COVID-19 Medical Expenses
Medical Payments Coverage
Trip Delays, Trip Interruption,
up to US$50,000
We take pride in being a partner with Trawick - which is recommended by Forbes as one of the BEST TRAVEL INSURANCE COMPANIES.
Trawick International Travel Insurance policies help you to travel with peace of mind no matter where in the world you are headed and leave you to focus on enjoying your trip.
For Claim Status:
|Medical maximum per policy period||$50,000|
|Deductible per policy period||$0|
|Co-insurance per policy period||100% up to Policy Maximum|
|COVERED TREATMENT OR SERVICE||MAXIMUM BENEFIT|
|Hospital room and board expenses||The average semi-private room rate|
|Covid-19 medical expenses||Covered and treated as any other Sickness|
|Ancillary hospital expenses||Covered|
|Icu room and board charges||3 times the average semi-private room rate|
|Physician’s non-surgical visits||Covered|
|Physician’s surgical expenses||Covered|
|Assistant physician’s surgical expenses||Covered|
|Outpatient medical expenses||Covered|
|Physiotherapy/physical medicine/ chiropractic expenses||Limited to $50 per visit, one visit per day and 10 visits per Policy Period|
|Dental treatment for injury, for pain to sound natural teeth||$500 per Policy Period|
|Emergency medical treatment of pregnancy||$2,500 per Policy Period|
|Mental or nervous disorder||$2,500 per Policy Period|
|Medical maximum per policy period||$50,000|
|Deductible per policy period||$0|
|Co-insurance per policy period||100% up to Policy Maximum|
|Medical maximum per policy period||$50,000|
|Deductible per policy period||$0|
|Co-insurance per policy period||100% up to Policy Maximum|
|Medical maximum per policy period||$50,000|
|Deductible per policy period||$0|
|Co-insurance per policy period||100% up to Policy Maximum|
* Not subject to Deductible
** This is a non-insurance service and is not a part of the insurance underwritten by Crum & Forster, SPC.
This Policy provides coverage for anyone while traveling outside their Home Country, providing coverage for you, your spouse/domestic partner/traveling companion and dependent children/grandchildren. Please note this policy IS NOT valid for travel from, in, or to the United States of America. We maintain Our right to investigate to verify that the eligibility requirements have been met. If and whenever We discover that the eligibility requirements have not been met, Our only obligation is refund of premium.
While the certificate is in effect, the Benefit Period does not apply. Upon termination of the certificate, in accordance with this provision, We will pay eligible medical expenses for up to 90 days beginning on the first day of diagnosis or treatment of a covered Sickness or Injury while a Covered Person is outside Their Home Country. The Benefit Period applies only to eligible medical expenses related to the eligible Sickness or Injury that began while the certificate was in effect. In the event you begin a benefit period while the certificate is in effect, and the certificate terminates because you return to your home country, we will continue to pay eligible medical expenses which are incurred in your home country during the benefit period until the exhaustion of the Benefit period or the Policy Medical Maximum, whichever comes first.
An eligible person will be insured on the latest of the following dates: 1. the Covered Person’s departure from Their Home Country; or 2. the date and time the Covered Person completed enrollment form and Their correct premium is received; or 3. the effective date requested and shown on the certificate.
The coverage provided with respect to the Named Insured shall terminate at 12:01 AM North American Central Time on the earliest of the following dates: 1. The date shown on the insurance confirmation card, for which the premium is paid; or 2. The date the Covered Person returns to Their Home Country; or 3. Three hundred and sixtyfour (364) days after the Covered Person's original effective date, unless extended.
An extension notice will be sent to the Covered Person before the Policy Period ends and includes links to extend prior to the termination date. The Covered Person is subject to the following rules at extension: If it is initially purchased for a minimum of 5 days. If available, additional periods are charged at the premium rate in force at the time of extension. 5 days premium is the minimum acceptable extension premium and 364 days premium is the maximum. There are no grace periods for extension. Once the policy has lapsed, reapplication is required. Please note, upon application for a new policy, the Pre-Existing Condition exclusion, deductible and co-insurance start over.
Full cancellation and refund will only be considered if We receive written request prior to the Effective Date of the coverage. If We receive a written request for cancellation and refund after the Effective Date of coverage, a partial cancellation and refund may be allowed. The following conditions apply: a) If any claims have been filed with Us, the premium is fully earned and is non-refundable. b) If no claims have been filed with the Company, then (i) a cancellation fee of US $25 will be charged; and (ii) only unused days premiums will be considered as refundable; and c) If after a refund is made, it is determined that a claim was presented to Us on a Covered Person’s behalf, the Covered Person will be fully responsible for that claim in its entirety.
