PLEASE READ THIS DOCUMENT CAREFULLY! occurs during a period of gestation in which a viable birth is not
State Notice: The Policy will contain reductions, limitations, exclusions and possible.
This document is not applicable to residents of all states. Residents of termination provisions. Full details of coverage are contained in Complications of Pregnancy do not include false labor, occasional
Florida, Georgia, Indiana, New Hampshire, New York, Oregon, the Policy. If there are any conflicts between the contents of this
Pennsylvania, Utah, and Washington can obtain their state specific spotting, Physician-prescribed rest during the period of
document and the Policy (form series T30337NUFIC), the Policy pregnancy, morning sickness, hyperemesis gravidarum,
documents by visiting www.travelguard.com/fulfillment or by calling will govern in all cases. Insurance underwritten by National Union
1.866.892.2836. preeclampsia and similar conditions associated with the
Fire Insurance Company of Pittsburgh, Pa., with its principal place management of a difficult pregnancy not constituting a
DESCRIPTION OF COVERAGE of business in New York, NY. Coverage may not be available in nosologically distinct complication of pregnancy.
“Deductible” means the amount of charges that must be incurred
by an Insured before benefits become payable. The amount of
Travel Companion IMPORTANT the Deductible is shown in the Schedule for each coverage to
This coverage is valid only if the appropriate plan cost has been which a Deductible applies.
SCHEDULE OF BENEFITS paid. Please keep this document as Your record of coverage “Departure Date” means the date on which the Insured is
under the plan. originally scheduled to leave on his/her Trip. This date is specified
in the travel documents.
All coverages are per person. MAXIMUM LIMIT
“Destination” means any place where the Insured expects to
Trip Cancellation ..................................100% of insured Trip Cost DEFINITIONS travel to on his/her Trip other than Return Destination as shown on
Trip Interruption....................................100% of insured Trip Cost (Capitalized terms within this the travel documents.
Bedside Traveling Companion - Daily Benefit.....................$100 Description of Coverage are defined herein) “Domestic Partner” means an opposite or a same-sex partner
“Actual Cash Value” means purchase price less depreciation. who is at least 18 years of age and has met all of the following
Trip Delay............................................................................$1,000 “Baggage” means luggage, travel documents, and personal
Missed Connection (Maximum of $200 per day)...............$1,000 requirements for at least 6 months: (1) resides with the Insured;
possessions whether owned, borrowed, or rented, taken by the (2) shares financial assets and obligations with the Insured; The
Baggage & Personal Effects Loss ......................................$1,500 Insured on the Trip. Insurer may require proof of the Domestic Partner relationship in
Baggage Delay ......................................................................$500 “Business Partner” means a person who: (1) is involved with the the form of a signed and completed Affidavit of Domestic
Accident Medical Expense................................................$50,000 Insured or the Insured’s Traveling Companion in a legal Partnership.
partnership; and (2) is actively involved in the daily management “Eligible Person” means a person who is a member of an eligible
Sickness Medical Expense ...............................................$50,000
of the business. class of persons as described in the Description of Eligible
Emergency Evacuation “Children”/“Child” means, with respect to the Emergency Persons section of the Master Application.
and Repatriation of Remains ............................................$50,000 Evacuation benefit, unmarried children of the Insured, including “Experimental or Investigative” means treatment, a device or
natural children from the moment of birth, and step, foster or prescription medication which is recommended by a Physician,
The following non-insurance services adopted children from the moment of placement in the Insured’s but is not considered by the medical community as a whole to be
are provided by Travel Guard. home, under age 25 and primarily dependent on the Insured for safe and effective for the condition for which the treatment, device
Travel Medical Assistance support and maintenance. However, the age limit does not apply or prescription medication is being used. This includes any
Worldwide Travel Assistance to a child who: (1) otherwise meets the definition of Children; and treatment, procedure, facility, equipment, drugs, drug usage,
(2) is incapable of self-sustaining employment by reason of mental devices, or supplies not recognized as accepted medical practice,
or physical incapacity. and any of those items requiring federal or other governmental
f your air arrangements are not booked by World Travel Holdings, “City” means an incorporated municipality having defined agency approval not received at the time services are rendered.
you will be covered for Trip Cancellation if your flights arrive and borders and does not include the high seas, uninhabited areas or “Family Member” means the Insured’s or Traveling Companion’s
depart from the same location as your land or water arrangements airspace. spouse, Domestic Partner, Child, daughter-in-law, son-in-law,
arrives and departs; AND your flight is within two weeks of your “Common Carrier” means an air, land, or sea conveyance brother, sister, mother, father, grandparents, grandchild, step-
land or water arrangements arrival and departure dates. operated under a license for the transportation of passengers for child, step-brother, step-sister, step-parents, parents-in-law,
hire. brother-in-law, sister-in-law, aunt, uncle, niece, nephew, legal
If your air arrangements are not booked by World Travel Holdings “Complications of Pregnancy” means conditions whose guardian, foster child, ward, or legal ward.
and are greater than 4 total days before and/or after your land or diagnoses are distinct from pregnancy but are adversely affected “Financial Default” means the total cessation or partial
water travel arrangements, you will also be covered for Trip by pregnancy or are caused by pregnancy. These conditions suspension of operations due to insolvency, with or without the
Interruption, Trip Delay, Medical Expense, Emergency Evacuation include acute nephritis, nephrosis, cardiac decompensation, filing of a bankruptcy petition by a tour operator, cruise line, or
& Repatriation of Remains, Baggage & Personal Effects Loss, and missed abortion and similar medical and surgical conditions of airline.
Baggage Delay on the day(s) you are flying to/from your comparable severity. Complications of Pregnancy also include “Hospital” means a facility that: (1) is operated according to law
destination. nonelective cesarean section, ectopic pregnancy which is for the care and treatment of sick or Injured people; (2) has
terminated and spontaneous termination of pregnancy, which organized facilities for diagnosis and surgery on its premises or in
T30337NUFIC-TG-DOC 008065 P1 3/10
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facilities available to it on a prearranged basis; (3) has 24 hour highways of any state or country that is rented or owned by the “Travel Supplier” means the tour operator, rental company,
nursing service by registered nurses (R.N.’s); and (4) is Insured. Owned or Rented Vehicle includes, but is not limited to, a cruise line, and/or airline that provides pre-paid travel
supervised by one or more Physicians available at all times. sedan, station wagon, jeep-type vehicle pickup, van, camper or arrangements for the Insured’s Trip.
A Hospital does not include: motor home type. Owned or Rented Vehicle does not include a “Traveling Companion” means a person or persons with whom
(1) a nursing, convalescent or geriatric unit of a hospital when a mobile home or any motor vehicle which is used in mass or public the Insured has coordinated travel arrangements and intends to
patient is confined mainly to receive nursing care; (2) a facility that transit. travel with during the Trip. A group or tour leader is not considered
is, other than incidentally, a clinic, a rest home, nursing home, “Physician” means a licensed practitioner of the healing arts a Traveling Companion, unless the Insured is sharing room
convalescent home, home health care, or home for the aged; nor including accredited Christian Science Practitioners, medical, accommodations with the group or tour leader.
does it include any ward, room, wing, or other section of the surgical, or dental, services acting within the scope of his/her “Trip” means a Trip for which coverage has been elected and the
hospital that is used for such purposes; or (3) any military or license. The treating Physician may not be the Insured, a plan payment paid, and all travel arrangements are arranged by
veterans hospital or soldiers home or any hospital contracted for Traveling Companion, a Family Member, or a Business Partner. World Travel Holdings prior to the Departure Date of the Trip; the
or operated by any national government or government agency for “Primary Residence” means a person's fixed, permanent and Trip does not exceed 120 days; and the Insured’s Destination is
the treatment of members or ex-members or the armed forces. principal home for legal and tax purposes. not to another home; travel is primarily by Common Carrier and
“Inclement Weather” means any severe weather condition which “Reasonable Additional Expenses” means expenses for meals, only incidentally by private conveyance.
