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Travel Insurance Certificate
Insure-a-Flight...
Travel Insurance and Assistance Services
Protect your
travel investment
What happens if you must cancel your flight or return home early
from your Trip because a family member is sick or injured or dies?
What about terrorists acts?
The Trip Cancellation/Interruption Benefit protects your covered air
ticket cost when you, an Immediate Family Member or Traveling
Companion cancel or interrupt a Trip for covered medical reasons and
many other reasons as well (see the "Other Covered Events"
definition for details). If you must interrupt your Trip for a
covered reason, the plan provides coverage for Your return air
flight cost (not to exceed one-way economy air ticket cost or first
class, if the original tickets were first class). The Travel Delay
Benefit reimburses you up to $100 for your meal and accommodation
expenses for a covered Trip delay.
What if your baggage is delayed?
Baggage Delay Benefits reimburse you up to $100 for your purchase of necessities if
your baggage is delayed for more than 24 hours.
Pay your Premium within 15 Days of your payment for your air
ticket and ...
The exclusion for Pre-Existing Conditions will be waived if you are
not already disabled from travel at the time you pay your premium.
See the Pre-Existing Condition definition which details the
Pre-Existing Conditions that are excluded.
|
Insure-a-Flight |
|
|
Travel Protection
Plan Benefits |
Maximum Benefit |
|
Pre-Departure Trip
Cancellation |
Up to Air Ticket
Cost |
|
Post-Departure
Trip Interruption |
Return Air Flight
Cost |
|
Travel Delay (12
Hours or More) |
Up to $100 |
|
On Call
24-Hour
Assistance Service |
Included |
Accidental Death &
Dismemberment $25,000
(Air Flight only)
|
|
Baggage Delay (24
Hours or More) |
$100 |
|
DESCRIPTION
OF COVERAGES
Who Is Eligible For Coverage
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.
When Coverage Begins
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 TravelSafe; 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 at 12:01
A.M. Standard Time on the
day after the date your premium is received by TravelSafe.
Post-Departure Trip Interruption coverage will take effect on the
Scheduled Departure Date of your Trip if the required premium
payment is received.
When Coverage Ends
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 this Policy.
Termination of the policy will not affect a claim for loss which
occurs after premium has been paid.
All coverage under this 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.
Summary of Coverages
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. We will pay 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 and
your Trip is not canceled.
| Please refer to the
Policy Definitions for an explanation of Pre-Existing
Conditions which are excluded under the Pre-Departure Trip
Cancellation Coverage. |
Post-Departure
Trip Interruption
We will pay a Post-Departure Trip Interruption Benefit, up to the
amount in the Schedule, if: 1) your arrival on your Trip is delayed
beyond the Scheduled Departure Date or 2) you are unable to continue
on your Trip after you have departed on your Trip due to your, an
Immediate Family Member's, Traveling Companion's, or Business
Partner's Sickness, Injury, or death.
For item 1) above, the Sickness or Injury must: a) commence while
your coverage is in effect under the policy; b) for item 2) above,
commence while you are on your Trip and your coverage is in effect
under the policy; and c) for both items 1) and 2) above, require the
examination and treatment by a Physician at the time the Trip is
interrupted or delayed; and d) in the written opinion of the
treating Physician, be so disabling as to delay your arrival on your
Trip or to prevent you from continuing your Trip.
We will pay a benefit if: 1) your arrival on your Trip is delayed
beyond the Scheduled Departure Date or 2) you are unable to continue
on your Trip after you have departed on your Trip due to Other
Covered Events, as defined.
Post-Departure Trip Interruption Benefits: We will reimburse you,
less any refund paid or payable, for one of the following:
(1) the additional transportation expenses by the most direct route
from the point you interrupted your Trip:
a) to the next scheduled
destination where you can catch up to your Trip; or
b) to the final destination of
your Trip; or
(2) the additional transportation expenses incurred by you by the
most direct route to reach your 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 a one-way economy air fare (or first class, if the
original tickets were first class) by the most direct route less any
refunds paid or payable for your unused original tickets.
| Please refer to the
Policy Definitions for an explanation of Pre-Existing
Conditions which are excluded under the Pre-Departure Trip
Cancellation Coverage. |
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:
1) Common Carrier delay; or
2) loss or theft of your passport(s), travel documents, or money; or
3) quarantine; or
4) hijacking; or
5) natural disaster or closure of public roadways by government
authorities due to adverse weather; or
6) Injury or Sickness of you, an Immediate Family Member traveling
with you, or a Traveling Companion; or
7) death of an Immediate Family Member traveling with you, or a
Traveling Companion.
