covered Injury or Illness as an Inpatient or dies during the Period of Coverage and at the time of such Hospitalization the Insured Person was traveling alone with a Child, the Company will reimburse the Insured Person up to the amount shown in the BENEFIT SUMMARY for the cost of a one-way economy commercial airline ticket to return the Child to their Country of Residence, including such economy commercial airline ticket cost for a chaperone if necessary and required by the airline for the safety of the Child, subject to the following conditions and limitations:

(1) the Insured Person must be outside the Country of Residence at the time of the Hospitalization as an Inpatient

(2) the return of the Child must occur during the Insured Person’s Hospitalization

(3) reimbursable costs are only for a one-way economy commercial airline ticket from the airport nearest to the Child at the time of the Insured Person’s Hospitalization to the airport within the Child’s Country of Residence

(4) all travel and transportation arrangements for the Child must be approved in advance by the Company in order to be eligible for coverage under this insurance

(5) the Company will deduct from the return transportation benefits payable hereunder the value, if any, of the unused commercial airline return ticket(s) possessed by or for the benefit of the Child at the time of the Insured Person’s Hospitalization. The Insured Person and/or the Child must first attempt to receive credit for or deduct toward the costs of the return trip.

The Company will not provide any benefits, reimbursements or coverages for any costs or expenses incurred by the Insured Person and/or by the Child for a return trip, if any, to the original location of the Child at the time of the Hospitalization.

CC. RETURN OF MORTAL REMAINS: Maximum Limit: Up to the Period of Coverage limit

In the event of the death of the Insured Person during the Period of Coverage as a result of an Illness or Injury covered under this insurance while the Insured Person is outside of their Country of Residence, the Company will reimburse the authorized personal representative or the estate of the Insured Person up to the amount shown in the BENEFIT SUMMARY for the costs and expenses incurred to return the Insured Person’s Mortal Remains to their Country of Residence and thereafter to the place of burial or other final disposition (but not including any costs of burial or other disposition); provided, however, that the Company must approve all costs and expenses related to the return of the Insured Person’s Mortal Remains in advance as a condition to the availability of this benefit; or up to the amount shown in the BENEFIT SUMMARY for preparation, local burial or cremation of the Insured Person’s Mortal Remains at the place of death in accordance with the commonly accepted cultural and religious beliefs practiced by the Insured Person. Coverage is not provided for burial and cremation costs incurred for religious practitioners, flowers, music, food or beverages.

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John Hancock Insurance Agency, Inc. John Hancock Insurance Agency, Inc.
Policy Name and Summary of Coverage
41

Bronze

$250,000 per person

EMERGENCY MEDICAL EVACUATION & MEDICALLY NECESSARY REPATRIATION

We will pay, subject to the limitations set out herein, for covered Emergency Medical Evacuation expenses reasonably incurred if You suffer an Accidental Injury or Emergency Sickness that warrants Your Emergency Medical Evacuation while You are on a Covered Trip. Benefits payable are subject to the Maximum Benefit per Insured shown on the Schedule of Benefits for all Emergency Medical Evacuations due to all injuries from the same Accident or all Emergency Sickness from the same or related causes.

A legally licensed Physician, in coordination with Our Assistance Company, must order the Emergency Medical Evacuation and must certify that the severity of Your Accidental Injury or Emergency Sickness warrants Your Emergency Medical Evacuation to the closest adequate medical facility. Assistance Company or We must review and approve the necessity of the Emergency Medical Evacuation based on the inadequacy of local medical facilities. The Emergency Medical Evacuation must be coordinated through the most direct and economical conveyance and route possible, such as air or land ambulance or commercial airline carrier.

Covered Emergency Medical Evacuation expenses are those for Medically Necessary Transportation, including Reasonable and Customary medical services and supplies incurred in connection with Your Emergency Medical Evacuation. Expenses for Transportation must be: a) recommended by the attending Physician; b) required by the standard regulations of the conveyance transporting You; and c) reviewed and pre-approved by Our designated Assistance Company.

We will also pay Reasonable and Customary expenses, for escort expenses required by You, if You are disabled during a Covered Trip and an escort is recommended in writing by an attending Physician and such expenses are pre-approved by Our designated Assistance Company.

In the event the Emergency Medical Evacuation is not approved by Our designated Assistance Company prior to the start of the evacuation, reimbursement may be limited to the amount Our designated Assistance Company would have authorized had the Emergency Medical Evacuation been approved.

If You are hospitalized for more than the number of days shown on the Schedule of Benefits following a covered Emergency Medical Evacuation, We will pay, subject to the limitations set out herein, for expenses:

a) to return You to your Primary residence in the United States, with an attendant if necessary, any of Your Dependent Children who were accompanying You when the Accidental Injury or Emergency Sickness occurred and were left alone as a result of same. Our payment will not exceed the cost of a single one-way economy airfare ticket, less the value of applied credit from any unused return travel tickets per person; and

b) to bring 1 person chosen by You to and from the Hospital or other medical facility where You are confined if You are alone, but not to exceed the cost of 1 round-trip economy fare

In addition to the above Covered Expenses, if We have previously evacuated You to a medical facility, We will pay Your airfare costs from that facility to Your primary residence, within 1 year from Your original Scheduled Return Date, less refunds from Your unused Transportation tickets. Airfare costs will be economy or first class if Your original tickets are first class. This benefit is available only if it is not provided under another coverage in the Policy.

Transportation of Spouse or Domestic Partner:: If You are confined to the Hospital for more than the number of days shown on the Schedule of Benefits or if the attending Physician certifies that due to Your Accidental Injury or Emergency Sickness, You will be required to stay in the Hospital for more than the number of consecutive days shown on the Schedule of Benefits or if You die on the Covered Trip and require Repatriation of Remains, We will return Your spouse or Domestic Partner to Your primary residence. Our payment will not exceed the cost of a single one-way economy airfare ticket, less the value of applied credit from any unused return travel ticket

Escort Service: We will pay to return any of Your dependent children who were accompanying You at the time of Your Accidental Injury or Emergency Sickness back to Your residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way economy fare, less the value of any applied credit from any unused return travel tickets for each person. The escort service must be arranged and approved by Us or Our Assistance Company.

REPATRIATION OF REMAINS

We will pay the reasonable Covered Expenses incurred to return Your body to Your place of permanent residence if You die due to Accidental Injury or a Covered Sickness during the Covered Trip. No payment will exceed the maximum shown on the Schedule of Benefits.

Covered Expenses include:
a) The collection of the body of the deceased;
b) the transfer of the body to a professional funeral home;
c) embalming and preparation of the body or cremation if so desired;
d) standard shipping casket;
e)any required consular proceedings;
f) the transfer of the casket to the airport and boarding of the casket onto the plane;
g) any required permits and corresponding airfare; and
h) the transfer of the deceased to their final destination.

All Covered Expenses must be approved in advance by Our designated Assistance Company.

Escort Service:

We will pay to return any of Your children who were accompanying You at the time of Your death back to Your primary residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way economy airfare ticket, less the value of any applied credit from any unused return travel tickets for each person. The escort service must be arranged and approved by Us or Our designated Assistance Company.

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42

Silver

$500,000 per person

EMERGENCY MEDICAL EVACUATION & MEDICALLY NECESSARY REPATRIATION

We will pay, subject to the limitations set out herein, for covered Emergency Medical Evacuation expenses reasonably incurred if You suffer an Accidental Injury or Emergency Sickness that warrants Your Emergency Medical Evacuation while You are on a Covered Trip. Benefits payable are subject to the Maximum Benefit per Insured shown on the Schedule of Benefits for all Emergency Medical Evacuations due to all injuries from the same Accident or all Emergency Sickness from the same or related causes.

A legally licensed Physician, in coordination with Our designated Assistance Company, must order the Emergency Medical Evacuation and must certify that the severity of Your Accidental Injury or Emergency Sickness warrants Your Emergency Medical Evacuation to the closest adequate medical facility. We or Our Assistance Company or We must review and approve the necessity of the Emergency Medical Evacuation based on the inadequacy of local medical facilities. The Emergency Medical Evacuation must be coordinated through the most direct and economical conveyance and route possible, such as air or land ambulance or commercial airline carrier.

Covered Emergency Medical Evacuation expenses are those for Medically Necessary Transportation, including Reasonable and Customary medical services and supplies incurred in connection with Your Emergency Medical Evacuation. Expenses for Transportation must be: a) recommended by the attending Physician; b) required by the standard regulations of the conveyance transporting You; and c) reviewed and pre-approved by Our designated Assistance Company.

We will also pay Reasonable and Customary expenses, for escort expenses required by You, if You are disabled during a Covered Trip and an escort is recommended in writing by an attending Physician and such expenses are pre-approved by Our designated Assistance Company.

If You are hospitalized for more than the number of days shown on the Schedule of Benefits following a covered Emergency Medical Evacuation, We will pay, subject to the limitations set out herein, for expenses:

a) to return You to your residence in the United States, with an attendant if necessary, any of Your Dependent Children who were accompanying You when the Accidental Injury or Emergency Sickness occurred and were left alone as a result of same. Our payment will not exceed the cost of a single one-way economy airfare ticket, less the value of applied credit from any unused return travel tickets per person; and

b) to bring 1 person chosen by You to and from the Hospital or other medical facility where You are confined if You are alone, but not to exceed the cost of 1 round-trip economy airfare ticket.

In addition to the above Covered Expenses, if We have previously evacuated You to a medical facility, We will pay Your airfare costs from that facility to Your primary residence, within 1 year from Your original Scheduled Return Date, less refunds from Your unused Transportation tickets. Airfare costs will be economy or first class if Your original tickets are first class. This benefit is available only if it is not provided under another coverage in the Policy.

Transportation of Spouse or Domestic Partner: If You are confined to the Hospital for more than the number of days shown on the Schedule of Benefits or if the attending Physician certifies that due to Your Accidental Injury or Emergency Sickness, You will be required to stay in the Hospital for more than the number of consecutive days shown on the Schedule of Benefits or if You die on the Covered Trip and require Repatriation of Remains, We will return Your spouse or Domestic Partner to Your primary residence. Our payment will not exceed the cost of a single one-way economy airfare ticket, less the value of applied credit from any unused return travel ticket.

Escort Service: We will pay to return any of Your children who were accompanying You at the time of Your Accidental Injury or Emergency Sickness back to Your primary residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way economy airfare ticket, less the value of any applied credit from any unused return travel tickets for each person. The escort service must be arranged and approved by Us or Our designated Assistance Company.

REPATRIATION OF REMAINS

We will pay the reasonable Covered Expenses incurred to return Your body to Your place of permanent residence if You die due to Accidental Injury or a Covered Sickness during the Covered Trip. No payment will exceed the maximum shown on the Schedule of Benefits.

Covered Expenses include: a) The collection of the body of the deceased; b) the transfer of the body to a professional funeral home; c) embalming and preparation of the body or cremation if so desired; d) standard shipping casket; e) any required consular proceedings; f) the transfer of the casket to the airport and boarding of the casket onto the plane; g) any required permits and corresponding airfare; and (h) the transfer of the deceased to their final destination. All Covered Expenses must be approved in advance by Our designated Assistance Company.

Escort Service: We will pay to return any of Your children who were accompanying You at the time of Your death back to Your primary residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way economy airfare ticket, less the value of any applied credit from any unused return travel tickets for each person. The escort service must be arranged and approved by Us or Our designated Assistance Company.

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43

Gold

$1,000,000 per person

EMERGENCY MEDICAL EVACUATION & MEDICALLY NECESSARY REPATRIATION

We will pay, subject to the limitations set out herein, for covered Emergency Medical Evacuation expenses reasonably incurred if You suffer an Accidental Injury or Emergency Sickness that warrants Your Emergency Medical Evacuation while You are on a Covered Trip. Benefits payable are subject to the Maximum Benefit per Insured shown on the Schedule of Benefits for all Emergency Medical Evacuations due to all injuries from the same Accident or all Emergency Sickness from the same or related causes.

A legally licensed Physician, in coordination with Our designated Assistance Company, must order the Emergency Medical Evacuation and must certify that the severity of Your Accidental Injury or Emergency Sickness warrants Your Emergency Medical Evacuation to the closest adequate medical facility. We or Our Assistance Company or We must review and approve the necessity of the Emergency Medical Evacuation based on the inadequacy of local medical facilities. The Emergency Medical Evacuation must be coordinated through the most direct and economical conveyance and route possible, such as air or land ambulance or commercial airline carrier.

Covered Emergency Medical Evacuation expenses are those for Medically Necessary Transportation, including Reasonable and Customary medical services and supplies incurred in connection with Your Emergency Medical Evacuation. Expenses for Transportation must be: a) recommended by the attending Physician; b) required by the standard regulations of the conveyance transporting You; and c) reviewed and pre-approved by Our designated Assistance Company.

We will also pay Reasonable and Customary expenses, for escort expenses required by You, if You are disabled during a Covered Trip and an escort is recommended in writing by an attending Physician and such expenses are pre-approved by Our designated Assistance Company.

If You are hospitalized for more than the number of days shown on the Schedule of Benefits following a covered Emergency Medical Evacuation, We will pay, subject to the limitations set out herein, for expenses:

a) to return You to your residence in the United States, with an attendant if necessary, any of Your Dependent Children who were accompanying You when the Accidental Injury or Emergency Sickness occurred and were left alone as a result of same. Our payment will not exceed the cost of a single one-way economy airfare ticket, less the value of applied credit from any unused return travel tickets per person; and

b) to bring 1 person chosen by You to and from the Hospital or other medical facility where You are confined if You are alone, but not to exceed the cost of 1 round-trip economy airfare ticket.

In addition to the above Covered Expenses, if We have previously evacuated You to a medical facility, We will pay Your airfare costs from that facility to Your primary residence, within 1 year from Your original Scheduled Return Date, less refunds from Your unused Transportation tickets. Airfare costs will be economy or first class if Your original tickets are first class. This benefit is available only if it is not provided under another coverage in the Policy.