delays the scheduled arrival or departure of a Common Carrier or taxi fares, essential phone calls and lodging which were “Trip Cost” means the dollar amount of Trip payments or
prevents the Insured from reaching his/her Destination when necessarily incurred as the result of a Trip Delay and which are deposits reflected on any required enrollment form which are
traveling by an Owned or Rented Vehicle. not provided by the Common Carrier or any other party free of subject to cancellation penalties or restrictions paid by the Insured
“Injury/Injured” means a bodily injury caused by an accident charge. prior to the Insured’s Trip Departure Date. Trip Cost will also
occurring while the Insured’s coverage under the Policy is in force, “Reasonable and Customary Charges” means an expense include the cost of any subsequent pre-paid payments or deposits
and resulting directly and independently of all other causes of which: paid by the Insured for the same Trip, after enrollment for
Loss covered by the Policy. The injury must be verified by a (1) is charged for treatment, supplies, or medical services coverage under this plan provided the Insured amends their
Physician. Medically Necessary to treat the Insured’s condition; enrollment form to add such subsequent payments or deposits
“Insured” means an Eligible Person for whom: (a) any required (2) does not exceed the usual level of charges for similar and pays any required additional plan cost prior to the Insured’s
plan cost has been paid; (b) while covered under the Policy. treatment, supplies or medical services in the locality where Departure Date.
“Insurer” means National Union Fire Insurance Company of the expense is incurred; and “Unforeseen” means not anticipated or expected and occurring
Pittsburgh, Pa. (3) does not include charges that would not have been made if no after the effective date of the coverage.
“Loss” means Injury or damage sustained by the Insured as a insurance existed. In no event will the Reasonable and “Uninhabitable” means (1) the building structure itself is unstable
consequence of one or more of the events against which the Customary Charges exceed the actual amount charged. and there is a risk of collapse in whole or in part; (2) there is
Insurer has undertaken to compensate the Insured. “Return Date” means the date on which the Insured is scheduled exterior or structural damage allowing elemental intrusion, such
“Medically Necessary” means that a treatment, service, or to return to the point where the Trip started or to a different as rain, wind, hail or flood; (3) immediate safety hazards have yet
supply: specified Return Destination. This date is specified in the travel to be cleared, such as debris on roofs or downed electrical lines;
(1) is essential for diagnosis, treatment, or care of the Injury or documents. or (4) the rental property is without electricity or water.
Sickness for which it is prescribed or performed; “Return Destination” means the place to which the Insured
(2) meets generally accepted standards of medical practice; expects to return from his/her Trip. ELIGIBILITY, EFFECTIVE &
(3) is ordered by a Physician and performed under his or her “Schedule” means the Schedule of Benefits. TERMINATION DATES
care, supervision, or order; and “Sickness” means an illness or disease diagnosed or treated by Eligibility
(4) is not primarily for the convenience of the Insured, Physician, a Physician. Travelers who enroll, accept and purchase coverage through the
other providers, or any other person. “Strike” means a stoppage of work: Travel Supplier no later than 10 days following their final Trip
“Mental, Nervous or Psychological Disorder” means a mental (1) announced, organized, and sanctioned by a labor union and payment date and prior to departing on their Trip.
or nervous health condition including, but not limited to: anxiety, (2) which interferes with the normal departure and arrival of a Effective Date: Trip Cancellation coverage will be effective for an
depression, neurosis, phobia, psychosis; or any related physical Common Carrier. Insured at 12:01 a.m. Standard Time on the date following
manifestation. This includes work slowdowns and sickouts. The Insured’s Trip payment by the Insurer or the Insurer’s authorized representative
“Natural Disaster” means a flood, hurricane, tornado, cancellation coverage must be effective prior to when the Strike is of any required plan cost.
earthquake, fire, wildfire, volcanic eruption, or blizzard that is due foreseeable. A Strike is foreseeable on the date labor union All other coverages will begin on the later of:
to natural causes. members vote to approve a Strike. (a) the date and time the Insured starts his/her Trip,
“Necessary Personal Effects” means items such as clothing “Transportation” means any land, sea or air conveyance provided any required plan cost has been paid.
and toiletry items, which were included in the Insured’s Baggage required to transport the Insured during an Emergency Termination Date: All coverage, other than Trip Cancellation,
and are required for the Insured’s Trip. Evacuation. Transportation includes, but is not limited to, air ends on the earlier of:
“Owned or Rented Vehicle” means a self-propelled private ambulances, land ambulances and private motor vehicles. (a) the date the Trip is completed;
passenger motor vehicle with four or more wheels which is of a (b) the scheduled Return Date;
type both designed and required to be licensed for use on the
4 5 6
(c) the Insured’s arrival at the Return Destination on a round Trip, treatment; (b) for which care or treatment was given or (g) failure of any tour operator, Common Carrier, person or
or the Destination on a one-way Trip. recommended by a Physician; (c) required taking prescription agency to provide the bargained-for travel arrangements.
The Trip Cancellation coverage ends on the earliest of: (a) the drugs or medicines, unless the condition for which the drugs The following exclusions apply to the Medical Expense
cancellation of the Insured’s Trip; or (b) the date and time the or medicines are taken remains controlled without any change Benefit:
Insured starts on his/her Trip. in the required prescription drugs or medicines. Benefits will not be provided for any loss resulting (in whole or in
The following exclusions apply to Baggage/Personal Effects part) from:
GENERAL EXCLUSIONS Loss and Baggage Delay: (a) routine physical examinations;
This plan does not cover any loss caused by or resulting from: Benefits will not be provided for any loss or damage to or resulting (b) mental health care;
(a) intentionally self-inflicted Injury, suicide, or attempted suicide (in whole or in part) from: (c) replacement of hearing aids, eye glasses, contact lenses and
of the Insured, Family Member, Traveling Companion or (a) animals, rodents, insects or vermin; sunglasses;
Business Partner while sane or insane; (b) bicycles (except when checked with a Common Carrier); (d) routine dental care;
(b) pregnancy, childbirth, or elective abortion, other than (c) motor vehicles, aircraft, boats, boat motors, ATV’s and other (e) any service provided by the Insured, a Family Member, or
Complications of Pregnancy; conveyances; Traveling Companion or Traveling Companion of Family
(c) participation in professional athletic events, motor sport, or (d) artificial prosthetic devices, false teeth, any type of Member;
motor racing, including training or practice for the same; eyeglasses, sunglasses, contact lenses, or hearing aids; (f) alcohol or substance abuse or treatment for the same.
