CSA: Vacation Guarantee (Silver Plan)
DESCRIPTION OF COVERAGE
(Questions? Call 1-800-694-4311)
PLEASE NOTE: THIS IS A SAMPLE DESCRIPTION OF COVERAGE. YOU WILL RECEIVE
YOUR STATE-SPECIFIC DESCRIPTION OF
COVERAGE THROUGH YOUR EMAIL CONFIRMATION, OR MAILED AS A HARD-COPY WHEN YOU
PURCHASE A CSA POLICY.
Who is Eligible For Coverage?
A person who has arranged to take a Covered Trip, pays the required plan payment,
and is a resident of the United States of America or Canada.
COVERAGE PERIOD
When Coverage Begins
All coverages (except Pre-Departure Trip Cancellation and Post-Departure Trip
Interruption) will take effect on the later of: 1) the date the plan payment has
been received by us; 2) the date and time you start your Covered Trip; or 3) 12:01
A.M. Standard Time on the Scheduled Departure Date of your Covered Trip.
Pre-Departure Trip Cancellation coverage will take effect at 12:01 A.M. Standard
Time on the day after the date your plan payment is received. Post-Departure Trip
Interruption coverage will take effect on the Scheduled Departure Date of your
Covered Trip if the required plan payment is received.
When Coverage Ends
All coverage ends on the earlier of:
1. The date the Covered Trip is completed;
2. The Scheduled Return Date;
3. Your arrival at the return destination on a roundtrip, or the destination on
a one-way trip;
4. Cancellation of the Covered Trip covered by the plan.
SUMMARY OF COVERAGES
Pre-Departure Trip Cancellation
We will pay a Pre-Departure Trip Cancellation Benefit, up to the amount in the
Schedule, if you are prevented from taking your Covered Trip due to your, a Family
Member s or Traveling Companion s, Sickness, Injury, or death, that occurs before
departure on your Covered Trip. The Sickness or Injury must: a) Commence while
your coverage is in effect under the plan; b) Require the examination and treatment
by a Physician, in person, at the time the Covered Trip is canceled; and c) In
the written opinion of the treating Physician, be so disabling as to prevent you
from taking your Covered Trip.
We will pay a benefit if you are prevented from taking your Covered Trip due
to Other Covered Events, as defined, that occur before departure on your Covered
Trip.
Pre-Departure Trip Cancellation Benefits
We will reimburse you, up to the amount in the Schedule, for the amount of forfeited,
prepaid, non-refundable, non-refunded, and published payments or deposits that
you paid for your Covered Trip. We will pay your additional cost as a result of
a change in the per-person occupancy rate for prepaid travel arrangements if a
Traveling Companion s Covered Trip is canceled and your Covered Trip is not canceled.
Post-Departure Trip Interruption
We will pay a Post-Departure Trip Interruption Benefit, up to the amount in the
Schedule, if: 1) Your arrival on your Covered Trip is delayed beyond the Scheduled
Departure Date; or 2) You are unable to continue on your Covered Trip after you
have departed on your Covered Trip due to your, Family Member s or Traveling Companion
s, Sickness, Injury, or death. For item 1) above, the Sickness or Injury must:
a) Commence while your coverage is in effect under the plan; b) For item 2) above,
commence while you are on your Covered Trip and your coverage is in effect under
the plan; and c) For both items 1) and 2) above, require the examination and treatment
by a Physician, in person, at the time the Covered Trip is interrupted or delayed;
and d) In the written opinion of the treating Physician, be so disabling as to
delay your arrival on your Covered Trip or to prevent you from continuing your
Covered Trip.
We will pay a benefit if you are unable to continue on your Covered Trip after
you have departed on your Covered Trip due to Other Covered Events, as defined.
Post-Departure Trip Interruption Benefits
We will reimburse you, less any refund paid or payable, for unused land or water
travel arrangements, plus one of the following:
- The additional transportation expenses by the most direct route from the
point you interrupted your Covered Trip:
- To the next scheduled destination where you can catch up to your Covered
Trip; or
- To the final destination of your Covered Trip; or
- The additional transportation expenses incurred by you by the most direct
route to reach your original Covered Trip destination if you are delayed and
leave after the Scheduled Departure Date.
However, the benefit payable under (1) and (2) above will not exceed the cost
of a one-way economy air fare (or first class, if the original tickets were
first class) by the most direct route less any refunds paid or payable for
your unused original tickets.
