Travel Protection "Plus" Plan
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||
PART A - Travel Arrangement Protection Benefits
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
SCHEDULE OF COVERAGES - PART A |
MAXIMUM BENEFIT AMOUNT |
| Trip Cancellation / Interruption | Up To Trip Cost |
| Delayed Arrival | Included |
| Occupancy Upgrade | Included |
| Trip Delay (Up To $100 Per Day) |
$500 |
Summary Of Coverages-Part A
TRIP CANCELLATION / INTERRUPTION
We will pay this benefit up to the amount on the Schedule of Coverages if a Trip is canceled, interrupted, or delayed due to:
(1) Sickness, Injury, or Covered Death of you, an Immediate Family Member, Traveling Companion, or Business Partner; or (2) Other Covered Events as defined in this plan.
Injury or Sickness must: 1) for Pre-Departure Trip Cancellation, commence while this plan is in force for you, or for Post-Departure Trip Interruption or Delay, commence while on your Trip; 2) in the written opinion of the treating Physician, be so disabling as to cause a Trip to be canceled, interrupted or delayed; and, 3) require the care and attendance of a Physician at the time of occurrence.
Please refer to the Plan Definitions for an explanation of Pre-Existing Conditions which are excluded under the Trip Cancellation/ Interruption coverage.
BENEFITS: Pre-Departure Cancellation
We will reimburse you for the amount of forfeited, non-refundable payments or deposits for your Trip if your Trip is canceled, or we will pay additional cost as a result of a change in the per person occupancy rate for prepaid travel arrangements if a Traveling Companion's Trip is canceled and your Trip is not canceled.
BENEFITS: Post-Departure Interruption
We will reimburse you, less any refund paid or payable, for unused land or water travel arrangements, plus one of the following:
(1) the additional transportation expenses incurred by you if your Trip is interrupted, either:
(a) to the return destination; or
(b) from the place that you left the Trip to the place that you may rejoin the Trip;
(2) the additional transportation expenses incurred by you to reach the original trip destination if you are delayed and leave after the Scheduled Departure Date;
However, the benefit payable under (1) and (2) above will not exceed the cost of economy airfare (or first class, if your original tickets were first class) by the most direct route less any refunds paid or payable for your unused original tickets.
(3) your additional cost as a result of a change in the per person occupancy rate for prepaid travel arrangements if a Traveling Companion's Trip is canceled or interrupted, and your Trip is continued.
We will pay for reasonable accommodation and traveling expenses until travel becomes possible up to the maximum shown in the Schedule of Coverages if your Trip is delayed for more than 12 hours.
Trip Delay must be caused by:
(a) Common Carrier delay; or
(b) lost or stolen passports, travel documents, or money; or
(c) quarantine; or
(d) natural disaster; or
(e) Injury or Sickness of you, an Immediate Family Member traveling with you, or a Traveling Companion; or
(f) Covered Death of an Immediate Family Member traveling with you or a Traveling Companion.
PART B - Travel Insurance Benefits Of This Part B Are Provided By The Insurance Company(ies) Listed Below
|
SCHEDULE OF COVERAGES - PART B |
MAXIMUM BENEFIT AMOUNT |
| Accidental Death and Dismemberment (Air Only) | $25,000 |
| Medical Expense / Emergency Assistance | $25,000 |
| Accident Medical Expense | Included |
| Sickness Medical Expense | Included |
| Emergency Dental Expense | Included |
| Emergency Medical Evacuation | Included |
| Repatriation | Included |
| Baggage / Travel Documents |
$1,000 |
| Baggage Delay |
$100 |
Summary Of Coverages-Part B
ACCIDENTAL DEATH & DISMEMBERMENT
We will pay this benefit up to the amount on the Schedule of Coverages if you are injured in an accident which occurs while you are on a Trip and covered under the plan, and you suffer one of the losses listed below within 365 days of the accident. The Principal Sum is the benefit amount shown on the Schedule of Coverages.
| LOSS |
PERCENTAGE OF PRINCIPAL SUM PAYABLE |
| Life | 100% |
| Both hands or feet, or sight of both eyes | 100% |
| One hand and one foot | 100% |
| One hand or one foot and sight of one eye | 100% |
| One hand | 50% |
| One foot | 50% |
| Sight of one eye | 50% |
If you suffer more than one loss from an accident, we 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.
With respect to "Air Flight" benefits, this insurance applies only if you are injured in an accident which happens while a passenger in or on, boarding or alighting from, an aircraft of a regularly scheduled airline or air charter company that is licensed to carry passengers for hire.