(d) mountaineering where ropes or guides are normally used. (e) tickets, keys, notes, securities, accounts, bills, currency,
The ascent or descent of a mountain requiring the use of deeds, food stamps or other evidences of debt, and other EXCESS INSURANCE LIMITATION
specialized equipment, including but not limited to pick-axes, travel documents (except passports and visas); The insurance provided by the Policy for all coverages except Trip
anchors, bolts, crampons, carabineers, and lead or top-rope (f) money, stamps, stocks and bonds, postal or money orders; Cancellation and Interruption shall be in excess of all other valid
anchoring equipment; (g) property shipped as freight, or shipped prior to the Departure and collectible insurance or indemnity. If at the time of the
(e) war or act of war, whether declared or not, civil disorder, riot, Date; occurrence of any Loss payable under the Policy there is other
or insurrection; (h) contraband, illegal transportation or trade; valid and collectible insurance or indemnity in place, the Insurer
(f) operating or learning to operate any aircraft, as student, pilot, (i) items seized by any government, government official or shall be liable only for the excess of the amount of Loss, over the
or crew; customs official; amount of such other insurance or indemnity, and applicable
(g) air travel on any air-supported device, other than a regularly (j) defective materials or craftsmanship; Deductible.
scheduled airline or air charter company; (k) normal wear and tear;
(h) loss or damage caused by detention, confiscation, or (l) deterioration; TRIP CANCELLATION & INTERRUPTION
destruction by customs; (m) sporting equipment damaged while being used; The Insurer will pay a benefit, up to the Maximum Limit shown on
(i) any unlawful acts, committed by the Insured, a Family (n) inherent vice or damage; the Schedule, if an Insured cancels his/her Trip or is unable to
Member, or a Traveling Companion, or Business Partner (o) radioactive contamination; continue on his/her Trip due to the following Unforeseen events:
whether insured or not; (p) mysterious disappearance; (a) Sickness, Injury or death of an Insured, Family Member,
(j) Mental, Nervous or Psychological Disorder; (q) breakage of brittle or fragile articles, such as cameras, Traveling Companion, or Business Partner;
(k) if the Insured’s tickets do not contain specific travel dates camera equipment and accessories, cellular phones, wireless 1) Injury or Sickness of an Insured, Traveling Companion or
(open tickets); handheld devices, musical instruments, radios, and similar Family Member traveling with the Insured must be so
(l) use of drugs, narcotics, or alcohol, unless administered upon property. disabling as to reasonably cause a Trip to be cancelled or
the advice of a Physician; interrupted, or which results in medically imposed
(m) any loss that occurs at a time when this coverage is not in The following exclusions apply to Trip Cancellation and Trip restrictions as certified by a Physician at the time of Loss
effect; Interruption: preventing your continued participation in the Trip.
(n) care or treatment which is not Medically Necessary; Benefits will not be provided for any loss resulting (in whole or in 2) The Insured must cancel or interrupt his/her Trip due to
(o) any Trip taken outside the advice of a Physician; part) from: Injury or Sickness of a Family Member not traveling with the
(p) military duty; (a) travel arrangements canceled by an airline, cruise line, or tour Insured.
(q) participation in underwater activities; operator, except as provided elsewhere in the plan; 3) Injury or Sickness of the Business Partner must be so
(r) PRE-EXISTING MEDICAL CONDITION EXCLUSION: The (b) changes by the Insured, a Family Member, or Traveling disabling as to reasonably cause the Insured to cancel or
Insurer will not pay for any Loss or expense incurred as the Companion, for any reason; interrupt the Trip to assume daily management of the
result of an Injury, Sickness or other condition of an Insured, (c) financial circumstances of the Insured, a Family Member, or a business. Such disability must be certified by a Physician.
Traveling Companion, Business Partner, or Family Member Traveling Companion; (b) Financial Default of an airline, cruise line, or tour operator
booked to travel with the Insured which, within the 60 day (d) any government regulation or prohibition; provided the Financial Default occurs more than 7 days
period immediately preceding and including the Insured’s (e) any business or contractual obligations of the Insured, a following an Insured's effective date for the Trip Cancellation
coverage effective date: (a) first manifested itself, worsened Family Member, or Traveling Companion, for any reason; or Trip Interruption Benefits. There is no coverage for the
or became acute or had symptoms which would have (f) an event which occurs prior to the Insured’s coverage Financial Default of any person, organization, agency, or firm
prompted a reasonable person to seek diagnosis, care or Effective Date;
7 8 9
from whom the Insured purchased travel arrangements BEDSIDE TRAVELING COMPANION 3. pre-paid, non-refundable trip payments for the unused portion
supplied by others; If a Traveling Companion or Family Member is hospitalized for at of the Trip.
(c) the Insured’s Primary Residence being made Uninhabitable least 1 day during the Trip, the Insurer will reimburse the Insured The Common Carrier must certify the delay of the regularly
by Natural Disaster; up to the Per Day and Maximum Limit shown in the Schedule for scheduled airline flight.
(d) the Insured, or a Traveling Companion being subpoenaed, reasonable additional expenses incurred for hotel and meals
required to serve on a jury, hijacked, or quarantined, required (receipts must be submitted) to remain near the Traveling BAGGAGE & PERSONAL EFFECTS LOSS
to appear as a witness in a legal action, provided the Insured Companion or Family Member. For purposes of this benefit, The Insurer will reimburse the Insured, up to the Maximum Limit
or a Traveling Companion is not 1) a party to the legal action, Traveling Companion or Family Member means the person is shown in the Schedule subject to the special limitations shown
or 2) appearing as a law enforcement officer; insured under this plan and accompanies the Insured on the Trip. below, for Loss, theft or damage to the Insured’s Baggage and
(e) the Insured or Traveling Companion is involved in an personal effects during the Insured’s Trip.
automobile accident, substantiated by a police report, while TRIP DELAY Special Limitations:
en route to the Insured’s Destination. The Insurer will reimburse the Insured up to the Maximum Limit(s) The Insurer will not pay more than:
shown on the Schedule for Reasonable Additional Expenses until • $250 for the first item and
SPECIAL NOTIFICATION OF CLAIM travel becomes possible if the Insured’s Trip is delayed 12 or more • thereafter, no more than $250 per each additional item
The Insured must notify Travel Guard as soon as reasonably consecutive hours from reaching their intended Destination as a • $500 aggregate on all Losses to: jewelry, watches and furs.
possible in the event of a Trip Cancellation or Interruption claim. If result of a cancellation or delay of a regularly scheduled airline
the Insured is unable to provide cancellation notice within the flight for one of the Unforeseen events listed below: Items over $150 must be accompanied by original receipts.
required timeframe, the Insured must provide proof of the (a) the Insured or Traveling Companion is quarantined;
circumstance that prevented timely notification. (b) Common Carrier delay; The Insurer will pay the lesser of:
Trip Cancellation Benefits: The Insurer will reimburse the (c) Inclement Weather which prohibits Insured’s departure; (1) the cash value (original cash value less depreciation) as
Insured for forfeited Trip Cost up to the Maximum Limit shown on (d) the Insured’s or Traveling Companion’s lost or stolen determined by the Insurer or,
the Schedule for Trips that are canceled prior to the scheduled passports, travel documents, or money; (2) the cost of replacement.
departure for their Trip due to the Unforeseen events shown (e) Natural Disaster;
above. (f) Strike; The Insurer may take all or part of the damaged Baggage at the
Trip Interruption Benefits: The Insurer will reimburse the (g) the Insured being involved in or delayed due to a traffic appraised or agreed value. In the event of a Loss to a pair or set
Insured up to the Maximum Limit shown on the Schedule for Trips accident while en route to a departure as substantiated by a of items, the Insurer may at its option:
that are interrupted due to the Unforeseen events shown above: police report. (1) repair or replace any part to restore the pair or set to its value
(a) forfeited, insured Trip Cost, and before the Loss; or
(b) additional transportation expenses incurred by the Insured, Incurred expenses must be accompanied by receipts. (2) pay the difference between the value of the property before
either and after the Loss.
(i) to the Return Destination; or This benefit is payable for only one delay per Insured, per Trip.
(ii) from the place that the Insured left the Trip to the place that BAGGAGE DELAY
the Insured may rejoin the Trip; or If the Insured incurs more than one delay in the same Trip the If the Insured’s Baggage is delayed or misdirected by the
(c) additional transportation expenses incurred by the Insured to Insurer will pay for the delay with the largest benefit up to the Common Carrier for more than 24 hours while on a Trip, the
reach the original Trip Destination if the Insured is delayed, Maximum Limits shown on the Schedule. Insurer will reimburse the Insured up to the Maximum Limit shown
and leaves after the Departure Date. on the Schedule for the purchase of Necessary Personal Effects.
