SECTION I. Coverages
provided such circumstances occurred after Your Effective Date.
provided such circumstances occurred after Your Effective Date.
| a. |
You or Your Traveling Companion being hijacked, quarantined, required to serve on a jury (notice of jury duty must be received after Your Effective Date) served with a court order to appear as a witness in a legal action in which You or Your Traveling Companion is not a party (except law enforcement officers);
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| b. |
Your or Your Traveling Companion’s principal place of residence or destination being rendered uninhabitable by fire, flood, burglary or other natural disaster within 10 days of departure;
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| c. |
Your or Your Traveling Companion’s place of employment is rendered unsuitable for business due to fire, flood, burglary or other natural disaster and You and/or Your Traveling Companion are required to work as a result;
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| d. |
a documented theft of passports or visas;
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| e. |
a permanent transfer of employment of 250 miles or more;
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| f. |
You or Your Traveling Companion being directly involved in a traffic accident, which must be substantiated by a police report, while en route to Your scheduled point of departure;
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| g. |
Unannounced Strike that causes complete cessation of services of Your Common Carrier for at least 12 consecutive hours;
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| h. |
Inclement Weather that causes complete cessation of services of Your Common Carrier for at least 12 consecutive hours;
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| i. |
mechanical breakdown that causes complete cessation of services of Your Common Carrier for at least 12 consecutive hours;
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| j. |
You or Your Traveling Companion is in the Military and called to emergency duty for a national disaster other than war;
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| k. |
Involuntary employer termination or layoff affecting You or a person(s) sharing the same room with You during Your Trip. Employment must have been with the same employer for at least 1 continuous year;
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| l. |
Revocation of Your previously granted leave or re-assignment due to war. Official written revocation/re-assignment by a supervisor or commanding officer of the appropriate branch of service will be required.
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Additional Trip Interruption Benefits: If Your Traveling Companion must remain hospitalized, benefits will also be paid for reasonable accommodation and transportation expenses incurred by You to remain with Your Traveling Companion up to $100 per day, limited to 10 days.
If You cannot continue travel due to a covered Injury or Sickness not requiring hospitalization, and You must extend Your Trip due to medically imposed restrictions, as certified by a Legally Qualified Physician, benefits will be paid for additional hotel nights up to $100 per day, limited to 10 days.
Single Supplement: Benefits will be paid, up to the Maximum Benefit Amount, for the additional cost incurred as a result of a change in the per person occupancy rate for prepaid Travel Arrangements if Your Family Member or Traveling Companion has his/her Trip delayed, canceled or interrupted for a covered reason and You do not cancel.
These benefits will not duplicate any benefits payable under the policy or any coverage(s) attached to the policy.
Missed Connection: If You miss Your cruise or tour departure because Your arrival at Your Trip destination is delayed for 3 or more hours, Benefits will be paid, on a one-time basis, up to the Maximum Benefit Amount, for a) the Additional Transportation Cost to join the Trip and b) the unused portion of the prepaid expenses for land or water Travel Arrangements, due to:
| a) |
any delay of a Common Carrier (the delay must be certified by the Common Carrier);
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| b) |
a documented weather condition preventing You from getting to the point of departure;
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| c) |
quarantine, hijacking, Strike, natural disaster, terrorism or riot.
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These benefits will not duplicate any benefits payable under the policy or any coverage(s) attached to the policy.
Travel Delay: Benefits will be paid for reasonable accommodation, meal, and local transportation expenses incurred by You, up to the Maximum Benefit Amount shown in the Schedule of Benefits, if You are delayed for 12 hours or more while in route to or from, or during a Trip, due to:
| a) |
any delay of a Common Carrier (the delay must be certified by the Common Carrier);
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| b) |
a traffic accident in which You or Your Traveling Companion are not directly involved (must be substantiated by a police report);
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| c) |
lost or stolen passports, travel documents or money (must be substantiated by a police report);
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| d) |
quarantine, hijacking, Strike, natural disaster, terrorism or riot;
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| e) |
a documented weather condition preventing You from getting to the point of departure. |
These benefits will not duplicate any benefits payable under the policy or any coverage(s) attached to the policy.
“Additional Transportation Cost” means the actual cost incurred for one-way Economy Transportation by a Common Carrier reduced by the value of an unused travel ticket.
“Baggage and Personal Effects” means luggage, personal possessions and travel documents taken by You during a Trip.
“
Business Partner” means an individual who (a) is involved in a legal general partnership with You and/or (b) is actively involved in the day to day management of Your business.
“Common Carrier” means any land, sea, and/or air conveyance operating under a valid license for the transportation of passengers for hire.