- Your additional cost as a result of a change in the per-person occupancy
rate for prepaid travel arrangements if a Traveling Companion s Covered Trip
is interrupted and your Covered Trip is continued.
Travel Delay
If your Covered Trip is delayed for 12 hours or more, we will reimburse you, up
to the amount shown in the Schedule for reasonable additional expenses incurred
by you for hotel accommodations, meals, telephone calls and local transportation
while you are delayed. We will not pay benefits for expenses incurred after travel
becomes possible.
Travel Delay must be caused by or result from: Common Carrier delay; or loss or
theft of your passport(s), travel documents or money; or quarantine; or hijacking;
or natural disaster; or closure of public roadways by government authorities due
to adverse weather; or a documented traffic accident while you are en route to
departure; or unannounced strike; or a civil disorder; or your Family Member traveling
with you, or a Traveling Companion s Injury or Sickness; or a Family Member traveling
with you or a Traveling Companion s death.
FLIGHT ACCIDENT
We will pay this benefit up to the amount on the Schedule if you are injured in
an Accident which occurs while you are on a Covered Trip and covered under the
certificate, and you suffer one of the losses listed below within 180 days of
the Accident. The principal sum is the benefit amount shown on the Schedule.
We will pay 100% of the principal sum for the loss of: life; both hands or feet,
or sight of both eyes; one hand and one foot; or one hand or one foot and sight
of one eye. We will pay 50% of the principal sum for loss of: one hand or one
foot, or sight of one eye.
If you suffer more than one loss from one Accident, we will pay only for the loss
with the larger benefit. Loss of a hand or foot means complete severance at or
above the wrist or ankle joint. Loss of sight of an eye means complete and irrecoverable
loss of sight.
Exposure and Disappearance
If by reason of an Accident covered by the certificate, you are unavoidably exposed
to the elements and as a result of such exposure suffer a loss for which benefits
are otherwise payable, such loss shall be covered hereunder.
If you are involved in an Accident which results in the sinking or wrecking of
a conveyance in which you were riding and your body is not located within one
year of such Accident, it will be presumed that you suffered loss of life resulting
from Injury caused by the Accident.
Air Flight Benefits
The benefits provided by the certificate for Air Flight applies only if you sustain
a covered loss in an Accident which occurs while a passenger in or on, boarding
or alighting from an aircraft of a regularly scheduled airline or an air charter
company that is licensed to carr y passengers for hire.
Medical or Dental Expense Benefits
We will pay this benefit, up to the amount on the Schedule for the following Covered
Expenses incurred by you, subject to the following: 1) Covered Expenses will only
be payable at the Usual and Customary level of payment; 2) Benefits will be payable
only for Covered Expenses resulting from a Sickness that first manifests itself
or an Injury that occurs while on a Covered Trip; 3) Benefits payable as a result
of incurred Covered Expenses will only be paid after benefits have been paid under
any Other Valid and Collectible Group Insurance in effect for you or in accordance
with the coordination of benefits provision, which is set forth below in jurisdictions
where excess coverage provisions are not permitted. We will pay that portion of
Covered Expenses which exceed the amount of benefits payable for such expenses
under your Other Valid and Collectible Group Insurance.
Please refer to the Definitions for an explanation of Pre-Existing Conditions
which are excluded under the Medical or Dental Expense Benefits.
Covered Expenses:
- Expenses for the following Physician-ordered medical services: services
of legally qualified Physicians and graduate nurses, charges for Hospital
confinement and services, local ambulance services, prescription drugs and
medicines, and therapeutic services, incurred by you within one year from
the date of your Sickness or Injury;
- Expenses for emergency dental treatment incurred by you during a Covered
Trip;
Emergency Assistance Benefits
We will pay this benefit, up to the amount on the Schedule for the following Covered
Expenses incurred by you, subject to the following: 1) Covered Expenses will only
be payable at the Usual and Customary level of payment; 2) Benefits will be payable
only for Covered Expenses resulting from a Sickness that first manifests itself
or an Injury that occurs while on a Covered Trip; 3) Benefits payable as a result
of incurred Covered Expenses will only be paid after benefits have been paid under
any Other Valid and Collectible Group Insurance in effect for you or in accordance
with the coordination of benefits provision, which is set forth below in jurisdictions
where excess coverage provisions are not permitted. We will pay that portion of
covered expenses which exceed the amount of benefits payable for such expenses
under your Other Valid and Collectible Group Insurance.