However, the benefit payable under (b) and (c) above will not The Insured Must: Contact Travel Guard as soon as he/she Incurred expenses must be accompanied by receipts. This benefit
exceed the cost of economy airfare or the same class as the knows his/her Trip is going to be delayed more than 12 hours. does not apply if Baggage is delayed after the Insured has
Insured’s original ticket less any refunds paid or payable by the reached his/her Return Destination.
most direct route. MISSED CONNECTION
If while on a Trip the Insured misses a Trip departure resulting MEDICAL EXPENSE BENEFIT
SINGLE OCCUPANCY from cancellation or delay of 3 or more hours of all regularly If, while on a Trip, an Insured suffers an Injury or Sickness that
The Insurer will reimburse the Insured, up to the Trip Cancellation scheduled airline flights due to Inclement Weather or Common requires him or her to be treated by a Physician the Insurer will
and Interruption Maximum Limit shown on the Schedule, for the Carrier caused delay, the Insurer will reimburse the Insured up to pay the Reasonable and Customary Charges, up to the Maximum
additional cost incurred during the Trip as a result of a change in the Maximum Limit shown in the Schedule for: Limit(s) shown on the Schedule of Benefits or Declarations Page.
the per person occupancy rate for prepaid, non-refundable travel 1. additional transportation expenses incurred by the Insured to The Insurer will reimburse the Insured for Medically Necessary
arrangements if a person booked to share accommodations with join the departed Trip; Covered Expenses incurred to treat such Injury or Sickness within
the Insured has his/her Trip cancelled or interrupted due to the 2. reasonable accommodation and meal expenses incurred up one year of the date of the accident that caused the Injury or the
Unforeseen events shown in the Trip Cancellation/Interruption to the per day amount shown in the Schedule; and onset of the Sickness provided the initial treatment was received
section and the Insured does not cancel.
10 11 12
during the Trip. The Injury must occur or the Sickness must begin limited to the amount the Insurer would have paid had the Insurer REPATRIATION OF REMAINS
while on a Trip, while covered under the policy. or their authorized representative been contacted. The Insurer will pay Repatriation Covered Expenses up to the
Covered Expenses: The Insurer will also pay a benefit for Reasonable and Customary Maximum Limit shown on the Schedule to return the Insured's
The Insurer will pay for: Charges incurred for an escort’s transportation and body to city of burial if he/she dies during the Trip.
• services of a Physician or Registered Nurse (R.N.); accommodations if an attending Physician recommends in writing
• Hospital charges; that an escort accompany the Insured. Repatriation Covered Expenses include, but are not limited to,
• X-ray(s); Emergency Evacuation means: the reasonable and customary expenses for transportation,
• local ambulance services to or from a Hospital; (a) the Insured's medical condition warrants immediate according to airline tariffs, of the remains by the most direct and
• artificial limbs, artificial eyes, artificial teeth, or other prosthetic Transportation from the place where the Insured is injured or economical conveyance and route possible.
devices; sick to the nearest adequate licensed medical facility where Travel Guard must make all arrangements and authorize all
• the cost of emergency dental treatment only during a Trip appropriate medical treatment can be obtained; expenses in advance for this benefit to be payable.
limited to a Maximum Limit shown in the Schedule. Coverage (b) after being treated at a local licensed medical facility, the Special Limitation: In the event the Insurer or the Insurer’s
for emergency dental treatment does not apply if treatment or Insured's medical condition warrants transportation to the authorized representative could not be contacted to arrange for
expenses are incurred after the Insured has reached his/her Insured’s home, or adequate licensed medical facility nearest Repatriation Covered Expenses, benefits are limited to the
Return Destination, regardless of the reason. The treatment the Insured’s home to obtain further medical treatment or to amount the Insurer would have paid had the Insurer or their
must be given by a Physician or dentist; recover; or authorized representation been contacted.
Advance Payment: If an Insured requires admission to a (c) both (a) and (b) above.
Hospital, Travel Guard will arrange advance payment, if required. LIMITATIONS: PAYMENT OF CLAIMS
Hospital confinement must be certified as Medically Necessary by (1) Benefits are only available under Emergency Evacuation if Claim Procedures: Notice of Claim: The Insured must call
the attending Physician. they are not provided under another coverage in the plan. Travel Guard as soon as reasonably possible, and be prepared to
(2) The Maximum Limit payable for both Emergency Evacuation describe the Loss, the name of the company that arranged the
EMERGENCY EVACUATION and Repatriation of Remains is shown in the Schedule. Trip (i.e., tour operator, cruise line, or charter operator), the Trip
& REPATRIATION OF REMAINS dates, and the amount that the Insured paid. Travel Guard will fill
The Insurer will pay for Covered Emergency Evacuation ADDITIONAL BENEFIT in the claim form and forward it to the Insured for his or her review
Expenses incurred if an Insured suffers an Injury or Sickness In addition to the above covered expenses, if the Insurer has and signature. The completed form should be returned to Travel
while he or she is on a Trip that warrants his or her Emergency previously evacuated an Insured to a medical facility, the Insurer Guard, PO Box 47, Stevens Point, Wisconsin 54481 (telephone
Evacuation. Benefits payable are subject to the Maximum Limit will pay his/her airfare costs from that facility to the Insured’s 1.866.892.2836). All claims of California residents will be
shown on the Schedule for all Emergency Evacuations due to all Return Destination, within one year from the Insured’s original administered by Mercury Claims Administrator Services, LLC. All
Injuries from the same accident or all Sicknesses from the same Return Date, less refunds from the Insured’s unused accident, health, and life claims will be administered by Mercury
or related causes. transportation tickets. Airfare costs will be economy, or same class Claims & Assistance of WI, LLC, in those states where it is
Covered Emergency Evacuation Expenses are the Reasonable as the Insured’s original tickets. licensed.
and Customary Charges for necessary Transportation, related Claim Procedures: Proof of Loss: The claim forms must be sent
medical services and medical supplies incurred in connection with If the Insured is hospitalized for more than 7 days following a back to Insurer no more than 90 days after a covered Loss occurs
the Emergency Evacuation of the Insured. All Transportation covered Emergency Evacuation, the Insurer will pay subject to the or ends, or as soon after that as is reasonably possible. All claims
arrangements made for evacuating the Insured must be by the limitations set out herein, for expenses for: under the policy must be submitted to Travel Guard no later than
most direct and economical route possible. Expenses for 1. Return of Children: If the Insured is unable to travel due to a one year after the date of Loss or insured occurrence or as soon
Transportation must be: covered Emergency Evacuation, the Insurer will pay to return any as reasonably possible. If Insurer has not provided claim forms
(a) ordered by the attending Physician who must certify that the of the Insured’s Children who were accompanying the Insured within 15 days after the notice of claim, other proofs of Loss
severity of the Insured’s Injury or Sickness warrants his or her when the Injury or Sickness occurred back to the Insured’s should be sent to Travel Guard by the date claim forms would be
Emergency Evacuation and adequate medical treatment is residence in the United States, including the cost of an attendant, due. The proof of Loss should include written proof of the
not locally available; if necessary; Such expenses shall not exceed the cost of a one- occurrence, type and amount of Loss, the Insured’s name, the
(b) required by the standard regulations of the conveyance way economy airfare ticket less the value of any applied credit participating organization name, and the policy number.
transporting the Insured; and from any unused return travel tickets for each person. Payment of Claims: When Paid: Claims will be paid as soon as
(c) authorized in advance by Travel Guard. In the event the 2. Bedside Visit: To bring one person chosen by the Insured to Travel Guard receives complete proof of Loss and verification of
Insured’s Injury or Sickness prevents prior authorization of the and from the medical facility where the Insured is confined if the age.
