World Med - Excluding USA

Plan Detail

Plan Administrator: USI Affinity Travel Insurance Services | AM Best Rating: A+ "Superior" | Underwriter: Lloyd's of London

Benefits


SCHEDULE OF BENEFITS AND LIMITS

Plan Details

 

Overall Maximum Limit

$500,000, $1,000,000, or $2,000,000

Maximum per Injury / Illness

$500,000, $1,000,000, or $2,000,000

Deductibles

$0, $250, $500, $1,000, or $2,500 per certificate period

Coinsurance – Claims incurred outside U.S.

We will pay 100% of eligible expenses after the deductible up to the overall maximum limit

Coinsurance – Claims incurred in U.S.

 

In-Network Payment

Within the PPO: We will pay 100% of eligible expenses, after the deductible, to the overall maximum limit

Out-of-Network Payment

Outside the PPO: Usual, reasonable, and customary. You may be responsible for any charges exceeding the payable amount.

Eligible expenses are subject to deductible, coinsurance, overall maximum limit, and are per certificate period unless specifically indicated otherwise.

Benefit

Benefit

Limit

Hospital Room and Board

Average semi-private room rate, including nursing services

Intensive Care Unit

Up to the overall maximum limit

Local Ambulance

Usual, reasonable and customary charges, when covered illness or injury results in hospitalization as inpatient

Emergency Room Co-payment

Claims incurred outside the U.S.

No co-payment

Claims incurred in U.S.

You shall be responsible for a $250 co-payment for each use of emergency room for an illness unless you are admitted to the hospital. There will be no co-payment for emergency room treatment of an injury

Urgent Care Center Co-payment

Claims incurred outside the U.S.

No co-payment

Claims incurred in U.S.

For each visit, you shall be responsible for a $25 co-payment, after which coinsurance will apply.

– Co-payment is waived for members with a $0 deductible.

– not subject to deductible

Outpatient Physical Therapy and Chiropractic Care

Usual, reasonable and customary charges. Must be ordered in advance by a physician

Emergency Dental Treatment due to Accident

Up to $2,000

 

Emergency Dental (Acute Onset of Pain)

Up to $200 - not subject to deductible or coinsurance

 

Emergency Eye Exam for a Covered Loss

Up to $150. $50 deductible per occurrence (plan deductible is waived).

Acute Onset of Pre-existing Condition (excludes chronic and congenital conditions)

Age 60-69: $20,000

Under age 60: $200,000

Terrorism

Up to $50,000 lifetime maximum, eligible medical expenses only

Optional Hazardous Activities Rider

Up to the overall maximum limit

Optional Intercollegiate or Interscholastic Sports Rider

Up to $20,000

All Other Eligible Medical Expenses

Up to the overall maximum limit

Emergency Travel Benefits

Limit

Emergency Medical Evacuation

Up to $1,000,000 lifetime maximum - not subject to deductible, coinsurance, or overall maximum limit

Repatriation of Remains

Up to $50,000 - not subject to deductible, coinsurance, or overall maximum limit

Local Burial or Cremation

Up to $2,500 lifetime maximum - not subject to deductible

Emergency Reunion

Up to $100,000, subject to a maximum of 15 days - not subject to deductible or coinsurance

Return of Minor Children

Up to $50,000 - not subject to deductible or coinsurance

Political Evacuation

Up to $50,000 lifetime maximum - not subject to deductible or coinsurance

Trip Interruption

Up to $10,000 - not subject to deductible or coinsurance

Accidental Death & Dismemberment

Ages 18 through 69

Under age 18

Lifetime Maximum - $50,000

Death - $50,000

Loss of 2 Limbs - $50,000

Loss of 1 Limb - $25,000

Lifetime Maximum - $5,000

Death - $5,000

Loss of 2 Limbs - $5,000

Loss of 1 Limb - $2,500

$250,000 maximum benefit any one family or group.