We will pay Covered Accident and Sickness Medical Expenses up to the Maximum Benefit as outlined in the Schedule of Benefits and after each Insured satisfies any Deductible, without regard to any other Health Care Plan benefits payable for the Insured. We will pay these benefits without regard to any Coordination of Benefits provision in any other Health Care Plan.
All benefits payable are subject to the Maximum Benefit Limits, and any applicable sub-limits, listed in the Schedule of Benefits.
If a covered Sickness or Injury occurs during the Policy Period, and the Covered Person requires medical or surgical treatment, benefits are payable for the following covered expenses. The first charges must be incurred within 90 days after the date of the covered Sickness or Injury or the treatment must occur within 24 hours of the Unexpected Recurrence of a Pre-existing Condition.
No benefits will be paid for any expenses incurred which are in excess of usual and customary charges.
1. Hospital Room and Board Expenses: the average daily rate for a semi-private room when a Covered Person is Hospital Confined, and general nursing care is provided and charged for by the Hospital. In computing the number of days payable under this benefit, the date of admission will be counted but not the date of discharge. All charges in excess of the allowable semiprivate rate are the responsibility of the Covered Person.
2. Hospital Emergency Room Visits. Emergency Room Visit for an Illness with no direct Hospital Admittance will be subject to an additional deductible as outlined in the schedule of benefits.
3. Ancillary Hospital Expenses: Services and supplies as Medically Necessary and approved and covered by the Policy including meals and special diets (only for the Covered Person), use of operating room and related facilities, use of intensive care and related services to include x-ray (including reading charges) , laboratory and other diagnostic tests, drugs, medications, biological anesthesia and oxygen services, and administration of blood products. This does not include personal services of a non-medical nature. 4. Intensive Care Unit Expenses: Room and Board: 3 times the average semiprivate room rate when a Covered Person is Hospital Confined in a bed in the Intensive Care Unit and nursing services other than private duty nursing services.
5. Medical Emergency Care Expenses incurred within 24 hours of Unexpected Recurrence of a Pre-existing Condition. These expenses include the attending Physician’s charges, x-rays, laboratory procedures, use of the emergency room and supplies.
6. Physician non-surgical treatment and examination expenses including the Physician’s initial visit, each Medically Necessary follow-up visit and consultation visits when referred by the attending Physician.
7. Physician’s Surgical Expenses.
8. Assistant Physician Surgical Expenses when Medically Necessary.
9. Anesthesiologist expenses for pre-operative screening and administration of anesthesia during a surgical procedure on an outpatient basis.
10. Outpatient Medical expenses.
11. Physician Visits
12. Physiotherapy Physical Medicine/Chiropractic Expenses on an Inpatient or outpatient basis including treatment and office visits connected with such treatment when prescribed by a Physician, including diathermy, ultrasonic, whirlpool, heat treatments, adjustments, manipulation, or any form of physical therapy.
14. Emergency dental treatment and restoration of sound natural teeth, including x-rays, required as a result of an Accident or to relieve pain.
15. Ambulance Service Benefits are provided for medically necessary emergency ground ambulance transportation from the emergency site to the nearest Hospital able to provide the required level of care.
16. Prescription Drug Expenses including dressings, drugs and medicines prescribed by a Physician.
17. Emergency medical treatment of pregnancy.
18. Mental or nervous disorders.
19. Medically Necessary treatment for COVID-19, SARS-CoV-2, and any mutation or variation of SARS-CoV-2.
Unexpected Recurrence of a Pre-Existing Condition - Benefits are payable for Covered Expenses resulting from a sudden, Unexpected Recurrence of a Pre-Existing Condition while traveling outside the Covered Person’s Home Country. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or treatments existent or necessary prior to the Effective Date of coverage.
Ambulance Service Benefits are provided for medically necessary emergency ground or air ambulance transportation as required from the emergency site to the nearest Hospital able to provide the required level of care.