“Domestic Partner” means a person who is at least eighteen years of age and 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 continuous cohabitation throughout the 180 day period prior to Your Effective Date of the Plan; and 3) an affidavit of domestic partnership if recognized by the jurisdiction within which they reside.
“Economy Transportation” means the lowest published available transportation rate for a ticket on a Common Carrier matching the original class of transportation that You purchased for the Trip.
“Family Member” means any of the following who resides in the United States, Canada, or Mexico: You or Your Traveling Companion’s: legal spouse (or common-law spouse where legal), legal guardian, son or daughter (adopted, foster, step or in-law), brother or sister (includes step or in-law), parent (includes step or in-law), grandparent (includes in-law), grandchild, aunt, uncle, niece or nephew, Domestic Partner, an employed caregiver who lives with You, or a person for whom You are the primary caregiver with whom You have lived for 12 continuous months prior to the effective date of Your Plan, whether or not they travel with You.
“Hospital” means: (a) a place which is licensed or recognized as a general hospital by the proper authority of the state in which it is located; (b) a place operated for the care and treatment of resident inpatients with a registered graduate nurse (RN) always on duty and with a laboratory and X-ray facility; (c) a place recognized as a general hospital by the Joint Commission on the Accreditation of Hospitals. Not included is a hospital or institution licensed or used principally: (1) for the treatment or care of drug addicts or alcoholics; or (2) as a clinic continued or extended care facility, skilled nursing facility, convalescent home, rest home, nursing home or home for the aged.
“
Inclement Weather” means any weather condition that delays the scheduled arrival or departure of a Common Carrier.
“Injury” or “Injuries” means accidental bodily injuries: (a) received while insured under the Policy and any attached coverages; (b) resulting in loss independently of sickness and all other causes; and (c) not excluded from coverage.
“Intoxicated” means a blood alcohol level that equals or exceeds the legal limit for operating a motor vehicle in the state or jurisdiction where You are located at the time of an incident.
“Insured” means the person who purchased the Trip and who has paid the required plan cost for the protection plan provided herein, and also referred to as You and Your.
“Legally Qualified Physician” means a physician or a Christian Science Practitioner: (a) other than You, a Traveling Companion or a Family Member; (b) practicing within the scope of his/her license; and (c) recognized as a physician in the place where the services are rendered.
“Maximum Benefit Amount” means the maximum amount payable for coverage provided to You as shown in the Schedule of Benefits.
“Medical Treatment” means treatment advice or consultation by a Legally Qualified Physician.
“Medically Necessary” means a service or supply which: (a) is recommended by the attending Legally Qualified Physician; (b) is appropriate and consistent with the diagnosis in accord with accepted standards of community practice; (c) could not have been omitted without adversely affecting Your condition or quality of medical care; (d) is delivered at the most appropriate level of care and not primarily for the sake of convenience; and (e) is not considered experimental unless coverage for experimental services or supplies is required by law.
“Pre-Existing Condition” means any injury, sickness or condition (including any condition from which death ensues) of You, Your Traveling Companion, or Your or Your Traveling Companion’s Family Member traveling with You or Your Business Partner which within the 60 day period prior to the effective date of Your Trip Cancellation coverage under the Policy: (a) manifested itself, became acute or exhibited symptoms which would have caused one to seek diagnosis, care or treatment; (b) required taking prescribed drugs or medicine, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or (c) required medical treatment or treatment was recommended by a Legally Qualified Physician.
“Program Medical Advisor” means One Call Worldwide Travel Services Network, Inc.
“Scheduled Departure Date” means the date on which You are originally scheduled to leave on the Trip.
“Scheduled Return Date” means the date on which You are originally scheduled to return to the point of origin or the original final destination.
“Sickness” means an illness or disease that is diagnosed or treated by a Legally Qualified Physician after the effective date of insurance and while You are covered under the Policy.
“Strike” means any stoppage of work: (a) as a result of a combined effort of workers which was unannounced and unpublished at the time travel services were purchased; and (b) which interferes with the normal departure and arrival of a Common Carrier.
“Terrorist Incident” means an incident deemed a terrorist act by the United States Government that causes property damage and loss of life.
“Third Party” means a person or entity other than You or the Company.
“Transportation Expense” means: (a) the cost of conveyance of You and any medical personnel (if Medically Necessary); and (b) Medically Necessary services or supplies.
“Travel Arrangements” means: (a) transportation; (b) accommodations; and (c) other specified services arranged by the Travel Supplier for the Trip. Air arrangements covered for Trip Cancellation or Interruption also include any direct round trip air flights booked by others, to and from the Scheduled Trip Departure and return cities, provided the dates of travel for the air flights are within 10 total days of the scheduled Trip dates.