- not subject to deductible, coinsurance, or overall maximum limi

Optional Enhanced Accidental Death & Dismemberment Rider

 

Lifetime Maximum - $100,000

Death - $100,000

Loss of 2 Limbs - $100,000

Loss of 1 Limb - $50,000

- not subject to deductible, coinsurance, or overall maximum limit

Lost Checked Luggage

 

Up to $1,000 - not subject to deductible or coinsurance

Lost or Stolen Passport/Travel Visa

Up to $100 - not subject to deductible or coinsurance

Natural Disaster - Replacement Accommodations

 

Up to $250 a day for 5 days - not subject to deductible or coinsurance

Hospital Indemnity

 

$100 per day for 5 days for inpatient hospitalization - not subject to deductible or coinsurance

Personal Liability

Up to:

$10,000 lifetime maximum

$10,000 third person injury

$10,000 third person property

$2,500 related third person property

- not subject to deductible, coinsurance, or overall maximum limit

Optional Crisis Response Rider with Natural Disaster Evacuation

Up to $100,000 per certificate period, with $10,000 maximum for Natural Disaster Evacuation

- not subject to deductible or overall maximum limit

Certificate Period means the period of time beginning on the date and time of the certificate effective date and ending on the date and time of the certificate termination date.

Coinsurance means your payment of eligible expenses as specified in the Schedule of Benefits and Limits.

Deductible means the dollar amount of eligible expenses, specified in the Schedule of Benefits and Limits that you must pay per certificate period before eligible expenses are paid.

Usual, Reasonable and Customary means the lesser of the following:

1. One and a half times (150%) of the charges payable under the United States Medicare program, for claims incurred outside the PPO network within the U.S., or

2. Most common charge for similar services, medicines or supplies within the area in which the charge is incurred, so long as those charges are reasonable. What is defined as usual, reasonable and customary charges will be determined by us. In determining whether a charge is usual, reasonable and customary, we may consider one or more of the following factors: the level of skill, extent of training, and experience required to perform the procedure or service; the length of time required to perform the procedure or services as compared to the length of time required to perform other similar services; the severity or nature of the illness or injury being treated; the amount charged for the same or comparable services, medicines or supplies in the locality; the amount charged for the same or comparable services, medicines or supplies in other parts of the country; the cost to the provider of providing the service, medicine or supply; such other factors we, in the reasonable exercise of discretion, determine are appropriate.

MEDICAL & REPATRIATION EXPENSES

Subject to the limits set forth in the Schedule of Benefits and Limits, and subject to the conditions and restrictions contained in this provision, we will pay the following expenses incurred while this insurance is in effect.

MEDICAL EXPENSES

YOU ARE COVERED:

1. Charges made by a hospital for:

a. Daily room and board and nursing services not to exceed the average semi-private room rate; and

b. Daily room and board and nursing services in Intensive Care Unit; and

c. Use of operating, treatment or recovery room; and

d. Services and supplies which are routinely provided by the hospital to persons for use while inpatients; and

e. Emergency treatment of an injury, even if hospital confinement is not required; and

f. Emergency treatment of an illness; subject to emergency room co-pay as outlined in the Schedule of Benefits and Limits. ER co-payment is waived when you are directly admitted to the hospital as inpatient for further treatment of that illness.

2. Surgery at an outpatient surgical facility, including services and supplies.

3. Charges made by a physician for professional services, including surgery. Charges for an assistant surgeon are covered up to 20% of the usual, reasonable and customary charge of the primary surgeon, but standby availability will not be deemed to be a professional service and therefore is not covered hereunder.

4. Dressings, sutures, casts or other supplies which are medically necessary and administered by or under the supervision of a physician, but excluding nebulizers, oxygen tanks, diabetic supplies, other supplies for use or application at home, and all devices or supplies for repeat use at home, except durable medical equipment.

5. Diagnostic testing using radiology, ultrasonographic or laboratory services (psychometric, intelligence, behavioral and educational testing are not included).

6. Artificial limbs, eyes or larynx, breast prosthesis or basic functional artificial limbs, but not the replacement or repair thereof.

7. Reconstructive surgery when the surgery is directly related to surgery which is covered hereunder.

8. Hemodialysis and the charges by the hospital for processing and administration of blood or blood components but not the cost of the actual blood or blood components.

9. Oxygen and other gasses and their administration by or under the supervision of a physician.

10. Anesthetics and their administration by a physician.

11. Drugs which require prescription by a physician for treatment of a covered injury or illness, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of 60 days per prescription.

12. Care in a licensed extended care facility upon direct transfer from an acute care hospital.

13. Home nursing care in bed by a qualified licensed professional, provided by a home health care agency upon direct transfer from an acute care hospital and only in lieu of medically necessary inpatient hospitalization.

14. Emergency local ambulance transport necessarily incurred in connection with injury or illness resulting in inpatient hospitalization.

15. Emergency dental treatment and dental surgery necessary to restore or replace sound natural teeth lost or damaged in an accident which was covered under this insurance.