Benefits are payable if a Covered Person suffers a Sickness or Injury during the course of the Trip which requires Emergency Medical Evacuation from the place where the Covered Person suffers a Sickness or Injury to the nearest Hospital or other medical facility where appropriate medical treatment can be obtained; or transportation to the Covered Person’s Home Country to obtain further medical treatment in a Hospital or other medical facility or to recover after suffering a Sickness or Injury. An Emergency Medical Evacuation includes Medically Necessary medical treatment, medical services and medical supplies necessarily received in connection with such transportation. If after hospitalization or treatment for a covered Sickness or Injury, the Covered Person is unable to continue Their journey, Our designated Assistance Provider, in conjunction with the local attending Physician, will organize the Covered Person’s return to Their Home Country. If the gravity of the situation so dictates, Our designated Assistance Provider will ensure that appropriate medical care is provided to the Covered Person during the return journey. If Our designated Assistance Provider and the local attending medical practitioner consider the Covered Person stable enough to be medically repatriated, without endangering Their health, and They refuse repatriation, We will continue to pay medical expense benefits incurred after the date repatriation was recommended only up to the amount that would have been payable for the medical repatriation.
Benefits will not be payable unless We authorize in writing or by an authorized electronic or telephonic means all expenses in advance. Benefits will not be payable unless: 1. the Physician ordering the Emergency Medical Evacuation certifies the severity of the Covered Person’s Sickness or Injury requires an Emergency Medical Evacuation; 2. all transportation arrangements made for the Emergency Medical Evacuation are by the most direct and economical conveyance and route possible; 3. the charges incurred are Medically Necessary and do not exceed the usual level of charges for similar transportation, treatment, services or supplies in the locality where the expense is incurred ; and 4. do not include charges that would not have been made if there were no insurance.
Benefits are payable for the Covered Person’s extrication from the Host Country due to an Occurrence which could result in grave physical harm or death. The Occurrence must take place while coverage is in effect, and while the Covered Person is traveling outside of Their Home Country. Benefits will be paid for: 1. Transportation and Related Costs to the Nearest Place of Safety, necessary to ensure the Covered Person’s safety and well-being as determined by the Designated Security Consultant. 2. Transportation and Related Costs within 14 days of the Political Evacuation to either to the country in which the Covered Person is traveling while covered by the Policy; or the Covered Person’s Home Country; or 3. consulting services by a Designated Security Consultant for seeking information on a Missing Person or kidnapping cases, if the Covered Person is kidnapped or reported as a Missing Person to local or international authorities. Benefits will not be payable unless We (or Our authorized Assistance Provider) authorize in writing, or by an authorized electronic or telephonic means, all expenses in advance, and services are rendered by the Assistance Provider. The Assistance Provider is not responsible for the availability of transport services. Where a Political Evacuation becomes impractical due to hostile or dangerous conditions, a Designated Security Consultant will endeavor to maintain contact with the Covered Person until a Political Evacuation occurs. Political Evacuation Benefits are payable only once for any one Occurrence. If, after a Political Evacuation is completed, it becomes evident that the Covered Person was an active participant in the events that led to the Occurrence, We have the right to recover all Transportation and Related costs from the Covered Person. Benefits will be payable for evacuation during a period of civil unrest, insurrection or natural disasters that could not have been foreseen prior to the Covered Person’s departure from Their Home Country of origin.
Benefits are payable for the cost of one economy airfare ticket and other local travel related expenses including the reasonable expenses incurred for lodging and meals of a Covered Person’s Immediate Family Member for a period of up to 10 days, to join the Covered Person at the Hospital where the Covered Person is confined and to accompany the Covered Person back to their Home Country, if needed, provided: 1. the Emergency Medical Evacuation Benefit is payable under the Policy; 2. the Covered Person is alone outside of Their Home Country; 3 . the place of confinement is more than 100 miles from the Covered Person’s Home Country; and 4. expenses were authorized in advance by the Company.
If the Covered Person is the only person traveling with minor Dependent children who are under the age of 21, or with a Travel Companion, and the Covered Person suffers a Sickness or Injury and must be Hospital Confined for at least 48 consecutive hours, or are medically evacuated to another location, benefits are payable for the cost of the Dependent or Travel Companion’s one way economy airfare ticket and/or ground transportation ticket to Their Home Country. All transportation arrangements must be made by the most direct and economical route and conveyance possible and may not exceed the usual level of charges for similar transportation in the locality where the expense is incurred. Benefits will not be paid unless all expenses are approved in advance by Us, and services are rendered by the Assistance Provider.