“Traveling Companion” means a person or persons with whom a covered person has coordinated Travel Arrangements and intends to travel with during the Trip.
“Travel Supplier” means Monograms.
“Trip” means scheduled trips, tours or cruises for which: (a) coverage is requested; and (b) the required premium is submitted prior to the Scheduled Departure Date.
“Usual and Customary Charges” means those comparable charges for similar treatment, services and supplies in the geographic area where treatment is performed.
SECTION III. When Coverage Begins and Ends
Your Term of Coverage:
For Trip Cancellation: Coverage begins on Your “Effective Date” which is at 12:01 a.m. on the date Monograms receives the appropriate cost for this policy for Your Trip and ends at the point and time of departure on Your Scheduled Departure Date.
For Travel Delay: Coverage is in force while en route to and from and during the Trip.
For all other coverages: All Other Benefits begin on 12:01 a.m. on Your Scheduled Departure Date. Coverage ends at the point and time of return on Your Scheduled Return Date.
In the event the Scheduled Departure Date and/or the Schedule Return Date are delayed, or the point and time of departure and/or point and time of return are changed because of circumstances over which neither the Travel Supplier nor You have control Your term of coverage shall be automatically adjusted accordance with the Travel Supplier’s notice to Us of the delay or change.
SECTION IV. General Limitations and Exclusions
Benefits are not payable for any loss due to, arising or resulting from:
1. suicide, attempted suicide or any intentionally self-inflicted injury while sane or insane (in Missouri, sane only);
2. an act of declared or undeclared war;
3. participating in maneuvers or training exercises of an armed service;
4. riding, driving or participating in races, or speed or endurance contests;
5. mountaineering (engaging in the sport of scaling mountains generally requiring the use of picks, ropes, or other special equipment);
6. participating as a member of a team in an organized sporting competition;
7. participating in skydiving, hang gliding, bungee cord jumping, or scuba diving if the depth exceeds 130 feet or if You are not certified to dive and a dive master is not present during the dive;
8. piloting or learning to pilot or acting as a member of the crew of any aircraft;
9. being Intoxicated, as specifically defined in the policy, or under the influence of any controlled substance unless administered on the advice of a Legally Qualified Physician;
10. the commission of or attempt to commit a felony or being engaged in an illegal occupation;
11. normal childbirth, normal pregnancy (except complications of pregnancy) or voluntary induced abortion;
12. dental treatment (except as coverage is otherwise specifically provided herein);
13. amounts which exceed the Maximum Benefit Amount for each coverage as shown in the Schedule of Benefits;
14. due to a Pre-Existing Condition, as defined in the Policy. The Pre-Existing Condition Limitation does not apply to the Emergency Medical Evacuation or Return of Remains coverage; or
15. a mental or nervous condition, unless hospitalized.
The Pre-Existing Condition Exclusion is waived if payment for this plan is received by Monograms with Your initial deposit/payment for Your Trip.
Please Note: This plan may not be purchased after You have made final payment for Your Trip.
Present all claims to the Program Administrator:
Trip Mate Inc.*
9225 Ward Parkway, Suite 200
Kansas City, Missouri 64114
Tel: 1-800-888-7292
Plan Number: F372M
Claims may also be reported/completed online at:
www.tripmate.com
*In CA, dba Trip Mate Insurance Agency
SECTION V. General Provisions - New York Only
Subrogation: If the Company has made a payment for a loss under this coverage, and the person to or for whom payment was made has a right to recover damages from the Third Party responsible for the loss, the Company will be subrogated to that right. You shall help the Company exercise the Company’s rights in any reasonable way that the Company may request: nor do anything after the loss to prejudice the Company’s rights: and in the event You recover damages from the Third Party responsible for the loss, You will hold the proceeds of the recover for the Company in trust and reimburse the Company to the extent of the Company’s previous payment for the loss.
Excess Insurance: The insurance provided by this Policy shall be in excess of all other valid and collectible insurance or indemnity. If at the time of the occurrence of any loss there is other valid and collectible insurance or indemnity in place, the Company shall be liable only for the excess of the amount of loss, over the amount of such other insurance or indemnity, and applicable deductible. Recovery of losses from other parties does not result in a refund of premium paid.