16. Emergency dental treatment necessary to resolve acute onset of pain, provided treatment is obtained within 24 hours of the acute onset of pain.

17. Emergency Eye Exam if your prescription corrective lenses are lost or damaged due to a covered loss and an exam is required to obtain a lens prescription for medically necessary correction lenses, but not for the replacement cost of prescription corrective lenses or contact lenses.

18. Medically necessary rental of durable medical equipment (consisting of a standard basic hospital bed and or a standard basic wheelchair) up to the purchase prices.

19. Outpatient physical therapy or chiropractic care if prescribed by a physician who is not affiliated with the physical therapy or chiropractic practice, necessarily incurred to continue recovery from a covered injury or illness.

20. Injury or illness resulting from participation in sports or athletic activities not otherwise excluded under this insurance.

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions.

EMERGENCY MEDICAL EVACUATION

YOU ARE COVERED:

1. Emergency air transportation to a suitable airport nearest to the hospital where you will receive treatment; and

2. Emergency ground transportation necessarily preceding emergency air transportation; and from the destination airport to the hospital where you will receive treatment.

YOU ARE NOT COVERED unless you fulfill the following conditions:

1. The evacuation is recommended by the attending physician who certifies that it is medically necessary and that transportation by any other method would result in the loss of your life or limb; and

2. The evacuation is agreed upon by you or your relative; and

3. Travel arrangements, excluding Emergency Local Ambulance, are approved in advance and coordinated by us.

YOU ARE NOT COVERED IF:

1. The illness or injury giving rise to the expense is not covered under this insurance; or

2. Medically necessary treatment, services and supplies can be provided locally; or

3. If transportation by any other method would not result in the loss of your life or limb; or

4. The condition giving rise to the Emergency Medical Evacuation did not occur spontaneously and without advance warning, either in the form of physician recommendation or symptoms which would have caused a prudent person to seek medical attention prior to the onset of the emergency; or

5. Expenses are directly or indirectly from anything in the General Exclusions.

We will provide Emergency Medical Evacuation only to the nearest hospital that is qualified to provide the medically necessary treatment, services and supplies to prevent your loss of life or limb.

The timeliness of arrangements can be affected by circumstances which are not within our control such as: availability of transportation equipment and staff, delays or restrictions on flights caused by mechanical problems, government officials, telecommunications problems, weather and other acts of God. We shall not be held liable for any delays that are not within our direct and immediate control.

Notwithstanding the foregoing, and if you are visiting the U.S., we will pay for expenses to return you to your home country if the attending physician and our medical consultant agree that transfer to your home country is more appropriate than transfer to the nearest qualified hospital.

TRIP INTERRUPTION

YOU ARE COVERED:

1. The cost of an economy one-way air or ground transportation ticket for you to the terminal serving the area of your principal residence, and/or

2. The cost of an economy one-way air and/or ground transportation ticket for you from the area where you were hospitalized following an Emergency Medical Evacuation to the area where you were initially evacuated from or to the terminal serving the area of your principal residence.

YOU ARE NOT COVERED unless you fulfill the following conditions:

1. You provide proof of one or more of the following events: destruction, after departure from home country, resulting from fire or weather of more than 40% of your principal residence, or death of a parent, spouse, sibling, child, or grandchild; or

2. Following a covered Emergency Medical Evacuation, the attending physician states that it is medically necessary for you to return to your home country or to the area from which you were initially evacuated for continued treatment, recuperation and recovery.

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions.

RETURN OF MINOR CHILDREN

YOU ARE COVERED:

1. The cost of a one-way economy air and/or ground transportation ticket for each covered minor child to the terminal serving the area of the principle residence of each minor child.

YOU ARE NOT COVERED unless you fulfill the following conditions:

1. You are the only person age 18 or older, traveling with one or more minor children under the age of 18 who are also covered hereunder; and

2. You are hospitalized for treatment of a covered illness or injury, resulting in the children being left unattended for a period of time expected to exceed 36 hours; and

3. The Return of Minor Children benefit must be agreed upon by you and/or by an authorized adult relative of the affected, covered minor children.

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions.

The timeliness of arrangements can be affected by circumstances which are not within our control such as: availability of transportation equipment and staff, delays or restrictions on flights caused by mechanical problems, government officials, telecommunications problems, weather and other acts of God. We shall not be held liable for any delays that are not within our direct and immediate control.