Transportation of Spouse or Domestic Partner: If You are confined to the Hospital for more than the number of days shown on the Schedule of Benefits or if the attending Physician certifies that due to Your Accidental Injury or Emergency Sickness, You will be required to stay in the Hospital for more than the number of consecutive days shown on the Schedule of Benefits or if You die on the Covered Trip and require Repatriation of Remains, We will return Your spouse or Domestic Partner to Your primary residence. Our payment will not exceed the cost of a single one-way economy airfare ticket, less the value of applied credit from any unused return travel ticket.

Escort Service: We will pay to return any of Your children who were accompanying You at the time of Your Accidental Injury or Emergency Sickness back to Your primary residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way economy airfare ticket, less the value of any applied credit from any unused return travel tickets for each person. The escort service must be arranged and approved by Us or Our designated Assistance Company.

REPATRIATION OF REMAINS

We will pay the reasonable Covered Expenses incurred to return Your body to Your place of permanent residence if You die due to Accidental Injury or a Covered Sickness during the Covered Trip. No payment will exceed the maximum shown on the Schedule of Benefits.

Covered Expenses include: a) The collection of the body of the deceased; b) the transfer of the body to a professional funeral home; c) embalming and preparation of the body or cremation if so desired; d) standard shipping casket; e) any required consular proceedings; f) the transfer of the casket to the airport and boarding of the casket onto the plane; g) any required permits and corresponding airfare; and h) the transfer of the deceased to their final destination. All Covered Expenses must be approved in advance by Our designated Assistance Company.

Escort Service: We will pay to return any of Your children who were accompanying You at the time of Your death back to Your primary residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way economy airfare ticket, less the value of any applied credit from any unused return travel tickets for each person. The escort service must be arranged and approved by Us or Our designated Assistance Company.

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MedjetAssist MedjetAssist
Policy Name and Summary of Coverage
44

Annual Membership

2 transports per year

WORLDWIDE REPATRIATION

Subject to limitations on services described herein, when a Medjet Member becomes hospitalized as an inpatient due to illness or injury while traveling 150 miles or more from his or her Residence Address as defined herein, Medjet will arrange for medical transportation and repatriation services to the hospital of the Member’s choice in the Member’s Home Country.

Affiliate aircraft used for the medical transport of Medjet Members are fully equipped intensive care aircraft staffed with specially trained medical teams. However, if the Member’s condition permits, the Member will be transported by scheduled commercial airline while in the care of a Medjet authorized
medical escort.

MEDICAL TRANSPORT SERVICES

A. Availability

Medjet medical transport services are available to any Member who qualifies for medical transport services in accordance with these Rules and Regulations, is hospitalized as an inpatient 150 miles or more from his or her Residence Address and is accepted as a patient into an available inpatient bed by an admitting physician at the hospital of the Member’s choice in the Member’s Home Country.

Medjet medical transport services are not available to a Member with mild lesions, simple injuries such as sprains, simple fractures or mild illnesses that can be treated by local doctors and do not prevent the Member from continuing his or her trip or returning home without medical attention.

Both the originating and receiving hospitals must be accessible by ground ambulance to transport the Member to and from an airfield capable of accommodating a Medjet authorized aircraft (in the case of a medical transport via medically dedicated air transport) or a commercial aircraft (in the case of medical transport via commercial airline in the care of a Medjet authorized commercial medical escort).

Due to the limited medical facilities and testing available on cruise ships, the Member must be admitted to a hospital on shore before scheduling medical transport to another hospital.

The time frame for medical transport is dependent on affiliate aircraft availability, required permits and visas for the respective countries, and other factors that may be beyond Medjet’s control.

Members must have proper documentation to return to their country of residence. Medjet is not responsible for obtaining these documents in the event of a request for transport.

B. Commercial Medical Escort Service

Medjet will arrange for medical transport via commercial airline in business class, if available, in the care of a Medjet authorized commercial medical escort if:

1. the Member requires continued inpatient hospitalization;

2. the remaining inpatient hospitalization can be completed at a hospital of the Member’s choice in the Member’s Home Country; and

3. the Member can be returned by commercial airline in the care of a Medjet authorized commercial medical escort.

One (1) traveling companion may accompany each Member being transported via scheduled commercial airline, at no additional cost, via economy class.

C. Medically Dedicated Air Transport Service

Medjet will arrange for medical transport via medically dedicated air transport on a Medjet authorized aircraft if:

1. the Member requires continued inpatient hospitalization;

2. the remaining inpatient hospitalization can be completed at a hospital of the Member’s choice in the Member’s Home Country; and

3. the Member cannot be returned by commercial airline in the care of a Medjet authorized commercial medical escort.

One (1) traveling companion may accompany each Member being transported on a Medjet authorized aircraft during a medically dedicated air transport, at no additional cost, provided space is available and the Member’s care will not be compromised.

While Medjet makes every effort to accommodate its Members, due to limited space available on medical aircraft, the Member and any accompanying passenger are limited to one small carry-on bag each.

D. Transport Criteria

All arrangements for medical transport and repatriation will be made by Medjet. Decisions regarding the urgency of the case, the best timing and the most suitable means of transportation will be made by Medjet after consultation with the local attending physician.

Medical Assessment – Medjet will require a Medical Assessment in order to determine membership benefits and stability for transport. The Medical Assessment requires a consultation between the Member’s treating physician, who will provide a final or interim diagnosis that will require continued inpatient hospitalization, and a Medjet physician, who will review and evaluate the treating physician’s diagnosis in order to determine the Member’s transport requirements.

A Member must be medically stable for medical transport. Assuming all other medical transport criteria are met, a Member who is initially considered medically unstable for transport to the hospital of the Member’s choice in the Member’s Home Country may first be transported to the nearest appropriate medical facility for initial stabilization. After this initial stabilization, Medjet will arrange continued transport to the hospital of the Member’s choice in the Member’s Home Country if the Member continues to meet medical transport criteria.

SPECIALTY HOSPITAL TRANSFER

Only Medjet Members with a continuous active membership without lapse since April 1, 2008, have access to the following Medjet Specialty Hospital Transfer service: Subject to limitations on services described herein, when a Medjet Member (under age 75) becomes hospitalized as an inpatient due to
illness or injury while traveling less than 150 miles from his or her Residence Address, and the attending physician and Medjet physician agree that medical treatment or procedures required for the Member’s care are not available at the current facility, Medjet will arrange medical transport to a specialty hospital of the Member’s choice, in the Member’s Home Country, as long as the facility is greater than 150 miles from the Member’s Residence Address on file and an admitting physician at the specialty hospital has accepted the Medjet Member as a patient into an available inpatient bed.

TRANSPORT OF MORTAL REMAINS

In the event of a Member’s death while traveling 150 miles or more away from the Member’s Residence Address, Medjet will arrange and pay reasonable and customary charges up to $6,000 for the preparation and return of the Member’s remains to the Member’s Home Country. These charges will be at the sole discretion of Medjet.

This membership benefit includes:

• Domestic and international paperwork fees
• Preparation of the Member’s remains for transport
• Transport container
• Ground and airline transport of the Member’s remains from the referring funeral home to the funeral home of choice in the Member’s Home Country
• One death certificate

COVID-19 SPECIALIZED TRANSFER

Subject to all other Rules and Regulations and the following additional limitations on services described herein, when a Member (whose Home Country is the United States, Canada or Mexico) becomes hospitalized as an inpatient due to Covid-19, is more than 150 miles from their Residence Address, and requires continued inpatient hospitalization, Medjet will arrange for Covid-19 Specialized Transfer to the Member’s hospital of choice within their Home Country.

For more information about the Covid-19 Specialized Transfer benefit, please visit the Covid-19 Services Information Page on Medjet.com.

Members otherwise eligible for transfer for Covid-19 must not exceed the maximum allowable height, weight and girth requirements set forth by the manufacturers of Covid-19 transport pods utilized in the safe transfer of Covid-19 positive patients. Please contact Medjet if you have questions or concerns regarding the sizing requirements prior to travel.

No traveling companions or family members will be allowed to accompany patients transported for Covid19.

If a hospitalized Member is under quarantine by a hospital, a government or any other regulatory entity exercising jurisdiction and that medical facility, government or regulatory entity will not allow transfer, transport will not be possible.

The receiving hospital selected by the hospitalized Medjet Member must agree to accept the patient.

Otherwise, Medjet’s transport to that hospital will not be possible.

The time frame for Covid-19 Specialized Transfer WILL BE extended beyond that of typical medical transports and is dependent on multiple factors including, but not limited to, affiliate availability to transfer Covid-19 patients, required permits or permissions and any other factors that are beyond Medjet’s control.

With respect to Covid-19 specialized transfers, to the extent of any actual or claimed inconsistency between the Covid-19 Specialty Transfer provisions and any other provision(s) of the Rules and Regulation, the Covid-19 Specialty Transfer provisions control.

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45

MedjetAssist Extended Stay

2 transports per year

WORLDWIDE REPATRIATION

Subject to limitations on services described herein, when a Medjet Member becomes hospitalized as an inpatient due to illness or injury while traveling 150 miles or more from his or her Residence Address, as defined herein, Medjet will arrange for medical transportation and repatriation services to the hospital of the Member’s choice in the Member’s Home Country.

Affiliate aircraft used for the medical transport of Medjet Members are fully equipped intensive care aircraft staffed with specially trained medical teams. However, if the Member’s condition permits, the Member will be transported by scheduled commercial airline while in the care of a Medjet authorized medical escort.

MEDICAL TRANSPORT SERVICES

A. Availability

Medjet medical transport services are available to any Member who qualifies for medical transport services in accordance with these Rules and Regulations, is hospitalized as an inpatient 150 miles or more from his or her Residence Address and is accepted as a patient into an available inpatient bed by an admitting physician at the hospital of the Member’s choice in the Member’s Home Country. Medjet medical transport services are not available to a Member with mild lesions, simple injuries such as sprains, simple fractures or mild illnesses that can be treated by local doctors and do not prevent the Member from continuing his or her trip or returning home without medical attention.

Both the originating and receiving hospitals must be accessible by ground ambulance to transport the Member to and from an airfield capable of accommodating a Medjet authorized aircraft (in the case of a medical transport via medically dedicated air transport) or a commercial aircraft (in the case of medical transport via commercial airline in the care of a Medjet authorized commercial medical escort). Due to the limited medical facilities and testing available on cruise ships, the Member must be admitted to a hospital on shore before scheduling medical transport to another hospital.

The time frame for medical transport is dependent on affiliate aircraft availability, required permits and visas for the respective countries, and other factors that may be beyond Medjet’s control.

Members must have proper documentation to return to their country of residence. Medjet is not responsible for obtaining these documents in the event of a request for transport.

B. Commercial Medical Escort Service

Medjet will arrange for medical transport via commercial airline in business class, if available, in the care of a Medjet authorized commercial medical escort if:

1. the Member requires continued inpatient hospitalization;

2. the remaining inpatient hospitalization can be completed at a hospital of the Member’s choice in the Member’s Home Country; and

3. the Member can be returned by commercial airline in the care of a Medjet authorized commercial medical escort. One (1) traveling companion may accompany each Member being transported via scheduled commercial airline, at no additional cost, via economy class.

C. Medically Dedicated Air Transport Service

Medjet will arrange for medical transport via medically dedicated air transport on a Medjet authorized aircraft if:

1. the Member requires continued inpatient hospitalization;

2. the remaining inpatient hospitalization can be completed at a hospital of the Member’s choice in the Member’s Home Country; and

3. the Member cannot be returned by commercial airline in the care of a Medjet authorized commercial medical escort. One (1) traveling companion may accompany each Member being transported on a Medjet authorized aircraft during a medically dedicated air transport, at no additional cost, provided space is available and the Member’s care will not be compromised.

While Medjet makes every effort to accommodate its Members, due to limited space available on medical aircraft, the Member and any accompanying passenger are limited to one small carry-on bag each.

D. Transport Criteria

All arrangements for medical transport and repatriation will be made by Medjet. Decisions regarding the urgency of the case, the best timing and the most suitable means of transportation will be made by Medjet after consultation with the local attending physician.

Medical Assessment – Medjet will require a Medical Assessment in order to determine membership benefits and stability for transport. The Medical Assessment requires a consultation between the Member’s treating physician, who will provide a final or interim diagnosis that will require continued inpatient hospitalization, and a Medjet physician, who will review and evaluate the treating physician’s diagnosis in order to determine the Member’s transport requirements.

A Member must be medically stable for medical transport.

Assuming all other medical transport criteria are met, a Member who is initially considered medically unstable for transport to the hospital of the Member’s choice in the Member’s Home Country may first be transported to the nearest appropriate medical facility for initial stabilization. After this initial stabilization, Medjet will arrange continued transport to the hospital of the Member’s choice in the Member’s Home Country if the Member continues to meet medical transport criteria.

SPECIALTY HOSPITAL TRANSFER

Only Medjet Members with a continuous active membership without lapse since April 1, 2008, have access to the following Medjet Specialty Hospital Transfer service: Subject to limitations on services described herein, when a Medjet Member (under age 75) becomes hospitalized as an inpatient due to illness or injury while traveling less than 150 miles from his or her Residence Address, and the attending physician and Medjet physician agree that medical treatment or procedures required for the Member’s care are not available at the current facility, Medjet will arrange medical transport to a specialty hospital of the Member’s choice, in the Member’s Home Country, as long as the facility is greater than 150 miles from the Member’s Residence Address on file and an admitting physician at the specialty hospital has accepted the Medjet Member as a patient into an available inpatient bed.

