The following are key words and phrases used in this certificate. When these words and phrases, or forms of them, are used, they are capitalized. As You read this certificate, refer back to these definitions.
Accident: means a sudden, unexpected, unusual, specific and abrupt event. Such event must occur by chance at an identifiable time and place while coverage is in force. Any loss caused by, or resulting from a sickness or disease is not an Accident.
Actual Cash Value: means the original cost of Your Baggage and Personal Effects less any depreciation as determined by Us.
Additional Transportation Cost: means the actual cost incurred for one-way, Economy Transportation as charged by a Common Carrier, reduced by the value of an unused travel ticket.
Baggage and Personal Effects: means any luggage or goods being used by You during a Covered Trip.
Bankruptcy: means the filing of a petition for voluntary or involuntary bankruptcy in a court of competent jurisdiction under Chapter 7 or Chapter 11 of the United States Bankruptcy Code 11 U.S.C. Subsection 101 et seq.
Business Partner: means an individual who has at least a 20% ownership interest in a commercial enterprise in which You also have at least a 20% ownership interest; and You are both actively engaged in the daily management of the business.
Commercial Rental Vehicle Agency: means an agency licensed under the laws of the jurisdiction of operation which rents vehicles for the personal use of its customers subject to the terms and conditions found within a rental agreement.
Common Carrier: means any public land, water, or air conveyance operated under a license for the transportation of passengers for hire.
Confirmation of Coverage: means the coverage confirmation provided to You following enrollment and payment of the applicable premium as calculated on the enrollment form. The Confirmation of Coverage is attached to and made a part of this certificate.
Covered Trip: means scheduled trips, tours or cruises for which:
1) coverage is requested;
2) the required premium is paid prior to Your Effective Date of coverage; and
3) the trip exceeds 150 miles from Your Primary Residence.
Default: means the inability to provide contracted services due to total cessation or complete suspension of operations due to financial insolvency, with or without the filing of a Bankruptcy petition, whether voluntary or involuntary, by a tour operator, cruise line, airline, or other Travel Supplier which is duly licensed in the states of operation other than the person, organization, agency or firm from whom You directly purchased or to whom You paid for Your Covered Trip.
Destination: means the place to which You expect to travel on Your Covered Trip.
Economy Transportation: means transportation at the lowest published available rate for a ticket on a Common Carrier matching the original class of transportation that You purchased for the Covered Trip.
Emergency: means an unforeseen Sickness or Injury that requires immediate Medical Treatment to prevent or alleviate existing danger to life or health. An Emergency no longer exists when medical evidence indicates that You are able to return to Your Point of Origin or to continue with the Covered Trip without endangering Your life or physical health.
Emergency Medical Expenses: means expense incurred during Your Covered Trip for Emergency services and supplies listed below and ordered or prescribed by a Physician as Medically Necessary for diagnosis or treatment. Such Expenses are limited to:
1) the services of a Physician;
2) Hospital or ambulatory medical-surgical center services (this will also include expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a hospital room for recovery of an Injury or Sickness); and
3) transportation furnished by a professional ambulance company to and from a Hospital; and
4) prescribed drugs, prosthetics and therapeutic services and supplies.
Family Member: means legal spouse or common-law spouse (where legal), legal guardian, legal ward, son or daughter (adopted, foster, step or in-law), brother or sister (includes step or in-law), parent (includes step or in-law), grandparent (includes in-law), great-grandparent, grandchild, great-grandchild, aunt, uncle, niece, nephew or Key Person provided such Family Member resides in the United States, Canada or Mexico.
Hospital: means an institution established according to law which:
1) holds a license as a Hospital (if required in the state);
2) operates primarily for the reception, care and
treatment of sick or injured persons as in-patients;
3) provides 24-hour nursing service;
4) has a staff of one or more Physicians available at all times;
5) provides organized facilities for diagnosis and surgery;
6) is not primarily a clinic, nursing, rest or convalescent home or a skilled nursing facility or similar establishment; and
7) is not, other than incidentally, a place for treatment of alcoholism, drug addiction or mental or nervous disorders.
The nursing service must be by registered or graduate nurses on duty or call. Confinement in a special unit of a Hospital used primarily as a nursing, rest or convalescent home or skilled nursing facility will not be deemed to be a confinement in a Hospital.
Host at Destination: means the person, at his or her usual place of residence, with whom You have arranged overnight accommodation for the majority of Your Covered Trip. A Host at Destination does not include any commercial facilities.
Inclement Weather: means any weather condition that delays the scheduled arrival or departure of a Common Carrier.
Injury: means bodily injury caused by an Accident: The injury must:
1) occur while Your coverage is in force;
2) result, directly and independently of all other causes; and
3) be certified by a local attending Physician.
Insured: means the eligible person whose insurance is in force under terms of the Policy.
Key Person: means
1) an employed caregiver of Your legal dependent; or
2) a person to whom You are not married and with whom You have cohabited for 12 continuous months.
Maximum Benefit Amount: means the maximum amount payable for each coverage as shown in Your Confirmation of Coverage.