Additional Claims Provisions Specific to Baggage: Your Duties after Loss of or Damage to Property or Delay of Baggage: In case of loss, theft, damage or delay of baggage or personal effects, You must: a) take all reasonable steps to protect, save or recover the property; b) promptly notify, in writing, either the police, hotel proprietors, ship lines, airlines, railroad, bus, airport or other station authorities, tour operators or group leaders, or any Common Carrier or bailee who has custody of Your property at the time of loss; c) produce records needed to verify the claim and its amount and permit copies to be made; d) provide to the Company, within 90 days from the date of loss, a detailed proof of loss signed and sworn to; and e) be examined, if requested.
SECTION VI. Coordination of Benefits - New York Only
Applicability: The Coordination of Benefits (“COB”) provision applies to this Plan when You have health care coverage under more than one Plan.
One Call
Worldwide Travel Services Network
When outside the USA or Canada, call us collect through a local operator (you will first have to enter the International Access Code of the country you are calling from). Within the USA or Canada, use the toll free number.
| Within U.S.A. & Canada |
Outside U.S.A. & Canada |
| 1-800-555-9095 |
1-603-894-4710 |
| |
| YOUR PLAN NUMBER: F372M |
| |
Medical Assistance - Our multi-lingual professionals are available 24 hours a day to provide help, advice and referrals for medical emergencies. We will help you locate local physicians, dentists, or medical facilities.
Medical Consultation and Monitoring - If you are hospitalized, we will contact you and your treating physician to monitor your condition to assure you are receiving appropriate care and assess the need for further assistance. We will also contact your personal physician and family at home when necessary or requested to keep them informed of your situation.
Medical Evacuation - When medically necessary, we will arrange and pay for appropriate transportation, including an escort, if required, to a suitable hospital, treatment facility or home. Payment for Medical Evacuation is available only for covered claims and up to the amount of coverage provided in the policy. All medical transportation services must be authorized and arranged by One Call. In the event of an unauthorized Medical Evacuation, reimbursement may be limited or coverage may be invalidated.
Emergency Medical Payments - We will assist you in the advancement of funds or guarantee payments (up to the policy limits) to a hospital or other medical provider, if required, to secure your admission, treatment or discharge.
Prescription Assistance - We will assist you with replacing medications that are lost, stolen or spoiled during your Trip, either locally or by special courier.
Repatriation of Remains - In the event of death while on a Trip, we will arrange for the preparation and transportation required to return your remains to your Home.
24 Hour Legal Assistance - If while on your Trip you encounter legal problems, we will help you find a local legal advisor. If you are required to post bail or provide immediate payment of legal fees, we will assist you in arranging a funds transfer from family or friends.
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.
One Call Travel Solutions
24-Hour Worldwide Travel Services
Message Services - We will transmit emergency messages to family, friends or business associates and let you know that the message has been received.
Language Interpretation Services - We provide interpretation services in major languages and will refer you to appropriate local services, if needed.
Emergency Cash Transfer - We will help arrange an emergency cash transfer (wire transfer, travelers checks, etc.) of your funds from home or from friends or family in medical or travel emergency situations where additional funds are required.
Pre-Trip Travel Services - We provide 24-Hour information, help and advice for your planned Trip such as: passport and visa information, requirements and replacement; travel health information or advisories; vaccine recommendations and requirements; government agency contact information (i.e. embassies, consulates, and other departments or agencies); weather and currency information.
Travel Document and Ticket Replacement - When important travel documents (such as passports and visas) are lost or stolen, we will help you to secure replacements. We will also help you when airline or other travel tickets are lost or stolen. We will assist you with reporting your loss, reissuing tickets and obtaining the money required for this purpose (you are responsible for providing the funds).
One Call Concierge Services
• Restaurant, shopping, hotel recommendations/reservations
• Local transport (rental car/limousine, etc.) information and reservations
• Sporting, theatre, night life and event information (sports scores, stock quotes, gift suggestions, etc.), recommendations and ticketing
• Golf course information, referrals, recommendations and tee times
• Tracking and assisting with the return of lost or delayed baggage
While we strive to provide help and advice for problems encountered by travelers wherever or whenever they occur, situations may arise beyond our control when immediate resolution is not possible. We will make every reasonable effort to refer you to appropriate medical and legal providers, but neither the Insurer nor One Call Worldwide Travel Services Network may be held responsible for the availability, quality or results of any medical treatment or your failure to obtain medical treatment.
The 24-Hour Assistance Services are provided by:
One Call Worldwide Travel Services Network, Inc.
Edition: 11/2009
The information contained on these
web pages is a representation of the Travel Protection Plan information
as of November 1, 2009.
Legal Notice & Disclaimer
Statement click here.
Copyright © 2009 Trip Mate, Inc. (In CA,
dba Trip Mate Insurance Agency) All Rights Reserved.