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Travel Insurance Certificate
Waiver of the Pre-Existing Condition
Exclusion
The policy exclusion for Pre-Existing
Conditions will be waived provided: 1) your premium
is received by Travelong within 7 days of the initial
deposit/payment for your Trip and 2) you are not disabled
from travel at the time you pay your premium. Please
note, this policy may
not be purchased after you have made your final payment
for your Trip.
Schedule: Fare Portal, Inc.,
dba Travelong
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| Benefit |
Accidental
Death & Dismemberment (Air Flight)
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$25,000 |
Pre-Departure
Trip Cancellation
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Up
To Air Ticket Cost |
Post-Departure
Trip Interruption
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Return
Air Flight Cost |
Travel
Delay
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$100 |
| Baggage Delay
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$100 |
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A person who has arranged to
take a Trip, and pays the required premium, and is
a citizen or resident of the United States of America
or Canada.
All coverages (except Pre-Departure
Trip Cancellation and Post-Departure Trip Interruption)
will take effect on the later of 1) the date the premium
has been received by Travelong; 2) the date and time
you start your Trip; or 3) 12:01 A.M. Standard Time
on the Scheduled Departure Date of your Trip.
Pre-Departure Trip Cancellation coverage will take effect on the date
your premium is received by Travelong.
Post-Departure Trip Interruption coverage will take effect on the Scheduled
Departure Date of your Trip if the required premium payment is received.
Your coverage automatically ends
on the earlier of: 1) the date the Trip is completed;
2) the Scheduled Return Date; 3) your arrival at the
return destination on a round-trip, or the destination
on a one-way trip; 4) cancellation of the Trip covered
by the Policy.
Termination of the policy will not affect a claim for loss that occurs
after premium has been paid.
All coverages under the policy will be extended if your entire Trip is
covered by the policy 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.
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Please see the Definitions for
an explanation of Pre-Existing Conditions which
are excluded under the Pre-Departure
Trip Cancellation, Post-Departure Trip Interruption
and Travel Delay. (Unless
this exclusion is waived, see Waiver of the Pre-Existing
Condition Exclusion for details) |
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Accidental Death and Dismemberment
We will pay this benefit up to the amount on the Schedule if you are
injured in an Accident while a passenger in or on an aircraft of a regularly
scheduled airline or an air charter company that is licensed to carry
passengers for hire while you are on a Trip and covered under the policy,
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.
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If you suffer more than one loss from one 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. |
Pre-Departure Trip Cancellation
We will pay a Pre-Departure Trip Cancellation Benefit, up to the amount
in the Schedule if you are prevented from taking your Trip due to your,
an Immediate Family Member’s, Traveling Companion’s, or Business
Partner’s Sickness, Injury, or death, that occurs before departure
on your Trip. The Sickness or Injury must: a) commence while your coverage
is in effect under the policy; b) require the examination and treatment
by a Physician at the time the Trip is canceled; and c) in the written
opinion of the treating Physician, be so disabling as to prevent you
from taking your Trip.
We will pay a benefit if you are prevented from taking your Trip due
to Other Covered Events, as defined, that occur before departure on your
Trip.
Pre-Departure Trip Cancellation
Benefits: We will reimburse you, up to the amount
in the Schedule for the amount of prepaid, forfeited,
non-refundable Payments or Deposits that you paid for
your Trip.
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Travel
Delay
If your Trip is delayed for 12 hours or more, we will reimburse you,
up to the amount shown in the Schedule for reasonable additional expenses
incurred by you for hotel accommodations, meals, telephone calls and
local transportation while you are delayed. We will not pay benefits
for expenses incurred after travel becomes possible.
Travel Delay must be caused by or result
from: Common Carrier delay; or loss or theft of your
passport(s), travel documents or money; or quarantine; or hijacking;
or natural disaster or closure of public roadways by government
authorities due to adverse weather; or Injury or Sickness of
you, an Immediate Family Member traveling with you, or a Traveling
Companion; or death of you, an Immediate Family Member traveling
with you, or a Traveling Companion. |
Baggage Delay
We will reimburse you, less any amount paid or payable from any other
valid and collectible insurance or indemnity, up to the amount shown
in the Schedule for the cost of reasonable additional clothing and personal
articles purchased by you, if your Baggage is delayed for 24 hours or
more during your Trip.
We will also reimburse you up to $25 for expenses incurred during your
Trip to expedite the return of your delayed Baggage. This coverage terminates
upon your arrival at the return destination of your Trip. |
In this Policy, “you”, “your” and “yours” refer
to the Insured. “We”, “us” and “our” refer
to the company providing this insurance. In addition certain words and
phrases are defined as follows:
“Air Carrier” means
any air conveyance operated under a license for the transportation
of passengers for hire.