Maximum Waiver Amount: means the maximum limit of benefits for Trip Cancellation and Emergency Medical Expenses, as stated on Your Confirmation of Coverage, where the Pre-existing Exclusion is not applied.
Medical Treatment: means treatment, advice or consultation by a Physician or care provided under a Physician’s supervision or direction.
Medically Necessary: means an Emergency treatment, service or supply that is:
1) recommended by the local attending Physician;
2) performed under the Physician’s care, or supervision; and
3) determined by Us to be:
a) consistent with generally accepted medical practice for the Injury or Sickness;
b) could not have been omitted without adversely affecting Your condition or quality of medical care;
c) is delivered at the most appropriate level of care, and not primarily for the sake of convenience; and
d) is not considered experimental unless coverage for experimental service or supply is required by law.
Natural Disaster: means a disaster resulting from natural causes including flood, hurricane, tornado, earthquake, volcanic eruption or blizzard.
Organized Labor Strike: means any stoppage of work:
1) as a result of the combined effect of workers which was unannounced and unpublished at the time coverage under the Policy was purchased;
2) that interferes with the normal departure and arrival of a Common Carrier.
It does not include a general strike whereby all or most of the workers of a country, province, state, city or town cease work.
Physician: means a medical doctor or a Christian Science practitioner who is:
1) practicing within the scope of his or her license; and
2) recognized as a physician in the place where medical services are rendered. Physician does not include You, a Traveling Companion or a Family Member.
Point of Origin: means Your original place of departure for Your Covered Trip. TADEF-21AA
Pre-existing Condition: means a condition occurring during the 60 day period immediately prior to Your Effective Date:
1) for which medical advice, care or treatment was received or recommended by a Physician regardless of whether or not a diagnosis was made and;
2) which produced symptoms or whose onset or manifestation occurred during such 60 day period. Such symptoms must have been significant enough to establish manifestation or onset which would have:
a) caused an ordinarily prudent person to seek diagnosis or treatment; or
b) enabled a Physician to diagnose such illness, disease, injury or other condition.
A Pre-existing Condition does not include any condition which is solely controlled through the taking of prescription medication and which has remained stable or controlled without any adjustment or change in the required prescription throughout the 60 day period immediately prior to Your Effective Date.
Primary Residence: means Your principal domicile.
Published Penalties: means any published cancellation penalties issued by Your travel agency or Travel Supplier that apply to all clients of the travel agency or Travel Supplier and can be documented at time of the Covered Trip sale. Published Penalties includes any penalties imposed by the travel agency or Travel Supplier of up to 10% of the Covered Trip Cost (excluding taxes and other non-commissionable items); or 10% of the amount You have paid towards the Trip, whichever is less.
Rental Vehicle: means any motor vehicle rented from a Commercial Rental Vehicle Agency as described in the rental agreement. A Rental Vehicle does not include trucks, vans, buses, motorcycles, mopeds, motorbikes, recreational all-terrain vehicles, campers, trailers, limousines, and vehicles 20 years of age or older, any vehicles specifically designed for off-road use and any exotic vehicles including, but not limited to Aston Martin, Bentley, Bricklin, Daimler, De Lorean, Excalibur, Ferrari, Jensen, Lamborghini, Lotus, Maserati, Mercedes Benz, Porsche, Rolls Royce, or any other similar vehicle.
Scheduled Departure Date: means the date on which You are originally scheduled to leave Your Point of Origin.
Scheduled Return Date: means the date You are originally scheduled to return to the Point of Origin as shown in Your Confirmation of Coverage.
Sickness: means an illness or disease which is diagnosed or treated by a Physician after Your Effective Date and while You are covered under the Policy.
Terrorist Incident: means the unsanctioned and illegal use of violence (excluding general civil disturbance, rioting, an act of war whether declared or undeclared or the intentional release of a biological material), which caused destruction of property, Injury, or death by an individual or group for the express or implied purpose of achieving a political, ethnic, or religious goal or result.
Transportation Expense: means
1) the cost of the conveyance of You and any medical
personnel (if Medically Necessary); and
2) Medically Necessary services and supplies
provided during Your conveyance.
Travel Arrangements: means:
2) travel accommodations; and
3) other specified services arranged by the Travel Supplier for the Covered Trip.
Traveling Companion: means a person with whom You
1) have coordinated Travel Arrangements; and
2) intend to travel with during Your Covered Trip (up to a maximum of 4 persons including You).
Note: a group or tour leader is not considered a Traveling Companion unless You are sharing room accommodations with the group or tour leader.
Travel Supplier: means any entity or organization that coordinates or supplies travel services for You.
Trip Cost: means all prepaid Covered Trip costs that are subject to cancellation penalties or restrictions including the cost of any subsequent arrangements added to Your Covered Trip.
Usual and Customary Charges: means the amount charged for similar or comparable treatment, services and supplies in the geographic area where treatment is performed.
We, Our and Us: mean Old Republic Insurance Company.
You, Your and Yours: mean the Insured to whom this certificate is issued.