Liaison International Option 2

Plan Detail

Plan Administrator: Seven Corners | AM Best Rating: A "Excellent"  | Underwriter: United States Fire Insurance Company & Lloyd's of London

Benefits


 

Benefit Limit
Medical Maximum: $50,000; $100,000; $500,000; $1,000,000 (ages 80+, maximum limited to $15,000)
Deductible: $0; $100; $250; $500; $1000; $2500 Deductible is per person per Period of Coverage, maximum of three (3) Period of Coverage Deductibles per family. The selected Deductible and Coinsurance amount must be met for each one hundred and eighty-seven (187) day period. (see Continuing Coverage)
Coinsurance: Traveling to the United States After You pay the Deductible, the plan pays 100% of the next $2,500 of eligible expenses, then 80% to the selected Medical Maximum
Hospital Indemnity: $150 per night, up to a maximum of thirty (30) days

If You are confined to a Hospital as a registered Inpatient as the result of an Illness or Injury which occurs during Your Period of Coverage, this plan will pay Benefits up to $150 per day of confinement, in addition to any other covered expense, up to a maximum of thirty (30) days. You must be traveling outside of the United States and Canada in order to receive benefits.
Dental (Sudden relief of pain): $100

This plan shall pay in excess of the chosen Deductible and Coinsurance up to a maximum of $100, for emergency Treatment for the relief of pain to sound natural teeth.
Dental (Accident coverage): To a maximum of $500

This Plan shall pay in excess of the chosen Deductible and Coinsurance of up to a maximum of $500, for emergency Treatment to repair or replace sound natural teeth damaged as the result of a covered accident.
Emergency Medical Evacuation/ Repatriation: $300,000 (in addition to the Medical Maximum)

The Plan will pay Covered Expenses incurred if any covered Injury or Illness commences during the Period of Coverage that results in the Medically Necessary Emergency Medical Evacuation or Repatriation (Your medical condition warrants immediate transportation from the medical facility where You are located to the nearest adequate medical facility where medical Treatment can be obtained).*
Home Country Coverage: Incidental Trips to The Home Country: Up to $50,000; Extension of Benefits: Up to $5,000

Incidental Trips to Your Home Country: This benefit covers you for incidental trips to your Home Country (30 days per one hundred and eighty-seven (187) days of purchased coverage or pro rata thereof - example: approximately 5 days per month of purchased coverage). Maximum benefit is reduced to $50,000 for any Illness or Injury occurring while on an incidental trip to your Home Country.

Please Note: If You do not use Your Home Country Coverage days within Your Period of Coverage, they do not extend after Your Expiration Date.

Extension of Benefits: This plan shall pay for Covered Expenses incurred in your Home Country up to $5,000 for conditions that are first diagnosed and treated outside Your Home Country (Does not apply for Emergency Medical Evacuation or Repatriation).
Return of Mortal Remains: $50000

The Program will pay the reasonable Covered Expenses incurred up to a maximum of $50,000 to return your remains to your Home Country, if you should die.*
Emergency Reunion: $50000

When Emergency Medical Evacuation or Repatriation is ordered and the attending Physician recommends that a family member travel with You, the plan will arrange and pay, up to $50,000, for a round trip economy-class transportation for one individual of Your choice, from Your Home Country, to be at Your side while You are hospitalized.*
Return of Minor Child(ren): $50000

Should You be traveling alone with a Minor Child(ren) and are hospitalized because of a covered Illness or Injury and the Minor Child(ren), under age nineteen (19), is left unattended, the Plan will arrange and pay up to $50,000 for a one way economy fare to their Home Country (including the cost of an attendant escort, if necessary to insure the safety and welfare of a Minor Child(ren)).*
Interruption of Trip: $5000

If You are unable to continue the trip due to the death of an Immediate Family member (parent, spouse, sibling or child) or due to serious damage to Your principal residence from fire, flood or similar natural disaster (tornado, earthquake, hurricane, etc.), the Plan will reimburse (up to $5,000) for the cost of economy travel, less the value of applied credit from an unused return travel ticket, to return You home to Your area of principal residence.*
Loss of Checked Luggage: $250