MEDICAL EXPENSE / EMERGENCY ASSISTANCE
We will pay this benefit, up to the amount on the Schedule of Coverages, for the following Covered Expenses incurred by you subject to the following:
(1) Covered Expenses will only be payable at the Usual and Customary level of payment;
(2) benefits will be payable only for Covered Expenses resulting from a Sickness that first manifests itself or an Injury that occurs while on a Trip;
(3) benefits payable as a result of incurred Covered Expenses will only be paid after benefits have been paid under any Other Valid and Collectible Group Insurance in force for you. We will pay that portion of Covered Expenses which exceed the amount of benefits payable for such expenses under your Other Valid and Collectible Group Insurance.
Covered Expenses:
(1) expenses for the following Physician-ordered medical services: services of legally qualified Physicians and graduate nurses, charges for Hospital confinement and services, local ambulance services, prescription drugs and medicines, and therapeutic services and supplies, incurred by you within one year from the date of your Sickness or Injury;
(2) expenses for emergency dental treatment incurred by you during a Trip;
(3) expenses incurred for Physician-ordered emergency medical evacuation, including medically appropriate transportation and necessary medical care en route, to the nearest suitable Hospital, when you are critically ill or injured and no suitable local care is available, subject to the prior approval of the Program Medical Advisors;
(4) expenses incurred for medical evacuation, including medically appropriate transportation and medical care en route to a Hospital or to your place of residence in the United States of America, when deemed medically necessary by the attending Physician, subject to the prior approval of the Program Medical Advisors;
(5) expenses for transportation, not to exceed the cost of one round-trip economy class air fare, to the place of hospitalization for one person chosen by you, provided you are traveling alone and are hospitalized for more than 7 days;
(6) expenses for transportation, not to exceed the cost of one-way economy class air fare to your place of residence in the United States of America, including escort expenses, when an Insured who is 18 years of age or younger is left unattended due to the death or hospitalization of an accompanying adult(s), subject to the prior approval of the Program Medical Advisors;
(7) expenses for one-way economy class air fare (or first class, if your original tickets were first class) to your place of residence in the United States of America, from a medical facility to which you were previously evacuated, less any refunds paid or payable from your unused transportation tickets, if these expenses are not covered elsewhere in this plan;
(8) expenses for preparation and air transportation of your remains to your place of residence in the United States of America, or up to an equivalent amount for a local burial in the country where death occurred, if you die while outside the United States of America.
Please refer to the Plan Definitions for an explanation of Pre-Existing Conditions which are excluded under the Medical Expense / Emergency Assistance Coverage.
BAGGAGE / TRAVEL DOCUMENTS
We will pay this benefit, less any amount paid or payable from any other valid and collectable insurance or indemnity, up to the amount on the Schedule of Coverages. We will pay all direct loss, damage or destruction due to an accident to your Baggage, passports, and visas during your Trip. We will also pay for loss due to unauthorized use of your credit cards, if you have 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 Common Carrier, and delivery is delayed, this coverage will continue until such property is delivered to you. This coverage does not include loss caused by the delay.
Property Not Covered: We will not pay for damage to or loss of:
(1) animals;
(2) property used in trade, business, or for the production of income, household furniture, musical instruments, brittle or fragile articles, or sporting equipment if the loss results from the use thereof;
(3) boats, motors, motorcycles, motor vehicles, aircraft, and other conveyances or equipment, or parts for such conveyances;
(4) artificial limbs or other prosthetic devices, artificial teeth, dental bridges or dentures, hearing aids, any type of eyeglasses, sunglasses, or contact lenses;
(5) documents or tickets, except for administrative fees required to reissue tickets;
(6) money, stamps, stocks and bonds, postal or money orders, or credit cards, except as noted above;
(7) property shipped as freight or shipped prior to the Scheduled Departure Date;
(8) contraband.
Special Limitation: We will not pay more than $500 (or the Baggage/Travel Documents Limit, if less) on all losses to jewelry, watches, precious gems, articles consisting in whole or in part of gold, silver or platinum, cameras, camera equipment, and furs. Items not included above are subject to a $250 per item limit.
Losses Not Covered: We will not pay for loss arising from:
(1) defective materials or craftsmanship; or
(2) normal wear and tear, gradual deterioration, inherent vice; or
(3) rodents, animals, insects or vermin; or
(4) theft or pilferage from an unattended vehicle; or
(5) mysterious disappearance; or
(6) electrical current, including electric arcing that damages or destroys electrical devices or appliances.
Payment of Loss: We will pay the cost of repair or replacement of your damaged Baggage, less depreciation; or at our option, we may repair or replace your Baggage. We will notify you within 30 days after we receive your proof of loss. We may take all or part of the damaged Baggage at the appraised or agreed value. In the event of a loss to a pair or set of items, we will:
(1) repair or replace any part to restore the pair or set to its value before the loss; or (2) pay the difference between the value of the property before and after the loss.