Covered Expenses:
- Expenses incurred by you for Physician-ordered emergency medical evacuation,
including medically appropriate transportation and necessary medical care
en route, to the nearest suitable Hospital, when you are critically ill or
injured and no suitable local care is available, subject to the Program Medical
Advisors prior approval;
- Expenses for transportation, not to exceed the cost of one round-trip economy
class air fare, to the place of hospitalization for one person chosen by you,
provided that you are traveling alone and are hospitalized for more than 7
days;
- Expenses for transportation, not to exceed the cost of one-way economy
class air fare, to your place of residence in the United States of America
or Canada, including escort expenses, if you are 18 years of age or younger
and left unattended due to the death or hospitalization of an accompanying
adult(s), subject to the Program Medical Advisors prior approval;
- Expenses for one-way economy class air fare (or first class, if your original
tickets were first class) to your place of residence in the United States
of America or Canada, from a medical facility to which you were previously
evacuated, less any refunds paid or payable from your unused transportation
tickets, if these expenses are not covered elsewhere in the certificate.
- Repatriation expenses for preparation and air transportation of your remains
to your place of residence in the United States of America or Canada, or up
to an equivalent amount for a local burial in the country where death occurred,
if you die while outside the United States of America or Canada.
Your duties in the event of a Medical or Dental Expense:
- You must provide us with all bills and reports for medical and/or dental
expenses claimed.
- You must provide any requested information, including but not limited to,
an explanation of benefits from any other applicable insurance.
- You must sign a patient authorization to release any information required
by us, to investigate your claim.
Baggage and Personal Effects Benefit
We will reimburse you, less any amount paid or payable from any Other Valid and
Collectible Insurance or indemnity, up to the amount shown in the Schedule, for
direct loss, theft, damage or destruction of your Baggage, passports or visas
during your Covered Trip. We will also pay for loss due to unauthorized use of
your credit cards, if you have complied with all of the credit card conditions
imposed by the credit card companies.
Valuation and Payment of Loss
Payment of loss under the Baggage and Personal Effects Benefit will be calculated
based upon an Actual Cash Value basis. For items without receipts, payment of
loss will be calculated based upon 75% of the Actual Cash Value at the time of
loss. At our option, we may elect to repair or replace your Baggage. We will notify
you within 30 days after we receive your proof of loss.
We may take all or part of damaged Baggage as a condition for payment of loss.
In the event of a loss to a pair or set of items, we will: 1) Repair or replace
any part to restore the pair or set to its value before the loss; or 2) Pay the
difference between the value of the property before and after the loss.
Continuation of Coverage
If the covered Baggage, passports or visas are in the custody of a Common Carrier,
and delivery is delayed, this coverage will continue until the property is delivered
to you. This continuation of coverage does not include loss caused by or resulting
from the delay.
Items Not Covered
We will not pay for damage to or loss of: animals; property used in trade, business
or for the production of income; household furniture; musical instruments; brittle
or fragile articles; sporting equipment if the loss results from the use thereof;
boats; motors; motorcycles; motor vehicles; aircraft; other conveyances or equipment,
or parts for such conveyances; artificial limbs or other prosthetic devices; artificial
teeth; dental bridges; dentures; dental braces; retainers or other orthodontic
devices; hearing aids; any type of eyeglasses, sunglasses or contact lenses; documents
or tickets, except for administrative fees required to reissue tickets; money;
stamps; stocks and bonds; postal or money orders; securities; accounts; bills;
deeds; food stamps; credit cards, except as noted above; property shipped as freight
or shipped prior to the Scheduled Departure Date; or contraband.
Losses Not Covered
We will not pay for loss arising from: defective materials or craftsmanship; or
normal wear and tear, gradual deterioration, inherent vice; or rodents, animals,
insects or vermin; or mysterious disappearance; or electrical current, including
electric arcing that damages or destroys electrical devices or appliances.
Your Duties in the Event of a Loss
In case of loss, theft or damage to Baggage and personal effects, you should:
1) Immediately report the situation incident to the hotel manager, tour guide
or representative, transportation official, local police or other local authorities
and obtain their written report of your loss; and 2) Take reasonable steps to
protect your Baggage from further damage, and make necessary, reasonable and temporary
repairs. We will reimburse you for these expenses. We will not pay for further
damage if you fail to protect your Baggage.