If your checked luggage is permanently lost by the airline, the program will reimburse you for the replacement of clothing and personal hygiene items lost to a per article limit of $50 (Maximum Benefit is up to $250). This benefit is secondary to any other (including airline) coverage available. You must furnish proof to the Company that full reimbursement has been obtained from the airline.
Local Ambulance Expense: $5,000
Accidental Death & Dismemberment (AD&D): $25,000 Principal Sum for Insured or Insured Spouse, $5,000 for Dependent Child(ren) Note: In the event of a Common Carrier Accidental Death, this benefit will not be paid.
Common Carrier Accidental Death: $50,000 Principal Sum for Insured or Insured Spouse; $10,000 per Dependent child(ren) under age of nineteen (19); $250,000 Maximum per family
Hospital Room & Board: Usual, reasonable and customary to the selected Medical Maximum
Intensive Care: Usual, reasonable and customary to the selected Medical Maximum
Outpatient Medical Expenses: Usual, reasonable and customary to the selected Medical Maximum
Terrorism: Usual, reasonable and customary to the selected Medical Maximum (This benefit not available for states underwritten by Certain Underwriters at Lloyd’s of London)
Acute Onset of a Pre-existing Condition: Up to $15,000 for non-U.S. citizens under age 70 traveling to the United States (Age 70+, no benefit).

If you are under age 70, you are covered for an Acute Onset of a Pre-existing Condition as defined below. Coverage is available up to $15,000 Lifetime Maximum for Eligible Medical Expenses and up to $25,000 Lifetime Maximum for Emergency Medical Evacuation.
An “Acute Onset of a Pre-existing Condition” is a sudden and unexpected outbreak or recurrence of a Pre-existing Condition(s) which occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent care. The Acute Onset of a Pre-existing Condition must occur after the effective date of the policy. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence. A Pre-existing Condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute Onset. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or Treatments existent or necessary prior to the Effective Date of coverage.
Benefit Period: 180 days
Hazardous Sport Coverage Hazardous Sport Coverage: the following are covered if the required premium has been paid: motorcycle/motor scooter riding (whether as a driver or passenger), hang gliding, parachuting, bungee jumping, water skiing, snow skiing, snowmobiling, snowboarding, snorkeling and spelunking.

Parachuting shall mean an activity involving the breaking of a free fall from an airplane using a parachute.

*NOTE: In the event of Emergency Medical Evacuation, Repatriation, Return of Mortal Remains, Emergency Reunion, Return of Minor Child(ren) or Interruption of Trip benefit is needed or utilized, all arrangements must be made by Seven Corners Assist. Complete details about the benefits and the required notification of Seven Corners Assist are contained in the Program Summary.

Medical Expenses

Liaison® International Plan shall pay Usual, Reasonable and Customary charges for Covered Expenses, excess of the chosen Deductible and Coinsurance up to the selected Medical Maximum, incurred by You due to an Accidental Injury or Illness which occurred during the Period of Coverage while traveling outside Your Home Country (except as provided under the Home Country Coverage). All bodily disorders existing simultaneously which are due to the same or related causes shall be considered one Disablement. If a Disablement is due to causes which are the same or related to the cause of a prior Disablement, the Disablement shall be considered a continuation of the prior Disablement and not a separate Disablement. The initial Treatment of an Injury or Illness must occur within thirty (30) days of the date of Injury or onset of Illness.

Only such expenses which are specifically enumerated in the following list of charges, which are incurred within one hundred and eighty (180) days from the date of accident or onset of Illness and which are not excluded shall be considered Covered Expenses:
  1. Charges made by a Hospital for semi-private room and board, floor nursing and other services inclusive of charges for professional service and with the exception of personal services of a non-medical nature; provided, however, that expenses do not exceed the Hospital’s average charge for semi-private room and board accommodations.
  2. Charges made for Intensive Care or Coronary Care charges and nursing services.
  3. Charges made for diagnosis, Treatment and Surgery by a Physician.
  4. Charges made for an operating room.
  5. Charges made for Outpatient Treatment, same as any other Treatment covered on an Inpatient basis. This includes ambulatory Surgical centers, Physicians’ Outpatient visits/examinations, clinic care, and Surgical opinion consultations.
  6. Charges made for the cost and administration of anesthetics.
  7. Charges for medication, x-ray services, laboratory tests and services, the use of radium and radioactive isotopes, oxygen, blood, transfusions, iron lungs, and medical Treatment.
  8. Charges for physiotherapy, if recommended by a Physician for the Treatment of a specific Disablement and administered by a licensed physiotherapist.
  9. Dressings, drugs, and Medicines that can only be obtained upon a written prescription of a Physician or Surgeon.
  10. Local transportation to or from the nearest Hospital or to and from the nearest Hospital with facilities for required Treatment. Such transportation shall be by licensed ground ambulance only to a limit of $5,000, within the metropolitan area in which You are located at that time the service is used. If You are in a rural area, then licensed air ambulance transportation to the nearest metropolitan area shall be considered a Covered Expense.