BAGGAGE DELAY
We will pay up to the amount shown in the Schedule of Coverages for the cost of reasonable additional clothing and personal articles purchased by you, if your Baggage is delayed for more than 24 hours during the Trip.
PART C - The following Provisions, Definitions, Exclusions and Procedures apply to Part A - Travel Arrangement Protection and Part B - Travel Insurance Benefits
|
Who is eligible for coverage A person who takes a Trip and makes the required payment for the plan. When coverage begins The Pre-Departure Trip Cancellation Benefit is effective on the date payment for the plan is received by Lindblad Expeditions. The Post-Departure Trip Interruption Benefit is effective on the Scheduled Departure Date. All other coverages will begin on the later of:
When coverage ends All coverage ends on the earlier of:
Termination of the plan will not affect a claim for loss which occurs after payment for the plan has been received. All coverage under this plan will be extended if your entire Trip is covered by the plan and your return is delayed by unavoidable circumstances beyond your control. If coverage is extended for the above reasons, coverage will end on the earlier of the date you reach your originally scheduled return destination or seven (7) days after the Scheduled Return Date. Extension of Coverage All coverage under the plan will be extended, if:
If coverage is extended for the above reasons, coverage will end on the earlier of:
"Baggage" means luggage, personal possessions, and travel documents taken by you on the Trip. "Business Partner" means an individual who is involved with you in a legal partnership and shares in the management of the business. "Common Carrier" means any land, water, or air conveyance operated under a license for the transportation of passengers for hire, not including taxi cabs, or rented, leased, or privately owned motor vehicles. "Covered Death" means your death or the death of an Immediate Family Member, Traveling Companion or Business Partner which is the direct result of a Sickness or Injury as defined in this plan. "Elective Treatment" means any medical treatment or surgical procedure that is not medically necessary including any service, treatment, or supplies that are deemed by the federal, or a state or local government authority, or by us to be research or experimental or that is not recognized as a generally accepted medical practice. "Hospital" means an institution which meets all of the following requirements: (1) it must be operated according to law; (2) it must give 24-hour medical care, diagnosis, and treatment to the sick or injured on an inpatient basis for which a charge is made; (3) it must provide diagnostic and surgical facilities supervised by Physicians; (4) registered nurses must be on 24-hour call or duty; (5) the care must be given either on the hospital's premises or in facilities available to the hospital on a pre-arranged basis. A Hospital is not: a rest, convalescent, extended care, rehabilitation or other nursing facility; a facility which primarily treats mental illness, alcoholism, or drug addiction (or any ward, wing or other section of the hospital used for such purposes); or a facility which provides hospice care (or wing, ward other section of a hospital used for such purposes). "Immediate Family Member" means your or your Traveling Companion's spouse, child, spouse's child, daughter-in-law, son-in-law, brother, sister, mother, father, grandparents, grandchild, step-brother, step-sister, step-parents, parents-in-law, brother-in-law, sister-in-law, aunt, uncle, niece, nephew, guardian, or ward. "Injury" means bodily injury caused by an accident which 1) occurs while your coverage is in force under this plan and 2) requires examination and treatment by a Physician. The injury must be the direct cause of loss and must be independent of all other causes and must not be caused by, or result from, Sickness. "Insured" means an Eligible Person who takes a Trip, completes any required enrollment form, and pays any required premium. The words "you", "your" or "yours" mean the Insured. "Other Covered Events" means only the following unforeseeable events or their consequences which occur while coverage is in force under this plan: (1) Air Carrier delays resulting from organized labor strikes that affect public transportation; (2) arrangements canceled by an airline resulting from inclement weather or organized labor strikes that affect public transportation; (3) a change in plans by you, an Immediate Family Member traveling with you, or Traveling Companion, resulting from one of the following events which occurs while coverage is in force under this plan:
"Other Valid and Collectible Group Insurance" means any group policy or contract which provides for payment of medical expenses incurred because of Physician, nurse, dental or Hospital care or treatment; or the performance of surgery or administration of anesthesia. The policy or contract providing such benefits includes group or blanket insurance policies; service plan contracts; employee benefit plans; or any plan arranged through an employer, labor union, employee benefit association or trustee; or any group plan created or administered by the federal or a state government or its agencies. In the event any other group plan provides for benefits in the form of services in lieu of monetary payment, the usual and customary value of each service will be considered a Covered Expense. "Physician" means a person licensed as a medical doctor by the jurisdiction in which he is resident to practice the healing arts. He must be practicing within the scope of his license for the service or treatment given and may not be you, a Traveling Companion or an Immediate Family Member. "Program Medical Advisors" means individuals appointed by ON CALL INTERNATIONAL. "Scheduled Departure Date" means the date on which you are originally scheduled to