Baggage Delay Benefit
We will reimburse you up to the amount shown in the Schedule for the cost of reasonable
additional clothing and personal articles purchased by you, if your Baggage is
delayed for 24 hours or more during your Covered Trip.
Rental Car Damage Benefit
If you rent a car while on your Covered Trip and the car is damaged due to collision,
theft, vandalism, windstorm, fire, hail, flood or any cause not in your control
while in your possession, or the car is stolen while in your possession and not
recovered, we will pay you the lesser of: a) The cost of repairs and rental charges
imposed by the rental company while the car is being repaired; or b) The Actual
Cash Value of the car, up to the amount shown on the Schedule.
Coverage is provided to you, provided you are a licensed driver, and are listed
on the rental agreement. This coverage is primary to other forms of insurance
or indemnity.
Coverage is not provided for loss due to:
- Any obligation of you, a Traveling Companion or a Family Member traveling
with you assume under any agreement (except insurance collision Deductible).
- Rentals of trucks, campers, trailers, off-road, or motor bikes, motorcycles,
recreational vehicles or Exotic Vehicles.
- Any loss which occurs if you or Travel Companion or Family Member traveling
with you are in violation of the rental agreement.
- Failure to report the loss to the proper local authorities and the rental
car company.
- Damage to any other vehicle, structure or person as a result of a covered
loss.
Your Duties in the Event of a Loss:
You must:
- Take all reasonable, necessary steps to protect the vehicle and prevent
further damage to it;
- Report the loss to the appropriate local authorities and the rental company
as soon as possible;
- Obtain all information on any other party involved in an Accident, such
as name, address, insurance information and driver's license number;
- Provide us all documentation such as rental agreement, police report and
damage estimate.
This coverage is not available in all States. If you have availablity questions,
please call us at 800-487-4722.
DEFINITIONS
In this Policy, "you" , "your" and "yours" refer to the Insured. "We" , "us" and
"our" refer to the company providing this coverage. In addition, certain words
and phrases are defined as follows:
ACCIDENT means a sudden, unexpected, unintended and external event, which
causes Injury.
ACTUAL CASH VALUE means purchase price less depreciation.
COMMON CARRIER means any land, water or air conveyance operated under a
license for the transportation of passengers for hire, not including taxicabs
or rented, leased or privately owned motor vehicles.
BAGGAGE means luggage, personal possessions and travel documents taken
by you on the Covered Trip.
COVERED TRIP means: 1) A period of round-trip travel away from Home to
a destination outside your city of residence; the purpose of the Trip is business
or pleasure and is not to obtain health care or treatment of any kind; the Trip
has defined departure and return dates specified when the Insured enrolls; the
Trip does not exceed 365 days or, 2) A period of one-way travel that starts in
the US or Canada (except US citizens may begin their Trip outside the US, if returning
to the US); the purpose of the Trip is business or pleasure and is not to obtain
health care or treatment of any kind; the Trip has defined departure and arrival
dates and defined departure and arrival places specified when the Insured applies;
and the Trip does not exceed 31 days in length.
DEDUCTIBLE means the amount, which must be incurred by you before benefits
are paid under the policy plan.
DOMESTIC PARTNER means a person who is at least eighteen years of age and
you can show: 1) Evidence of financial interdependence, such as joint bank accounts
or credit cards, jointly owned property, and mutual life insurance or pension
beneficiary designations; 2) Evidence of cohabitation for at least the previous
6 months; and 3) An affidavit of domestic partnership if recognized by the jurisdiction
within which they reside.
ELECTIVE TREATMENT AND PROCEDURES means any medical treatment or surgical
procedure that is not medically necessary including any service, treatment, or
supplies that are deemed by the federal, or a state or local government authority,
or by us to be research or experimental or that is not recognized as a generally
accepted medical practice.
EXOTIC VEHICLE includes Alfa Romeo, Aston Martin, Auburn, Avanti, Bentley,
Bertone, BMC/Leyland, BMW M Series, Bradley, Bricklin, Cosworth, Clenet, De Lorean,
Excalibre, Ferrari, Iso, Jaguar, Jensen Healy, Lamborghini, Lancia, Lotus, Maserati,
Morgan, Pantera, Panther, Pininfarina, Rolls Royce, Rover, Stutz, Sterling, Triumph,
TVR, Corvette, Mercedes Benz, Porsche, and MG. You must contact CSA Travel Protection
before renting to obtain confirmation that the vehicle is covered.