Emergency Evacuation, Travel Guard (1.866.892.2836 or Insured is alone and is hospitalized for more than 7 days following Payment of Claims: To Whom Paid: Benefits are payable to the
collect 1.715.295.5452) must be notified as soon as a covered Emergency Evacuation. The Insurer will pay for Insured who applied for coverage and paid any required plan cost.
reasonably possible. expenses to bring one person chosen by the Insured. The Any benefits payable due to that Insured’s death, will be paid to
Special Limitation: In the event Travel Guard could not be payment will not to exceed the cost of one round-Trip economy the survivors of the first surviving class of those that follow:
contacted to arrange for emergency Transportation, benefits are airfare ticket.
13 14 15
(1) the Beneficiary named by that Insured and on file with Travel Common Carrier and receipts for the Necessary Personal Effects Subrogation. To the extent the Insurer pays for a Loss suffered
Guard purchases. by an Insured, the Insurer will take over the rights and remedies
(2) to his/her spouse, if living. If no living spouse, then Medical Expense Payment of Loss: The Insured must provide the Insured had relating to the Loss. This is known as
(3) in equal shares to his/her living children. If there are none, Travel Guard with: (a) all medical bills and reports for medical subrogation. The Insured must help the Insurer preserve its rights
then expenses claimed; and (b) a signed patient authorization to against those responsible for its Loss. This may involve signing
(4) in equal shares to his/her living parents. If there are none, release medical information to Travel Guard. any papers and taking any other steps the Insurer may reasonably
then require. If the Insurer takes over an Insured's rights, the Insured
(5) in equal shares to his/her living brothers and sisters. If there The following provisions apply to Baggage Delay and must sign an appropriate subrogation form supplied by the
are none, then Baggage/Personal Effects Loss: Insurer.
(6) to the Insured’s estate. Notice of Loss. If the Insured's property covered under the As a condition to receiving the applicable benefits listed above, as
Policy is lost or damaged, the Insured must: they pertain to this Subrogation provision, the Insured agrees,
If a benefit is payable to a minor or other person who is incapable (a) notify Travel Guard as soon as possible; except as may be limited or prohibited by applicable law, to
of giving a valid release, the Insurer may pay up to $3,000 to a (b) take immediate steps to protect, save and/or recover the reimburse the Insurer for any such benefits paid to or on behalf of
relative by blood or connection by marriage who has assumed covered property; the Insured, if such benefits are recovered, in any form, from any
care or custody of the minor or responsibility for the incompetent (c) give immediate notice to the carrier or bailee who is or may be Third Party or Coverage.
person’s affairs. Any payment Insurer makes in good faith fully liable for the loss or damage; Coverage – as used in this Subrogation section, means no fault
discharges Insurer to the extent of that payment. (d) notify the police or other authority in the case of robbery or motorist coverage, uninsured motorist coverage, underinsured
theft within 24 hours. motorist coverage, or any other fund or insurance policy (except
Benefits for Medical Expense/Emergency Evacuation services Proof of Loss. The Insured must furnish the Insurer with proof of coverage provided under the Policy to which this Description of
may be payable directly to the provider of the services. However, Loss. Proof of Loss includes police or other local authority reports Coverage is attached) and any fund or insurance policy providing
the provider: (a) must comply with the statutory provision for direct or documentation from the appropriate party responsible for the the Policyholder with coverage for any claims, causes of action or
payment, and (b) must not have been paid from any other Loss. It must be filed within 90 days from the date of Loss. rights the Insured may have against the Policyholder.
sources. Failure to comply with these conditions shall not invalidate any Third Party – as used in this Subrogation section, means any
Trip Cancellation and Trip Interruption Payment of Loss: The claims under the Policy. person, corporation or other entity (except the Insured, the
Insured must provide Travel Guard documentation of the Settlement of Loss. Claims for damage and/or destruction shall Policyholder and the Insurer).
cancellation or interruption and proof of the expenses incurred. be paid immediately after proof of the damage and/or destruction
The Insured must provide proof of payment for the Trip such as is presented to the Insurer. Claims for lost property will be paid GENERAL PROVISIONS
canceled check or credit card statements, proof of refunds after the lapse of a reasonable time if the property has not been Physical Examination and Autopsy. The Insurer at its own
received, copies of applicable tour operator or Common Carrier recovered. The Insured must present acceptable proof of Loss expense has the right and opportunity to examine the person of
cancellation policies, and any other information reasonably and the value. any individual whose Loss is the basis of claim under the Policy
required to prove the Loss. Claims involving Loss due to Sickness, Valuation. The Insurer will not pay more than the Actual Cash when and as often as it may reasonably require during the
Injury, or death require signed patient (or next of kin) authorization Value of the property at the time of Loss. At no time will payment pendency of the claim and to make an autopsy in case of death
to release medical information and an attending Physician’s exceed what it would cost to repair or replace the property with where it is not forbidden by law.
statement. The Insured must provide Travel Guard with all unused material of like kind and quality. Beneficiary Designation and Change. The Insured’s
air, rail, cruise, or other tickets if he/she is claiming the value of Disagreement Over Size of Loss. If there is a disagreement beneficiary(ies) is (are) the person(s) designated by the Insured
those unused tickets. about the amount of the Loss either the Insured or the Insurer can and on file with Travel Guard.
Baggage and Personal Effects Loss Payment of Loss: The make a written demand for an appraisal. After the demand, the An Insured over the age of majority and legally competent may
Insured Must: (a) report theft Losses to police or other local Insured and the Insurer each select their own competent change his or her beneficiary designation at any time, unless an
authorities as soon as possible; (b) take reasonable steps to appraiser. After examining the facts, each of the two appraisers irrevocable designation has been made, without the consent of
protect his/her Baggage from further damage and make will give an opinion on the amount of the Loss. If they do not the designated beneficiary(ies), by providing Travel Guard with a
necessary and reasonable temporary repairs; (The Insurer will agree, they will select an arbitrator. Any figure agreed to by 2 of written request for change. When the request is received,
reimburse the Insured for those expenses. The Insurer will not pay the 3 (the appraisers and the arbitrator) will be binding. The whether the Insured is then living or not, the change of beneficiary
for further damage if the Insured fails to protect his/her Baggage); appraiser selected by the Insured is paid by the Insured. The will relate back to and take effect as of the date of execution of the
(c) allow the Insurer to examine the damaged Baggage and/or the Insurer will pay the appraiser it chooses. The Insured will share written request, but without prejudice to the Insurer on account of
Insurer may require the damaged item to be sent in the event of with us the cost for the arbitrator and the appraisal process. any payment made by it prior to receipt of the request.
payment; or (d) send sworn proof of Loss as soon as possible Benefit to Bailee. This insurance will in no way inure directly or Assignment. An Insured may not assign any of his or her rights,
from date of Loss, providing amount of Loss, date, time, and indirectly to the benefit of any carrier or other bailee. privileges or benefits under the Policy.