POLITICAL EVACUATION

YOU ARE COVERED:

1. The cost of transportation by the most economical means possible for you to the nearest country of safety or to your home country. We will determine to which country you will be evacuated.

YOU ARE NOT COVERED unless you fulfill the following conditions:

1. The U.S. Department of State has issued a level 3 or level 4 travel advisory after your arrival in the destination country; and

2. You contact us within 10 days of the date the travel advisory is issued.

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions. 1. The illness or injury giving rise to the expense are covered under this insurance; and

2. Travel arrangements are approved in advance and coordinated by us.

REPATRIATION OF REMAINS

YOU ARE COVERED:

1. Air or ground transportation of bodily remains or ashes to the airport or ground transportation terminal nearest your principal residence; and

2. Reasonable costs of preparation of the remains necessary for transportation.

YOU ARE NOT COVERED unless you fulfill the following conditions:

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions.

We are held harmless and shall not be held liable for loss of or any damage or other impairment to bodily remains incurred during the repatriation process or otherwise.

The timeliness of arrangements can be affected by circumstances which are not within our control such as: availability of transportation equipment and staff, delays or restrictions on flights caused by mechanical problems, government officials, telecommunications problems, weather and other acts of God. We shall not be held liable for any delays that are not within our direct and immediate control.

INDEMNITY BENEFIT & VISITATION EXPENSES

HOSPITAL INDEMNITY

YOU ARE COVERED:

1. The Hospital Indemnity benefit for each night you spend in the hospital. 1. You must provide verification of an eligible inpatient hospitalization.

YOU ARE NOT COVERED unless you fulfill the following conditions:

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions.

EMERGENCY REUNION

YOU ARE COVERED:

1. The cost of an economy round-trip air or ground transportation ticket for one relative for transportation to the terminal serving the area where you are hospitalized or are to be hospitalized following Emergency Medical Evacuation; and 1. You have a covered Emergency Medical Evacuation.

2. Reasonable expenses for lodging and meals for the relative, which are incurred in the area where you are hospitalized for a period not to exceed 15 days.

YOU ARE NOT COVERED unless you fulfill the following conditions:

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions. 1. Replacement of clothes and personal hygiene items, not to exceed $50 any one item.

TRAVEL ASSISTANCE

LOST CHECKED LUGGAGE

YOU ARE COVERED:

YOU ARE NOT COVERED unless you fulfill the following conditions:

1. The lost checked luggage must have been checked, in accordance with routine luggage checking procedures, for transportation with you, on board a regularly scheduled commercial airline or cruise line, upon which you were a fare-paying passenger; and

2. You must file a formal claim for lost luggage with the transportation provider, and follow all instructions and take all measures as directed by the transportation provider to locate and retrieve the lost checked luggage; and

3. You must provide us with copies of all documentation of the claim filed with the transportation provider, and a written statement from the transportation provider confirming that the luggage was checked and after careful search, the luggage remains missing; and

4. The lost checked luggage must be lost as of the date of our payment and as of that date, must have been lost for at least 10 days.

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions. 1. Reimbursement for reasonable cost in replacing your passport or travel visa.

LOST OR STOLEN PASSPORT/TRAVEL VISA

YOU ARE COVERED:

YOU ARE NOT COVERED unless you fulfill the following conditions:

1. You exercise reasonable care for the safety and supervision of the passport or travel visa; and

2. Loss or theft is reported to the police within 24 hours and a written police report is obtained; and

3. You provide receipts for the costs associated with the passport or travel visa replacement.

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions. 1. Replacement accommodations in the event you are displaced from planned paid accommodations due to evacuation from forecasted natural disaster or following a natural disaster strike

NATURAL DISASTER - REPLACEMENT ACCOMMODATIONS

YOU ARE COVERED:

YOU ARE NOT COVERED unless you fulfill the following conditions:

1. Following receipt of proof of payment for the accommodations from which you were displaced.

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions.

Displaced means required to depart a destination due to an evacuation ordered by prevailing authorities.

