Safe Travels Elite

Plan Detail

Plan Administrator: Trawick International | AM Best Rating: A | Underwriter: Crum and Forster, SPC

Description


ELIGIBILITY This Policy provides coverage to non-US citizens who reside outside the USA and are traveling outside of Their Home Country to visit solely the United States, or to visit a combination of the United States and other countriesworldwide. The Insured must arrive in the USA before traveling to other countries. This Policy is not available to green card holders in the USA. This Policy is not available to anyone age 90 or above. Coverage in countries outside the USA and your Home Country is available for up to 180 days during your Policy Period.

We maintain Our right to investigate to verify that the eligibility requirements have been met. If and whenever We discover that the eligibility requirements have not been met, Our only obligation is refund of premium. Maximum Age: Coverage ceases on the Covered Person's 90th birthday.

CONTINUATION OF TREATMENT PERIOD If a covered Sickness or Injury requires continuing Treatment after the expiration of the Policy Period, a Covered Person may receive continuing Treatment for the covered Sickness or Injury for up to six (6) months per Sicknessor Injury, subject to the following: if the Policy Period expires while the Covered Person is outside the Home Country, a covered Sickness or Injury incurred while outside and prior to returning to the Home Country, and that covered Sickness or Injury requires continuing Treatment, the Company will review and determine the date of initial Treatment for the covered Sickness or Injury, and ifsuch date is prior to the expiration of the Policy Period, Eligible Medical Expenses for the covered Sickness or Injury will continue to be reimbursed until there has been at least the minimum number of days of continuous Treatment for the covered Sickness or Injury, subject to the limitsset forth in the Schedule of Benefits/Limits, and all other Terms of the insurance plan. In order to be eligible for coverage under the Continuation of Treatment Period provision, the Covered Person must be covered by an insurance policy, benefit plan, or Other Coverage for expenses or charges incurred by the Covered Person, and the Other Coverage remains in effect during the duration of coverage with the Company

EFFECTIVE DATE

An eligible person will be insured on the latest of the following dates: 1. the Covered Person’s departure from Their Home Country; 2. the date and time the Covered Person completed enrollment form and Their correct premium is received; or 3. the effective date requested and shown on the certificate.

TERMINATION DATE Coverage will end on the earliest of the date: 1. the Covered Person’s return to Their Home Country, except as provided under Return to Home Country Benefit, if eligible; or 2. the termination date shown on the certificate for which premium has been paid; or 3.the date the Maximum Benefit for the loss has been paid

Please note, certain words used in this document have specific meanings.

These terms will be capitalized throughout the document. “Accident” means a sudden, unexpected and unintended event.

“Acute Onset of a Pre-Existing Condition” means a sudden and unexpected outbreak or recurrence of a Pre- Existing Condition which 1) 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 and immediate medical care; and 2) occurs a minimum of 48 hours after the Effective Date of the policy and 3) treatment is obtained within 24 hours of the sudden and unexpected outbreak or recurrence. A Pre-Existing Condition that is a Congenital condition orthat gradually becomes worse over time will not be considered Acute Onset.

“Assistance Provider” means On Call International

"Automobile" means a self-propelled, private passenger motor vehicle with four or more wheels that is a type both designed and required to be licensed for use on the highway of any state or country. Automobile includes, but is not limited to, a sedan, station wagon, sport utility vehicle, or a motor vehicle of the pickup, van, camper, or motor-home type. Automobile does not include a mobile home or any motor vehicle that is used in mass or public transit.

“Common Carrier" means any public conveyance that is operated via a published schedule and to which a fare ispaid. This is inclusive of Bus, Rail, Air and Sea transportation.

“Company” means Crum & Forster SPC.

“Covered Accident” means an Accident that occurs while coverage is in force for a Covered Person and results ina loss or Injury covered by the Policy for which benefits are payable.

“Covered Expenses” means expenses actually incurred by or on behalf of a Covered Person for treatment, services and supplies covered by the Policy. Coverage under the Policy must remain continuously in force from the date of the Accident or Sickness until the date treatment, services or supplies are received for them to be a Covered Expense.

A Covered Expense is deemed to be incurred on the date such treatment, service or supply, that gave rise to the expense or the charge, was rendered or obtained. “Covered Loss” or “Covered Losses” means an accidental death, dismemberment or other Injury covered under the Policy.

“Covered Person” means any Insured and Dependent for whom the required premium is paid (herein also referredto as “ You” or “Your” or “They” or  “Their”).