cause of Loss, and a complete list of damaged/lost items. The following provision applies to Medical Expense, Legal Actions. No action at law or in equity may be brought to
Baggage Delay Payment of Loss: The Insured must provide Baggage/Personal Effects Loss and Emergency Evacuation recover on the Policy prior to the expiration of 60 days after written
documentation of the delay or misdirection of Baggage by the and Repatriation of Remains: proof of Loss has been furnished in accordance with the
16 17 18
requirements of the Policy. No such action may be brought after eight-hundredths of one per cent or more of alcohol, by weight or Notice to Washington DC Residents:
the expiration of 3 years after the time written proof of Loss is such person has sustained such Injury while under the influence T30341NUFIC-DC
required to be furnished. of intoxicating liquor or any drug or both. The Pre-existing Medical Condition Exclusion is amended as
Concealment or Fraud: The Insurer does not provide coverage if “Riot” means a tumultuous disturbance of the public peace by follows:
the Insured has intentionally concealed or misrepresented any three or more persons assembled together and acting with a (r) PRE-EXISTING MEDICAL CONDITION EXCLUSION: The
material fact or circumstance relating to the policy or claim. common intent. Insurer will not pay for any Loss or expense incurred as the result
Payment of Premium: Coverage is not effective unless all The General Exclusions relating to suicide and Mental, Nervous of an Injury, Sickness or other condition of an Insured, Traveling
premium due has been paid to Travel Guard prior to a date of Loss and Psychological Disorders do not apply to the medical benefits. Companion, Business Partner or Family Member which, within the
or insured occurrence. The General Exclusion relating to use of drugs is deleted in its 60 day period immediately preceding and including the Insured’s
Termination of the Policy: Termination of the policy will not affect entirety and replaced with the following: “voluntary use of any coverage effective date: (a) first manifested itself, worsened or
a claim for Loss which occurs while the policy is in force. controlled substance as defined in Title II of the Comprehensive became acute or had symptoms which would have prompted a
Transfer of Coverage: Coverage under the policy cannot be Drug Abuse Prevention and Control Act of 1970, as now or person to seek diagnosis, care or treatment; (b) for which care or
transferred by the Insured to anyone else. hereafter amended, unless as prescribed by his physician for the treatment was given or recommended by a Physician; (c) required
Insured;” taking prescription drugs or medicines, unless the condition for
STATE SPECIFIC NOTICES The General Exclusion relating to Experimental or Investigative which the drugs or medicines are taken remains controlled without
Notice to Colorado Residents: treatment or procedures is amended to add the following: any change in the required prescription drugs or medicines.
T30341NUFIC-CO “unless such treatment or procedure has successfully completed The definition of Medically Necessary is amended to add: “The
The phrase “or insane” is deleted from the intentionally self- a phase III clinical trial of the federal Food and Drug fact that a Physician may prescribe, order, recommend or approve
inflicted Injury, suicide or attempted suicide exclusion when it Administration;” a service or supply does not of itself make it Medically Necessary
applies to Medical Expense Benefit and Emergency Evacuation. The General Exclusion relating to unlawful acts is amended to or covered by this plan.”
replace “unlawful acts” with “felonies”. The definition of Domestic Partner is amended as follows:
Notice to Connecticut Residents: The Medical Expense exclusion relating to alcohol or substance “Domestic Partner” means a person with whom an individual
T30341NUFIC-CT abuse is amended to read “ Intoxication or voluntary use of any maintains a committed familial relationship characterized by
The definition of Hospital with respect to the military or veterans controlled substance as defined in Title II of the Comprehensive mutual caring and the sharing of a mutual residence. Each partner
hospital is amended to add “for which no charge is normally Drug Abuse Prevention and Control Act of 1970, as now or must be at least 18 years old and competent to contract, be the
made”. hereafter amended, unless as prescribed by his physician for the sole Domestic Partner of the other person and not be married.
The definition of Medically Necessary is deleted in its entirety and Insured”. General Exclusions (j) and (l) are amended to add "except as
replaced with the following: The Excess Insurance Limitation provision does not apply to the state mandates".
“Medically Necessary” means health care services that a health benefits.
physician, exercising prudent clinical judgment, would provide to The Pre-existing Medical Condition exclusion is deleted and Notice to Illinois Residents:
a patient for the purpose of preventing, evaluating, diagnosing, or replaced with the following: The Insurer will not pay for any loss T30341NUFIC-IL
treating an illness, Injury, disease, or its symptoms, and that are or expense incurred as the result of an Injury, Sickness or other The definition of Complications of Pregnancy is amended to
(1) in accordance with generally accepted standards of medical condition of an Insured, Traveling Companion, Business Partner delete “hyperemesis gravidarum and preeclampsia”.
practice; (2) clinically appropriate, in terms of type, frequency, or Family Member for which medical advice, diagnosis, care or
extent, site, and duration and considered effective for the patient's treatment was recommended or received within 60 days The definition of Injury is amended to read as follows:
illness, Injury, or disease; and (3) not primarily for the convenience immediately preceding the Insured’s coverage effective date. Injury/Injured means a bodily injury caused by an accident
of the patient, physician, or other health care provider and not The Medical Expense Payment of Loss provision is amended to occurring while the Insured’s coverage under the Policy is in force
more costly than an alternative service or sequence of services at add the following provision regarding appeals for medical claims and resulting directly from all other causes of Loss covered by the
least as likely to produce equivalent therapeutic or diagnostic which have been denied. Policy. The Injury must be verified by a Physician.
results as to the diagnosis or treatment of that patient's illness, If your medical claim is denied in whole or in part by the Insurer The General Exclusions provision is amended as follows:
Injury, or disease. “Generally accepted standards of medical based on medical necessity or refusal by the Insurer to pre-certify, “Any unlawful acts committed” is deleted and replaced with
practice” means standards that are based on credible scientific you may appeal the denial to the Commissioner of Insurance. “commission of or attempt to commit a felony”.
evidence published in peer-reviewed medical literature generally Your appeal to the Commissioner must be made within sixty (60) The Excess Insurance Limitation provision is deleted in its entirety.
recognized by the relevant medical community or otherwise days of your receipt of the Insurer’s final written notice of denial.
consistent with the standards set forth in policy issues involving Your written appeal must be submitted on forms provided by and Notice to Kansas Residents:
clinical judgment. prescribed by the Department of Insurance and must include a T30341NUFIC-KS
The following definitions are added: general release, executed by You, of all pertinent medical records The Disagreement Over Size of Loss provision in the Additional
“Intoxication” means a person with an elevated blood alcohol and a filing fee of twenty-five dollars ($25).The decision by the Claims Procedures section is amended to read as follows: If
content of a ratio of alcohol in the blood of such person that is Department of Insurance is final and binding. there is a disagreement about the amount of the Loss either the
Insured or the Insurer can make a written request for an appraisal.
19 20 21
Appraisal or Arbitration will take place only if both parties agree, replaced with “Children born during the Trip are covered for (3) any military or veterans hospital or soldiers home or any
voluntarily to have the Loss appraised or arbitrated. After medical expenses for the first 31 days from the moment of birth at hospital contracted for or operated by any national
examining the facts, each of the two appraisers will give an no additional expense. Continuation of coverage until the end of government or government agency for the treatment of
opinion on the amount of the Loss. If they do not agree, they will the Trip will be subject to notification of the birth and payment of members or ex-members or the armed forces for which no
select an arbitrator. Any figure agreed to by 2 of the 3 (the any applicable premium. charge is made.
appraisers and the arbitrator) will be binding. The appraiser The General Exclusions section is amended to delete the The Subrogation provision will not apply to the Medical Expense
selected by the Insured is paid by the Insured. The Insurer will following exclusion: “use of drugs, narcotics or alcohol, unless benefit.
pay the appraiser it chooses. The Insured will share with us the administered upon the advice of a Physician. The time period in the Proof of Loss provision is amended to 180
cost for the arbitrator and the appraisal process. The “Payment of Claims: When Paid” provision is deleted and days.
The Subrogation Provision in the Additional Claims Procedures replaced with the following: The following notice is added: This plan includes all of the
section is amended by adding: Medical coverage will not be Payment of Claims: Claims will be approved or denied within 30 applicable benefits mandated by the North Carolina Insurance
subrogated. days after Travel Guard receives the claim. If the claim is Code, but is issued under a group master policy located in another
The expiration period in the Legal Actions provision in the General approved Travel Guard will pay the claim within 30 days after its state and may be governed by that state’s laws.”