Natural Disaster means an event of natural cause, including wildfire, earthquake, windborne dust or sand, volcanic eruption, tsunami, snow, rain or wind, that results in widespread and severe damage. Natural disaster does not include the direct or indirect effect of rain, wind or water associated with named storms meeting the definition of hurricane or typhoon, except in instances where:

1. The path of the named storm deviates by a distance of greater than 200 miles within a 72-hour period from the path forecast by a nationally recognized meteorological service; or

2. Less than 72 hours advance notice of a potential landfall for a named storm exists.

BORDER ENTRY PROTECTION

YOU ARE COVERED:

If you are traveling on a Visitor Visa B-2 for tourism, for visiting family or friends, or on holiday, and you are denied entry to the United States at the border by customs officials:

1. Reimbursement for the cost of an economy one-way air or ground transportation ticket to the original country of origin; or

2. Common carrier change fee to the original country of origin less the amount credited for any unused portion of the return travel arrangements.

YOU ARE NOT COVERED unless you fulfill the following conditions:

1. You must return to the country of origin; and

2. You must not be a citizen or of the United States, have home country of the United States, and/or have permanent residency in the United States.

YOU ARE NOT COVERED IF:

1. You are traveling to the United States without a Visitor Visa B-2, or you are travelling illegally; or

2. You are from a country named on any active executive order at the time of purchase; or

3. You are on the United States terror watch list; or

4. You were denied entry to the United States upon arrival or while en route to the United States because you have violated any rule, law, condition of or guideline regarding the visa upon which you are traveling; or

5. You are visiting the United States for medical treatment, participation by amateurs in musical, sports, or similar events or contests, if compensation is received; or

6. You are visiting the United States for studies that receive credits towards a degree; or

7. You committed a crime en route or upon entry to the United States which caused or would have caused you to be returned to your country of origin; or

8. The United States government or the common carrier has paid, offered to pay, or will pay for your repatriation to your country of origin; or

9. You have an unused return ticket or credit issued by the common carrier. If credit is not used, the amount reimbursed will be reduced by the amount of the credit.

Country of Origin means the country you were in when you first departed for the United States.

Executive Order means a rule or order issued by the United States President on how federal agencies are to use their resources and having the force of law

1. Death – we will pay the amount indicated in the Schedule of Benefits to the beneficiary; or

ACCIDENTAL DEATH AND DISMEMBERMENT

YOU ARE COVERED:

2. Loss of 2 or more limbs or eyes – we will pay you the amount indicated in the Schedule of Benefits; or

3. Loss of 1 limb or eye – we will pay you the amount indicated in the Schedule of Benefits.

YOU ARE NOT COVERED unless you fulfill the following conditions:

1. The accident giving rise to the Accidental Death or Dismemberment must be covered under this insurance; and

2. Death must occur within 30 days of the sudden, unintentional and unexpected occurrence and not be contributed to by illness or disease.

YOU ARE NOT COVERED IF:

1. Accidents or loss caused by or contributed to by any of the following:

a. Terrorism, war or act of war, whether declared or undeclared;

b. Your participation in a riot, insurrection or violent disorder;

c. Your service in the armed forces of any country;

d. Suicide or attempted suicide or self-inflicted injury, while sane or insane;

e. The voluntary use of any chemical compound, poison or drug, unless used according to the directions of a physician;

f. Committing or attempting to commit a felony;

g. Sickness, mental health disorder, or pregnancy;

h. As the result of intoxication as defined by the laws of the jurisdiction in which the accident occurred, whether directly or indirectly;

i. Myocardial infarction or cerebrovascular accident (CVA / Stroke);

j. Infection, except infection through a wound caused solely by an accident;

k. Injury while riding, boarding, or alighting from an aircraft if you were operating the aircraft, learning to operate the aircraft, serving as a member of the aircraft crew, or if the aircraft was being used for any purpose other than passenger transportation;

l. Medical or surgical treatment for any of the above; or

m. Any non-covered sports activities.

2. Expenses arise directly or indirectly from anything in the General Exclusions.

In no event will our payment under this benefit total more than the principal sum. The maximum liability under Accidental Death and Dismemberment for any group or family is limited to $250,000.

Accidental Death means a sudden, unintentional and unexpected occurrence caused solely by external, visible means resulting in physical injury to you and your subsequent death. Death must occur within 30 days of the sudden, unintentional and unexpected occurrence and not be contributed to by illness or disease.

Accidental Dismemberment means a sudden, unintentional and unexpected occurrence caused solely by external, visible means and resulting in complete severance from the body of one or more limbs or eyes and not contributed to by illness or disease. For purposes of the Accidental Death and Dismemberment benefit, the term “limb” shall mean: the arm when the severance is at or above (toward the elbow) the wrist, or the leg when the severance is at or above (toward the knee) the ankle. Loss of eye(s) shall mean: complete, permanent, irrevocable loss of sight.