FAMILY MEMBER includes your or your Traveling Companion s dependent, spouse,
child, spouse s child, son/daughter-in-law, parent(s), sibling(s), brother/sister,
grandparent(s), grandchild, step-brother/sister, step-parent( s), parent(s)-in-law,
brother/sister-in-law, guardian, Domestic Partner, foster child, or ward.
FINANCIAL INSOLVENCY means the total cessation or complete suspension of
operations due to insolvency, with or without the filing of a bankruptcy petition,
or the total cessation or complete suspension of operations following the filing
of a bankruptcy petition, whether voluntary or involuntary, by a tour operator,
cruise line, airline, rental car company, hotel, condominium, railroad, motor
coach company, or other supplier of travel services which is duly licensed in
the state(s) of operation other than the entity or the person, organization, agency
or firm from whom you directly purchased or paid for your Covered Trip provided
the Financial Insolvency occurs more than 7 days following your effective date
for the Trip Cancellation Benefits. There is no coverage for the total cessation
or complete suspension of operations for losses caused by fraud or negligent misrepresentation
by the supplier of travel services.
HOME means your primary or secondary residence.
HOSPITAL means an institution, which meets all of the following requirements:
- It must be operated according to law;
- It must give 24 hour medical care, diagnosis and treatment to the sick
or injured on an inpatient basis;
- It must provide diagnostic and surgical facilities supervised by Physicians;
- Registered nurses must be on 24 hour call or duty; and
- The care must be given either on the hospital s premises or in facilities
available to the hospital on a pre-arranged basis.
A Hospital is not: a rest, convalescent, extended care, rehabilitation or other
nursing facility; a facility which primarily treats mental illness, alcoholism,
or drug addiction (or any ward, wing or other section of the hospital used for
such purposes); or a facility which provides hospice care (or wing, ward or other
section of a hospital used for such purposes).
INJURY means bodily harm caused by an accident which: 1) Occurs while your
coverage is in effect under the plan; and 2) Requires examination and treatment
by a Physician. The Injury must be the direct cause of loss and must be independent
of all other causes and must not be caused by, or result from, Sickness.
INSURED means an eligible person who arranges a Covered Trip, and pays
any required plan payment.
OTHER COVERED EVENTS means only the following unforeseeable events or their
consequences which occur while coverage is in effect under this Policy:
- Air and land and water common carrier delays resulting from inclement weather,
or mechanical breakdown of the aircraft, ship or boat or motor coach on which
you are scheduled to travel, or organized labor strikes that affect public
transportation;
- Arrangements canceled by an airline, cruise line, motor coach company,
or tour operator, resulting from inclement weather, mechanical breakdown of
the aircraft, ship or boat or motor coach on which the Insured is scheduled
to travel, or organized labor strikes that affect public transportation.
Items #1 and #2 above, are subject to the following conditions:
- The scheduled carrier connecting times must be 45 minutes or longer
and meet airline required legal minimum connect times; and
- The scheduled time between arrival at the Scheduled Trip Departure
City and the scheduled trip departure must be 2 hours or longer.
- Arrangements canceled by a tour operator, cruise line, airline, rental
car company, hotel, condominium, railroad, motor coach company, or other supplier
of travel services, resulting from Financial Insolvency;
Coverage for Financial Insolvency is included if:
Your premium for this insurance plan and your enrollment form is received
within 14 days of the date your initial trip deposit is received.
See the definition of Financial Insolvency which details the coverage provided.