Benefits are payable for preparation and return of a Covered Person’s body to Their Home Country if they die due to a Sickness or Injury. Covered Expenses include: Expenses for embalming or cremation; The least costly coffin or receptacle adequate for transporting the remains; Transporting the remains by the most direct and least costly conveyance and route possible. Expenses must be approved in advance and coordinated by the Assistance Provider. This benefit excludes fees for return of personal effects, religious or secular memorial services, clergymen, flowers, music, announcements, guest expenses and similar personal burial preferences.
Benefits are payable, if the Covered Person is confined to a Hospital provided; 1. The Hospital stay is the direct result, from no other causes, of Injuries sustained in a Covered Accident or Sickness that occurs while the Policy is in effect; and 2. The Hospital say begins within 3 days of a Covered Accident or Sickness and lasts for at least 3 days. The benefit will be paid retroactive to the first day of the Hospital stay. Benefit payments will end on the first of the following: 1. The date the Hospital Stay ends; 2. The date the Covered Person dies; 3. The 15th day of hospitalization; or 4. The date the coverage terminates.
We will pay the Benefit Amount for felonious assault, if Accidental Bodily Injury that results from felonious assault causes a Covered Person to suffer one of the losses shown below within 365 days from the felonious assault. The Benefit Amount for felonious assault is payable in addition to any other applicable Benefit Amounts under this policy. Any assault by a family member is not covered under this benefit.
Co-ordinated Benefit Plans, LLC on
Behalf of Crum and Forster
PO Box 2069
Fairhope AL 36533
For claim status or questions please call
Toll Free: 866-696-0409
Email [email protected]
We will not pay for any Accidental Death and Dismemberment or Paralysis loss or Injury that is caused by or that results from:
1. intentionally self-inflicted Injury.
2. suicide or attempted suicide.
3. war or any act of war, whether declared or not (except as provided by the Policy).
4. service in the military, naval or air service of any country.
5. disease or bacterial infection except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food.
6. hernia of any kind.
7. piloting or serving as a crewmember or riding in any aircraft except as a passenger on a regularly scheduled or charter airline.
8. commission of, or attempt to commit, a felony.
9. Injury or Sickness that occurs while the Covered Person has been determined to be legally intoxicated as determined according to the laws of the jurisdiction in which the Injury or Sickness occurred, or under the influence of any narcotic, barbiturate, or hallucinatory drug, unless administered by a Doctor and taken in accordance with the prescribed dosage.
10. flying in any aircraft being used for or in connection with acrobatic or stunt flying, racing or endurance tests; flying in any rocket propelled aircraft; flying in any aircraft being used for or in connection with crop dusting, or seeding or spraying, firefighting, exploration, pipe or power line inspection, any form of hunting bird or fowl herding, aerial photography, banner towing or any test or experimental purpose; flying any aircraft which is engaged in flight which requires a special permit or waiver from the authority having jurisdiction over civil aviation, even if granted.
11. specific named hazards: Abseiling, Aviation (except when traveling as a passenger in a commercial aircraft), BASE Jumping, Bobsleigh, BMX, Bungee Jumping, Canopying, Canyoning, Caving, Extreme sports, High Diving,
Hang Gliding, Heli-skiing, Hot Air Ballooning, Inline Skating, Jet Skiing, Kayaking, Luge, Motocross,
Motorcycling, MotoX, Mountaineering, Mountain biking, Mountain Climbing, Paragliding, Parasailing,
Parascending, Piloting any Aircraft, Racing of any kind, Rock Climbing, Rodeo Activities, Rappelling, Scuba Diving, Ski Jumping, Skydiving, Snow Skiing, Snowboarding, Snowmobiling, Spelunking, Surfing, Trekking, Water Skiing, Wind Surfing, White Water Rafting, Zip Lining, Zorbing.
12. All professional, semi-professional, amateur, club, intramural, interscholastic or intercollegiate sports.
In addition to the Exclusions above, We will not pay Medical Expense Benefits for any loss, treatment or services that results from or contributed to by:
1. Pre-Existing Conditions, as defined.
2. declared or undeclared war or any act thereof.
3. services, supplies or treatment, including any period of Hospital confinement, which were not recommended, approved and certified as necessary and reasonable by a Physician.
4. suicide or any attempt thereat while sane or self-destruction or any attempt thereat while insane.
5. Injury sustained while participating in a professional, semi-professional, amateur, club, intramural, interscholastic or intercollegiate sport (except as provided by the Athletic Sport Rider).