leave on your Trip. "Scheduled Return Date" means that date on which you are originally scheduled to return to the point where the Trip started or to a different final destination. "Scheduled Tour Departure City" means a city where the scheduled land tour on which you are to participate originates. "Sickness" means an illness or disease of the body which: 1) requires examination and treatment by a Physician, and 2) commences while this plan is in force. An illness or disease of the body which first manifests itself and then worsens or becomes acute prior to the effective date of this plan is not a Sickness as defined herein and is not covered by this plan. "Traveling Companion" means a person whose name appears with yours on the same Trip arrangement and who, during the Trip, will share accommodations with you in the same room, cabin, condominium unit, apartment unit or other lodging. "Trip" means a scheduled trip for which coverage is elected and payment received, and all travel arrangements are arranged by Lindblad Expeditions prior to the Scheduled Departure Date of the Trip. "Usual and Customary" means the usual charge made by a provider for necessary medical services, treatment or supplies. It may not exceed the general level of charges for similar necessary services, treatment or supplies made by other providers in the area where the service or treatment is given or the supply bought. Plan Exclusions The following exclusion applies to the Accidental Death and Dismemberment coverage: (1) We will not pay for loss caused by or resulting from sickness of any kind. The following exclusions apply to all Coverages of Part A and Part B: (2) This plan does not cover loss caused by, or resulting from:
Important Note: Exclusion 2, Item s) above, applies to you, an Immediate Family Member, Traveling Companion or Business Partner. To facilitate prompt claims settlement:
In case of loss, theft or damage to personal belongings, immediately report the situation to the hotel manager, tour guide or representative, transportation official or local police and obtain their written report of your loss. Where to Present a Claim All claims should be presented to the Program Administrator. The address and telephone number are as follows: Trip Mate Insurance Agency, Inc. TRIP MATE / ON CALL INTERNATIONAL 24-hour Telephone Service - Multi-lingual professionals are available 24 hours a day to provide help and advice with a medical or legal emergency. International Medical Assistance - If you are in need of medical attention, ON CALL will help you locate local physicians, dentists, or medical facilities. ON CALL will also monitor your condition and contact your personal physician and family, if requested. Medical Evacuation* - If you need to be transported to a different hospital or treatment facility, or back home, ON CALL will arrange and pay for transportation and a special medical escort if required. Telephone Interpretation Service - In a medical emergency, ON CALL provides interpretation services in major languages and will transmit urgent messages to family, friends, and business, if requested. * Payment for these services is available only for covered claims and up to the amount of coverage provided in the plan. Failure to call ON CALL INTERNATIONAL may invalidate your Medical Expense and/or Trip Interruption or Delay claim.
*From outside the United States & Canada, you will first have to enter the International Access Code of the country you are calling from. On Call Group Number: 416 Please Note: Neither the Insurer(s) nor On Call International shall be responsible for the availability, quality or results of any medical treatment or your failure to obtain medical treatment. This brochure is a brief description of the benefits available to you under the Travel Protection Plan. Since the Master Policy which provides the insurance benefits of Part B, is complete in detail, the final interpretation of any provision or claim will be governed by the Master Policy. ACCESS YOUR MEDICAL RECORDS ONLINE WITH TRAVELER PDQ With our exclusive Traveler PDQ Service, you can assure that your important medical records are available to you or any Physician chosen by you, anytime, anywhere in the world, quickly, wherever internet access is available. Register online at your convenience, at www.travelerpdq.com or call, toll free, 1-800-379-9887. It's free during your insured Trip! Your Program Code for Traveler PDQ is: 416
|
|||||||||
The Travel Protection Plan is Administered by:
Trip Mate Insurance Agency, Inc.
9225 Ward Parkway
Kansas City, Missouri 64114
Tel: 1-800-888-7292 (Toll-Free)
Please read and familiarize yourself with the benefits, services, provisions, exclusions, and definitions in this Description of Coverage Brochure which is your evidence of coverage (if your payment for the plan has been received) and should be retained.
Notice to Florida Residents
Your homeowner's policy, if any, may provide coverage for loss of personal effects. You are not required to purchase baggage insurance in connection with purchase of tickets or in connection with the lease or rental of a motor vehicle.
Part B- Travel Insurance Underwritten by:
Monumental General Casualty Company (all states except as other wise noted) &
Monumental Life Insurance Company (AK, ME, NH, NC, WI, WY) &
Stonebridge Casualty Insurance Company (CO, MI, MN, NY, VT
Additional Part B, Insurance Provisions apply to Oregon residents. Click Here for Details
Traveler PDQ Service provided by:
MedStrong International Corporation
|
The information contained on these web pages are a representation of the travel protection plan information as of March 1, 2003. These web pages provide a brief description of the benefits available under the plans. The Master Policies are complete in detail and the final interpretation of any provision or claim will be governed by the Master Policies. Legal Notice & Disclaimer Statement click here. |