- A change in plans by you, a Family Member traveling with you, or Traveling
Companion resulting from one of the following events which occurs while coverage
is in effect under this Policy:
- Being directly involved in a documented traffic accident while en route
to departure;
- Being hijacked, quarantined, required to serve on a jur y, or required
by a court order to appear as a witness in a legal action, provided you,
a Family Member traveling with you or a Traveling Companion is not 1)
A party to the legal action, or 2) Appearing as a law enforcement officer;
- Your Home made uninhabitable by fire, flood, volcano, earthquake, hurricane
or other natural disaster;
- Being called into active military service to provide aid or relief
in the event of a natural disaster;
- A documented theft of passports or visas;
- A Terrorist Act which occurs in your departure
city or in a city which is a scheduled destination for your Covered Trip
provided the Terrorist Act occurs within 30 days of the Scheduled Departure
Date for your Covered Trip;
- A cancellation of your Covered Trip if your arrival on the Trip is
delayed and causes you to lose 50% or more of the scheduled Covered Trip
duration due to the reasons covered under the Covered Travel Delay Benefit;
OTHER VALID AND COLLECTIBLE GROUP INSURANCE means any group policy or contract
which provides for payment of medical expenses incurred because of Physician,
nurse, dental or Hospital care or treatment; or the performance of surgery or
administration of anesthesia. The policy or contract providing such benefits includes
group or blanket insurance policies; service plan contracts; employee benefit
plans; or any plan arranged through an employer, labor union, employee benefit
association or trustee; or any group plan created or administered by the federal
or a state or local government or its agencies. In the event any other group plan
provides for benefits in the form of services in lieu of monetary payment, the
usual and customary value of each service rendered will be considered a Covered
Expense.
PHYSICIAN means a person licensed as a medical doctor by the jurisdiction
in which he/she is resident to practice the healing arts. He/she must be practicing
within the scope of his/her license for the service or treatment given and may
not be you, a Traveling Companion, or a Family Member of yours.
PRE-EXISTING CONDITION means an illness, disease,
or other condition during the 180-day period immediately prior to your effective
date for which you or your Traveling Companion or Family Member is scheduled or
booked to travel with you:
- Received or received a recommendation for a diagnostic test, examination,
or medical treatment; or
- Took a prescription for drugs or medicine.
Item (2) of this definition does not apply to a condition which is treated or
controlled solely through the taking of prescription drugs or medicine and remains
treated or controlled without any adjustment or change in the required prescription
throughout the 180-day period before coverage is effective under this Policy.
The exclusion for Pre-Existing Conditions will be waived if:
- Your premium for this insurance plan and your enrollment form is received
within 14 days of the date your initial trip deposit is received;
- You are not disabled from travel at the time you pay your premium;
- The booking for this trip must be the first and only booking for this travel
period and destination.
SCHEDULED DEPARTURE DATE means the date on which you are originally scheduled
to leave on your Covered Trip.
SCHEDULED RETURN DATE means the date on which you are originally scheduled
to return to the point where the Covered Trip started or to a different final
destination.
SICKNESS means an illness or disease of the body which requires examination
and treatment by a Physician.
TERRORIST ACT means an act of violence, other than civil disorder or riot,
(that is not an act of war, declared or undeclared) that results in loss of life
or major damage to property, by any person acting on behalf of or in connection
with any organization which is generally recognized as having the intent to overthrow
or influence the control of any government.
TRAVELING COMPANION means a person whose name(s) appear(s) with you on
the same Covered Trip arrangement.
USUAL AND CUSTOMARY CHARGE means those charges for necessary treatment
and services that are reasonable for the treatment of cases of comparable severity
and nature. This will be derived from the mean charge based on the experience
in a related area of the service delivered and the MDR (Medical Data Research)
schedule of fees valued at the 90th percentile and the Anesthesia Relative Value
Guide.
CERTIFICATE EXCLUSIONS
The following exclusion applies to the Air Flight Accident coverage:
- We will not pay for loss caused by or resulting from Sickness of any kind.