TRANSPORT OF MORTAL REMAINS

In the event of a Member’s death while traveling 150 miles or more away from the Member’s Residence Address, Medjet will arrange and pay reasonable and customary charges up to $6,000 for the preparation and return of the Member’s remains to the Member’s Home Country. These charges will be at the sole discretion of Medjet.

This membership benefit includes:

• Domestic and international paperwork fees
• Preparation of the Member’s remains for transport
• Transport container
• Ground and airline transport of the Member’s remains from the referring funeral home to the funeral home of choice in the Member’s Home Country
• One death certificate

COVID-19 SPECIALIZED TRANSFER

Subject to all other Rules and Regulations and the following additional limitations on services described herein, when a Member (whose Home Country is the United States, Canada or Mexico) becomes hospitalized as an inpatient due to Covid-19, is more than 150 miles from their Residence Address, and requires continued inpatient hospitalization, Medjet will arrange for Covid-19 Specialized Transfer to the Member’s hospital of choice within their Home Country.

For more information about the Covid-19 Specialized Transfer benefit, please visit the Covid-19 Services Information Page on Medjet.com.

Members otherwise eligible for transfer for Covid-19 must not exceed the maximum allowable height, weight and girth requirements set forth by the manufacturers of Covid-19 transport pods utilized in the safe transfer of Covid-19 positive patients. Please contact Medjet if you have questions or concerns regarding the sizing requirements prior to travel.

No traveling companions or family members will be allowed to accompany patients transported for Covid19.

If a hospitalized Member is under quarantine by a hospital, a government or any other regulatory entity exercising jurisdiction and that medical facility, government or regulatory entity will not allow transfer, transport will not be possible.

The receiving hospital selected by the hospitalized Medjet Member must agree to accept the patient. Otherwise, Medjet’s transport to that hospital will not be possible.

The time frame for Covid-19 Specialized Transfer WILL BE extended beyond that of typical medical transports and is dependent on multiple factors including, but not limited to, affiliate availability to transfer Covid-19 patients, required permits or permissions and any other factors that are beyond Medjet’s control.

With respect to Covid-19 specialized transfers, to the extent of any actual or claimed inconsistency between the Covid-19 Specialty Transfer provisions and any other provision(s) of the Rules and Regulations, the Covid-19 Specialty Transfer provisions control.

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46

MedjetAssist Short Term Plan

1 transport per person

WORLDWIDE REPATRIATION

Subject to limitations on services described herein, when a Medjet Member becomes hospitalized as an inpatient due to illness or injury while traveling 150 miles or more from his or her Residence Address as defined herein, Medjet will arrange for medical transportation and repatriation services to the hospital of the Member’s choice in the Member’s Home Country.

Affiliate aircraft used for the medical transport of Medjet Members are fully equipped intensive care aircraft staffed with specially trained medical teams. However, if the Member’s condition permits, the Member will be transported by scheduled commercial airline while in the care of a Medjet authorized medical escort.

MEDICAL TRANSPORT SERVICES

A. Availability

Medjet medical transport services are available to any Member who qualifies for medical transport services in accordance with these Rules and Regulations, is hospitalized as an inpatient 150 miles or more from his or her Residence Address and is accepted as a patient into an available inpatient bed by an admitting physician at the hospital of the Member’s choice in the Member’s Home Country.

Medjet medical transport services are not available to a Member with mild lesions, simple injuries such as sprains, simple fractures or mild illnesses that can be treated by local doctors and do not prevent the Member from continuing his or her trip or returning home without medical attention.

Both the originating and receiving hospitals must be accessible by ground ambulance to transport the Member to and from an airfield capable of accommodating a Medjet authorized aircraft (in the case of a medical transport via medically dedicated air transport) or a commercial aircraft (in the case of medical transport via commercial airline in the care of a Medjet authorized commercial medical escort).

Due to the limited medical facilities and testing available on cruise ships, the Member must be admitted to a hospital on shore before scheduling medical transport to another hospital.

The time frame for medical transport is dependent on affiliate aircraft availability, required permits and visas for the respective countries, and other factors that may be beyond Medjet’s control.

Members must have proper documentation to return to their country of residence. Medjet is not responsible for obtaining these documents in the event of a request for transport.

B. Commercial Medical Escort Service

Medjet will arrange for medical transport via commercial airline in business class, if available, in the care of a Medjet authorized commercial medical escort if:

1. the Member requires continued inpatient hospitalization;

2. the remaining inpatient hospitalization can be completed at a hospital of the Member’s choice in the Member’s Home Country; and

3. the Member can be returned by commercial airline in the care of a Medjet authorized commercial medical escort.

One (1) traveling companion may accompany each Member being transported via scheduled commercial airline, at no additional cost, via economy class.

C. Medically Dedicated Air Transport Service

Medjet will arrange for medical transport via medically dedicated air transport on a Medjet authorized aircraft if:

1. the Member requires continued inpatient hospitalization;

2. the remaining inpatient hospitalization can be completed at a hospital of the Member’s choice in the Member’s Home Country; and

3. the Member cannot be returned by commercial airline in the care of a Medjet authorized commercial medical escort.

One (1) traveling companion may accompany each Member being transported on a Medjet authorized aircraft during a medically dedicated air transport, at no additional cost, provided space is available and the Member’s care will not be compromised.

While Medjet makes every effort to accommodate its Members, due to limited space available on medical aircraft, the Member and any accompanying passenger are limited to one small carry-on bag each.

D. Transport Criteria

All arrangements for medical transport and repatriation will be made by Medjet. Decisions regarding the urgency of the case, the best timing and the most suitable means of transportation will be made by Medjet after consultation with the local attending physician.

Medical Assessment – Medjet will require a Medical Assessment in order to determine membership benefits and stability for transport. The Medical Assessment requires a consultation between the Member’s treating physician, who will provide a final or interim diagnosis that will require continued inpatient hospitalization, and a Medjet physician, who will review and evaluate the treating physician’s diagnosis in order to determine the Member’s transport requirements.

A Member must be medically stable for medical transport.

Assuming all other medical transport criteria are met, a Member who is initially considered medically unstable for transport to the hospital of the Member’s choice in the Member’s Home Country may first be transported to the nearest appropriate medical facility for initial stabilization. After this initial
stabilization, Medjet will arrange continued transport to the hospital of the Member’s choice in the Member’s Home Country if the Member continues to meet medical transport criteria.

TRANSPORT OF MORTAL REMAINS

In the event of a Member’s death while traveling 150 miles or more away from the Member’s Residence Address, Medjet will arrange and pay reasonable and customary charges up to $6,000 for the preparation and return of the Member’s remains to the Member’s Home Country. These charges will be at the sole discretion of Medjet.

This membership benefit includes:

• Domestic and international paperwork fees
• Preparation of the Member’s remains for transport
• Transport container
• Ground and airline transport of the Member’s remains from the referring funeral home to the funeral home of choice in the Member’s Home Country
• One death certificate

COVID-19 SPECIALIZED TRANSFER

Subject to all other Rules and Regulations and the following additional limitations on services described herein, when a Member (whose Home Country is the United States, Canada or Mexico) becomes hospitalized as an inpatient due to Covid19, is more than 150 miles from their Residence Address, and requires continued inpatient hospitalization, Medjet will arrange for Covid-19 Specialized Transfer to the Member’s hospital of choice within their Home Country.

For more information about the Covid-19 Specialized Transfer benefit, please visit the Covid-19 Services Information Page on Medjet.com.

Members otherwise eligible for transfer for Covid-19 must not exceed the maximum allowable height, weight and girth requirements set forth by the manufacturers of Covid-19 transport pods utilized in the safe transfer of Covid-19 positive patients. Please contact Medjet if you have questions or concerns regarding the sizing requirements prior to travel.

No traveling companions or family members will be allowed to accompany patients transported for Covid-19.

If a hospitalized Member is under quarantine by a hospital, a government or any other regulatory entity exercising jurisdiction and that medical facility, government or regulatory entity will not allow transfer, transport will not be possible.

The receiving hospital selected by the hospitalized Medjet Member must agree to accept the patient. Otherwise, Medjet’s transport to that hospital will not be possible.

The time frame for Covid-19 Specialized Transfer WILL BE extended beyond that of typical medical transports and is dependent on multiple factors including, but not limited to, affiliate availability to transfer Covid-19 patients, required permits or permissions and any other factors that are beyond Medjet’s control.

With respect to Covid-19 specialized transfers, to the extent of any actual or claimed inconsistency between the Covid-19 Specialty Transfer provisions and any other provision(s) of the Rules and Regulations, the Covid-19 Specialty Transfer provisions control.

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Nationwide Mutual Insurance Company Nationwide Mutual Insurance Company
Policy Name and Summary of Coverage
47

Essential

$250,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;

b) after being treated at a local Hospital, Your medical condition warrants Transportation to Your Home where You reside, to obtain further medical treatment or to recover; or

c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;
b) required by the standard regulations of the conveyance transporting You; and
c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the Company’s authorized Travel Assistance Company.

Notwithstanding the forgoing, in the event the Emergency Evacuation services are not arranged by the Company’s authorized Travel Assistance Company, the Company, in its sole discretion, may elect to evaluate the need for the Emergency Evacuation and provide limited reimbursement for the portion of the expenses related to such Emergency Evacuation as would have been authorized by Company’s authorized Travel Assistance Company.

Transportation of Minor Children: If You are expected to be in the Hospital for more than seven (7) days following a covered Emergency Evacuation, or pass away during the Trip, the Company will return Your unattended minor child(ren) (under the age of eighteen (18)) who is/are accompanying You on the scheduled Trip, to the domicile of a person nominated by You or Your next of kin with an attendant if necessary.

Hospital Companion:

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

REPATRIATION OF REMAINS

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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48

Prime

$1,000,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;

b) after being treated at a local Hospital, Your medical condition warrants Transportation to Your Home where You reside, to obtain further medical treatment or to recover; or

c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;

b) required by the standard regulations of the conveyance transporting You; and

c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the Company’s authorized Travel Assistance Company.

Notwithstanding the forgoing, in the event the Emergency Evacuation services are not arranged by the Company’s authorized Travel Assistance Company, the Company, in its sole discretion, may elect to evaluate the need for the Emergency Evacuation and provide limited reimbursement for the portion of the expenses related to such Emergency Evacuation as would have been authorized by Company’s authorized Travel Assistance Company.

Transportation of Minor Children: If You are expected to be in the Hospital for more than seven (7) days following a covered Emergency Evacuation, or pass away during the Trip, the Company will return Your unattended minor child(ren) (under the age of eighteen (18)) who is/are accompanying You on the scheduled Trip, to the domicile of a person nominated by You or Your next of kin with an attendant if necessary.

Hospital Companion:

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

REPATRIATION OF REMAINS

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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49

Cruise Universal

$250,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;

b) after being treated at a local Hospital, Your medical condition warrants Transportation to Your Home where You reside, to obtain further medical treatment or to recover; or

c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;

b) required by the standard regulations of the conveyance transporting You; and

c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the Company’s authorized Travel Assistance Company.

Notwithstanding the forgoing, in the event the Emergency Evacuation services are not arranged by the Company’s authorized Travel Assistance Company, the Company, in its sole discretion, may elect to evaluate the need for the Emergency Evacuation and provide limited reimbursement for the portion of the expenses related to such Emergency Evacuation as would have been authorized by Company’s authorized Travel Assistance Company.

Transportation of Minor Children: If You are expected to be in the Hospital for more than seven (7) days following a covered Emergency Evacuation, or pass away during the Trip, the Company will return Your unattended minor child(ren) (under the age of eighteen (18)) who is/are accompanying You on the scheduled Trip, to the domicile of a person nominated by You or Your next of kin with an attendant if necessary.
Hospital Companion:

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

REPATRIATION OF REMAINS

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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50

Cruise Choice

$500,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;

b) after being treated at a local Hospital, Your medical condition warrants Transportation to Your Home where You reside, to obtain further medical treatment or to recover; or

c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;

b) required by the standard regulations of the conveyance transporting You; and

c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the Company’s authorized Travel Assistance Company.

Notwithstanding the forgoing, in the event the Emergency Evacuation services are not arranged by the Company’s authorized Travel Assistance Company, the Company, in its sole discretion, may elect to evaluate the need for the Emergency Evacuation and provide limited reimbursement for the portion of the expenses related to such Emergency Evacuation as would have been authorized by Company’s authorized Travel Assistance Company.

Transportation of Minor Children: If You are expected to be in the Hospital for more than seven (7) days following a covered Emergency Evacuation, or pass away during the Trip, the Company will return Your unattended minor child(ren) (under the age of eighteen (18)) who is/are accompanying You on the scheduled Trip, to the domicile of a person nominated by You or Your next of kin with an attendant if necessary.

Hospital Companion:

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

REPATRIATION OF REMAINS

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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51

Cruise Luxury

$1,000,000 per person

EMERGENCY EVACUATION

The Company will pay benefits for Covered Evacuation Expenses incurred, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation and verified and arranged by the Travel Assistance Company.

Emergency Evacuation means:

a) Your medical condition warrants immediate Transportation from the Hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;

b) after being treated at a local Hospital, Your medical condition warrants Transportation to Your Home where You reside, to obtain further medical treatment or to recover; or

c) both a) and b), above.

Covered Evacuation Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

a) recommended by the attending Physician;
b) required by the standard regulations of the conveyance transporting You; and
c) authorized in advance by the Company or its authorized Travel Assistance Company and arranged by the Company’s authorized Travel Assistance Company.

Notwithstanding the forgoing, in the event the Emergency Evacuation services are not arranged by the Company’s authorized Travel Assistance Company, the Company, in its sole discretion, may elect to evaluate the need for the Emergency Evacuation and provide limited reimbursement for the portion of the expenses related to such Emergency Evacuation as would have been authorized by Company’s authorized Travel Assistance Company.

