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Travel GuardCruise, Tour and TravelDescription of CoveragePRE-EXISTING MEDICAL CONDITION EXCLUSION WAIVERIf insurance was purchased within 15 calendar days of "initial trip payment," the Pre-Existing Medical Condition Exclusion will be waived. (Day one is the date the "initial trip payment" is received.) This is applicable to all coverages contained in the policy. In order to receive the waiver of Pre-Existing Conditions, the amount of Trip Cancellation coverage purchased must equal the full pre-paid nonrefundable portions of all trip arrangements.The Insured must be medically able to travel when he/she pays his/her premium. In the event that a claim is filed, the Injury or illness must be substantiated to our Claims Department.PRE-EXISTING MEDICAL CONDITION EXCLUSION APPLICABLE TO ALL COVERAGESThe Insurer will not pay for loss or expense incurred as the result of Injury or Sickness of an Insured or Immediate Family Member which manifests itself, worsened, became acute, or had symptoms, which would prompt a reasonable person to seek diagnosis, care, or treatment, or request treatment by a physician or treatment had been recommended during the 60 days immediately preceding and including the Insured's coverage effective date, unless the condition is controlled through the taking of prescription drugs or medication and remains controlled throughout the 60-day period. A Sickness has manifested itself when medical care, treatment, or diagnosis has been given.Blanket Travel Accident InsuranceThis document describes the benefits and basic provisions of the Policy. Read it with care. The Policy is the only contract under which benefits are paid.PLEASE READ THIS DOCUMENT CAREFULLY!Insurance CoverageUnderwritten by the American Home Assurance Company, a New York insurance company, with its principal place of business at 70 Pine Street, New York, New York 10270. It is currently authorized to transact business in all states and the District of Columbia. NAIC No. 19380. Collision Damage Waiver underwritten by the National Union Fire Insurance Company of Pittsburgh, PA, with its principal place of business at 70 Pine Street, New York, New York 10270. It is currently authorized to transact business in all states and the District of Columbia. NAIC No. 19445. This is only a brief description of the insurance coverage(s) available under policy series T30253AHAC. The Policy contains reductions, limitations, exclusions, and termination provisions. Full details of the coverage are contained in the Policy. If there are any conflicts between this document and the Policy, the Policy shall govern. SCHEDULE OF BENEFITSThe benefits are described in detail under "Description of Coverages." All coverages are per person. All coverages are Primary. The benefits are only applicable if the appropriate premium has been paid and are payable based on the limits reflected on the Schedule of Benefits page. (Please see attachment.)DEFINITIONS"Actual Cash Value" means purchase price less depreciation."Baggage" means luggage and personal possessions, whether owned, borrowed, or rented, taken by the Insured on the Trip. "Business Partner" means an individual who:
"Complication of Pregnancy" means a condition whose diagnosis is distinct from pregnancy but adversely affected or caused by pregnancy. It does not include any condition associated with the management of a difficult pregnancy not consisting of a classifiable distinct Complication of Pregnancy. "Default" means any failure of a provider of travel-related services (including any tour operator) to provide the bargained-for travel services or to refund money due the Insured. "Destination" means the place where the Insured expects to travel on his/her Trip, as shown on the Enrollment Form. "Domestic Partner" means an opposite or a same-sex partner who is at least 18 years of age and has met all of the following requirements for at least 6 months:
"Exotic Vehicle" means
"Felonious Assault" means an act of violence against the Insured or a Traveling Companion requiring medical treatment in a Hospital. A Felonious Assault may not be inflicted by the Insured, an Immediate Family Member, Traveling Companion, or Traveling Companions Immediate Family Member. "Financial Default" means either
"Injury" means a bodily injury caused by an accident occurring while the Policy is in force as to the Insured whose Injury is the basis of a claim, and resulting directly and independently of all other causes of loss covered by the Policy. The Injury must be verified by a Physician. "Insured" means the person named on the individual Enrollment Form. "Insurer" means American Home Assurance Company on all coverages with the exception of Collision Damage Waiver. For Collision Damage Waiver coverage, Insurer means National Union Fire Insurance Company of Pittsburgh, PA. "Medically Necessary" means that a treatment, service, or supply:
"Physician" means a government-licensed practitioner of the healing arts including accredited Christian Science Practitioners, acting within the scope of his/her license. The treating Physician may not be the Insured, Immediate Family Member, or a Traveling Companion. "Primary" means the Insurer will pay first. "Reasonable and Customary Charges" means an expense which:
"Reasonable Additional Expenses" means any expenses for meals and lodging which were necessarily incurred as the result of a Trip Interruption or Travel Delay and which are not provided by the Common Carrier or any other party free of charge. "Return Destination" means the place to which the Insured expects to return from his/her Trip. "Sickness" means an illness or disease which requires treatment by a Physician. "Strike" means a stoppage of work
"Terrorist Incident" means an act of violence, other than civil disorder or riot (that is not an act of war, declared or undeclared), that results in loss of life or major damage to property, by any person acting on behalf of or in connection with any organization which is generally recognized as having the intent to overthrow or influence the control of any government. "Travel Agent" means the travel agent, tour operator, or other entity from which the Insured purchases his/her coverage or travel arrangements, and includes all officers, employees, and affiliates of the travel agent or tour operator. "Traveling Companion" means a person or persons with whom you have coordinated travel arrangements and intend to travel with during the Trip. A group or tour leader is not considered a Traveling Companion, unless you are sharing room accommodations with the group or tour leader. "Trip" means a period of round-trip travel away from home to a Destination outside the Insured's city of residence; the purpose of the Trip is business or pleasure and is not to obtain health care or treatment of any kind; the Trip has defined departure and return dates specified when the Insured applies; the Trip does not exceed 365 days; and the Insured's Destination is not to another home; travel is primarily by Common Carrier and only incidentally by private conveyance. "Trip Completion Date" means the date on which the Insured is scheduled to return to the point where the Trip started, or to a different specified Return Destination. "Trip Departure Date" means the date on which the Insured is originally scheduled to leave on his/her Trip. This date is shown on the Individual Enrollment form. INDIVIDUAL ELIGIBILITY, EFFECTIVE & TERMINATION DATESPersons eligible for insurance under the policy are any traveler(s) who purchases his/her insurance through or from a properly licensed agent/agency located in the U.S., who enrolls for coverage and pays the premium, providing he/she has not already departed on his/her Trip.Effective Date: After premium is paid by the Insured and the Enrollment Form is completed and signed, TRIP CANCELLATION BENEFIT (and Change of Mind benefit, if applicable) will be effective:
GENERAL EXCLUSIONS - APPLICABLE TO ALL COVERAGESThese exclusions apply to all benefits. In addition to any exclusions which apply to a particular benefit (called "Additional Exclusions"), the policy does not cover loss caused by:
TRIP CANCELLATION & INTERRUPTIONThe Insurer will pay this Primary benefit up to the Maximum Limit shown on the Schedule of Benefits if a Trip is canceled or interrupted due to any of the following unforeseen reasons:
The Insurer will reimburse for the following:
TRAVEL DELAYThe Insurer will reimburse incurred expenses up to $200 a day to the Maximum Limit shown on the Schedule of Benefits if the Insured's Trip is delayed for more than six hours for Reasonable Additional Expenses until travel becomes possible. Incurred expenses must be accompanied by receipts. This benefit is payable for only one delay per Insured, per Trip. Travel Delay must be caused by reasons listed under Trip Cancellation & Interruption, in addition to:
MISSED CONNECTIONSThe Insurer will reimburse this benefit up to the Maximum Limit shown on the Schedule of Benefits if Inclement Weather or Carrier causes cancellation or a delay of all regularly scheduled airline flights for three to less than twelve hours to your point of departure. You can collect up to $500 for additional transportation costs to join the Trip (must be same class of original tickets purchased). Reasonable accommodations and meals (up to $100 per day), and/or the non-refundable, unused portion of the prepaid expenses as long as the expense is supported by a proof of purchase and is not reimbursable by another source. Common Carrier must certify the delay of the regularly scheduled airline flight.LOSS OF BAGGAGE & PERSONAL EFFECTSThe Insurer will reimburse this Primary (see definition) benefit, up to the Maximum Limit shown on the Schedule of Benefits. The Insurer will pay for loss, theft, or damage to the Insured's Baggage, passports, and visas during the Insured's Trip. The Insurer will also pay for loss due to unauthorized use of the Insured's credit cards, if the Insured has complied with all credit card conditions imposed by the credit card companies.Continuation of Coverage: If the covered Baggage, passports, and visas are in the charge of a charter or Common Carrier, and delivery is delayed, this coverage will continue until such property is delivered to the Insured. This coverage does not include loss caused by the delay. Property Not Covered: The Insurer will not pay for damage or loss of:
The Insurer will not pay more than $500 aggregate on all losses to:
Additional Exclusions: In addition to the General Exclusions, the Insurer will not pay this benefit for loss due to:
In the event of a loss to a pair or set of items, the Insurer may at our option:
BAGGAGE DELAY BENEFITThe Insurer will reimburse incurred expenses up to the Maximum Limit shown on the Schedule of Benefits for Baggage which is delayed or misdirected more than 24 hours for the cost of necessary personal effects. Incurred expenses must be accompanied by receipts. This benefit does not apply if Baggage is delayed after the Insured has reached his/her Return Destination.MEDICAL EXPENSE BENEFITThe Insurer will pay this Primary (see definition) benefit, up to the Maximum Limit shown on the Schedule of Benefits.The Insurer will pay for medical expenses incurred by the Insured within one year from the date of Injury or Sickness provided initial treatment was received during the Trip. The Injury must occur or Sickness must begin while the Insured is covered by the policy. Covered Expenses: The Insurer will pay the Insured's Reasonable and Customary Charges for medical and surgical expenses. The Insurer will pay emergency dental treatment only during a Trip. Dental coverage does not apply if treatment or expenses are incurred after the Insured has reached his/her Destination, in the case of a one-way ticket, or Return Destination regardless of the reason. Payment for dental expenses incurred is limited to a maximum of $500. The treatment must be given by a Physician or dentist. The Insurer will pay for professional nursing, Hospital charges, Xray, ambulance services, and prosthetic devices. Physical therapy will be covered up to 90 days after the Insured reaches his/her Return Destination. Make sure you call Travel Guard (1.877.248.8992 or 1.715.345.0505) before you seek medical care while traveling. Where available, we can arrange direct payment to a member of our Preferred medical network, saving you the time and paperwork associated with reimbursement of medical expenses. By calling us first, we can authorize a cash advance for medical providers that require upfront payments. Our assistance coordinators also can help you locate the nearest and most appropriate medical provider, monitor your care, and provide updates to your family and/or employer. EMERGENCY MEDICAL TRANSPORTATION BENEFITThe Insurer will pay this Primary (see definition) benefit, up to the Maximum Limit shown on the Schedule of Benefits. The Insurer will arrange for emergency medical transportation services required by the Insured as the result of an Injury or emergency Sickness during a Trip.Covered Expenses: The Insurer will arrange and pay:
Additional Exclusions: In addition to the General Exclusions, the Insurer will not pay for services arranged without our prior consent or approval. ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITThe Insurer will pay this benefit up to the Maximum Limit shown on the Schedule of Benefits if:
In no event will the Insurer pay more than the Maximum benefit shown on the Schedule of Benefits for all losses due to the same accident. If the Insured suffers more than one loss from an accident, the Insurer will pay only for the loss with the larger benefit. Loss of a hand or foot means complete severance at or above the wrist or ankle joint. The Insurer will not pay more than 100% of the principal sum for all losses due to the same accident. Loss of sight of an eye means complete and irrecoverable loss of sight. Additional Exclusion: In addition to the General Exclusions, the Insurer will not pay for loss caused by or resulting from Sickness or disease of any kind. FLIGHT GUARD - FLIGHT ACCIDENT BENEFITThe Insurer will pay for the Insured's covered accidental loss of life, hand, foot, or sight which occurred:
If the Insured suffers more than one loss from an accident, the Insurer will pay only for the loss with the larger benefit. Loss of a hand or foot means complete severance at or above the wrist or ankle joint. "Scheduled Air Carrier" means any air carrier holding a certificate, license, or similar authorization for civilian scheduled air transport issued by the country of the aircraftfs registry, and which in accordance with that authorization flies, maintains, and publishes schedules and tariffs for regular passenger service between named cities at regular and specified times, but only if the aircraft is then being used for any regular or chartered flight operated by such carrier. The Insurer will not pay more than 100% of the principal sum for all losses due to the same accident. Loss of sight of an eye means complete and irrecoverable loss of sight. CHANGE YOUR MIND COVERAGEThe Insurer will reimburse up to $250 for cancellation penalties of a scheduled Trip by the Insured prior to the Trip Departure Date shown on the Enrollment Form because of a change in the Insured's plans.Other than this payment, no benefits are payable for loss caused by the Insured changing his/her plans. The Change Your Mind Coverage benefit will not be paid in combination with any other benefit, and is only in effect if the insurance was purchased within fifteen days of "initial trip payment." COLLISION DAMAGE WAIVERThe Insurer will pay this benefit up to the Maximum Limit shown on the Schedule of Benefits. Coverage does not apply in countries or states where the sale of this insurance is prohibited by law.If the Insured rents a car from a licensed auto rental company while on his/her Trip, and the car is damaged due to collision, theft, vandalism, windstorm, fire, hail, flood, or any cause not within the Insuredds control while in his/her possession, or the car is stolen while rented by the Insured and not recovered, the Insurer will pay the lesser of:
In addition to the General Exclusions, coverage is not provided for loss due to:
PAYMENT OF CLAIMSClaim Procedures: Notice of Claim: The Insured must call Travel Guard as soon as reasonably possible, and be prepared with what coverage the loss was under (i.e., Medical Expenses), the name of the company that arranged the Trip (i.e., tour operator, cruise line, or charter operator), the Trip dates, and the amount that the Insured paid. Travel Guard will fill in the claim form and forward it to the Insured for his or her review and signature. The completed form should be returned to Travel Guard Group, Inc., 1145 Clark Street, Stevens Point, Wisconsin 54481 (telephone 1.715.345.0505 or 1.800.826.7791). All claims of California residents will be administered by Mercury Claims Administrator Services, LLC.Claim Procedures: Proof of Loss: The claim forms must be sent back to Insurer no more than 90 days after a covered loss occurs or ends, or as soon after that as is reasonably possible. All claims under the policy must be submitted to Travel Guard no later than one year after the date of loss or insured occurrence or as soon as reasonably possible. If Insurer has not provided claim forms within 15 days after the notice of claim, other proofs of loss should be sent to Insurer by the date claim forms would be due. This proof of loss should include written proof of the occurrence, type and amount of loss, the Insured's name, the participating organization name, and the policy number. Payment of Claims: To Whom Paid: Benefits paid on account of an Insured's death will be paid to the beneficiary he/she has chosen. The choice must be in writing and filed with the Insurer, or filed with the Insurer or Insurers administrator if Insurer has agreed in advance. If the Insured has not chosen a beneficiary, or if there is no beneficiary alive when he/she dies, Insurer will pay the benefit:
Payment of Claims: When Paid: Claims will be paid as soon as Insurer receives complete proof of loss (and verification of age). Payment of Claims: To Whom Paid: Benefits for Medical Expenses emergency medical transportation services may be payable directly to the provider of the services. However, the provider:
GENERAL PROVISIONSActs of Agents - No agent or any person or entity has authority to accept service of the required proof of loss or demand arbitration on the Insurers behalf nor to alter, modify, or waive any of the provisions of the policy.Autopsy - The Insurer at its own expense, may require an autopsy where permitted by law. Insurer's Recovery Rights - In the event of a payment under the policy, the Insurer is entitled to all rights of recovery that the Insured, or the person to whom payment was made, has against another. The Insured must sign and deliver to the Insurer any legal papers relating to that recovery, do whatever is necessary to help the Insurer exercise those rights, and do nothing after the loss to harm the Insurer's rights. When an Insured has been paid benefits under the policy but also recovers from another policy, the amount recovered from the other policy shall be held in trust for the Insurer by the Insured and reimbursed to the Insurer the extent of the Insurer's payment. The provision does not apply in North Carolina. Legal Actions - No one may sue for benefits less than 60 days after due proof of loss is submitted, nor more than 3 years (or the minimum period of time permitted by state law, if greater) after the date claim forms are due. Payment of Premium - Coverage is not effective unless all premium due has been paid to Travel Guard prior to a date of loss or insured occurrence. Termination of the Policy - Termination of the policy will not affect a claim for loss which occurs while the policy is in force. Transfer of Coverage - Coverage