"Deductible" means the dollar amount of Covered Expenses that must be incurred as an out of-pocket expense by each Covered Person on a per incidence basis. The deductible must be met, by the Covered Person before Medical Expense Benefits can be paid or reimbursed. The deductible is applied to the first eligible claim processed.

“Dependent” means an Insured’s lawful spouse or domestic partner; or an Insured’s unmarried child, from the moment of birth to age 21, who is chiefly dependent on the Insured for support. A child, for eligibility purposes, includes an Insured’s natural child; adopted child, beginning with any waiting ` period pending finalization of the child’s adoption; or a stepchild who resides with the Insured or depends chiefly on the Insured for financial support. A Dependent may also include any person related to the Insured by blood or marriage and for whom the Insured is allowed a deduction under the Internal Revenue Code. Insurance will continue for any Dependent child who reaches the age limit and continues to meet the following conditions: 1. the child is handicapped, 2. is not capable of self-support and 3. depends chiefly on the Insured for support and maintenance. The Insured must send Ussatisfactory proof that the child meetsthese conditions, when requested. We will not ask for proof more than once a year.

"Diagnosis" means the result of examination or test by a licensed physician providing a specific international CPTor ICD10 code. Failure to obtain a covered Diagnosis will result in the denial of the claim.

"Diagnosis" means the result of examination or test by a licensed physician providing a specific international CPTor ICD10 code. Failure to obtain a covered Diagnosis will result in the denial of the claim.

"Diagnosis" means the result of examination or test by a licensed physician providing a specific international CPTor ICD10 code. Failure to obtain a covered Diagnosis will result in the denial of the claim.

"Home Country" means a country from which the Insured Person holds a passport. If the Insured Person holdspassports from more than one country, his or her Home Country will be that country which the Insured Personhas declared to Us in writing as his or her Home Country.

“Hospital” means an institution that: 1. operates as a Hospital pursuant to law for the care, treatment, and providing of in-patient services for sick or injured persons; 2. provides 24-hour nursing service by Registered Nurses on duty or call; 3. has a staff of one or more licensed physicians available at all times; 4. provides organized facilities for diagnosis, treatment and surgery, either: (i) on its premises; or (ii) in facilities available to it, on a pre-arranged basis; 5. is not primarily a nursing care facility, rest home, convalescent home, or similar establishment, or any separate ward, wing or section of a Hospital used as such; and 6. is not a place solely for drug addicts, alcoholics, or the aged or any separate ward of the Hospital.

“Hospital Confined” means an overnight stay as a registered resident bed-patient in a Hospital.

“Host Country” means any country, otherthan an OFAC excluded country, in which the Covered Person istravelingwhile covered under the Policy

“Immediate Family Member” means the spouse, parent, parent-in-law, grandparent, child, grandchild, brother, sister, fiancé, such person being related to the Covered Person.

"Incident" Any situation in which the terms and conditions of the policy are activated for either a Sickness,Accident or Injury

"Injury" means accidental bodily harm sustained by a Covered Person that results, directly and independently from all other causes, from a Covered Accident. All injuriessustained by one person in any one Accident, includingallrelated conditions and recurrentsymptomsofthese injuries, are considered a single Injury

“Medical Emergency” means a condition caused by an Injury or Sickness that manifests itself by symptoms of sufficient severity that a prudent layperson possessing an average knowledge of health and medicine would reasonably expect that failure to receive immediate medical attention would place the health of the person in serious jeopardy

“Medically Necessary” means a treatment, service or supply that is: 1. required to treat an Injury or Sickness; prescribed or ordered by a Physician or furnished by a Hospital; 2. performed in the least costly setting required by the Covered Person’s condition; and 3. consistent with the medical and surgical practices prevailing in the area for treatment of the condition at the time rendered. Purchasing or renting 1. air conditioners; 2. air purifiers; 3. motorized transportation equipment; 4. escalators or elevators in private homes; 5. eye glassframes or lenses; 6. hearing aids; 7. swimming pools or supplies for them; and 8. general exercise equipment are not considered Medically Necessary. A service or supply may not be Medically Necessary if a less intensive or more appropriate diagnostic or treatment alternative could have been used. We may, at Our discretion, consider the cost of the alternative to be the Covered Expense.

“Missing Bag Report” means a formal report of loss as filed with the common carrier commonly known as a PIR (Passenger Irregularity Report) or PAWOB (Passenger Arriving With Out Baggage). This must include the 6-digit Claim Number or the World Tracer Record Number as provided by the carrier.

“Missing Person” means a Covered Person who disappeared for an unknown reason and whose disappearance was reported to the appropriate authority(ies).