Transportation of Minor Children: If You are expected to be in the Hospital for more than seven (7) days following a covered Emergency Evacuation, or pass away during the Trip, the Company will return Your unattended minor child(ren) (under the age of eighteen (18)) who is/are accompanying You on the scheduled Trip, to the domicile of a person nominated by You or Your next of kin with an attendant if necessary.

Hospital Companion:
Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside provided that repatriation is not imminent.

Transportation services are provided if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company and are limited to necessary Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

REPATRIATION OF REMAINS

The Company will pay up to the Maximum Benefit shown on the Schedule of Benefits for the Covered Repatriation Expenses incurred to return Your body to the United States of America if You die during the Trip. This benefit is provided only if authorized in advance and arranged by the Company or the Company’s Travel Assistance Company.

Covered Repatriation Expenses include, but are not limited to, expenses for embalming, cremation, minimal casket container and transportation.

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Seven Corners Seven Corners
Policy Name and Summary of Coverage
52

Trip Protection Choice

$1,000,000 per person

MEDICAL EVACUATION AND REPATRIATION OF REMAINS

Benefits will be paid, up to the Maximum Benefit Amount shown in the Schedule of Benefits, when You suffer a Sickness, Injury, or loss of life, during Your Trip, for the following:

Emergency Medical Evacuation

We will pay for the Usual and Customary transportation expenses for an Emergency Medical Evacuation, to the nearest suitable Hospital or medical facility where Medically Necessary treatment is available to treat an Unforeseen Sickness or Injury provided:

1. the local attending Physician and Our designated Travel Assistance Services Provider determine that Your condition is acute, severe or life threatening; and

2. that adequate Medically Necessary treatment is not available in Your immediate area.

Medical Repatriation

Following an Emergency Medical Evacuation or a covered Injury or Sickness, We will pay for Medical Evacuation expenses to return You to Your point of origin, Your Primary Residence, or to a Hospital or medical facility closest to Your Primary Residence capable of providing continued treatment, if Your local attending Physician and Our designated Travel Assistance Services Provider determine that it is Medically Necessary.

We will pay for one of the following methods of transportation, as pre-approved (prior to the evacuation) and arranged by Us or Our designated Travel Assistance Services Provider:

a. one-way transportation;
b. commercial air upgrade to business or first class, less refunds from Your unused transportation tickets;
c. other covered land or air transportation including, but not limited to, commercial stretcher, Medical Escort, or the contracted charges for air ambulance.

Transportation must be via the most direct, efficient and economical method of conveyance. In all cases, where practical, economy fare will be utilized. If possible, Your Common Carrier tickets will be used.
We will also pay a benefit for Usual and Customary expenses incurred for a Medical Escort’s transportation and accommodations if an onsite attending Physician recommends in writing that a Medical Escort accompany You.

Medical Escort means a medically trained professional who is approved by Us or Our designated Travel Assistance Services Provider and is contracted to accompany and provide medical care to a sick or injured person while they are being transported.

We will not pay the benefits for any loss caused by or resulting from the transportation taken against the advice of the local attending Physician. Medical Evacuation expenses will only be payable at the Usual and Customary level or payment for necessary transportation, related medical services and medical supplies.

Repatriation of Remains

Benefits will be paid for covered Repatriation Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, to return Your body to Your city of Primary Residence or Your origination point or to the place of burial in the United States of America if You die during Your Trip. If You are located outside of the United States because of Your or Your Family Member’s service in the armed forces or government of the United States of America, You may choose to have Your body returned to any city within the United States of America or to any city within the country where You are stationed or Your Family Member is stationed.

Repatriation Expenses means:

a. embalming or local cremation; and
b. associated temporary storage costs for up to 60 days, or until local authorities of the country/state in which the death occurred, will permit further transportation of the body, whichever is later; and the most economical coffin or receptacle adequate to transport the remains;
c. the cost of transportation of the remains, by the most direct and economical conveyance and route possible, to:
1) the nearest location where the body can be embalmed or cremated, if not locally available; and/or 2) the receiving funeral home or morgue, at the Return Destination, or a different place of burial within United States or country where You are stationed or Your Family Member is stationed; and
d. the cost for the creation and transmission of necessary documentation required to transport the body, such as a death certificate, autopsy or police report.

All Repatriation Expenses must be authorized and arranged in advance by Us or Our designated Travel Assistance Services Provider. Once Your remains are claimed by the receiving funeral home or morgue, or in the event of local cremation, coverage under this benefit ends. Transportation expenses for the Emergency Medical Evacuation and Medical Repatriation must be authorized and arranged in advance by Us or Our designated Travel Assistance Services Provider.

Transportation of Children/Child: If You die or are Hospitalized for more than 7 consecutive days following or unable to travel due to an Emergency Medical Evacuation or Injury and Sickness that occurred during Your Trip, We will pay up to the cost of a single one-way economy transportation ticket, or same class as the original transportation ticket, less the value of any applied credit from any unused return travel tickets for each person, to return Your Children/Child who were accompanying You on Your Trip (and any accompanying minor persons under Your care) who are left unattended by Your death or Hospitalization to their Primary Residence or to Your residence in the United States, including the cost of an attendant, if considered necessary by Us or Our designated Travel Assistance Services Provider.

Transportation to Join You: If You are or will be Hospitalized for more than 7 consecutive days following or unable to travel due to an Emergency Medical Evacuation or Injury and Sickness that occurred during Your Trip, We will pay, up to the cost of a single round-trip economy transportation ticket, up to the Maximum Benefit Amount shown in the Schedule of Benefits, for Reasonable Expenses for one person chosen by You to visit Your bedside, provided You are traveling alone and Emergency Medical Evacuation or Medical Repatriation is not imminent.

You must provide all receipts for all covered expenses incurred during the stay.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

BEDSIDE TRAVELING COMPANION DAILY BENEFIT – up to $1,000.

We will reimburse You, up to the Maximum Benefit Amount shown in the Schedule of Benefits, if You are Hospitalized for at least 3 days during Your Trip, for Reasonable Expenses incurred for Your Traveling Companion to remain near You. For an Insured Child, a bedside companion is available immediately upon Hospital admission. For purposes of this benefit, Your Traveling Companion or traveling Family Member must be insured under this policy and accompany You on Your Trip.

You must provide all receipts for all covered expenses incurred during the stay.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

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53

Trip Protection Economy

$100,000 per person

EMERGENCY MEDICAL EVACUATION, MEDICAL REPATRIATION AND RETURN OF REMAINS

When You suffer loss of life for any reason or incur a Sickness or Injury during the course of Your Trip, the following benefits are payable, up to the Maximum Benefit Amount shown in the Schedule of Benefits.

1. Emergency Medical Evacuation: If the local attending Legally Qualified Physician and the authorized travel assistance company determine that transportation to a Hospital or medical facility is Medically Necessary to treat an unforeseen Sickness or Injury which is acute or life threatening and adequate Medical Treatment is not available in the immediate area, the Transportation Expense incurred will be paid for the Usual and Customary Charges for transportation to the closest Hospital or medical facility capable of providing that treatment.

If You are traveling alone and will be hospitalized for more than 7 consecutive days and Emergency Evacuation is not imminent, benefits will be paid to transport one person, chosen by You, by Economy Transportation, for a single visit to and from Your bedside.

If You are in the Hospital for more than 7 consecutive days and Your dependent children who are under 18 years of age and accompanying You on Your Trip are left unattended, Economy Transportation will be paid to return the dependents to their home (with an attendant, if considered necessary by the authorized travel assistance company).

2. Medical Repatriation: If the local attending Legally Qualified Physician and the authorized travel assistance company determine that it is Medically Necessary for You to return to Your primary place of residence because of an unforeseen Sickness or Injury which is acute or life-threatening, the Transportation Expense incurred will be paid for Your return to Your primary place of residence or to a Hospital or medical facility closest to Your primary place of place of residence capable of providing continued treatment via one of the following methods of transportation, as approved, in writing, by the authorized travel assistance company:

i) one-way Economy Transportation;

ii) commercial air upgrade (to Business or First Class), based on Your condition as recommended by the local attending Legally Qualified Physician and verified in writing and considered necessary by the authorized travel assistance company; or;

iii) other covered land or air transportation including, but not limited to, commercial stretcher, medical escort, or the Usual and Customary Charges for air ambulance, provided such transportation has been pre-approved and arranged by the authorized travel assistance company. Transportation must be via the most direct and economical route.

3. Return of Remains: In the event of Your death during a Trip, the expense incurred will be paid for minimally necessary casket or air tray, preparation and transportation of Your remains to Your primary place of residence in the United States of America or to the place of burial.

Benefits are paid less the value of Your original unused return travel ticket.

If benefits are payable and You have other insurance that may provide benefits for this same loss, We reserve the right to recover from such other insurance. You shall:

a) notify the Company of any other insurance;

b) help the Company exercise the Company’s rights in any reasonable way that the Company may request, including the filing and assignment of other insurance benefits;

c) not do anything after the loss to prejudice the Company’s rights; and

d) reimburse to the Company, to the extent of any payment the Company has made, for benefits received from such other insurance.

These benefits will not duplicate any other benefits payable under the Policy or any coverage(s) attached to the Policy.

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54

Trip Protection Elite

$1,000,000 per person

EMERGENCY MEDICAL EVACUATION, MEDICAL REPATRIATION AND RETURN OF REMAINS

When You suffer loss of life for any reason or incur a Sickness or Injury during the course of Your Trip, the following benefits are payable, up to the Maximum Benefit Amount shown in the Schedule of Benefits.

1. Emergency Medical Evacuation: If the local attending Legally Qualified Physician and the authorized travel assistance company determine that transportation to a Hospital or medical facility is Medically Necessary to treat an unforeseen Sickness or Injury which is acute or life threatening and adequate Medical Treatment is not available in the immediate area, the Transportation Expense incurred will be paid for the Usual and Customary Charges for transportation to the closest Hospital or medical facility capable of providing that treatment.

If You are traveling alone and will be hospitalized for more than 7 consecutive days and Emergency Evacuation is not imminent, benefits will be paid to transport one person, chosen by You, by Economy Transportation, for a single visit to and from Your bedside.

If You are in the Hospital for more than 7 consecutive days and Your dependent children who are under 18 years of age and accompanying You on Your Trip are left unattended, Economy Transportation will be paid to return the dependents to their home (with an attendant, if considered necessary by the authorized travel assistance company).

2. Medical Repatriation: If the local attending Legally Qualified Physician and the authorized travel assistance company determine that it is Medically Necessary for You to return to Your primary place of residence because of an unforeseen Sickness or Injury which is acute or life-threatening, the Transportation Expense incurred will be paid for Your return to Your primary place of residence or to a Hospital or medical facility closest to Your primary place of place of residence capable of providing continued treatment via one of the following methods of transportation, as approved, in writing, by the
authorized travel assistance company:

i) one-way Economy Transportation;

ii) commercial air upgrade (to Business or First Class), based on Your condition as recommended by the local attending Legally Qualified Physician and verified in writing and considered necessary by the authorized travel assistance company; or

iii) other covered land or air transportation including, but not limited to, commercial stretcher, medical escort, or the Usual and Customary Charges for air ambulance, provided such transportation has been pre-approved and arranged by the authorized travel assistance company. Transportation must be via the most direct and economical route.

3. Return of Remains: In the event of Your death during a Trip, the expense incurred will be paid for minimally necessary casket or air tray, preparation and transportation of Your remains to Your primary place of residence in the United States of America or to the place of burial.

Benefits are paid less the value of Your original unused return travel ticket.

If benefits are payable and You have other insurance that may provide benefits for this same loss, We reserve the right to recover from such other insurance. You shall:

a) notify the Company of any other insurance;

b) help the Company exercise the Company’s rights in any reasonable way that the Company may request, including the filing and assignment of other insurance benefits;

c) not do anything after the loss to prejudice the Company’s rights; and

d) reimburse to the Company, to the extent of any payment the Company has made, for benefits received from such other insurance.

These benefits will not duplicate any other benefits payable under the Policy or any coverage(s) attached to the Policy.

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55

Trip Protection Basic

$250,000 per person

MEDICAL EVACUATION AND REPATRIATION OF REMAINS

Benefits will be paid, up to the Maximum Benefit Amount shown in the Schedule of Benefits, when You suffer a Sickness, Injury, or loss of life, during Your Trip, for the following:

Emergency Medical Evacuation

We will pay for the Usual and Customary transportation expenses for an Emergency Medical Evacuation, to the nearest suitable Hospital or medical facility where Medically Necessary treatment is available to treat an Unforeseen Sickness or Injury provided:

1. the local attending Physician and Our designated Travel Assistance Services Provider determine that Your condition is acute, severe or life threatening; and

2. that adequate Medically Necessary treatment is not available in Your immediate area.

Medical Repatriation

Following an Emergency Medical Evacuation or a covered Injury or Sickness, We will pay for Medical Evacuation expenses to return You to Your point of origin, Your Primary Residence, or to a Hospital or medical facility closest to Your Primary Residence capable of providing continued treatment, if Your local attending Physician and Our designated Travel Assistance Services Provider determine that it is Medically Necessary. We will pay for one of the following methods of transportation, as pre-approved (prior to the evacuation) and arranged by Us or Our designated Travel Assistance Services Provider:

a. one-way transportation;
b. commercial air upgrade to business or first class, less refunds from Your unused transportation tickets;
c. other covered land or air transportation including, but not limited to, commercial stretcher, Medical Escort, or the contracted charges for air ambulance.

Transportation must be via the most direct, efficient and economical method of conveyance. In all cases, where practical, economy fare will be utilized. If possible, Your Common Carrier tickets will be used.

We will also pay a benefit for Usual and Customary expenses incurred for a Medical Escort’s transportation and accommodations if an onsite attending Physician recommends in writing that a Medical Escort accompany You.

Medical Escort means a medically trained professional who is approved by Us or Our designated Travel Assistance Services Provider and is contracted to accompany and provide medical care to a sick or injured person while they are being transported.