under the policy cannot be transferred by the Insured to anyone else without prior written consent. AIG - AIG CompaniesTRAVEL GUARD® ASSISTAll benefits provided are service benefits, not financial benefits. Any costs associated with benefits not purchased will be paid by the named Insured.24-Hour Medical Assistance 24-Hour Medical Monitoring: Physicians monitor the Insured's condition by maintaining close contact with the attending physicians, his/her family Physician, and Immediate Family Members. Medical Evacuation: Arrangements for any and all means necessary to transport the Insured back home when medically necessary. Emergency Medical Payments: If a Hospital demands a cash deposit or settlement prior to leaving, Travel Guard will assist in arranging the advancement of funds to cover on-site Medical Expenses. Prescription Assistance: Replacement of lost or stolen medication, through a local pharmacy or special courier. Transportation of Dependents: In the event of hospitalization, arrangements will be made for unattended minors traveling with the Insured to be flown home. Family Visit: If the Insured is hospitalized for ten or more days, Travel Guard will arrange transportation for an Immediate Family Member or close friend to visit him/her. Transportation of Mortal Remains: In the event of death while traveling, arrangements and payment for the return of remains to the place of burial. 24-Hour Legal Assistance In a legal emergency, referral to a local legal advisor and advance of funds for bail and legal fees. 24-Hour Travel Assistance Travel Documents Assistance: Travel Guard will help retrieve, report, and reissue lost or stolen travel documents. Emergency Cash Transfer: Travel Guard will, whenever possible, coordinate with the Insured and a wire agency, in obtaining funds in local currency for medical or travel emergencies. Emergency Message Center: Transmission of emergency messages to family and business associates. Interpretation Services: Travel Guard will provide emergency language support or referral to the appropriate local services. 24-HOUR LIVETRAVEL ASSISTANCEProvides 24-hour assistance for emergency travel needs. Allows you to make emergency travel changes such as rebooking flights, making hotel reservations, tracking lost luggage, and replacing lost credit cards. Call 1.800.826.8597 for assistance.Live Messaging- Relay of e-mail or phone message to family, friends, or business associates. Emergency Cash Transfer- Assistance in coordinating an emergency cash advance. Pre-trip Travel Advice- Around-the-clock access to
CONCIERGE SERVICESRestaurant Referrals and Reservations- Travel Guard will supply a restaurant referral based on your needs and desires. Additionally Travel Guard will arrange for reservations at the recommended restaurant. Based on availability.Ground Transportation- Travel Guard will locate and arrange for a transportation service to pick you up and deliver you to your desired destination. Event Ticketing- Travel Guard will assist with the purchase of tickets to such events as sporting events, theatre, and concerts. Based on availability. Tee Times and Course Recommendations- Travel Guard will facilitate the reservation of tee times at available courses and recommend alternatives in case of a booked course. Based on availability. Floral Services- Travel Guard will facilitate the ordering of flowers for such events as birthdays, anniversaries, holidays, and other special occasions. Non-insurance services through Travel Guard® Assist provided by Travel Guard®. Satisfaction Guaranteed - Travel Guard is committed to providing products and services that will exceed expectations. If You are not completely satisfied, You can receive a refund of the premium, minus the service fee. Requests must be submitted to Travel Guard in writing within 15 days of the effective date of the Policy, provided it is not past the original departure date. Concealment or Fraud - The Insurer does not provide coverage for the Insured if the Insured has intentionally concealed or misrepresented any material fact or circumstance relating to the policy or claim. Notice to California residents: The plan contains disability insurance benefits or health insurance benefits, or both, that only apply during your covered Trip. You may have coverage from other sources that already provides you with these benefits. You should review your existing policies. If you have any questions about your current coverage, call your insurer or health plan. Notice to Florida residents: The benefits of the policy providing the Insured's coverage is governed by the law of a state other than Florida. Notice to North Carolina residents: In North Carolina, insurance is underwritten by National Union Fire Insurance Company of Pittsburgh, PA, on Policy series 52735MO. Notice to Texas residents: The policy may provide a duplication of coverage already provided by the Insured's personal auto insurance, homeowneras, personal liability policy, or other source of coverage. |