Provisions section is amended to read 5 years. approval. If the approved claim is not paid within that period, The pre-existing conditions exclusion is amended to delete
“The Concealment or Fraud provision has been amended to add: Travel Guard will pay interest on the claim at the rate equal to the reference to “first manifested” and to replace “a reasonable
A “fraudulent insurance act” means an act committed by any prime rate at the largest bank in Nevada, as ascertained by the person” with “a person”.
person who, knowingly and with intent to defraud, presents, commissioner of financial institutions, on January 1 or July 1 as
causes to be presented or prepares with knowledge or belief that the case may be, immediately preceding the date of the Notice to South Carolina Residents:
it will be presented to or by an insurer, purported insurer, broker or transaction, plus 2 percent, upon all money from the time it T30341NUFIC-SC
any agent thereof, any written statement as part of, or in support becomes due. The “Physical Examination and Autopsy” provision is amended to
of, an application for the issuance of, or the rating of an insurance The “Claim Procedures: Proof of Loss” provision is amended to add: “The autopsy of a South Carolina resident must be performed
policy for personal or commercial insurance, or a claim for add the following: in the state of South Carolina.”
payment or other benefit pursuant to an insurance policy for If Travel Guard requires additional information or time to approve The “Legal Actions” provision is amended to replace the expiration
commercial or personal insurance which such person knows to or deny a claim, it will notify the Insured within 20 days after period of 3 years with 6 years.
contain materially false information concerning any fact material receipt of the claim, and at least once every 30 days thereafter
thereto; or conceals, for the purpose of misleading, information until the claim is approved or denied. The notice will contain the Notice to South Dakota Residents:
concerning any fact material thereto. reason why the additional information or time is required. Travel T30341NUFIC-SD
The Excess Insurance Limitation provision is deleted in its entirety. Guard will approve or deny the claim within: 30 days after it Exclusion (l) of the General Exclusions provision is deleted in its
receives the additional information; or 31 days after the last timely entirety.
Notice to Louisiana Residents: notice was provided. The “alcohol or substance abuse or treatment for the same”
T30341NUFIC-LA exclusion in the Medical Expenses Benefit Exclusions is deleted
The “use of drugs, narcotics or alcohol” exclusion is amended to Notice to North Carolina Residents: in its entirety.
read: “being under the influence of narcotics or intoxicants, unless T30341NUFIC-NC The Excess Insurance Limitation provision is not applicable to
prescribed by a Physician;” The definition of Hospital is deleted in its entirety and replaced Medical Expense Benefits.
The Subrogation provision is amended by adding the following: with the following: Exclusion (i) is amended to read “the Insured being under the
The Insurer’s right of subrogation will not be enforced until the “Hospital” means a facility that: influence of drugs during the commission of a felony”.
Insured has been made whole, as determined by a court of law, (1) is operated according to law, including North Carolina state The Legal Actions provision is amended to change the expiration
as a result of the Loss. The Insurer agrees to pay our portion of hospitals, for the care and treatment of sick or Injured people; period to six years.
the Insured’s attorneys’ fee or other costs associated with a claim (2) has organized facilities for diagnosis and surgery on its Notice to Texas Residents:
or lawsuit to the extent that we recover any portion of the benefits premises or in facilities available to it on a prearranged basis; T30341NUFIC-TX
paid under the policy pursuant to our right of subrogation. (3) has 24 hour nursing service by registered nurses (R.N.’s); and The Proof of Loss Provision is amended by adding the following:
The Family Member definition is amended to delete Domestic (4) is supervised by one or more Physicians available at all times. The Insurer will acknowledge receipt of the notice of claim in
Partner. A Hospital does not include: writing within 15 business days after the Insurer receives the
The Disagreement Over Size of Loss provision of the Additional (1) a nursing, convalescent or geriatric unit of a hospital when a claim. The Insurer will notify a claimant in writing of the
Claims procedures section are deleted in their entirety. patient is confined mainly to receive nursing care; acceptance or rejection of a claim not later than the 15th business
Notice to Nevada Residents: (2) a facility that is, other than incidentally, a clinic, a rest home, day after the date the Insurer receives all required documentation
T30341NUFIC-NV nursing home, convalescent home, home health care, or to secure final proof of Loss. If the Insurer rejects the claim, the
The Medical Expense Benefit is amended by removing the home for the aged; nor does it include any ward, room, wing, required notice will state the reasons for the rejection. If the
following provision: “This coverage does not apply to medical or other section of the hospital that is used for such purposes; Insurer is unable to accept or reject the claim within that time
expenses incurred by any Child born during the Trip.” and is or period, the Insurer will notify the claimant of the reasons that
22 23 24
additional time is needed. The Insurer will accept or reject the You may call National Union Fire Insurance Company of UNA ESTE AVISO A SU POLIZA:
claim not later than the 45th day after the claimant is notified. If the Pittsburgh, Pa.'s toll free number for information or to make a Este aviso es solo para proposito de informacion y no se convierte
claim is accepted, the Insurer will pay the claim within 5 days of complaint at: en parte o condicion del documento adjunto.
the notice of acceptance. If payment of the claim is delayed, the 1.800.551.0824
Insurer will pay the claim plus 18% interest per year, plus Notice to Wisconsin Residents:
reasonable attorney fees. If a lawsuit is filed, such attorney fees You may contact the Texas Department of Insurance to obtain T30341NUFIC-WI
shall be taxed as part of the costs in the case. information on companies, coverages, rights or complaints at: The Subrogation provision is amended to add the following
The Disagreement Over Size of Loss provision is amended as 1.800.252.3439 language:
follows: The Insurer’s right of subrogation will not be invoked until benefits
Disagreement Over Size of Loss. If there is a disagreement about You may write the Texas Department of Insurance: to which the Insured is entitled under the Policy are paid to or on
the amount of the Loss either the Insured or the Insurer can make P. O. Box 149104 behalf of the Insured, and the Insured has been made whole and
a written demand for an appraisal within 30 days of the date of the Austin, TX 78714-9104 is fully compensated for damages.
disagreement notice. Within 30 days after the demand, the Fax # (512) 475 1771 The Concealment or Fraud provision is deleted and replaced with
Insured and the Insurer each select their own competent Web: http://www.tdi.state.tx.us the following language:
appraiser and notify the other party. After examining the facts, E-mail: ConsumerProtection@tdi.state.tx.us Concealment or Fraud: The Insurer does not provide benefits for
each of the two appraisers will give an opinion on the amount of any Loss incurred if the Insured has intentionally concealed or
the Loss. If they do not agree, they will select an arbitrator or PREMIUM OR CLAIM DISPUTES: misrepresented any material fact or circumstance which impacts
request selection by the courts within 30 days of the appraisers’ Should you have a dispute concerning your premium or about a payment of such Loss.
opinions. Any figure agreed to by 2 of the 3 (the appraisers and claim you should contact the Insurer first. If the dispute is not The Proof of Loss provision is deleted and replaced with the
the arbitrator) or the court, will be binding. The appraiser selected resolved, you may contact the Texas Department of Insurance. following language:
by the Insured is paid by the Insured. The Insurer will pay the Proof of Loss. The Insured must furnish the Insurer with proof of
appraiser it chooses. The Insured will share with us the cost for ATTACH THIS NOTICE TO YOUR POLICY: Loss. Proof of Loss includes police or other local authority reports
the arbitrator and the appraisal process. This notice is for information only and does not become a part or or documentation from the appropriate party responsible for the
The Legal Actions provision is amended to change the expiration condition of the attached document. Loss. It must be filed within 90 days from the date of Loss.
period from 60 days to 90 days. Failure by the Insured to give notice within such time does not
The Excess Insurance Limitation provision does not apply to AVISO IMPORTANTE invalidate or reduce the claim unless the Insurer is prejudiced by
Medical Expense Benefit. Para obtener informacion o para someter una queja: the failure to give notice within such time.