Accidental Death and Dismemberment
We will pay this benefit up to the amount on the Schedule if you are
injured in an Accident which occurs while a passenger in or on,
boarding or alighting from 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.
|
Loss: |
Percentage of
Principal Sum Payable: |
|
Life |
100% |
|
Both Hands; Both
Feet or Sight of Both Eyes |
100% |
|
One Hand and One
Foot |
100% |
|
One Hand and
Sight of One Eye |
100% |
|
One Foot and
Sight of One Eye |
100% |
|
One Hand; One
Foot or Sight of One Eye |
50% |
|
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.
Baggage Delay
We will reimburse you 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 12 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.
Definitions
In this policy, "you", "your" or "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:
"Accident" means a sudden, unexpected, unintended and external
event, which causes Injury.
"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 taxi cabs, or rented, leased, or privately owned
motor vehicles.
"Domestic Partner" means a person who is at least 18 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 takes a Trip,
completes any required enrollment form, and pays any required
premium.
"Insurer" means Stonebridge Casualty Insurance Company,
Columbus, OH.
"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 inclement weather, mechanical
breakdown of the aircraft on which you are scheduled to travel, or
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;
Items #1 and #2 above apply only to Post-Departure Trip Interruption
Benefits.
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 15 days of the
initial deposit/payment for your Trip;
(h) a cancellation of your Trip if your arrival on the Trip is delayed and
causes you to lose 50% or more of the scheduled Trip duration due to
the reasons covered under the Travel Delay Benefit.
"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 Declarations.
"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, Business
Partner 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 individuals appointed by
ON CALL International, LLC.
"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 trip for which coverage is elected
and premium paid, and all travel arrangements are arranged prior to
the Scheduled Departure Date of the Trip.
Policy
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 exclusion applies to the 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 15 days of the
initial deposit/payment for your Trip and you are not
disabled from travel when you pay your premium. |
The following
exclusions apply 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.
| Important Note: Exclusion
3, Item v) above, applies to you, an Immediate Family
Member, Traveling Companion or Business Partner.
|
Notice to Florida
Residents
Your Homeowners 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.
Where
to Present a Claim
All claims should be presented to the Program Administrator:
Trip Mate (In CA, dba Trip Mate Insurance Agency)
9225 Ward Parkway, Suite 200
Kansas City, Missouri 64114
1-888-411-5378 (Toll Free)
When Reporting a
claim, please use the following:
Plan Number: 925A
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 925A. Additional information about
your policy is available at www.tripmate.com. You can also
request this information by calling Trip Mate at
1-888-411-5378.
In Canada: Life Investors Insurance Company of
America (except Baggage Delay) & Legacy General Insurance
Company, Markham, Ontario (Baggage Delay).
Note: This policy contains disability insurance
benefits or health insurance benefits, or both, that apply
only during a covered Trip. You may have coverage from other
sources that already provides you with these benefits. You
should review your existing policies. If you have any
questions about your current coverage, call your insurer or
health plan. |
ON CALL
INTERNATIONAL Assistance Service - Available Worldwide 24
Hours a day ...
With TravelSafe you'll have 24-hour, worldwide, collect call access
to ON CALL'S International Assistance services, including:
Information before you travel:
-
Visa and passport
requirements
-
Immunization
requirements
-
Currency exchange
rates & weather conditions
While traveling,
assistance with:
-
Arrangements for
emergency medical evacuation
-
Referrals to local physicians,
hospitals, and other medical providers
-
Monitoring your
condition and contacting your personal physician
-
Multilingual
interpretation services
-
Advance or
guarantee of medical payments
-
Urgent messages
to family, friends, and business
-
Arrangements for
escort/return home for minors
-
Arrangements for
hospital bedside visit by family member or friend
-
Return of mortal
remains
-
Emergency cash
advances
-
Tracking lost or
delayed Baggage
-
Replacing lost or
stolen travel documents or tickets
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.
|
Within U.S.A. & Canada
Outside U.S.A. & Canada
1-800-555-9095
1-603-894-4710* |
|
*From outside the United
States & Canada, you will first have to enter the
International Access Code of the country you are calling
from.
Plan
Number 925A |
Note: Neither
the Insurer nor ON CALL International, LLC. shall be responsible for
the availability, quality or results of any medical treatment or
your failure to obtain medical treatment. Plan Designed &
Marketed by:
TravelSafe
P.O. Box 7050
Wyomissing, PA 19610-9783
Call:866-467-2358 Fax: 800-303-6015
| Please read this
Insurance Certificate carefully, as it is your evidence
of coverage under this policy (once you have paid the
appropriate premium). If you have any questions about the
coverages offered or to report a claim, please contact
TripMate at 1-800-888-7292. Claims may also be reported
online and claim forms downloaded at
www.tripmate.com
Plan
Number 925A |
925A-06/06 590-03 |