“Baggage” means luggage,
personal possessions and travel documents taken by you on the
Trip.
“Business Partner” means
an individual who is involved, as a partner, with you in a legal
general 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 taxicabs
or rented, leased or privately owned motor vehicles.
“Domestic Partner” means
a person who is at least eighteen years of age and you can show:
1) evidence of financial interdependence, such as joint bank
accounts or credit cards, jointly owned property, and mutual
life insurance or pension beneficiary designations; 2) evidence
of cohabitation for at least the previous 6 months; and 3) an
affidavit of domestic partnership if recognized by the jurisdiction
within which they reside.
“Elective Treatment and Procedures” 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.
“Home” means your primary
or secondary residence.
“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; 3) it must provide diagnostic and surgical
facilities supervised by Physicians; 4) registered nurses must
be on 24 hour call or duty; and 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 or other section of a hospital used
for such purposes).
“Immediate Family Member” includes
your or the Traveling Companion’s spouse, child, spouse’s
child, son-daughter-in-law, parent(s), sibling(s), grandparent(s),
grandchild, step brother-sister, step-parent(s), parent(s)-in-law,
brother-sister-in-law, aunt, uncle, niece, nephew, guardian,
Domestic Partner, foster-child, or ward.
“Injury” means bodily
harm caused by an accident which: 1) occurs while your coverage
is in effect under the policy; 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 arranges a Trip and pays any required premium.
“Insurer” means Stonebridge
Casualty Insurance Company.
“Other Covered
Events” means only the following unforeseeable events
or their consequences which occur while coverage is in effect
under this Policy:
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 effect under this Policy: a) being
directly involved in a documented traffic accident while en route to
departure; b) being hijacked, quarantined, required to serve on a jury,
or required by a court order to appear as a witness in a legal action,
provided you, an Immediate Family Member traveling with you or a Traveling
Companion is not 1) a party to the legal action, or 2) appearing as a
law enforcement officer; c) your Home is made uninhabitable by fire,
flood, volcano, earthquake, hurricane or other natural disaster; d) being
called into active military service to provide aid or relief in the event
of a natural disaster; e) a documented theft of passports or visas; f)
a transfer of employment of 250 miles or more; g) a Terrorist
Act which occurs in your departure city or in a city which is a scheduled
destination for your Trip provided: 1) The Terrorist Act occurs within
30 days of the Scheduled Departure Date for your Trip; and 2) Your premium
is received within 7 days of the initial deposit/payment for your Trip.
“Payments or Deposits” means
the cash, check, or credit card amounts actually paid for your
Trip. Payments made in the form of a certificate, voucher or
discount are not Payments or Deposits as defined herein.
“Physician” means a person licensed as a medical doctor by
the jurisdiction in which he/she is resident to practice the healing arts. He/she
must be practicing within the scope of his/her license for the service or treatment
given and may not be you, a Traveling Companion, or an Immediate Family Member
of yours.
“Policy” means the
contract issued to the Policyholder providing the benefits specified
herein.
"Policyholder" means
the legal entity in whose name this Policy is issued, as shown
on the Benefit Schedule.
“Pre-Existing
Condition” means an illness, disease, or other condition
during the 60 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 60 day period before coverage
is effective under this policy.
“Program Medical Advisors” means
ON CALL INTERNATIONAL.
“Scheduled Departure Date” means
the date on which you are originally scheduled to leave on your
Trip.
“Scheduled Return Date” means
the date on which you are originally scheduled to return to the
point where the Trip started or to a different final destination.
“Sickness” means an
illness or disease of the body which: 1) requires examination
and treatment by a Physician, and 2) commences while the insurance
is in effect. An illness or disease of the body which first manifests
itself and then worsens or becomes acute prior to the effective
date of this insurance is not a Sickness as defined herein and
is not covered by the policy.
“Terrorist
Act” 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.
“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 round trip or one-way trip for which coverage has
been elected and the premium paid, and all travel arrangements
are arranged by Travelong prior to the Scheduled Departure
Date of the Trip.
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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 exclusion applies to the Medical Expense/Emergency Assistance,
Pre-Departure Trip Cancellation, Post-Departure Trip Interruption, and
Travel Delay coverages:
2. We will not pay for loss or expense caused by or incurred
resulting from a Pre-Existing Condition, as defined in the policy,
including death that results therefrom.