6. Sickness resulting from pregnancy (except as provided by Emergency Medical Treatment of Pregnancy).
7. Miscarriage resulting from Accident (except as provided by Emergency Medical Treatment of Pregnancy).
8. Immunizations, routine physical or other examinations where there are no objective indications or impairment in normal health, or laboratory diagnostic or x-ray examinations except in the course of a disability established by the prior call or attendance of a Physician, except as specifically provided for in this policy.
9. cosmetic or plastic surgery, except as the result of an accident.
10. elective surgery which can be postponed until the Covered Person returns to his or her Home Country.
11. any mental or nervous disorders or rest cures (except as provided in the Schedule by Mental or Nervous Disorders Charges).
12. any dental treatment (except as provided by the for Dental Treatment for Injury and Emergency alleviation of pain).
13. eye refractions or eye examinations for the purpose of prescribing corrective lenses for eye glasses or for the fitting thereof, unless caused by accidental bodily Injury incurred while covered under the Policy.
14. congenital anomalies and conditions arising out of or resulting therefrom.
15. services, supplies, or treatment expenses which are non-medical in nature.
16. the ordinary cost of a one-way airplane ticket used in the transportation back to the Covered Person’s country where an air ambulance benefit is provided.
17. expenses as a result of or in connection with an intentionally self-inflicted Injury.
18. Specific named hazards: Abseiling, Aviation (except when traveling as a passenger in a commercial aircraft), BASE Jumping, Bobsleigh, BMX, Bungee Jumping, Canopying, Canyoning, Caving, Extreme Sports,
High Diving, Hang Gliding, Heli-skiing, Hot Air Ballooning, Inline Skating, Jet Skiing, Kayaking, Luge,
Motocross, Motorcycling, MotoX, Mountaineering, Mountain Biking, Mountain Climbing, Paragliding,
Parasailing, Parascending, Piloting any Aircraft, Racing of any kind, Rock Climbing, Rodeo Activities, Rappelling, Scuba Diving, Ski Jumping, Skydiving, Snow Skiing, Snowboarding, Snowmobiling, Spelunking, Surfing, Trekking, Water Skiing, Wind Surfing, White Water Rafting, Zip Lining, Zorbing.
19. treatment paid for or furnished under any other individual or group policy, or other service or medical prepayment plan arranged through an employer to the extent so furnished or paid, or under any mandatory government program or facility set up for treatment without cost to any individual.
20. childbirth, miscarriage, birth control, artificial insemination, treatment for fertility or impotency, sterilization or reversal thereof or abortion.
21. organ transplants, marrow procedures and chemotherapy.
22. any sexually transmitted or venereal disease; and/or any testing for the following: HIV, Vaccine induced seropositivity to the AIDS virus, AIDS related Illnesses, ARC Syndrome, AIDS.
23. any treatment, service or supply not specifically covered by the Policy.
24. treatment by any Family Member or member of the Covered Person’s household.
25. treatment of hernia, Osgood-Schlatter’s Disease, osteochondritis, osteomyelitis, congenital weakness whether or not caused by a Covered Accident.
26. expense incurred for treatment of temporomandibular or cranio-mandibular joint dysfunction and associated myofascial pain.
27. any elective treatment, surgery, health treatment, or examination including any service, treatment or supplies that: (a) are deemed by Us to be experimental; and (b) are not recognized and generally accepted medical practices in the United States.
28. contact lenses, hearing aids, wheelchairs, braces, appliances, examinations or prescriptions for them, or repair or replacement of existing artificial limbs, orthopedic braces, orthotic devices, artificial eyes and larynx.
29. treatment or service provided by a private duty nurse or while confined primarily to receive custodial care, educational or rehabilitative care or nursing care.
30. covered medical expenses for which the Covered Person would not be responsible for in the absence of the Policy.
31. conditions that are not caused by a Covered Accident.
32. vocational, recreational, speech or music therapy.
33. traveling against the advice of a Physician, traveling while on a waiting list for inpatient Hospital or clinic treatment, or traveling for the purpose of obtaining medical treatment abroad.
34. any potentially fatal condition which was diagnosed before the date your coverage became effective or any condition for which You are traveling to seek treatment.
35. Expenses incurred in your Home Country or in the USA.
36. Payment for any medical services related to an illness when an Insured Person leaves a medical facility against medical advice.
37. Voluntary tests, including COVID-19 viral and/or antibody tests for healthy individuals.
We will not pay Natural Disasters or Political Evacuation benefits for expenses and fees:
1. payable under any other provision of the Policy.