Beneficiary means the individual named in your application to be the recipient of any Accidental Death benefit. If you do not designate a beneficiary on the application, the beneficiary is automatically as follows:

Members age 18 or older: 1. Spouse (if any), 2. Children (if any) equally, 3. Your estate.

Members under age 18: 1. Custodial Parent(s) (if any), 2. Siblings (if any) equally, 3. Your estate

1. You are covered for taking part in amateur/non-professional sports and activities, unless it is excluded below. Coverage is for recreational purposes incidental to a trip. 1. You must ensure the activity is adequately supervised and that appropriate safety equipment (such as protective headwear, life jackets etc.) are worn at all times.

SPORTS AND ACTIVITIES

YOU ARE COVERED:

YOU ARE NOT COVERED unless you fulfill the following conditions:

YOU ARE NOT COVERED IF:

1. The activity is organized athletics involving regular or scheduled practice and/or games; or

2. The activity is performed in a professional capacity or for any wage, reward, or profit; or

3. Expenses arise directly or indirectly from anything in the General Exclusions; or

4. Any of the excluded items listed below:

• All-Terrain Vehicles

• American Football

• Aussie Rules Football

• Aviation (except when traveling solely as a passenger in a commercial aircraft)

• Base Jumping

• Big Game Hunting or Safari

• Bobsleigh

• Boxing

• Bungee-Jumping

• Cave Diving

• Hang-Gliding

• Heli-Skiing

• Hot Air Ballooning as a Pilot

• Ice Hockey

• Jousting

• Kite-Surfing

• Luge

• Martial Arts

• Modern Pentathlon

• Motorized Dirt Bikes

• Mountaineering

• Outdoor Endurance Events

• Parachuting

• Paragliding

• Powerlifting

• Quad Biking

• Racing by any Animal, Motorized Vehicle, or BMX, and Speed Trials and Speedway

• Rugby

• Running with the Bulls

• Skeleton

• Sky Surfing

• Snow Skiing and Snowboarding

• Snow Mobiles

• Spelunking

• Sub Aqua Pursuits involving underwater breathing apparatus

• Surfing

• Tractors

• Waterskiing

• Whitewater Rafting

• Wrestling

PERSONAL LIABILITY

YOU ARE COVERED:

Up to the sum insured shown in the Schedule of Benefits and Limits (inclusive of legal costs and expenses) if you become legally liable to pay damages in respect of:

1. Accidental bodily injury, including death, illness and disease to a third person; and/or

2. Accidental loss of or damage to a third person’s material property (property that is both material and tangible); and/or

3. Accidental loss of or damage to a related third person’s material property (property that is both material and tangible).

YOU ARE NOT COVERED unless you fulfill the following conditions:

1. You or your legal representatives will give us written notice immediately if you have received notice of any prosecution or inquest in connection with any circumstances which may give rise to liability under this section.

2. No admission, offer, promise, payment or indemnity shall be made by or on behalf of you without our prior written consent.

3. Every claim notice, letter, writ or process or other document served on you shall be forwarded to us and immediately upon receipt.

4. We shall be entitled to take over and conduct in your name the defense or settlement of any claim or to prosecute in your name for our own benefit any claim for indemnity or damages against all other parties or persons.

5. We may at any time pay you in connection with any claim or series of claims the sum insured (after deduction of any sums already paid as compensation) or any lesser amount for which such claim(s) can be settled. Once this payment is made we shall relinquish the conduct and control and be under no further liability in connection with such claim(s) except for the payment of costs and expenses recoverable or incurred prior to the date of such payment.

6. We will consider paying or advancing, but without any obligation or contractual duty to do so, up to $2,500 to you or for your benefit to settle and compromise an asserted claim against you so long as:

a. The asserted claim is one that may be eligible for coverage under this insurance;

b. A lawsuit has not yet been filed, or, if already filed, no response has been filed;

c. You obtain a full written release and/or covenant-not-to-sue satisfactory to us; and

d. A full proof of claim and other necessary documentation is satisfactorily provided to us.