Exclusion #2 does not apply if your premium is received
within 7 days of the initial deposit/payment for your Trip
and your are not disabled from travel when you pay your premium. |
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The following
exclusion applies to all coverages:
3. We will not pay for any loss under the policy, caused by, or resulting
from:
a) suicide, attempted suicide, or
intentionally self-inflicted injury of you, a Traveling Companion,
Immediate Family Member, or Business Partner booked to travel with
you, while sane or insane (while sane in CO & MO);
b) mental, nervous, or psychological
disorders;
c) being under the influence of
drugs or intoxicants, unless prescribed by a Physician;
d) normal pregnancy or resulting
childbirth or elective abortion;
e) participation as a professional
in athletics;
f) participation in organized amateur
and interscholastic athletic or sports competition or events;
g) riding or driving in any motor
competition;
h) declared or undeclared war, or
any act of war;
i) civil disorder;
j) service in the armed forces of
any country;
k) nuclear reaction, radiation or
radioactive contamination;
l) operating or learning to operate
any aircraft, as pilot or crew;
m) mountain climbing, bungee cord
jumping, skydiving, parachuting, hang gliding, parasailing or travel
on any air supported device, other than on a regularly scheduled
airline or air charter company;
n) any unlawful acts, committed
by you or a Traveling Companion (whether insured or not);
o) any amount paid or payable under
any Worker’s Compensation, Disability Benefit or similar
law;
p) a loss or damage caused by detention,
confiscation or destruction by customs;
q) Elective Treatment and Procedures;
r) medical treatment during or arising
from a Trip undertaken for the purpose or intent of securing medical
treatment;
s) business, contractual or educational
obligations of you, an Immediate Family Member, Business Partner,
or Traveling Companion;
t) bankruptcy, financial insolvency,
default or failure to supply services by a travel supplier;
u) failure of any tour operator,
Common Carrier, or other travel supplier, person or agency to provide
the bargained-for travel arrangements;
v) loss that results from an illness,
disease, or other condition, event or circumstance which occurs
at a time when the policy is not in effect for you.
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| Important
Note: Exclusion 3, Item v above, applies to
you, an Immediate Family Member, Traveling Companion,
or Business Partner. |
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| International Travelers Assistance |
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.
Nurse Helpline–Registered
nurses are available 24 hours a day before and during your trip
to provide general health information, clinical assessment, and
health counseling to give you assistance in making appropriate
healthcare decisions.
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.
Failure to call ON CALL may invalidate your Trip Interruption or Delay
claim.
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The ON CALL Assistance Network extends worldwide.
If you are outside the United States or Canada,
call the local telephone operator for help in placing
your collect call. Within
the United States and Canada, use the toll free
number. Phone answered 24 hours daily.
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Within U.S.A. & Canada Outside
U.S.A. & Canada
1-800-555-9095 1-603-894-4710*
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*From outside the United States & Canada,
you will first have to enter the International Access
Code of the country you are calling from.
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PLAN
NUMBER: 435T
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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.
NEW “FREE” SERVICE!
Access Your Medical Records online |
With our exclusive Traveler PDQ Service,
you can assure that your important medical records are available to you
or any Physician chosen by you, at any time, anywhere in the world, quickly,
wherever there is internet access available. Register at www.travelerpdq.com
or call, toll free 1-800-379-9887. It’s
free during your insured Trip!
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Please
read this Insurance Certificate/brochure carefully, as
it is your evidence of coverage under the policy
(once you have paid the appropriate premium). If
you have any questions about the coverages offered
or to report a claim, please contact Trip Mate
at 1-800-888-7292. Claims may also be reported
online and claim forms downloaded at www.tripmate.com Plan
Number: 435T |
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All claims should be presented to the Program Administrator:
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Trip Mate*
9225 Ward Parkway
Kansas City, Missouri 64114
1-800-888-7292
Plan Number: 435T
*In CA, dba Trip Mate Insurance Agency
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The Travel Insurance is Underwritten
By:
Stonebridge Casualty Insurance
Company, Columbus, Ohio; (all states except
as otherwise noted) under Policy/Certificate Form
series TAHC5000. In CA, CT, HI, NE, NH, PA, TN and
TX Policy/Certificate Form series TAHC5100 and TAHC5200.
In IL, IN, KS, LA, OH, OR, VT, WA and WY Policy Form
#’s TAHC5100IPS and TAHC5200IPS.
Notice: If you are a resident of one
of the following states (IL, IN, KS, LA, OH, OR, VT, WA, WY) your
coverage is provided on an individual policy form. Your policy number
is your complete Name plus 435T. Additional forms complete your policy
and are available at www.tripmate.com. You can also request these
forms by calling Trip Mate at 1-800-888-7292.
The Traveler PDQ Service is provided by:
Worldwide PDQ, a division of Cargril Corporation
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