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Travel Guard® EssentialTRAVEL INSURANCE & LIVETRAVEL 24-HOUR ASSISTANCEPRE-EXISTING MEDICAL CONDITION EXCLUSION:The 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 180 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 180-day period. A Sickness has manifested itself when medical care, treatment, or diagnosis has been given.24-Hour Emergency Assistance Telephone Numbers Continental USA......1.800.826.1300 International.......1.715.345.0505 LiveTravel 24-Hour Assistance.......1.800.826.8597 Be sure to use the appropriate country and city codes when calling. - KEEP THESE NUMBERS WITH YOU WHEN YOU TRAVEL This 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. 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 Coverage Underwritten by the American Home Assurance Company, a member of the AIG Companies, 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.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. 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. "Contracted Departure Date" means the date on which the Insured is originally scheduled to leave on his/her Trip. "Contracted Return Date" means the date on which the Insured is scheduled to return to the point where the Trip started, or to a different specified Return Destination. "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:
"Experimental or Investigative" means treatment, a device or prescription medication which is recommended by a Physician, but is not considered by the medical community as a whole to be safe and effective for the condition for which the treatment, device or prescription medication is being used, including any treatment, procedure, facility, equipment, drugs, drug usage, devices, or supplies not recognized as accepted medical practice, and any of those items requiring federal or other governmental agency approval not received at the time services are rendered. "Exotic Vehicle" means
"Financial Default" means either
"Injury" means a bodily injury caused by an accident occurring while this 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. "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 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. "Reasonable and Customary Charges" means an expense which:
"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. 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 will be effective:
GENERAL EXCLUSIONSThese 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 AND INTERRUPTIONThe Insurer will pay this benefit up to the Maximum Limit shown on the Schedule of Benefits. If a Trip is canceled or interrupted for the Insured due to any of the following unforeseen circumstances:
The Insurer will reimburse for the following:
The Insurer will reimburse for the following:
The Insured Must: Contact LiveTravel (1.800.826.8597) as soon as he/she knows the Trip is going to be cancelled or interrupted. Failure to do so may affect coverage. In addition to the General Exclusions, coverage is not provided for losses caused by or as a result of:
TRAVEL DELAYThe Insurer will reimburse up to $100 a day to the Maximum Limit shown on the Schedule of Benefits if the Insured's Trip is delayed for more than 12 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:
The Insured Must: Contact LiveTravel (1.800.826.8597) as soon as he/she knows his/her Trip is going to be delayed more than 12 hours. Failure to do so may affect coverage. LOSS OF BAGGAGE AND PERSONAL EFFECTSThe Insurer will reimburse this benefit, up to the Maximum Limit shown on the Schedule of Benefits minus a $50 deductible. The Insurer will pay for loss, theft, or damage to the Insured's Baggage, passports, and visas during the Insured's Trip. There is a maximum of $4,000 per traveling group. 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:
Additional Exclusions: In addition to the General Exclusions, the Insurer will not pay this loss due to:
Benefits for Baggage and Personal Effects will be the excess of any amount paid or payable by a Common Carrier or other third party responsible for the loss. BAGGAGE DELAYThe Insurer will reimburse up to the Maximum Limit shown on the Schedule of Benefits for the cost of necessary personal effects purchased by the Insured during the Trip, if the Insured's Baggage is delayed or misdirected for more than 24 hours. Incurred expenses must be accompanied by receipts. This benefit does not apply if Baggage is delayed after the Insured reaches his/her Return Destination. The Insurer will also pay the reasonable cost to return the Insured's Baggage to his/her home, up to his/her limit of coverage.Payment of Loss: The Insured must provide documentation of the delay or misdirection of Baggage by the Common Carrier and receipts for the necessary personal effects purchased. MEDICAL EXPENSE BENEFITThe Insurer will pay this benefit, up to the Maximum Limit shown on the Schedule of Benefits minus a $50 deductible. The Insurer will pay for Reasonable and Customary Charges for medical and surgical 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 emergency dental treatment only during a Trip. Payment for dental expenses are limited to $500. Dental coverage does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination or Destination (in the case of a one-way ticket) regardless of the reason. The treatment must be given by a Physician or dentist. The Insurer will pay for professional nursing, Hospital charges, X-ray, and ambulance services and prosthetic devices. Physical therapy will be covered up to 90 days after the Insured reaches his/her Return Destination or Destination (in the case of a one-way ticket). Benefits payable will not exceed Reasonable and Customary Charges for similar services in the geographic area in which the services were rendered. If the Insured is covered by any other group, blanket health, accident insurance, or assistance plan, and would, as a result, receive total benefits in excess of the expenses actually incurred, the benefits the Insurer will pay will be reduced by such excess. The Insurer also will not pay for amounts paid or awarded under any workers' compensation, disability benefit, or similar law. Additional Exclusions: In addition to the General Exclusions, coverage is not provided for:
EMERGENCY MEDICAL TRANSPORTATIONThe Insurer will pay this benefit up to the Maximum Limit shown on the Schedule of Benefits. Mercury International will arrange for emergency medical transportation services required by the Insured as the result of any Injury or emergency Sickness during a Trip.Covered Expenses: Mercury International will arrange and pay:
Additional Benefit: In addition to the above covered expenses, if the Insurer has previously evacuated an Insured to a medical facility, the Insurer will pay his/her airfare costs from that facility to the Insured's Return Destination, within one year from the Insured's original Contracted Return Date, less refunds from the Insured's unused transportation tickets. Airfare costs will be economy, or first class if the Insured's original tickets are first class. This benefit is available only if it is not provided under another coverage in the policy. The Insured Must: Contact TRAVEL GUARD® (1.800.826.1300 or collect 1.715.345.0505) prior to arranging emergency medical transportation. Failure to do so may affect coverage. 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. Loss of sight of an eye means complete and irrecoverable loss of sight. "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 aircraft's 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. RENTER'S COLLISION INSURANCEThe Insurer will pay this benefit up to the Maximum Limit shown on the Schedule of Benefits subject to a $250 deductible. Coverage does not apply in countries or states where the sale of this insurance is prohibited by law. If the Insured rents a car while on his/her Trip, and the car is damaged due to collision, vandalism, windstorm, fire, hail or flood, while in his/her possession, 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 1.800.826.1300). All claims of California residents will be administered by Mercury Claims Administrator Services, LLC. All accident, health, and life claims will be administered by Mercury Claims & Assistance of WI, LLC, in those states where it is licensed.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. The 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:
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 Expense/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 Insurer's 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. 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. 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. This 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. 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 your coverage are governed primarily by the law of a state other than Florida. Notice: Your homeowners policy, if any, may provide coverage for loss of personal effects provided by any Baggage/Personal Effects coverage provided by this policy. This insurance is not required in connection with the Insured's purchase of travel tickets. The definition of "Hospital" applicable to residents of Florida is as follows: Hospital means a facility that:
Exclusion (j) does not apply to residents of 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, homeowner's, personal liability policy, or other source of coverage. TRAVEL 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 ASSISTANCE Provides 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 passport, visa, inoculation, and vaccine requirements; travel advisories; embassy and consulate contacts; travel health advisories; weather and currency information - all for the Insured's planned Destination. Non-insurance services through Travel Guard® Assist are 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. 107838-CT 12/05 TRAVEL GUARD® International 12/05 |