We will not pay the benefits for any loss caused by or resulting from the transportation taken against the advice of the local attending Physician.

Medical Evacuation expenses will only be payable at the Usual and Customary level or payment for necessary transportation, related medical services and medical supplies.

Repatriation of Remains

Benefits will be paid for covered Repatriation Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, to return Your body to Your city of Primary Residence or Your origination point or to the place of burial in the United States of America if You die during Your Trip. If You are located outside of the United States because of Your or Your Family Member’s service in the armed forces or government of the United States of America, You may choose to have Your body returned to any city within the United States of America or to any city within the country where You are stationed or Your Family Member is stationed.

Repatriation Expenses means:

a. embalming or local cremation; and
b. associated temporary storage costs for up to 60 days, or until local authorities of the country/state in which the death occurred, will permit further transportation of the body, whichever is later; and the most economical coffin or receptacle adequate to transport the remains;
c. the cost of transportation of the remains, by the most direct and economical conveyance and route possible, to:

1) the nearest location where the body can be embalmed or cremated, if not locally available; and/or 2) the receiving funeral home or morgue, at the Return Destination, or a different place of burial within United States or country where You are stationed or Your Family Member is stationed; and

d. the cost for the creation and transmission of necessary documentation required to transport the body, such as a death certificate, autopsy or police report.

All Repatriation Expenses must be authorized and arranged in advance by Us or Our designated Travel Assistance Services Provider. Once Your remains are claimed by the receiving funeral home or morgue, or in the event of local cremation, coverage under this benefit ends.

Transportation expenses for the Emergency Medical Evacuation and Medical Repatriation must be authorized and arranged in advance by Us or Our designated Travel Assistance Services Provider.

Transportation of Children/Child: If You die or are Hospitalized for more than 7 consecutive days following or unable to travel due to an Emergency Medical Evacuation or Injury and Sickness that occurred during Your Trip, We will pay up to the cost of a single one-way economy transportation ticket, or same class as the original transportation ticket, less the value of any applied credit from any unused return travel tickets for each person, to return Your Children/Child who were accompanying You on Your Trip (and any accompanying minor persons under Your care) who are left unattended by Your death or Hospitalization to their Primary Residence or to Your residence in the United States, including the cost of an attendant, if considered necessary by Us or Our designated Travel Assistance Services Provider.

Transportation to Join You: If You are or will be Hospitalized for more than 7 consecutive days following or unable to travel due to an Emergency Medical Evacuation or Injury and Sickness that occurred during Your Trip, We will pay, up to the cost of a single round-trip economy transportation ticket, up to the Maximum Benefit Amount shown in the Schedule of Benefits, for Reasonable Expenses for one person chosen by You to visit Your bedside, provided You are traveling alone and Emergency Medical Evacuation or Medical Repatriation is not imminent.

You must provide all receipts for all covered expenses incurred during the stay.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

BEDSIDE TRAVELING COMPANION DAILY BENEFIT – Up to $1,000

We will reimburse You, up to the Maximum Benefit Amount shown in the Schedule of Benefits, if You are Hospitalized for at least 3 days during Your Trip, for Reasonable Expenses incurred for Your Traveling Companion to remain near You. For an Insured Child, a bedside companion is available immediately upon Hospital admission. For purposes of this benefit, Your Traveling Companion or traveling Family Member must be insured under this policy and accompany You on Your Trip.

You must provide all receipts for all covered expenses incurred during the stay.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

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56

Travel Medical Basic incl US

$250,000 per person

Emergency Services and Assistance

We will make good faith efforts to provide the services and assistance in this Section 5. However, if We are unable to do so due to circumstances beyond Our control or due to circumstances that make it unsafe for persons to provide such services and assistance, then We will provide the services and assistance to the extent reasonable and possible. If We are unable to directly arrange services, Expenses incurred by You for services that would otherwise be covered under this Plan and that would typically be arranged by Us may be eligible for reimbursement and should be submitted for consideration. It is Your responsibility to preserve all documentation of related financial transactions You wish to be considered for reimbursement.

5.1 Emergency Medical Evacuation and Repatriation.

The Company will pay transportation and related medical Expenses incurred during such transportation up to the amount in the Schedule of Benefits if any covered Injury or Illness commences while You are outside Your Home Country during the Period of Coverage and results in Your Medically Necessary (i) Emergency Medical Evacuation; or (ii) Emergency Medical Repatriation following a covered Emergency Medical Evacuation. All transportation arrangements must be by the most direct and economical route.

The Emergency Medical Evacuation or Emergency Medical Repatriation must be arranged by Seven Corners Assist in consultation with Your local attending Physician. In the event You do not contact Seven Corners Assist, this benefit will be limited to the amount the Company would have paid if Seven Corners Assist was utilized. Only Expenses which are Medically Necessary and cost appropriate will be considered.

Pre-Existing Conditions Exclusion 8(bb) is waived for this benefit. All other exclusions in Section 8 apply to the coverage provided under this section.

5.2 Emergency Medical Reunion. $200 per day, 10-day limit, $25,000 maximum

When an Emergency Medical Evacuation is occurring or has occurred, or when an Emergency Medical Repatriation is to occur, and provided in each such case, that an Emergency Medical Reunion is recommended by Your attending Physician, the Company will arrange and pay up to the amount in the Schedule of Benefits for (i) round-trip economy class airfare for one (1) individual from Your Home Country, selected by You, to travel to and from the location where You are hospitalized; and (ii) reasonable travel and accommodation Expenses. The period of Emergency Medical Reunion cannot exceed ten (10) days including travel days.

The Emergency Medical Reunion must be arranged by Seven Corners Assist. In the event You do not contact Seven Corners Assist, this benefit will be limited to the amount the Company would have paid if Seven Corners Assist was utilized. Only Expenses which are Medically Necessary and cost appropriate will be considered.

Pre-Existing Conditions Exclusion 8(bb) is waived for this benefit. All other exclusions in Section 8 apply to the coverage provided under this section.

5.3 Bedside Visit – $1,000

If You are admitted as an Inpatient to a Hospital Intensive Care unit for more than three (3) days due to a covered Injury or Illness, and will not require an Emergency Medical Evacuation or Emergency Medical Repatriation, the Company will arrange and pay up to the amount in the Schedule of Benefits for either round trip economy class airfare or ground transportation ticket for one (1) individual from Your Home Country to travel to and from the location where You are hospitalized.

The Bedside Visit must be arranged by Seven Corners Assist. In the event You do not contact Seven Corners Assist, this benefit will be limited to the amount the Company would have paid if Seven Corners Assist was utilized. Only Expenses which are Medically Necessary and cost appropriate will be considered.

Pre-Existing Conditions Exclusion 8(bb) is waived for this benefit. All other exclusions in Section 8 apply to the coverage provided under this section.

5.4 Return of Child(ren) – $25,000

If You are traveling alone with a Child(ren) who is left unattended because You became hospitalized as a result of a covered Injury or Illness, the Company will arrange and pay up to the amount in the Schedule of Benefits for (i) one-way economy class airfare(s) for the Child(ren) to his or her Home Country; and (ii) services of an attendant or escort if necessary to ensure the safety and welfare of the Child(ren). Meals and lodging are not included in this benefit.

The Return of Child(ren) must be arranged by Seven Corners Assist. In the event You do not contact Seven Corners Assist, this benefit will be limited to the amount the Company would have paid if Seven Corners Assist was utilized. Only Expenses which are Medically Necessary and cost appropriate will be considered.

Pre-Existing Conditions Exclusion 8(bb) is waived for this benefit. All other exclusions in Section 8 apply to the coverage provided under this section.

5.5 Return of Mortal Remains – $25,000

Provided that You have not elected the benefit provided under Section 5.6, the Company will pay up to the amount in the Schedule of Benefits for the reasonable Expenses incurred for embalming, a minimally necessary container appropriate for transportation, shipping costs, and the necessary government authorizations to return Your remains to Your Home Country if You die while outside Your Home Country during the Period of Coverage from an Injury or Illness covered under this Insurance.

Pre-Existing Conditions Exclusion 8(bb) is waived for this benefit. All other exclusions in Section 8 apply to the coverage provided under this section.

5.6 Local Burial or Cremation – $25,000

Provided that You have not elected the benefit provided under Section 5.5, the Company will pay up to the amount in the Schedule of Benefits for the reasonable Expenses incurred for preparation and either Your local burial or Your cremation and repatriation of ashes if You die while outside Your Home Country during the Period of Coverage from an Injury or Illness covered under this Insurance. This benefit does not include the costs for the religious practitioners performing the service, flowers, music, food, beverages, or the cost of an urn. It does cover the cost of a suitable container required for repatriation of the ashes.

Pre-Existing Conditions Exclusion 8(bb) is waived for this benefit. All other exclusions in Section 8 apply to the coverage provided under this section.

3.3 Local Ambulance.

Inside the United States: $5,000
Outside the United States: Up to Medical Maximum

The Company will reimburse You up to the amount in the Schedule of Benefits for the Period of Coverage for local ambulance service from within the metropolitan area to the nearest Hospital having facilities required for Medically Necessary Treatment. Licensed air ambulance transportation may be substituted for a ground ambulance if You are in a rural area and unreachable by ground ambulance.

This benefit does not cover search and rescue operations or evacuation from remote areas with inherent heightened risk. Only Expenses which are deemed Medically Necessary and cost appropriate will be considered.

The Deductible and Coinsurance in Section 3.1 apply to this coverage and will be Your responsibility. The exclusions in Section 8 apply to the coverage provided under this section.

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57

Travel Medical Choice incl US

$500,000 per person

Emergency Medical Evacuation and Repatriation. $500,000 (separate from Medical Maximum)

We will make good faith efforts to provide the services and assistance in this Section 5. However, if We are unable to do so due to circumstances beyond Our control or due to circumstances that make it unsafe for persons to provide such services and assistance, then We will provide the services and assistance to the extent reasonable and possible. If We are unable to directly arrange services, Expenses incurred by You for services that would otherwise be covered under this Plan and that would typically be arranged by Us may be eligible for reimbursement and should be submitted for consideration. It is Your responsibility to preserve all documentation of related financial transactions You wish to be considered for reimbursement

5.1 Emergency Medical Evacuation and Repatriation.

The Company will pay transportation and related medical Expenses incurred during such transportation up to the amount in the Schedule of Benefits if any covered Injury or Illness commences while You are outside Your Home Country during the Period of Coverage and results in Your Medically Necessary (i) Emergency Medical Evacuation; or (ii) EmergencyMedical Repatriation following a covered Emergency Medical Evacuation. All transportation arrangements must be by the most direct and economical route.

The Emergency Medical Evacuation or Emergency Medical Repatriation must be arranged by Seven Corners Assist in consultation with Your local attending Physician. In the event You do not contact Seven Corners Assist, this benefit will be limited to the amount the Company would have paid if Seven Corners Assist was utilized. Only Expenses which are Medically Necessary and cost appropriate will be considered.

Pre-Existing Conditions Exclusion 8(aa) is waived for this benefit. All other exclusions in Section 8 apply to the coverage provided under this section.

5.2 Emergency Medical Reunion.

When an Emergency Medical Evacuation is occurring or has occurred, or when an Emergency Medical Repatriation is to occur, and provided in each such case, that an Emergency Medical Reunion is recommended by Your attending Physician, the Company will arrange and pay up to the amount in the Schedule of Benefits for (i) round-trip economy class airfare for one (1) individual from Your Home Country, selected by You, to travel to and from the location where You are hospitalized; and (ii) reasonable travel and accommodation Expenses. The period of Emergency Medical Reunion cannot exceed ten (10) days including travel days.

The Emergency Medical Reunion must be arranged by Seven Corners Assist. In the event You do not contact Seven Corners Assist, this benefit will be limited to the amount the Company would have paid if Seven Corners Assist was utilized. Only Expenses which are Medically Necessary and cost appropriate will be considered.Pre-Existing Conditions Exclusion 8(aa) is waived for this benefit. All other exclusions in Section 8 apply to the coverage provided under this section.

5.3 Bedside Visit.

If You are admitted as an Inpatient to a Hospital Intensive Care unit for more than three (3) days due to a covered Injury or Illness, and will not require an Emergency Medical Evacuation or Emergency Medical Repatriation, the Company will arrange and pay up to the amount in the Schedule of Benefits for either round-trip economy class airfare or ground transportation ticket for one (1) individual from Your Home Country to travel to and from the location where You are hospitalized.

The Bedside Visit must be arranged by Seven Corners Assist. In the event You do not contact Seven Corners Assist, this benefit will be limited to the amount the Company would have paid if Seven Corners Assist was utilized. Only Expenses which are Medically Necessary and cost appropriate will be considered.

Pre-Existing Conditions Exclusion 8(aa) is waived for this benefit. All other exclusions in Section 8 apply to the coverage provided under this section.

5.4 Return of Child(ren).

If You are traveling alone with a Child(ren) who is left unattended because You became hospitalized as a result of a covered Injury or Illness, the Company will arrange and pay up to the amount in the Schedule of Benefits for (i) one-way economy class airfare(s) for the Child(ren) to his or her Home Country; and (ii) services of an attendant or escort if necessary to ensure the safety and welfare of the Child(ren). Meals and lodging are not included in this benefit.

The Return of Child(ren) must be arranged by Seven Corners Assist. In the event You do not contact Seven Corners Assist, this benefit will be limited to the amount the Company would have paid if Seven Corners Assist was utilized. Only Expenses which are Medically Necessary and cost appropriate will be considered.

Pre-Existing Conditions Exclusion 8(aa) is waived for this benefit. All other exclusions in Section 8 apply to the coverage provided under this section.

5.5 Return of Mortal Remains.

Provided that You have not elected the benefit provided under Section 5.6, the Company will pay up to the amount in the Schedule of Benefits for the reasonable Expenses incurred for embalming, a minimally-necessary container appropriate for transportation, shipping costs, and the necessary government authorizations to return Your remains to Your Home Country if You die while outside Your Home Country during the Period of Coverage from an Injury or Illness covered under this Insurance.