The following exclusion applies to all coverages:
- We will not pay for any loss under the certificate, caused by, or resulting
from:
- Your, or your Traveling Companion's, or your Family Member's booked
to travel with you, suicide, attempted suicide, or intentionally self-inflicted
injury, while sane or insane (while sane in CO & MO);
- Mental, nervous, or psychological disorders;
- Being under the influence of drugs or intoxicants, unless prescribed
by a Physician;
- Normal pregnancy or resulting childbirth or elective abortion;
- Participation as a professional in athletics;
- Participation in organized amateur and interscholastic athletic or
sports competition or events;
- Riding or driving in any motor competition;
- Declared or undeclared war, or any act of war;
- Civil disorder (does not apply to Travel Delay);
- Service in the armed forces of any country;
- Nuclear reaction, radiation or radioactive contamination;
- Operating or learning to operate any aircraft, as pilot or crew;
- Mountain climbing, bungee cord jumping, skin diving, skydiving, parachuting,
hang gliding, parasailing or travel on any air-supported device, other
than on a regularly scheduled airline or air charter company;
- Any unlawful acts, committed by you or a Traveling Companion (whether
insured or not);
- Any amount paid or payable under any Worker's Compensation, Disability
Benefit or similar law;
- A loss or damage caused by detention, confiscation or destruction by
customs;
- Elective Treatment and Procedures;
- Medical treatment during or arising from a Covered Trip undertaken
for the purpose or intent of securing medical treatment;
- Financial Insolvency of the person, organization or firm from whom
you directly purchased or paid for your Covered Trip, Financial Insolvency
which occurred before your effective date for the Trip Cancellation Benefits,
or Financial Insolvency which occurs within 7 days following your effective
date for the Trip Cancellation Benefits;
- Business, contractual or educational obligations of you, a Family Member,
or a Traveling Companion;
- Failure of any tour operator, Common Carrier, or other travel supplier,
person or agency to provide the bargained-for travel arrangements other
than Financial Insolvency;
- A loss that results from an illness, disease, or other condition, event
or circumstance which occurs at a time when the plan is not in effect
for you.
GENERAL PROVISIONS
Arbitration If we and you disagree on the amount of loss, either may make
written demand for arbitration. In this event, each party will select a competent
and impartial arbitrator. The two arbitrators will select a third. If they cannot
agree within 30 days, either may request that selection be made by a judge of
a court having jurisdiction. Each party will (1) Pay the expense if incurred and
(2) Bear the expenses of the third arbitrator equally. A decision agreed to by
two arbitrators will be binding.
Concealment or Fraud We do not provide coverage if you have intentionally
concealed or misrepresented any material fact or circumstance relating to the
coverage plan.
Conformity to Law Any provision of the plan that is in conflict with the
laws of the state in which it is issued is amended to conform with the laws of
that state.
Duplication of Coverage You may only purchase one certificate from us for
each Covered Trip. If you do purchase more than one certificate for a specific
Covered Trip, the Maximum Limit of Coverage payable will be as specified in the
certificate with the highest level of benefits. We will refund plan payments received
from you under any other certificate.
Entire Contract Any statement you make is a representation and not a warranty.
No statement will be used by us to void or reduce benefits unless that statement
is a part of any written application or enrollment form.
The plan may be changed at any time by written agreement between us. Only our
President, Vice President or Secretary may change or waive the provisions of the
policy plan. No agent or other person may change the policy plan or waive any
of its terms. The change will be endorsed on the policy plan.
Examination Under Oath As often as we may reasonably require, you or any
person making a claim under the plan must submit to examination under oath.
Maximum Limit of Coverage The maximum benefit amount for each claim is
listed in the Schedule or enrollment form, subject to the individual benefit amount
and the company s Maximum Limit of Liability. The total limit of our liability
for any one covered event, in which two or more persons submit a claim, is subject
to the individual benefit amount and the company s Maximum Limit of Liability.
In the event of multiple claims by you for one event, the available funds will
be distributed in order of notice of claim by each insured subject to the above
limitations.
Our Right to Recover From Others We have the right to recover any payments
we have made from anyone who may be responsible for the loss. You and anyone else
we insure must sign any papers and do whatever is necessary to transfer this right
to us. You and anyone else we insure will do nothing after the loss to affect
our rights.
CLAIMS PROVISIONS
Notice of Claim We must be given written notice of claim within 90 days
after a covered loss occurs. If notice cannot be given within that time, it must
be given as soon as reasonably possible. Notice may be given to us or to our authorized
agent. Notice should include the claimant s name and enough information to identify
him or her.
Proof of Loss Written Proof of Loss must be sent to us within 90 days after
the date the loss occurs. We will not reduce or deny a claim if it was not reasonably
possible to give us written Proof of Loss within the time allowed. In any event,
you must give us written Proof of Loss within twelve (12) months after the date
the loss occurs unless you are legally incapacitated.
Physical Examination and Autopsy At our expense, we have the right to have
you examined as often as necessary while a claim is pending. At our expense, we
may require an autopsy unless the law or your religion forbids it.
Legal Actions No legal action may be brought to recover on the plan within
60 days after written proof of loss has been given. No such action will be brought
after three years from the time written proof of loss is required to be given.
If a time limit of the plan is less than allowed by the laws of the State where
you live, the limit is extended to meet the minimum time allowed by such law.