“Natural Disaster” means storm (wind, rain, snow, sleet, hail, lightning, dust or sand) earthquake, flood, volcaniceruption, wildfire or other similar event that: 1. is due to natural causes; and 2. results in such severe and widespread damage that the area of damage is officially declared a disaster area by the government in which the Covered Person’s Trip occurs and the area is deemed to be uninhabitable or dangerous.

“Nearest Place of Safety” means a location determined by the Designated Security Consultant where: 1. the Covered Person can be presumed safe from the Occurrence that precipitated the Covered Person’s Political Evacuation; and the Covered Person has access to Transportation; and 2. the Covered Person has the availabilityof temporary lodging, if needed.

“Necessities” means personal hygiene items and clothing

“Occurrence” means any ofthe following situationsinvolving a Covered Person: 1. expulsion from a Host Countryor being declared persona non-grata on the written authority ofthe recognized government of a Host Country; 2. political or military events involving a Host Country, if the Appropriate Authorities issue an Advisory stating that citizens of the Covered Person’s Home Country or citizens of the Host Country should leave the Host Country; 3. deliberate physical harm of the Covered Person confirmed by documentation or physical evidence or a threat against the Covered Person’s health and safety as confirmed by documentation and/or physical evidence; 4. Natural Disaster in the area the Covered Person is traveling to and occurring after Their effective date; 5. the Covered Person had been deemed kidnapped or a Missing Person by local or international authorities and, whenfound, his or her safety and/or well-being are in question within seven days of his or her being found.

“Physician/Doctor” means a licensed health care provider acting within the scope of his or her license and rendering care or treatment to a Covered Person that is appropriate for the conditions and locality. It will not include a Covered Person or a member of the Covered Person’s Immediate Family or household

“Policy Period” means the dates as shown on the Covered Person’s certificate for which premium has been pai

“Political Evacuation” means the extrication of a Covered Person from the Host Country due to an Occurrence which could result in grave physical harm or death to the Covered Person and is certified by a governing authorityvia declaration or warning

"Pre-Existing Condition” means Any Injury, Illness, Sickness, disease, or other physical, medical, Mental orNervous Disorder, condition or ailment that, with reasonable medical certainty, existed at the time ofApplication or at any time during the 36 months prior to the Effective Date of this insurance, whether or not previously manifested, symptomatic or known, diagnosed, Treated, or disclosed to the Company prior to the Effective Date, and including any and all subsequent, chronic or recurring complications or consequencesrelated thereto or resulting or arising therefrom. This specifically includes but is not limited to any medicalcondition, Sickness, Injury, Illness, disease, Mental Illness or Mental Nervous Disorder, for which medical advice, diagnosis, care or Treatment was recommended or received or for which a reasonably prudent person would have sought Treatment during the 36 month period immediately preceding the Effective Date of Coverage underthis Certificate. A Pre-Existing Condition which is a chronic or congenital condition or that gradually becomes worse over time and/or known, scheduled, required, or expected medical care, drugs or Treatments existing or necessary prior to the Effective Date are not considered to be an Acute Onset

“Related Costs” means food, lodging and, if necessary, physical protection for the Covered Person during the Transport to the Nearest Place of Safety

“Sickness” means an illness, disease or condition of the Covered Person that causes a loss for which a Covered Person incurs medical expenses while covered under the Policy. All related conditions and recurrent symptomsof the same or similar condition will be considered one Sickness.

“Sickness” means an illness, disease or condition of the Covered Person that causes a loss for which a Covered Person incurs medical expenses while covered under the Policy. All related conditions and recurrent symptomsof the same or similar condition will be considered one Sickness.

"TerminationDate"meansthe coverage provided with respectto the Named Insured shallterminate at 12:01 AMNorth American Central Time on the earliest of the following dates: 1. The date shown on the insurance confirmation card, for which the premium is paid; or 2. The date the Covered Person returns to Their Home Country; or 3. Three hundred and sixty-four (364) days after the Covered Person's original effective date, unless extended; or 4. The date the Covered Person becomes a United States citizen

“Trip” meanstravel by air, land, or sea from the Covered Person’s Home Country. “Usual and Customary Charge” means the average amount charged by most providers for treatment, service or supplies in the geographic area where the treatment, service or supply is provided.

“We”, “Our”, “Us” means The Company, or Crum & Forster SPC.

“Well Doctor Visit” means one visit to a Physician that occurs within the first 21 days from the effective date andwhere the provider uses one of these ICD10 Diagnosis codes only - V70.0-Routine medical exam, Z00.00- Encounter for general adult medical examination without abnormal findings c) Z00.129- Encounter for routine child health examination without abnormal findings.