Pre-Existing Conditions Exclusion 8(aa) is waived for this benefit. All other exclusions in Section 8 apply to the coverage provided under this section.

5.6 Local Burial or Cremation.

Provided that You have not elected the benefit provided under Section 5.5, the Company will pay up to the amount in the Schedule of Benefits for the reasonable Expenses incurred for preparation and either Your local burial or Your cremation and repatriation of ashes if You die while outside Your Home Country during the Period of Coverage from an Injury or Illness covered under this Insurance.This benefit does not include the costs for the religious practitioners performing the service, flowers, music, food, beverages, or the cost of an urn. It does cover the cost of a suitable container required for repatriation of the ashes.

Pre-Existing Conditions Exclusion 8(aa) is waived for this benefit. All other exclusions in Section 8 apply to the coverage provided under this section..

3.2 Local Ambulance.

The Company will reimburse You up to the amount in the Schedule of Benefits for the Period of Coverage for local ambulance service from within the metropolitan area to the nearest Hospital having facilities required for Medically Necessary Treatment. Licensed air ambulance transportation maybe substituted for a ground ambulance if You are in a rural area and unreachable by ground ambulance.This benefit does not cover search and rescue operations or evacuation from remote areas with inherent heightened risk. Only Expenses which are deemed Medically Necessary and cost appropriate will be considered.

The Deductible and Coinsurance in Section 3.1 apply to this coverage and will be Your responsibility. The exclusions in Section 8 apply to the coverage provided under this section.

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Tin Leg Tin Leg
Policy Name and Summary of Coverage
58

Economy

$100,000 per person

EMERGENCY EVACUATION and REPATRIATION OF REMAINS

The 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 Your 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 Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible and required by the standard regulations of the conveyance transporting You.

Expenses for Transportation must be:

a) ordered by the onsite attending Physician who must certify that the severity of Your Injury or Sickness warrants Your Emergency Evacuation and adequate medical treatment is not locally available; and

b) authorized in advance by Tin Leg. In the event Your Injury or Sickness prevents prior authorization of the Emergency Evacuation, Tin Leg 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 You.

Special Limitation: In the event Tin Leg 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 Medically Necessary 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 You are medically able to be transported; or Advanced authorization by Tin Leg is needed for (a), (b) and c) 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 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 You 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.

Tin Leg must make all arrangements and authorize all expenses in advance.

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59

Economy

$100,000 per person

EMERGENCY EVACUATION & REPATRIATION OF REMAINS

The Company will pay for Covered Emergency Evacuation Expenses incurred due to an Injury or Sickness that occurs to the Insured while on a Trip, up to the Maximum Limit shown in the Schedule. In the event of death, the Company will pay for Covered Repatriation Expenses up to the Maximum Limit shown in the Schedule to return the Insured’s body to the City of burial.

Special Limitation: In the event the Travel Insurance Administrator could not be contacted to arrange for Emergency Evacuation or Repatriation of Remains, benefits are limited to the amount the Company would have paid had the Company or its authorized representative been contacted.

Covered Emergency Evacuation Expenses are the Reasonable and Customary Charges for necessary transportation, related medical services and medical supplies incurred in connection with an Emergency Evacuation. All transportation arrangements made for evacuation must be by the most direct and economical route possible and required by the standard regulations of the transporting conveyance. If possible, the Insured’s Common Carrier tickets will be used.

Expenses for transportation must be:

a) Ordered by the onsite attending Physician who must certify that the severity of the Injury or Sickness warrants an Emergency Evacuation and adequate medical treatment is not locally available; and

b) Authorized in advance by the Travel Insurance Administrator. In the event the 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 an escort in writing.

Emergency Evacuation – means:

a) Transportation from the place where the Insured isInjured 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 Medically Necessary treatment is needed but not locally available; and the Insured is medically able to travel; or

c) Transportation to the adequate licensed medical facility nearest to the Insured’s 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.

Advanced authorization by the Travel Insurance Administrator is needed for a), b) and c) above.

ADDITIONAL BENEFITS

In addition to the above covered expenses, if the Company has previously evacuated the Insured to a medical facility, the Company will reimburse for airfare costs, less refunds from Unused transportation tickets, from that facility to the Return Destination or home, within one year from the original Return Date. Airfare costs will be based on medical necessity or same class as the Insured’s original tickets.

If the Insured is hospitalized for more than 7 days following a covered Emergency Evacuation, the Company will reimburse, subject to the limitations set out herein, the expenses for:

a) Return of Children: Return of Children, who were accompanying the Insured when the Injury or Sickness occurred, to the Insured’s 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.

b) Bedside Traveling Companion: The Company will reimburse the Insured for reasonable expenses incurred for Lodging and meals shown in the Schedule for the Traveling Companion to remain near the Insured. For an insured Child, a bedside companion is available immediately upon Hospital admission. Receipts must be submitted.

Coverage for this benefit ends on the discharge date from the hospital.

c) Bedside Visit: If the Insured is alone the Company will reimburse the Insured for the transportation costs to bring one person, chosen by the Insured, to and from the medical facility where the Insured is confined. The payment will not exceed the cost of one round-Trip economy airfare ticket.

Covered Repatriation Expenses are 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. This coverage ends when the body is returned to the City of burial.

The Travel Insurance Administrator must make all arrangements and authorize all expenses in advance.

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60

Standard

$200,000 per person

EMERGENCY EVACUATION and REPATRIATION OF REMAINS

The 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 Your 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 Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible and required by the standard regulations of the conveyance transporting You.

Expenses for Transportation must be:

a) ordered by the onsite attending Physician who must certify that the severity of YourInjury or Sickness warrants Your Emergency Evacuation and adequate medical treatment is not locally available; and

b) authorized in advance by Tin Leg. In the event Your Injury or Sickness prevents prior authorization of the Emergency Evacuation, Tin Leg 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 You.

Special Limitation: In the event Tin Leg 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 Medically Necessary 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 You are medically able to be transported; or If the Emergency Evacuation Upgrade is selected and the appropriate cost has been paid, the following will also apply:

d) Transportation from an adequate licensed medical facility to an adequate licensed medical facility of Your choice for further Medically Necessary treatment if the onsite attending Physician certifies that You are medically able to travel.

Advanced authorization by Tin Leg 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 the Insured is confined if the Insured is alone. The payment will not exceed the cost of one round-Trip economy airfare ticket. This additional benefit only applies if the Emergency Evacuation Upgrade is purchased.

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 You 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, subject to the Transportation Maximum Limit shown in the Schedule.

Tin Leg 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.

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61

Standard

$200,000 per person

EMERGENCY EVACUATION & REPATRIATION OF REMAINS

The Company will pay for Covered Emergency Evacuation Expenses incurred due to an Injury or Sickness that occurs to the Insured while on a Trip, up to the Maximum Limit shown in the Schedule. In the event of death, the Company will pay for Covered Repatriation Expenses up to the Maximum Limit shown in the Schedule to return the Insured’s body to the City of burial.

Special Limitation: In the event the Travel Insurance Administrator could not be contacted to arrange for Emergency Evacuation or Repatriation of Remains, benefits are limited to the amount the Company would have paid had the Company or its authorized representative been contacted.

Covered Emergency Evacuation Expenses are the Reasonable and Customary Charges for necessary transportation, related medical services and medical supplies incurred in connection with an Emergency Evacuation. All transportation arrangements made for evacuation must be by the most direct and economical route possible and required by the standard regulations of the transporting conveyance. If possible, the Insured’s Common Carrier tickets will be used.

Expenses for transportation must be:

a) Ordered by the onsite attending Physician who must certify that the severity of the Injury or Sickness warrants an Emergency Evacuation and adequate medical treatment is not locally available; and

b) Authorized in advance by the Travel Insurance Administrator. In the event the 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 an escort in writing.

Emergency Evacuation – means:

a) 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; 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 Medically Necessary treatment is needed but not locally available; and the Insured is medically able to travel; or

c) Transportation to the adequate licensed medical facility nearest to the Insured’s 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.

Advanced authorization by the Travel Insurance Administrator is needed for (a), (b) and © above.

ADDITIONAL BENEFITS

In addition to the above covered expenses, if the Company has previously evacuated the Insured to a medical facility, the Company will reimburse for airfare costs, less refunds from Unused transportation tickets, from that facility to the Return Destination or home, within one year from the original Return Date. Airfare costs will be based on medical necessity or same class as the Insured’s original tickets.

If the Insured is hospitalized for more than 7 days following a covered Emergency Evacuation, the Company will reimburse, subject to the limitations set out herein, the expenses for:

a) Return of Children: Return of Children, who were accompanying the Insured when the Injury or Sickness occurred, to the Insured’s 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.

b) Bedside Traveling Companion: The Company will reimburse the Insured for reasonable expenses incurred for Lodging and meals shown in the Schedule for the Traveling Companion to remain near the Insured. For an insured Child, a bedside companion is available immediately upon Hospital admission. Receipts must be submitted. Coverage for this benefit ends on the discharge date from the hospital.

c) Bedside Visit: If the Insured is alone the Company will reimburse the Insured for the transportation costs to bring one person, chosen by the Insured, to and from the medical facility where the Insured is confined. The payment will not exceed the cost of one round-Trip economy airfare ticket.

Covered Repatriation Expenses are 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. This coverage ends when the body is returned to the City of burial.

The Travel Insurance Administrator must make all arrangements and authorize all expenses in advance.

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62

Luxury

$250,000 per person

EMERGENCY EVACUATION and REPATRIATION OF REMAINS

The 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 Your 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 Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible and required by the standard regulations of the conveyance transporting You.

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 Tin Leg. In the event the Insured’s Injury or Sickness prevents prior authorization of the Emergency Evacuation, Tin Leg 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 Tin Leg 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 Medically Necessary 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; or

If the Emergency Evacuation Upgrade is selected and the appropriate cost has been paid, the following will also apply:

d) Transportation from an adequate licensed medical facility to an adequate licensed medical facility of Your choice for further Medically Necessary treatment if the onsite attending Physician certifies that the Insured is medically able to travel.

Advanced authorization by Tin Leg 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 the Insured is confined if the Insured is alone. The payment will not exceed the cost of one round-Trip economy airfare ticket. This additional benefit only applies if the Emergency Evacuation Upgrade is purchased.

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 You 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.

Tin Leg 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.

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63

Luxury

$250,000 per person

EMERGENCY EVACUATION & REPATRIATION OF REMAINS

The Company will pay for Covered Emergency Evacuation Expenses incurred due to an Injury or Sickness that occurs to the Insured while on a Trip, up to the Maximum Limit shown in the Schedule. In the event of death, the Company will pay for Covered Repatriation Expenses up to the Maximum Limit shown in the Schedule to return the Insured’s body to the City of burial.

Special Limitation: In the event the Travel Insurance Administrator could not be contacted to arrange for Emergency Evacuation or Repatriation of Remains, benefits are limited to the amount the Company would have paid had the Company or its authorized representative been contacted.

Covered Emergency Evacuation Expenses are the Reasonable and Customary Charges for necessary transportation, related medical services and medical supplies incurred in connection with an Emergency Evacuation. All transportation arrangements made for evacuation must be by the most direct and economical route possible and required by the standard regulations of the transporting conveyance. If possible, the Insured’s Common Carrier tickets will be used.

Expenses for transportation must be:

a) Ordered by the onsite attending Physician who must certify that the severity of the Injury or Sickness warrants an Emergency Evacuation and adequate medical treatment is not locally available; and

b) Authorized in advance by the Travel Insurance Administrator. In the event the 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 an escort in writing.

Emergency Evacuation – means:

a) 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; 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 Medically Necessary treatment is needed but not locally available; and the Insured is medically able to travel; or

c) Transportation to the adequate licensed medical facility nearest to the Insured’s 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.

Advanced authorization by the Travel Insurance Administrator is needed for a), b) and c) above.

ADDITIONAL BENEFITS

In addition to the above covered expenses, if the Company has previously evacuated the Insured to a medical facility, the Company will reimburse for airfare costs, less refunds from Unused transportation tickets, from that facility to the Return Destination or home, within one year from the original Return Date. Airfare costs will be based on medical necessity or same class as the Insured’s original tickets.

If the Insured is hospitalized for more than 7 days following a covered Emergency Evacuation, the Company will reimburse,subject to the limitations set out herein, the expenses for:

a) Return of Children: Return of Children, who were accompanying the Insured when the Injury or Sickness occurred, to the Insured’s 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.

b) Bedside Traveling Companion: The Company will reimburse the Insured for reasonable expenses incurred for Lodging and meals shown in the Schedule for the Traveling Companion to remain near the Insured. For an insured Child, a bedside companion is available immediately upon Hospital admission. Receipts must be submitted. Coverage for this benefit ends on the discharge date from the hospital.

c) Bedside Visit: If the Insured is alone the Company will reimburse the Insured for the transportation costs to bring one person, chosen by the Insured, to and from the medical facility where the Insured is confined. The payment will not exceed the cost of one round-Trip economy airfare ticket.

Covered Repatriation Expenses are the reasonable and customary expenses for

a) The most economical coffins or receptacles adequate for transportation of the remains; and

b) Transportation of the remains, by the most direct and economical conveyance and route possible. This coverage ends when the body is returned to the City of burial.

The Travel Insurance Administrator must make all arrangements and authorize all expenses in advance.

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64

Adventure

$1,000,000 per person

EMERGENCY EVACUATION and REPATRIATION OF REMAINS

The 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 Your 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 Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible and required by the standard regulations of the conveyance transporting You.