2. that are recoverable through the Covered Person’s employer.
3. arising from or attributable to an actual fraudulent, dishonest or criminal act committed or attempted by the Covered Person, acting alone or in collusion with other persons.
4. arising from or attributable to an alleged:
a. violation of the laws of country in which the Covered Person is traveling while covered under the Policy; or
b. violation of the laws of the Covered Person’s Home County.
5. due to the Covered Person’s failure to maintain and possess duly authorized and issued required travel documents and visas.
6. for repatriation of remains expenses.
7. for common or endemic or epidemic diseases or global pandemic disease as defined by the World Health Organization.
8. for medical services.
9. for monies payable in the form of a ransom, if a Missing Person case evolves into a kidnapping.
10. arising from or attributable, in whole or in part, to: a. a debt, insolvency, commercial failure, the repossession of any property by any title holder or lien holder or any other financial cause; b. noncompliance by the Covered Person with regard to any obligation specified in a contract or license.
11. due to military or political issues if the Covered Person’s Security Evacuation request is made more than 30 days after the Appropriate Authority(ies) Advisory was issued.
Please note, certain words used in this document have specific meanings. These terms will be capitalized throughout the document.
“Accident” means a sudden, unexpected and unintended event.
“Appropriate Authority(ies)” means the government authority(ies) in the Covered Person’s Home Country or the government authority(ies) of the Host Country.
“Assistance Provider” shall mean On Call Assistance.
"Automobile" means a self-propelled, private passenger motor vehicle with four or more wheels that is a type both designed and required to be licensed for use on the highway of any state or country. Automobile includes, but is not limited to, a sedan, station wagon, sport utility vehicle, or a motor vehicle of the pickup, van, camper, or motorhome type. Automobile does not include a mobile home or any motor vehicle that is used in mass or public transit.
“Benefit Period” shall mean the 90 days following the onset of a Covered Accident, Injury or Sickness in which to receive Medically Necessary Covered Expenses. If the Covered Person’s Policy terminates during Their Benefit Period, They will still be eligible to receive Treatment so long as the Treatment is within Their Benefit Period and They are outside Their Home Country. Payment for Treatment will continue until the exhaustion of the Benefit Period or the Policy Medical Maximum or the return to Their Home Country, whichever comes first.
“Company” means Crum & Forster SPC
“Covered Accident” means an Accident that occurs while coverage is in force for a Covered Person and results in a loss or Injury covered by the Policy for which benefits are payable.
“Covered Expenses” means expenses actually incurred by or on behalf of a Covered Person for treatment, services and supplies covered by the Policy. Coverage under the Policy must remain continuously in force from the date of the Accident or Sickness until the date treatment, services or supplies are received for them to be a Covered Expense.
A Covered Expense is deemed to be incurred on the date such treatment, service or supply, that gave rise to the expense or the charge, was rendered or obtained.
“Covered Loss” or “Covered Losses” means an accidental death, dismemberment or other Injury covered under the Policy.
“Covered Person” means any Insured and Dependent for whom the required premium is paid (herein also referred to as “ You” or “Your” or “They” or “Their”).
"Deductible" means the dollar amount of Covered Expenses that must be incurred as an out of-pocket expense by each Covered Person on a per incidence basis. The deductible must be met, by the Covered Person before Medical Expense Benefits can be paid or reimbursed. The deductible is applied to the first eligible claim processed.
“Dependent” means an Insured’s lawful spouse or domestic partner; or an Insured’s unmarried child, from the moment of birth to age 21, who is chiefly dependent on the Insured for support. A child, for eligibility purposes, includes an Insured’s natural child; adopted child, beginning with any waiting period pending finalization of the child’s adoption; or a stepchild who resides with the Insured or depends chiefly on the Insured for financial support. A Dependent may also include any person related to the Insured by blood or marriage and for whom the Insured is allowed a deduction under the Internal Revenue Code. Insurance will continue for any Dependent child who reaches the age limit and continues to meet the following conditions: 1. the child is handicapped, 2. is not capable of selfsupport and 3. depends chiefly on the Insured for support and maintenance. The Insured must send Us satisfactory proof that the child meets these conditions, when requested. We will not ask for proof more than once a year.
“Designated Security Consultant” means an employee of a security firm under contract with Us or our Assistance Provider who is experienced in security and measures necessary to ensure the safety of the Covered Person(s) in his or her care.