Benefits for loss of life will be paid to your estate, or if no estate, to your
beneficiary. All other benefits are paid directly to you, unless otherwise directed.
Any accrued benefits unpaid at your death will be paid to your estate, or if no
estate, to your beneficiary. If you have assigned your benefits, we will honor
the assignment if a signed copy has been filed with us. We are not responsible
for the validity of any assignment.
TRAVEL INSURANCE IS UNDERWRITTEN BY
Monumental General Casualty Company (all states except as otherwise noted -
A.M. Best rating A- as of 4/22/2003) under Policy Form # TAHC2000GPC; Certificate
#TAHC2000GCC.
Stonebridge Casualty Insurance Company (AL, AZ, CO, DE, ID, MN, NJ, NM, NY,
ND, PA, and VT - A.M. Best rating A- as of 4/22/2003) under Policy Form # TAHC5000GPS,
Certificate # TAHC5000GCS.
Description of 24-Hour
Emergency Hotline Services
for
CSA Travel Protection
This plan is administered by CSA Insurance Services.
CSA's designated provider, OnCall International, will provide these assistance
services.
AVAILABLE SERVICES
There are various 24-Hour Emergency Hotline Services provided under the CSA Travel
Protection packages. A description of all 24-Hour Emergency Hotline Services offered
are contained in this document.
The 24-Hour Emergency Hotline Services are only available to persons whose primary
residence is in the United States or Canada. This plan is administered by Customized
Services Administrators.
DESCRIPTION OF 24-HOUR EMERGENCY HOTLINE SERVICES
How to Call the 24-Hour Emergency Hotline
If you need emergency help for an available service you can call 24-hours a
day from within the United States, or call (collect) from anywhere else. You
should have your certificate or policy number, your location, a local telephone
number, and details of the situation. The assistance provider will confirm your
enrollment and assist you. If you cannot call collect from your location, dial
direct and give the assistance coordinator your telephone number and location
and they will call you back.
Seek local help if your emergency is immediate and life threatening, and
contact the assistance provider by calling the hotline as soon as reasonably
possible.
Help services have been included in this program to provide, whenever possible,
on-the-spot and immediate assistance for those unexpected problems that can
arise during your trip.
There may be times when circumstances beyond the assistance provider's control
hinder their endeavors to provide help services; they will, however, make all
reasonable efforts to provide services and help resolve your problem.
The assistance provider's staff will do their best to refer you to appropriate
providers. However, the assistance provider and CSA cannot be held responsible
for the quality or results of any services provided by these independent practitioners.
Availability of Services
The 24-hour hotline services become available when you actually start your trip.
Services end the earliest of: midnight on the day the program expires; when
you reach your return destination; or when you complete your trip.
Medical Referral
If an emergency occurs during a trip that requires you to seek urgent medical
advice you should call the 24-hour hotline to obtain the names of local qualified
doctors who speak your language. If additional medical services are required,
the assistance provider is prepared to consult with the attending physician
and provide such assistance as they believe to be in your best interest.
Emergency Cash Transfer
If your cash or travelers checks are lost or stolen, or unanticipated emergency
expenses are incurred, the assistance provider will, whenever possible, help
arrange for an emergency cash transfer in currency, travelers checks, or other
form acceptable to the assistance provider. These funds must come from your
major credit card(s) or from family and/or friends.
Legal Referral
The assistance provider will provide travelers with access or referrals to the
most conveniently located attorneys available during regular working hours.
Assistance will also be provided in obtaining bail bonds in those geographical
locations where such bonds are customarily issued. You are responsible for contracted
legal fees.
Lost Ticket and Passport Assistance
The assistance provider will, whenever possible, provide you with referrals
and information to assist in obtaining replacement for lost or stolen travel
documents, passports, travel tickets, etc.
Emergency Prescription Refill Assistance
The assistance provider will assist you, whenever possible, in obtaining a replacement
of an existing prescription when your medication has been lost, stolen, or if
you are in need of a refill. The prescription will be refilled by a licensed
pharmacist or other authorized personnel in the country in which you are traveling.
It will be replaced with the same brand of medication prescribed in the U.S.,
or the equivalent in the country in which you are traveling. The refill may
require a visit to a local physician. You should be prepared to furnish the
assistance provider with a copy of your original prescription and/or the name
and phone number of your regular attending physician. Replacement medication
and visit to a local physician will be at your expense.