Expenses for Transportation must be:

a) ordered by the onsite attending Physician who must certify that the severity of YourInjury or Sickness warrants Your Emergency Evacuation and adequate medical treatment is not locally available; and

b) authorized in advance by the Travel Insurance Administrator. In the event Your 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 Medically Necessary 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 You are medically able to be transported; or

Advanced authorization by the Travel Insurance Administrator is needed for a), b) and c) 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 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.

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65

Adventure

$1,000,000 per person

EMERGENCY EVACUATION & REPATRIATION OF REMAINS

The Company will pay for Covered Emergency Evacuation Expenses incurred due to an Injury or Sickness that occurs to the Insured while on a Trip, up to the Maximum Limit shown in the Schedule. In the event of death, the Company will pay for Covered Repatriation Expenses up to the Maximum Limit shown in the Schedule to return the Insured’s body to the City of burial.

Special Limitation: In the event the Travel Insurance Administrator could not be contacted to arrange for Emergency Evacuation or Repatriation of Remains, benefits are limited to the amount the Company would have paid had the Company or its authorized representative been contacted.

Covered Emergency Evacuation Expenses are the Reasonable and Customary Charges for necessary transportation, related medical services and medical supplies incurred in connection with an Emergency Evacuation. All transportation arrangements made for evacuation must be by the most direct and economical route possible and required by the standard regulations of the transporting conveyance. If possible, the Insured’s Common Carrier tickets will be used.

Expenses for transportation must be:

a) Ordered by the onsite attending Physician who must certify that the severity of the Injury or Sickness warrants an Emergency Evacuation and adequate medical treatment is not locally available; and

b) Authorized in advance by the Travel Insurance Administrator. In the event the 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 an escort in writing.

Emergency Evacuation – means:

a) 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; 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 Medically Necessary treatment is needed but not locally available; and the Insured is medically able to travel; or
c) Transportation to the adequate licensed medical facility nearest to the Insured’s 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.

Advanced authorization by the Travel Insurance Administrator is needed for a), b) and c) above.

ADDITIONAL BENEFITS

In addition to the above covered expenses, if the Company has previously evacuated the Insured to a medical facility, the Company will reimburse for airfare costs, less refunds from Unused transportation tickets, from that facility to the Return Destination or home, within one year from the original Return Date. Airfare costs will be based on medical necessity or same class as the Insured’s original tickets.

If the Insured is hospitalized for more than 7 days following a covered Emergency Evacuation, the Company will reimburse, subject to the limitations set out herein, the expenses for:

a) Return of Children: Return of Children, who were accompanying the Insured when the Injury or Sickness occurred, to the Insured’s 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.

b) Bedside Traveling Companion: The Company will reimburse the Insured for reasonable expenses incurred for Lodging and meals shown in the Schedule for the Traveling Companion to remain near the Insured. For an insured Child, a bedside companion is available immediately upon Hospital admission. Receipts must be submitted. Coverage for this benefit ends on the discharge date from the hospital.

c) Bedside Visit: If the Insured is alone the Company will reimburse the Insured for the transportation costs to bring one person, chosen by the Insured, to and from the medical facility where the Insured is confined. The payment will not exceed the cost of one round-Trip economy airfare ticket.

Covered Repatriation Expenses are the reasonable and customary expenses for
a) The most economical coffins or receptacles adequate for transportation of the remains; and
b) Transportation of the remains, by the most direct and economical conveyance and route possible. This coverage ends when the body is returned to the City of burial.

The Travel Insurance Administrator must make all arrangements and authorize all expenses in advance.

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66

Gold

$500,000 per person

EMERGENCY MEDICAL EVACUATION & MEDICALLY NECESSARY REPATRIATION

We will pay, subject to the limitations set out herein, for covered Emergency Medical Evacuation expenses reasonably incurred if You suffer an Accidental Injury or Emergency Sickness that warrants Your Emergency Medical Evacuation while You are on a Covered Trip. Benefits payable are subject to the Maximum Benefit per Insured shown on the Schedule of Benefits for all Emergency Medical Evacuations due to all injuries from the same Accident or all Emergency Sickness from the same or related causes.

A legally licensed Physician, in coordination with Our designated Assistance Company, must order the Emergency Medical Evacuation and must certify that the severity of Your Accidental Injury or Emergency Sickness warrants Your Emergency Medical Evacuation to the closest adequate medical facility. We or Our Assistance Company or We must review and approve the necessity of the Emergency Medical Evacuation based on the inadequacy of local medical facilities. The Emergency Medical Evacuation must be coordinated through the most direct and economical conveyance and route possible, such as air or land ambulance or commercial airline carrier.

Covered Emergency Medical Evacuation expenses are those for Medically Necessary Transportation, including Reasonable and Customary medical services and supplies incurred in connection with Your Emergency Medical Evacuation. Expenses for Transportation must be: a) recommended by the attending Physician; b) required by the standard regulations of the conveyance transporting You; and c) reviewed and pre-approved by Our designated Assistance Company.

We will also pay Reasonable and Customary expenses, for escort expenses required by You, if You are disabled during a Covered Trip and an escort is recommended in writing by an attending Physician and such expenses are pre-approved by Our designated Assistance Company.

If You are hospitalized for more than the number of days shown on the Schedule of Benefits following a covered Emergency Medical Evacuation, We will pay, subject to the limitations set out herein, for expenses:

a) to return You to your residence in the United States, with an attendant if necessary, any of Your Dependent Children who were accompanying You when the Accidental Injury or Emergency Sickness occurred and were left alone as a result of same. Our payment will not exceed the cost of a single one-way economy airfare ticket, less the value of applied credit from any unused return travel tickets per person; and

b) to bring 1 person chosen by You to and from the Hospital or other medical facility where You are confined if You are alone, but not to exceed the cost of 1 round-trip economy airfare ticket.

In addition to the above Covered Expenses, if We have previously evacuated You to a medical facility, We will pay Your airfare costs from that facility to Your primary residence, within 1 year from Your original Scheduled Return Date, less refunds from Your unused Transportation tickets. Airfare costs will be economy or first class if Your original tickets are first class. This benefit is available only if it is not provided under another coverage in the Policy.

Transportation of Spouse or Domestic Partner: If You are confined to the Hospital for more than the number of days shown on the Schedule of Benefits or if the attending Physician certifies that due to Your Accidental Injury or Emergency Sickness, You will be required to stay in the Hospital for more than the number of consecutive days shown on the Schedule of Benefits or if You die on the Covered Trip and require Repatriation of Remains, We will return Your spouse or Domestic Partner to Your primary residence. Our payment will not exceed the cost of a single one-way economy airfare ticket, less the value of applied credit from any unused return travel ticket.

Escort Service: We will pay to return any of Your children who were accompanying You at the time of Your Accidental Injury or Emergency Sickness back to Your primary residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way economy airfare ticket, less the value of any applied credit from any unused return travel tickets for each person. The escort service must be arranged and approved by Us or Our designated Assistance Company.

REPATRIATION OF REMAINS

We will pay the reasonable Covered Expenses incurred to return Your body to Your place of permanent residence if You die due to Accidental Injury or a Covered Sickness during the Covered Trip. No payment will exceed the maximum shown on the Schedule of Benefits.

Covered Expenses include: a) The collection of the body of the deceased; b) the transfer of the body to a professional funeral home; c) embalming and preparation of the body or cremation if so desired; d) standard shipping casket; e) any required consular proceedings; f) the transfer of the casket to the airport and boarding of the casket onto the plane; g) any required permits and corresponding airfare; and h) the transfer of the deceased to their final destination. All Covered Expenses must be approved in advance by Our designated Assistance Company.

Escort Service: We will pay to return any of Your children who were accompanying You at the time of Your death back to Your primary residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way economy airfare ticket, less the value of any applied credit from any unused return travel tickets for each person. The escort service must be arranged and approved by Us or Our designated Assistance Company.

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67

Basic

$200,000 per person

EMERGENCY EVACUATION AND REPATRIATION OF REMAINS

We will reimburse you, up to the maximum amount shown in the schedule of benefits, for covered emergency evacuation expenses incurred due to your injury or sickness that occurs while on a covered trip.

Covered emergency evacuation expenses are the reasonable and customary charges for medically necessary transportation, related medical services, and medical supplies required by the standard regulations of the conveyance transporting you incurred during your Emergency Evacuation. The transportation must be:

a. Ordered by the onsite attending physician, who must certify that the severity of your injury or sickness warrants the Emergency Evacuation;

b. Authorized in advance by us or our designated representative. In the event your injury or sickness prevents prior authorization of the Emergency Evacuation, we or our designated representative must be notified as soon as reasonably possible; and

c. By the most direct and economical route possible.

We will also pay a benefit for reasonable and customary charges incurred for an escort’s or contracted attendant’s services, and the escort’s or attendant’s transportation and accommodations, if an attending physician recommends that an escort or attendant accompany you. This coverage is inclusive of the maximum limit of the Emergency Evacuation benefit.

Transportation will be provided:

a. From the place where your injury or sickness occurs to the nearest adequate licensed medical facility where appropriate medical treatment can be obtained; and

b. 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 medically necessary treatment is needed but not locally available, and you are medically able to travel; and

c. To your primary residence, or an adequate licensed medical facility nearest your primary residence, to obtain further medical treatment or to recover after being treated at a local licensed medical facility, if the onsite attending physician determines that you are medically able to be transported and that the transportation is medically appropriate.

Special Limitation: In the event we or our authorized representative could not be contacted to arrange for Covered Emergency Evacuation Expenses, benefits are limited to the amount we would have paid had we or our authorized representative been contacted.

REPATRIATION OF REMAINS COVERAGE

We will reimburse you for Repatriation covered expenses up to the maximum amount shown in the schedule of benefits to return your remains if you die while on the covered trip.

Repatriation covered expenses are limited to the reasonable and customary charges for the expenses listed below. We or our authorized representative must make all arrangements and authorize all expenses in advance.

Repatriation covered expenses include the reasonable and customary charges for:

a. Embalming or cremation; and

b. Associated temporary storage costs for up to fifteen (15) days, or until local authorities will permit further transportation of the body, whichever is later; and

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, to:

1. The nearest location where the body can be embalmed or cremated, if not locally available; and

2. The receiving funeral home or morgue, the return destination, or a different place of burial within your country of residence; and

e. The cost for creation and transmission of necessary documentation to transport the body, such as a death certificate, autopsy or police report, up to five (5) copies per document.

Special Limitation:

In the event we or our authorized representative could not be contacted to arrange for Repatriation covered expenses, benefits are limited to the amount we would have paid had we or our authorized representative been contacted.

Advance Payment

We will pay a benefit, up to the maximum limit shown in the schedule of benefits, directly to the provider if, while on a covered trip, you suffer an injury or sickness which requires an emergency evacuation or repatriation of remains, and payment is required prior to transportation or repatriation. This amount will be deducted from the Emergency Evacuation and Repatriation of Remains benefit limit, shown in the schedule of benefits. You agree to reimburse this payment to us if: a) you do not file a claim for the expenses incurred as outlined in the Payment of Claims section; or b) it is determined that your emergency evacuation or repatriation of remains claim is not covered.

We will provide advance payment when required and requested by you. However:

a. We reserve the right to deny a request for advance payment, if we confirm that your claim is not covered under the policy; and

b. An advance payment made by us is not a guarantee of claim approval.

Emergency Evacuation and Repatriation of Remains Exclusions:

In addition to the General Limitations and Exclusions, the following exclusions apply to the Emergency Evacuation and Repatriation of Remains Benefit. No benefits will be paid for any loss for, caused by, or resulting from:

a. Transportation taken against the advice of the attending physician;

b. Intentionally self-inflicted injury, suicide, or attempted suicide by you;

c. You or the traveling companion are traveling for the purpose of securing medical treatment;

d. Normal pregnancy or childbirth, or elective abortion. However, unforeseen complications of pregnancy are not excluded;

e. Your participation in adventure activities, extreme activities, winter activities or dangerous activities, except as a spectator;

f. Your mental, nervous or psychological disorder;

g. Expenses incurred by any child born during the covered trip;

h. Any loss that occurs on a covered trip with a destination less than one hundred (100) miles from your primary residence or to another residence of you or the traveling companion, or on a covered trip that is not at least overnight in length; or

i. Pre-existing medical conditions.

For purposes of this coverage, the following definition is added:

Medically appropriate means an adequate and acceptable course of treatment or transportation in the opinion of the onsite attending physician.

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68

Platinum

$500,000 per person

EMERGENCY EVACUATION AND REPATRIATION OF REMAINS

We will reimburse you, up to the maximum amount shown in the schedule of benefits, for covered emergency evacuation expenses incurred due to your injury or sickness that occurs while on a covered trip.

Covered emergency evacuation expenses are the reasonable and customary charges for medically necessary transportation, related medical services, and medical supplies required by the standard regulations of the conveyance transporting you incurred during your Emergency Evacuation.

The transportation must be:

a. Ordered by the onsite attending physician, who must certify that the severity of your injury or sickness warrants the Emergency Evacuation;
b. Authorized in advance by us or our designated representative. In the event your injury or sickness prevents prior authorization of the Emergency Evacuation, we or our designated representative must be notified as soon as reasonably possible; and
c. By the most direct and economical route possible.

We will also pay a benefit for reasonable and customary charges incurred for an escort’s or contracted attendant’s services, and the escort’s or attendant’s transportation and accommodations, if an attending physician recommends that an escort or attendant accompany you. This coverage is inclusive of the maximum limit of the Emergency Evacuation benefit.

Transportation will be provided:

a. From the place where your injury or sickness occurs to the nearest adequate licensed medical facility where appropriate medical treatment can be obtained; and
b. 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 medically necessary treatment is needed but not locally available, and you are medically able to travel; and
c. To your primary residence, or an adequate licensed medical facility nearest your primary residence, to obtain further medical treatment or to recover after being treated at a local licensed medical facility, if the onsite attending physician determines that you are medically able to be transported and that the transportation is medically appropriate.