“Economy Fare” means the lowest published rate for a one-way economy ticket.
“Evacuation Advisory” means a formal recommendation issued by the Appropriate Authorities that the Covered Person or citizens of his or her Home Country or Country of Residence or citizens of the Host Country leave the Host Country.
“Hazard” means: a) Any delay of a Common Carrier (including Inclement Weather); b) Any delay by a traffic Accident en route to a departure, in which You or Your Traveling Companion is not directly involved; c) Any delay due to lost or stolen passports, travel documents or money, Quarantine, hijacking, unannounced Strike, Natural Disaster, civil commotion or riot; d) A closed roadway causing cessation of travel to the destination of the Trip (substantiated by the department of transportation, state police, etc.).
“Health Care Plan” means a policy or other benefit or service arrangement for medical or dental care or treatment under: 1. group or blanket coverage, whether on an insured or self-funded basis; 2. Hospital or medical service organizations on a group basis; 3. Health Maintenance Organizations on a group basis; 4. group labor-management plans; 5. employee benefit organization plans; 6. association plans on a group or franchise basis; or 7. any other group employee welfare benefit plan as defined in the employee Retirement income Security Act of 1974, as amended.
"Home Country" means the country which the Covered person has declared to US in writing as his or her true, fixed and permanent home and principal establishment.
“Hospital” means an institution that: 1. operates as a Hospital pursuant to law for the care, treatment, and providing of in-patient services for sick or injured persons; 2. provides 24-hour nursing service by Registered Nurses on duty or call; 3. has a staff of one or more licensed physicians available at all times; 4. provides organized facilities for diagnosis, treatment and surgery, either: (i) on its premises; or (ii) in facilities available to it, on a prearranged basis; 5. is not primarily a nursing care facility, rest home, convalescent home, or similar establishment, or any separate ward, wing or section of a Hospital used as such; and 6. is not a place solely for drug addicts, alcoholics, or the aged or any separate ward of the Hospital.
“Hospital Confined” means an overnight stay as a registered resident bed-patient in a Hospital.
“Host Country” means any country, other than an OFAC excluded country, in which the Covered Person is traveling while covered under the Policy.
“Immediate Family Member” means the spouse, parent, parent-in law, grandparent, child, grandchild, brother, sister, fiancé, aunt, uncle, niece or nephew, such person being related to the Covered Person.
"Injury" means accidental bodily harm sustained by a Covered Person that results, directly and independently from all other causes, from a Covered Accident. All injuries sustained by one person in any one Accident, including all related conditions and recurrent symptoms of these injuries, are considered a single Injury.
“Medical Emergency” means a condition caused by an Injury or Sickness that manifests itself by symptoms of sufficient severity that a prudent layperson possessing an average knowledge of health and medicine would reasonably expect that failure to receive immediate medical attention would place the health of the person in serious jeopardy.
“Medically Necessary” means a treatment, service or supply that is: 1. required to treat an Injury or Sickness; prescribed or ordered by a Physician or furnished by a Hospital; 2. performed in the least costly setting required by the Covered Person’s condition; and 3. consistent with the medical and surgical practices prevailing in the area for treatment of the condition at the time rendered. Purchasing or renting 1. air conditioners; 2. air purifiers; 3. motorized transportation equipment; 4. escalators or elevators in private homes; 5. eye glass frames or lenses; 6. hearing aids; 7. swimming pools or supplies for them; and 8. general exercise equipment are not considered Medically Necessary. A service or supply may not be Medically Necessary if a less intensive or more appropriate diagnostic or treatment alternative could have been used. We may, at Our discretion, consider the cost of the alternative to be the Covered Expense.
“Missing Bag Report” means a formal report of loss as filed with the common carrier commonly known as a PIR (Passenger Irregularity Report) or PAWOB (Passenger arriving without baggage). This must include the 6-digit Claim Number or the World Tracer Record Number as provided by the carrier.
“Missing Person” means a Covered Person who disappeared for an unknown reason and whose disappearance was reported to the Appropriate Authority(ies).
“Natural Disaster” means storm (wind, rain, snow, sleet, hail, lightning, dust or sand) earthquake, flood, volcanic eruption, wildfire or other similar event that: 1. is due to natural causes; and 2. results in such severe and widespread damage that the area of damage is officially declared a disaster area by the government in which the Covered Person’s Trip occurs and the area is deemed to be uninhabitable or dangerous.