YOU ARE NOT COVERED FOR:

1. Intentionally committed acts, or arising from the influence of alcohol or drugs not medically prescribed by a licensed physician;

2. Bodily injury, illness or disease of any person under a contract of employment, service or apprenticeship with you when the bodily injury, illness or disease arises out of and in the course of their employment to you, or in connection with any trade, business or profession;

3. Loss or damage to property belonging to or held in trust by or in the custody or control of you other than temporary accommodation occupied by you in the course of the trip;

4. Bodily injury or damage caused directly or indirectly in connection with the ownership, possession or use by you or on behalf of you of: aircraft, hovercraft, watercraft, motorized vehicles, parachute, parasail, glider, firearms, fireworks, explosives, deadly weapons, or any racing activity;

5. Any damages, losses or claims caused in whole or in part by you during any hunt or as a result of hunting;

6. Bodily injury caused directly or indirectly in connection with the ownership, possession or occupation of land or buildings, immobile property or caravans or trailers;

7. Damages resulting from any fire, flood, wind, hail, waterleak, gas leak, explosion or other catastrophe;

8. Fraudulent, dishonest or criminal acts of you or any person authorised by you;

9. The consequences of any breach, violation or failure to perform any contractual undertakings or obligations, whether verbal or in writing;

10. Punitive or exemplary damages, or fines, penalties, assessments or claims by any governmental authorities or regulatory bodies;

11. Gambling, gaming, or betting of any kind;

12. Animals or pets belonging to you, or in your care, custody or control;

13. Expenses arise directly or indirectly from anything in the General Exclusions. 1. Eligible Medical Expenses for treatment of injuries and illnesses resulting from an Act of Terrorism, up to the limit set forth in the Schedule of Benefits and Limits, provided all of the following conditions are met.

Third Person means any individual, natural person, or other legal entity or person, other than you or a related third person.

Related Third Person means your relative, your traveling companion, your traveling companion’s relative, and any other person, individual or family member with whom you are residing or being hosted.

TERRORISM

YOU ARE COVERED:

YOU ARE NOT COVERED unless you fulfill the following conditions:

1. The injury or illness does not result from the use of any biological, chemical, cyber, radioactive or nuclear agent, material, device or weapon;

2. You have no direct or indirect involvement in the Act of Terrorism;

3. The Act of Terrorism is not in a country or location where U.S. Department of State has issued a level 3 or level 4 travel advisory that has been in effect within the 6 months immediately prior to your date of arrival; and

4. You have not failed to depart a country or location within 10 days following the date a level 3 or level 4 travel advisory for that country or location is issued by the United States government.

YOU ARE NOT COVERED IF:

1. Loss, damage, cost or expense directly or indirectly caused by, resulting from or in connection with any of the following regardless of any other cause or event contributing concurrently or in any other sequence to the loss, damage, cost or expense:

a. War, invasion, acts of foreign enemies, hostilities or warlike operations (whether war be declared or not), civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power;

b. The use of any biological, chemical, cyber, radioactive or nuclear agent, material, device or weapon; however, this exclusion shall not apply where you are exposed to nuclear radioactive and/or radioactive material for the purpose of medical treatment;

c. Any Act of Terrorism, not specifically covered above;

d. Coverage for loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to (a), (b) or (c) above; or

e. Expenses arise directly or indirectly from anything in the General Exclusions.

For the purpose of this insurance, an “Act of Terrorism” means an act, including but not limited to, the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization(s) or government(s) committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear.

If we allege that by reason of this exclusion, any loss, damage, cost or expense is not covered by this insurance, the burden of proving the contrary shall be upon you.

In the event any portion of this exclusion is found to be invalid or unenforceable, the remainder shall remain in full force and effect.

Cyber means the use or operations, as a means for inflicting harm, of any computer, computer software program, malicious code, computer virus or process or any other electronic system.

LOCAL BURIAL OR CREMATION

YOU ARE COVERED:

1. For you to be buried or cremated in the country of death in lieu of Repatriation of Remains up to the specified benefit maximum.

YOU ARE NOT COVERED unless you fulfill the following conditions:

1. The illness or injury giving rise to the expense is covered under this insurance; and

2. Travel arrangements are approved in advance and coordinated by us.

YOU ARE NOT COVERED IF:

1. The death occurs in your home country; or

2. The Emergency Medical Evacuation or Repatriation of Remains benefit is used; or

3. Expenses arise directly or indirectly from anything in the General Exclusions.

The timeliness of arrangements can be affected by circumstances which are not within our control such as: availability of transportation equipment and staff, delays or restrictions on flights caused by mechanical problems, government officials, telecommunications problems, weather and other acts of God. We shall not be held liable for any delays that are not within our direct and immediate control.