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This document and the Description of Coverages together comprise your individual policy. Your Policy Number is your First Name, Middle Initial and Last Name plus 416.
This Policy is issued to you. The Policy is issued in consideration of payment of premiums as provided by its terms. We agree to pay benefits in accordance with all the provisions of this Policy. Premiums are payable to us or our agent in amounts as set forth by us. This Policy is executed at Baltimore, Maryland. This insurance policy is underwritten by Monumental General Casualty Company, 520 Park Avenue, Baltimore, Maryland 21201
The Description of Coverages is amended with respect to residents of Oregon as follows:
The following sections are added:
PREMIUMS
We provide insurance coverage in return for premium payment. Premiums are payable by you. Premium rates charged for this insurance coverage shall be as set forth by us.
GENERAL PROVISIONS
CLERICAL ERROR. Clerical errors or delays in keeping records for this Policy will not deny insurance which would otherwise have been granted, nor extend insurance which otherwise would have ceased, and will call for a fair adjustment of premium and benefits to correct the error.
CONFORMITY TO LAW. Any provision of this Policy which is in conflict with the laws of the state in which it is issued is amended to conform with the laws of that state.
ENTIRE CONTRACT; CHANGES. This Policy and any other attachments is the entire contract between us. Any statement you make is a representation and not a warranty. No statement will be used by us to void or reduce benefits unless that statement is a part of the written application.
This Policy may be changed at any time by written agreement between us. Only our President, Vice President or Secretary may change or waive the provisions of this Policy. No agent or other person may change this Policy or waive any of its terms. The change will be endorsed on this Policy.
INCONTESTABILITY. After this Policy has been in force for two years, it can only be contested for non-payment of premiums. No statement made by you can be used in a contest after his insurance has been in force two years during his lifetime. No statement you make can be used in a contest unless it is in writing and signed by him.
OUR RIGHT TO RECOVER FROM OTHERS. We have the right to recover any payments we have made from anyone who may be responsible for the loss. You and any one else we insure must sign any papers and do whatever is necessary to transfer this right to us. You and anyone else we insure will do nothing after the loss to affect our rights.
CLAIMS PROVISIONS
NOTICE OF CLAIM We must be given written notice of claim within 20 days after a covered loss occurs. If notice cannot be given within that time, it must be given as soon as reasonably possible. Notice may be given to us or to our authorized agent. Notice should include the Insured's name and enough information to identify him.
CLAIM FORMS When we receive notice of claim, you will be sent forms to file proof of loss. If the forms are not sent within 15 days after we receive notice, then the claimant will meet the proof of loss requirements by giving us a written statement of the nature and extent of the loss. This must be sent to us within the time limit stated in the Proof of Loss provision.
PROOF OF LOSS Written Proof of Loss must be sent to us within 90 days after the date the loss occurs. We will not reduce or deny a claim if it was not reasonably possible to give us written Proof of Loss within the time allowed. In any event, you must give us written Proof of Loss within twelve (12) months after the date the loss occurs unless you are legally incapacitated.
PHYSICAL EXAMINATION AND AUTOPSY At our expense, we have the right to have the Insured examined as often as necessary while a claim is pending. At our expense, we may require an autopsy unless the law or your religion forbids it.
LEGAL ACTIONS No legal action may be brought to recover on this Policy within 60 days after written proof of loss has been given. No such action will be brought after three years from the time written proof of loss is required to be given. If a time limit of this Policy is less than allowed by the laws of the State where you live, the limit is extended to meet the minimum time allowed by such law.
PAYMENT OF CLAIMS Claims for benefits provided by this Policy will be paid as soon as written proof is received.
Benefits are paid directly to you unless otherwise directed. Any accrued benefits unpaid at your death will be paid to your estate, or if no estate, to your beneficiary. If you have has assigned your benefits, we will honor the assignment if a signed copy has been filed with us. We are not responsible for the validity of any assignment.
The brochure section entitled "CLAIMS PROCEDURE" is deleted in its entirety and replaced as follows:
CLAIMS PROCEDURE
To facilitate prompt claims settlement:
(1) Report any claim as soon as possible.
(2) Report claims directly to the Program Administrator, your Tour Operator or Travel Agent.
(3) Upon your report of a claim, you will receive a claim form, which should be fully completed and returned along with any documentation, etc., as explained below.
Baggage: In case of loss, theft, or damage to personal belongings, immediately contact the hotel manager, tour guide or representative, transportation official or local police, report the occurrence and obtain a written statement. Submit claim first to the party responsible (i.e. airlines, hotel, etc.). Forward copies of the outcome of your claim to the Program Administrator. 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.
Accident/Sickness Medial Expenses: Obtain receipts from the treating Physicians, etc., stating the amounts paid and listing the diagnosis and treatment. Forward a copy of their final disposition of your claim to the Program Administrator. Keep all documentation, such as receipts from the treating Physicians or other medical providers stating the diagnosis, treatment, and amount paid.
NOTE: Per the Claims Provisions section set forth above, a claim form will not be necessary if you meet the proof of loss requirements by providing us with a written statement of the nature and extent of the loss.
In the DEFINITIONS section, the definitions of "Other Valid and Collectible Group Insurance" and "Usual and Customary" and all language relating thereto are deleted in their entirety and the definition of "Pre-Existing Condition" is deleted and replaced as follows:
"Pre-Existing Condition" means an illness, disease, or other condition during the 90 day period immediately prior to your effective date for which you or your Traveling Companion or Immediate Family Member scheduled or booked to travel with you: 1) received, or received a recommendation for, a diagnostic test, examination, or medical treatment; or 2) took or received a prescription for drugs or medicine. Item (2) of this definition does not apply to a condition which is treated or controlled solely through the taking of prescription drugs or medicine and remains treated or controlled without any adjustment or change in the required prescription throughout the 90 day period before coverage is effective under this policy.
The "DEFINITIONS" section is amended to include the following:
"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.
The following is a list of the forms and riders that comprise this document and the brochure to which it is attached:
TAHC2000GPC.OR, TAH2000ADR.OR, TAH2100GPC.OR, TAH2100TD7.OR, TAH2100PW2.OR
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