“Nearest Place of Safety” means a location determined by the Designated Security Consultant where: 1. the Covered Person can be presumed safe from the Occurrence that precipitated the Covered Person’s Political Evacuation; and the Covered Person has access to Transportation; and 2. the Covered Person has the availability of temporary lodging, if needed.
“Necessities” means personal hygiene items and clothing.
“Occurrence” means any of the following situations involving a Covered Person: 1. expulsion from a Host Country or being declared persona non-grata on the written authority of the recognized government of a Host Country; 2. political or military events involving a Host Country, if the Appropriate Authorities issue an Advisory stating that citizens of the Covered Person’s Home Country or citizens of the Host Country should leave the Host Country; 3. deliberate physical harm of the Covered Person confirmed by documentation or physical evidence or a threat against the Covered Person’s health and safety as confirmed by documentation and/or physical evidence; 4. Natural Disaster in the area the Covered Person is traveling to and occurring after Their effective date; 5. the Covered Person had been deemed kidnapped or a Missing Person by local or international authorities and, when found, his or her safety and/or well-being are in question within seven days of his or her being found.
“Policy Period” means the dates as shown on the Covered Person’s certificate for which premium has been paid.
“Political Evacuation” means the extrication of a Covered Person from the Host Country due to an Occurrence which could result in grave physical harm or death to the Covered Person and is certified by a governing authority via declaration or warning.
“Pre-Existing Condition” means Any Injury, illness, Sickness, disease, or other physical, medical, mental or nervous disorder, condition or ailment that, with reasonable medical certainty, existed at the time of Application or at any time during the 36 months prior to the Effective Date of this insurance, whether or not previously manifested, symptomatic or known, diagnosed, Treated, or disclosed to the Company prior to the Effective Date, and including any and all subsequent, chronic or recurring complications or consequences related thereto or resulting or arising therefrom. This specifically includes but is not limited to any medical condition, Sickness, Injury, illness, disease, mental illness or mental nervous disorder, for which medical advice, diagnosis, care or Treatment was recommended or received or for which a reasonably prudent person would have sought Treatment during the 36 month period immediately preceding the Effective Date of Coverage under this Certificate. A Pre-Existing Condition which is a chronic or congenital condition or that gradually becomes worse over time and/or known, scheduled, required, or expected medical care, drugs or Treatments existing or necessary prior to the Effective Date are not considered to be an Acute Onset.
“Quarantine” means Your strict isolation imposed by a Government authority or Physician to prevent the spread of disease. An embargo preventing You from entering a country is not a Quarantine.
“Reasonable Expenses” means any meal, lodging, local transportation and essential phone call expense that were necessarily incurred as the result of a covered event, and that were not provided free of charge or otherwise reimbursed by a Common Carrier, Travel Supplier or other party.
“Related Costs” means food, lodging and, if necessary, physical protection for the Covered Person during the Transport to the Nearest Place of Safety.
“Sickness” means an illness, disease or condition of the Covered Person that causes a loss for which a Covered Person incurs medical expenses while covered under the Policy. All related conditions and recurrent symptoms of the same or similar condition will be considered one Sickness.
"Supplemental Restraint System" means an airbag that inflates upon impact for added protection to the head and chest areas.
“Transport” or “Transportation” means the most efficient and available method of conveyance. Where practical, economy fare will be utilized. If possible, the Covered Person’s common carrier tickets will be used.
“Traveling Companion” means a person or persons with whom the Covered Person has coordinated travel arrangements, shares the same accommodations as the Covered Person, and intends to travel with the Covered Person during the Trip.
“Trip” means travel by air, land, or sea from the Covered Person’s Home Country.
“Unexpected Recurrence of a Pre-Existing Condition” means a sudden and unexpected outbreak or recurrence of a Pre- Existing Condition which occurs 1) spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent and immediate medical care; 2) is a minimum of 48 hours after the Effective Date of the policy; and 3) prior to the age shown in the Schedule of Benefits/Limits with treatment being obtained within 24 hours of the sudden and unexpected outbreak or recurrence. A Pre-Existing Condition that is a congenital condition or that gradually becomes worse over time will not be considered an Unexpected Recurrence.
“Usual and Customary Charge” means the average amount charged by most providers for treatment, service or supplies in the geographic area where the treatment, service or supply is provided.
“We”, “Our”, “Us” means The Company, or Crum & Forster SPC
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