The Pre-Existing Medical Condition Exclusion is amended to The Payment of Claims: When Paid: is deleted and replaced
remove “first manifested itself” and to replace “reasonable person” Usted puede llamar al numero de telefono gratis de National with the following language:
with “ordinarily prudent person”. Union Fire Insurance Company of Pittsburgh, Pa. para Payment of Claims: When Paid: Claims will be paid as soon as
The following provisions are added: informacion o para someter una queja al: Travel Guard receives complete proof of Loss and verification of
TEXAS LAWS GOVERN POLICIES. Any contract of insurance 1.800.551.0824 age, but not later than 30 days.
payable to any citizen or inhabitant of this State by any insurance Puede communicarse con el Departamento de Seguros de Texas
company or corporation doing business within this State shall be para obtener informacion acerca de companias, coberturas, Notice to Vermont Residents:
held to be a contract made and entered into under and by virtue derechos o quejas al: U30000DDBG
of the laws of this State relating to insurance, and governed 1.800.252.3439 Vermont law requires that health insurers offer coverage to parties
hereby, notwithstanding such policy or contract of insurance may Puede escribir al Departamento de Seguros de Texas: to a Civil Union that is equivalent to coverage provided to married
provide that the contract was executed and the premiums and P. O. Box 149104 persons. This endorsement is made a part of and amends the
policy (in case it becomes a demand) should be payable without Austin, TX 78714-9104 Policy or Description of Coverage on the later of: (1) 3/1/2009; or
this State, or at the home office of the company or corporation Fax # (512) 475 1771 (2) the Policy Effective Date; or (3) the Description of Coverage
issuing the same. Web: http://www.tdi.state.tx.us Effective Date, to which this Endorsement is attached. It is subject
ELECTED OFFICIALS. An insurer may not cancel or refuse to E-mail: ConsumerProtection@tdi.state.tx.us to all of the provisions, limitations, and exclusions of the Policy or
renew an insurance policy based solely on the fact that the Description of Coverage except as they are specifically modified
policyholder is an elected official. DISPUTAS SOBRE PRIMAS O RECLAMOS: by this Endorsement.
53593DBG Si tiene una disputa concerniente a su prima o a un reclamo, debe 1.The definition of Civil Union is added to and made a part of the
IMPORTANT NOTICE comunicarse con la compania primero. Si no se resuelve la Definitions section.
To obtain information or make a complaint: disputa, puede entonces communicarse con el departamento Civil Union – means that two eligible persons have established a
(TDI). relationship pursuant to 15 V.S.A. chapter 23 of Vermont’s Statues
and may receive the benefits and protections and be subject to the
responsibilities of spouses.
25 26 27
2.The definition of Party(ies) to a Civil Union is added to and made to a private employer's enrollment of a Party to a Civil Union in an • Currency Conversion or purchase
a part of the Definitions section. ERISA employee welfare benefit plan. However, governmental • Up-to-the-minute information on local medical advisories,
Party(ies) to a Civil Union – means an Insured who has employers (not federal government) are required to provide health epidemics, required immunizations and available preventive
established a Civil Union with another person pursuant to 15 benefits to the dependents of a Party to a Civil Union if the public measures
V.S.A. chapter 23 and 18 V.S.A. chapter 106. employer provides health benefits to the dependents of married • Up-to-the-minute travel supplier strike information
3.The definitions, terms, conditions or any other provisions of the persons. Federal law also controls group health insurance • Legal referrals/bail bond assistance
Policy, Description of Coverage, and/or Riders and Endorsements continuation rights under "COBRA" for employers with 20 or more • Worldwide public holiday information
to which this mandatory Endorsement is attached are hereby employees as well as the Internal Revenue Code treatment of
amended and superseded as follows: health insurance premiums. As a result, Parties to a Civil Union *Non-insurance services are provided by Travel Guard.
Terms that mean or refer to a marital relationship, or that may and their families may or may not have access to certain benefits
be construed to mean or refer to a marital relationship, such under the Policy, Description of Coverage, Rider, or Endorsement Any payments under the policy will only be made in full
as “marriage”, “spouse”, “husband”, “wife”, “dependent”, “next that derive from federal law. You are advised to seek expert compliance with all United States of America economic or trade
of kin”, “relative”, “beneficiary”, “survivor”, “immediate family” advice to determine your rights under the Policy. sanction laws or regulations, including, but not limited to,
and any other such terms include the relationship created by sanctions, laws and regulations administered and enforced by the
a Civil Union. ASSISTANCE SERVICES* U.S. Treasury Department's Office of Foreign Assets Control
Terms that mean or refer to the inception or dissolution of a All Assistance Services listed below are not insurance benefits (“OFAC”). Therefore, any expenses incurred or claims made
marriage, such as “date of marriage”, “divorce decree”, and are not provided by the Insurer. involving travel that is in violation of such sanctions, laws and
“termination of marriage” and any other such terms include Travel Medical Assistance regulations will not be covered under the policy. For more
the inception or dissolution of a Civil Union. • Emergency medical transportation assistance information, you may consult the OFAC internet website at:
Terms that mean or refer to family relationships arising from a • Physician/hospital/dental/vision referrals www.treas.gov/offices/enforcement/ofac/ or a Travel Guard
marriage, such as “family”, “immediate family”, “dependent”, • Repatriation of mortal remains assistance representative.
“children”, “next of kin”, “relative”, “beneficiary”, “survivor” and • Return travel arrangements
any other such terms include family relationships created by a • Emergency prescription replacement assistance
Civil Union. • Dispatch of doctor or specialist
4. As provided in this Endorsement the term child or covered child • Medical evacuation quote
shall mean a child (natural, stepchild, legally adopted child, a • In-patient and out-patient medical case management
minor, or a disabled child) who is: (1) dependent on the Insured • Qualified liaison for relaying medical information to family
for support and maintenance; and (2) born to or brought to: (a) a members
marriage; or (b) a Civil Union established according to Vermont • Arrangements of visitor to bedside of hospitalized Insured
law. • Eyeglasses and corrective lens replacement assistance
5.The defined terms Eligible Spouse or Insured Spouse, or the • Medical payment arrangements
term spouse, wherever they appear in the Policy, Description of • Medical cost containment/expense recovery and overseas
Coverage, Rider, Endorsement, and/or Application are deemed to investigation
include a Party to a Civil Union. • Medical bill audits
THIS ENDORSEMENT IS NOT MEANT TO PROVIDE • Shipment of medical records
DEPENDENT COVERAGE IF DEPENDENT COVERAGE IS • Medical equipment rental/replacement assistance
NOT PROVIDED UNDER THE POLICY. Worldwide Travel Assistance
CAUTION: FEDERAL LAW RIGHTS MAY OR MAY NOT BE • Lost baggage search; stolen luggage replacement assistance
AVAILABLE • Lost passport/travel documents assistance
Vermont law grants parties to a Civil Union the same benefits, • ATM locator
protections and responsibilities that flow from marriage under • Emergency cash transfer assistance 24-Hour Emergency Assistance
state law. However, some or all of the benefits, protections and • Travel information including visa/passport requirements Telephone Numbers
responsibilities related to health insurance that are available to • Emergency telephone interpretation assistance Continental USA………1.866.892.2836
married persons under federal law may not be available to Parties • Urgent message relay to family, friends or business International.………1.715.295.5452
to a Civil Union. For example, federal law, the Employee Income associates Be sure to use the appropriate country
Retirement Security Act of 1974 known as "ERISA", controls the • Up-to-the-minute travel delay reports and city codes when calling.
employer/employee relationship with regard to determining • Long-distance calling cards for worldwide telephoning - KEEP THESE NUMBERS WITH YOU WHEN YOU TRAVEL -
eligibility for enrollment in private employer health benefit plans. • Inoculation information
Because of ERISA, Act 91 does not state requirements pertaining • Embassy or Consulate Referral
008065 P1 3/10 Travel Guard 10/1//10
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