Special Limitation: In the event we or our authorized representative could not be contacted to arrange for Covered Emergency Evacuation Expenses, benefits are limited to the amount we would have paid had we or our authorized representative been contacted.

REPATRIATION OF REMAINS COVERAGE

We will reimburse you for Repatriation covered expenses up to the maximum amount shown in the schedule of benefits to return your remains if you die while on the covered trip.

Repatriation covered expenses are limited to the reasonable and customary charges for the expenses listed below. We or our authorized representative must make all arrangements and authorize all expenses in advance.

Repatriation covered expenses include the reasonable and customary charges for:

a. Embalming or cremation; and

b. Associated temporary storage costs for up to fifteen (15) days, or until local authorities will permit further transportation of the body, whichever is later; and

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, to:

1. The nearest location where the body can be embalmed or cremated, if not locally available; and

2. The receiving funeral home or morgue, the return destination, or a different place of burial within your country of residence; and

e. The cost for creation and transmission of necessary documentation to transport the body, such as a death certificate, autopsy or police report, up to five (5) copies per document.

Special Limitation:

In the event we or our authorized representative could not be contacted to arrange for Repatriation covered expenses, benefits are limited to the amount we would have paid had we or our authorized representative been contacted.

Advance Payment

We will pay a benefit, up to the maximum limit shown in the schedule of benefits, directly to the provider if, while on a covered trip, you suffer an injury or sickness which requires an emergency evacuation or repatriation of remains, and payment is required prior to transportation or repatriation. This amount will be deducted from the Emergency Evacuation and Repatriation of Remains benefit limit, shown in the schedule of benefits. You agree to reimburse this payment to us if: a) you do not file a claim for the expenses incurred as outlined in the Payment of Claims section; or b) it is determined that your emergency evacuation or repatriation of remains claim is not covered.

We will provide advance payment when required and requested by you. However:

a. We reserve the right to deny a request for advance payment, if we confirm that your claim is not covered under the policy; and

b. An advance payment made by us is not a guarantee of claim approval.
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69

Silver

$1,000,000 per person

EMERGENCY MEDICAL EVACUATION & MEDICALLY NECESSARY REPATRIATION

We will pay, subject to the limitations set out herein, for covered Emergency Medical Evacuation expenses reasonably incurred if You suffer an Accidental Injury or Emergency Sickness that warrants Your Emergency Medical Evacuation while You are on a Covered Trip. Benefits payable are subject to the Maximum Benefit per Insured shown on the Schedule of Benefits for all Emergency Medical Evacuations due to all injuries from the same Accident or all Emergency Sickness from the same or related causes.

A legally licensed Physician, in coordination with Our Assistance Company, must order the Emergency Medical Evacuation and must certify that the severity of Your Accidental Injury or Emergency Sickness warrants Your Emergency Medical Evacuation to the closest adequate medical facility. The Assistance Company or We must review and approve the necessity of the Emergency Medical Evacuation based on the inadequacy of local medical facilities.

The Emergency Medical Evacuation must be coordinated through the most direct and economical conveyance and route possible, such as air or land ambulance or commercial airline carrier.

Covered Emergency Medical Evacuation expenses are those for Medically Necessary Transportation, including Reasonable and Customary medical services and supplies incurred in connection with Your Emergency Medical Evacuation. Expenses for Transportation must be:

a. Recommended by the attending Physician;
b. Required by the standard regulations of the conveyance transporting You; and
c. Reviewed and pre-approved by Our Assistance Company.

We will also pay Reasonable and Customary expenses, for Escort expenses required by You, if You are disabled during a Covered Trip and an Escort is recommended in writing by an attending Physician and such expenses are preapproved by Our Assistance Company. In the event the Emergency Medical Evacuation is not approved by Our designated Assistance Company prior to the start of the evacuation, reimbursement may be limited to the amount Our designated Assistance Company would have authorized had the Emergency Medical Evacuation been approved.

If You are hospitalized for more than the number of days shown on the Schedule of Benefits following a covered Emergency Medical Evacuation, We will pay, subject to the limitations set out herein, for expenses:

a. To return You to Your Primary Residence in the United States, with an attendant if necessary, any of Your Dependent Children who were accompanying You when the Accidental Injury or Emergency Sickness occurred and were left alone as a result of same. Our payment will not exceed the cost of a single one-way Economy Fare, less the value of applied credit from any Unused return travel tickets per person; and
b. To bring one (1) person chosen by You to and from the Hospital or other medical facility where You are confined if You are alone, but not to exceed the cost of one (1) round-trip Economy Fare. In addition to the above covered expenses, if We have previously evacuated You to a medical facility, We will pay Your airfare costs from that facility to Your Primary Residence, within 1 year from Your original Scheduled Return Date, less refunds from Your Unused Transportation tickets. Airfare costs will be Economy Fare or first class if Your original tickets are first class. This benefit is available only if it is not provided under another coverage in the Policy.

Transportation of Spouse or Domestic Partner:
If:
a. You are confined to the Hospital for more than the number of days shown on the Schedule of Benefits;
b. The attending Physician certifies that due to Your Accidental Injury or Emergency Sickness, You will be required to stay in the Hospital for more than the number of consecutive days shown on the Schedule of Benefits; or
c. You die on the Covered Trip and require Repatriation of Remains,

We will return Your Spouse or Domestic Partner to Your Primary Residence. Our payment will not exceed the cost of a single one-way Economy Fare, less the value of applied credit from any Unused return travel ticket.

Escort Service: We will pay to return any of Your Dependent Children who were accompanying You at the time of Your Accidental Injury or Emergency Sickness back to Your Primary Residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way Economy Fare, less the value of any applied credit from any Unused return travel tickets for each person. The Escort service must be arranged and approved by Us or Our Assistance Company.

REPATRIATION OF REMAINS

We will pay the reasonable Covered Repatriation Expenses incurred to return Your body to Your Primary Residence if You die due to Accidental Injury or Covered Sickness during the Covered Trip, up to the maximum amount shown on the Schedule of Benefits.

Covered Repatriation Expenses include:

a. The collection of the body of the deceased;
b. The transfer of the body to a professional funeral home;
c. Embalming and preparation of the body or cremation if so desired;
d. Standard shipping casket;
e. Any required consular proceedings;
f. The transfer of the casket to the airport and boarding of the casket onto the plane;
g. Any required permits and corresponding airfare; and
h. The transfer of the deceased to their final destination.

All Covered Expenses must be approved in advance by Our Assistance Company.

Escort Service: We will pay to return any of Your Dependent Children who were accompanying You at the time of Your death back to Your Primary Residence, including the cost of an attendant for a minor child. Such expenses shall not exceed the cost of a one-way economy airfare ticket, less the value of any applied credit from any unused return travel tickets for each person. The escort service must be arranged and approved by Us or Our Assistance Company.

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Policy Name and Summary of Coverage
70

Worldwide Trip Protector Plus

$1,000,000 per person

EMERGENCY MEDICAL EVACUATION, MEDICAL REPATRIATION AND RETURN OF REMAINS

When You suffer loss of life for any reason or incur a Sickness or Injury during the course of Your Trip, the following benefits are payable, up to the Maximum Benefit Amount shown in the Confirmation of Benefits.

1. Emergency Medical Evacuation: If the local attending Legally Qualified Physician and the authorized travel assistance company determine that transportation to a Hospital or medical facility is Medically Necessary to treat an unforeseen Sickness or Injury which is acute or life threatening and adequate Medical Treatment is not available in the immediate area, the Transportation Expense incurred will be paid for the Usual and Customary Charges for transportation to the closest Hospital or medical facility capable of providing that treatment.

If You are traveling alone and will be hospitalized for more than 7 consecutive days and Emergency Evacuation is not imminent, benefits will be paid to transport one person, chosen by You, by Economy Transportation, for a single visit to and from Your bedside.

If You are in the Hospital for more than 7 consecutive days and Your dependent children who are under 18 years of age and accompanying You on Your Trip are left unattended, Economy Transportation will be paid to return the dependents to their home (with an attendant, if considered necessary by the authorized travel assistance company).

2. Medical Repatriation: If the local attending Legally Qualified Physician and the authorized travel assistance company determine that it is Medically Necessary for You to return to Your primary place of residence because of an unforeseen Sickness or Injury which is acute or life-threatening, the Transportation Expense incurred will be paid for Your return to Your primary place of residence or to a Hospital or medical facility closest to Your primary place of residence capable of providing continued treatment via one of the following methods of transportation, as approved, in writing, by the authorized travel assistance company:

i) one-way Economy Transportation;

ii) commercial air upgrade (to Business or First Class), based on Your condition as recommended by the local attending Legally Qualified Physician and verified in writing by the authorized travel assistance company; or

iii) other covered land or air transportation including, but not limited to, commercial stretcher, medical escort, or the Usual and Customary Charges for air ambulance, provided such transportation has been pre-approved and arranged by the authorized travel assistance company. Transportation must be via the most direct and economical route.

HOSPITAL OF CHOICE

Subject to the terms and conditions of item # 2, You may choose to be transported to a Hospital in a city within the United States of America other than Your primary place of residence, but the maximum amount payable is limited to the cost of transportation to Your primary place of residence.

3. Return of Remains: In the event of Your death during a Trip, the expense incurred will be paid for minimally necessary casket or air tray, preparation and transportation of Your remains to Your primary place of residence in the United States of America or to the place of burial.

Benefits are paid less the value of Your original unused return travel ticket.

These benefits will not duplicate any other benefits payable under the Policy or any coverage(s) attached to the Policy.

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71

Worldwide Trip Protector

$1,000,000 per person

MEDICAL EVACUATION AND REPATRIATION OF REMAINS

Benefits will be paid, up to the Maximum Benefit Amount shown in the Schedule of Benefits, when You suffer a Sickness, Injury, or loss of life, during Your Trip, for the following:

Emergency Medical Evacuation

We will pay for the Usual and Customary transportation expenses for an Emergency Medical Evacuation, to the nearest suitable Hospital or medical facility where Medically Necessary treatment is available to treat an Unforeseen Sickness or Injury provided:

1. the local attending Physician and Our designated Travel Assistance Services Provider determine that Your condition is acute, severe or life threating; and

2. that adequate Medically Necessary treatment is not available in Your immediate area.

Medical Repatriation

Following an Emergency Medical Evacuation or a covered Injury or Sickness, We will pay for Medical Evacuation expenses to return You to Your point of origin, Your Primary Residence, or to a Hospital of Choice or medical facility closest to Your Primary Residence capable of providing continued treatment, if Your local attending Physician and Our designated Travel Assistance Services Provider determine that it is Medically Necessary.

We will pay for one of the following methods of transportation, as pre-approved (prior to the evacuation) and arranged by Us or Our designated Travel Assistance Services Provider:

a. one-way economy transportation;

b. commercial air upgrade to business or first class, less refunds from Your unused transportation tickets;

c. other covered land or air transportation including, but not limited to, commercial stretcher, Medical Escort, or the contracted charges for air ambulance.

Transportation must be via the most direct, efficient and economical method of conveyance. In all cases, where practical, economy fare will be utilized. If possible, Your Common Carrier tickets will be used.

We will also pay a benefit for Usual and Customary expenses incurred for a Medical Escort’s transportation and accommodations if an onsite attending Physician recommends in writing that a Medical Escort accompany You. Medical Escort means a medically trained professional who is approved by Us or Our designated Travel Assistance Services Provider, and is contracted to accompany and provide medical care to a sick or injured person while they are being transported.

Hospital of Choice: You may choose to be transported to a Hospital in a city within the United States of America other than the city of Your Primary Residence. The maximum amount payable is limited to the cost of transportation to Your Primary Residence.

Repatriation of Remains

Benefits will be paid for covered Repatriation Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, to return Your body to Your city of Primary Residence or Your origination point or to the place of burial in the United States of America if You die during Your Trip.

Repatriation Expenses means:

a) embalming or local cremation; and
b) associated temporary storage costs for up to 30 days, or until local authorities of the country/state in which the death occurred, will permit further transportation of the body, whichever is later; and the most economical coffin or receptacle adequate to transport the remains;
c) the cost of transportation of the remains, by the most direct and economical conveyance and route possible, to:

1) the nearest location where the body can be embalmed or cremated, if not locally available; and/or 2) the receiving funeral home or morgue, at the Return Destination, or a different place of burial within United States; and

d) the cost for the creation and transmission of necessary documentation required to transport the body, such as a death certificate, autopsy or police report

Transportation expenses for the Emergency Medical Evacuation and Medical Repatriation must be authorized and arranged in advance by Us or Our designated Travel Assistance Services Provider.

Transportation of Children/Child: If You die or are Hospitalized for more than 7 consecutive days following an Emergency Medical Evacuation or Injury and Sickness that occurred during Your Trip, We will pay up to the cost of a single one-way economy transportation ticket, or same class as the original transportation ticket, less the value of any applied credit from any unused return travel tickets for each person, to return Your Children/Child who were accompanying You on Your Trip (and any accompanying minor persons under Your care) who are left unattended by Your death or Hospitalization to their Primary Residence or to Your residence in the United States, including the cost of an attendant, if considered necessary by Us or Our designated Travel Assistance Services Provider.

Bedside Visit Transportation to Join You: If You are or will be Hospitalized for more than 7 consecutive days following an Emergency Medical Evacuation or Injury and Sickness that occurred during Your Trip, We will pay, up to the cost of a single round-trip economy transportation ticket, up to the Maximum Benefit Amount shown in the Schedule of Benefits, for Reasonable Additional Expenses for one person chosen by You to visit Your bedside, provided You are traveling alone and Emergency Medical Evacuation is not imminent.

Additional Medical Evacuation Benefits are supplemental to benefits provided under Medical Evacuation and Medical Repatriation and Your Medical Evacuation and Medical Repatriation coverage may not exceed the amount shown in the Schedule of Benefits.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

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72