SIRIUS AMERICA INSURANCE COMPANY
New York, NY 10036
GROUP
TRAVEL INSURANCE CERTIFICATE
GROUP
Single Trip Air, Cruise & Tour Travel
Insurance Program
We promise and
agree to provide You with the benefits described in the Policy, as outlined in
this Certificate. We make this promise
and agreement in consideration of Your application and payment of the premium
in full. The benefits are subject to
all provisions, terms, conditions, limitations and exclusions of the
Policy. The Certificate is not part of
the Policy. Any conflict between the
terms of the Certificate and the Policy will be decided in favor of the Policy.
POLICYHOLDER: National Small Business Travel
& Health Association
TO FILE A CLAIM:
From North America, call: (1) 866-243-7524
From outside North America, call: (1) 317-655-9798
Mail to: iTravelInsured
P.O.
Box 44914
Indianapolis,
IN 46244
Right to Cancel
If You are not satisfied for any reason, You may return this
Certificate to Us within 10 days after receipt provided You have not already
departed on Your Trip or filed a claim.
Premium will then be refunded, and this Certificate will be void from
the beginning.
Notice to California residents: This plan contains disability
insurance benefits or health insurance benefits, or both, that only apply
during Your Covered Trip. You may have coverage from other sources that already
provides You with these benefits. You should review Your existing policies. If
You have any questions about Your current coverage, call Your insurer or health
plan.
Notice to Florida residents: The benefits of the Policy
providing Your coverage are governed primarily by the law of a state other than
Florida. This Policy may provide a
duplication of coverage already provided by the Insured’s homeowner’s, personal
liability policy or other source of coverage.
Notice to Texas residents: This Policy may provide a
duplication of coverage already provided by the Insured’s personal auto
insurance, homeowner’s, personal liability policy or other source of coverage.
SECTION 1. SCHEDULE OF BENEFITS
BENEFITS
|
MAXIMUM BENEFIT PER INSURED SUBJECT TO THE
AGGREGATE LIMIT (or unless otherwise noted) |
|
Trip
Cancellation/Interruption |
Trip Cost up to
$20,000 as confirmed on Your coverage verification letter |
|
Travel Delay |
$500 ($100 per day after 24
hours or up to $500 for missed
connection) |
|
Baggage and Personal
Possessions |
$1,000 |
|
Baggage Delay |
$100 |
|
Emergency
Medical/Dental Expense |
$10,000 |
|
Emergency Medical
Evacuation / Repatriation |
$20,000 |
|
Emergency Reunion or
Return of Mortal Remains |
$3,000 |
|
Common Carrier
Accidental Death & Dismemberment |
Principal Sum -
$100,000 |
The total aggregate limit of
benefits payable in the event of any one Accident involving 2 or more Insureds
is $1,500,000 under the Policy. In the
event of multiple claims for a single Accident, benefits will be reduced so
that each Insured’s benefit amount will be a proportionate share of the total
amount payable for all Insureds under this provision up to the total aggregate
limit of liability.
“Accidental or Accident” means an unexpected and unforeseen event or incident,
including a Terrorist Incident.
“Baggage” means luggage and personal
possessions, whether owned, borrowed or rented, that is taken or purchased by
You on the Covered Trip.
“Business Partner” means an individual who
owns at least 10% of the same business as You and is actively involved in the
day-to-day management of that business, and there are no more than three
partners together who own the same business.
“Certificate” means an outline of the
terms of coverage and provisions of the Policy, which includes this document
and Your application.
“Common Carrier” means any land, water, or air conveyance operated under a
license for the transportation of passengers for hire.
“Covered Trip” means any travel and sojourn to a Destination more than 120
miles from the starting point of the Covered Trip and not exceeding 30
consecutive days.
“Departure Date” means the scheduled date to begin the Covered Trip as
referenced on Your coverage verification letter for this Certificate.
“Destination” means one or more cities to which You are scheduled to
travel on a Covered Trip.
“Emergency” means a sudden, unexpected, unforeseen occurrence demanding
immediate action.
“Family Member” means Your spouse, children, brothers or sisters (including
in-laws), parents (including in-laws), grandparents (including in-laws),
grandchildren, aunts, uncles, nieces, nephews, legal guardians, and legal wards.
“Financial Default” means the complete suspension of operations due to
financial circumstances whether or not a bankruptcy petition is filed, or a
partial suspension of operation following a filing of a bankruptcy petition in
a court of competent jurisdiction under Chapter 7 or Chapter 11 of the U.S.
Bankruptcy Code.
“Hospital”
means an institution
or medical facility that
meets all of the following requirements:
1.
Properly
accredited and where required by law, holds a license as a Hospital;
2.
Operates
mainly for the care and treatment of sick or injured persons as inpatients;
3.
Provides
twenty-four hours a day nursing care by registered nurses;
4.
Has a
staff of one or more Physicians available at all times;
5.
Provides
organized facilities for diagnosis and surgical procedures;
6.
Not
primarily a clinic, nursing home or convalescent home or similar place of
business; and
7.
Not
mainly a place for treating alcoholics or drug addicts.
With respect to outpatient surgery or diagnostic testing, an ambulatory
surgical center or a clinic will be considered a Hospital. Such facility must be properly accredited
and, where required by law, hold a license allowing the facility to operate as
such.
“Illness” means an Emergency sickness, impairment or physical
condition that involves inpatient care in a Hospital, or requires Emergency
treatment by a qualified Physician.
“Injury” means trauma or damage to any part of the body caused solely by
Accident and not contributed to by any other cause.
“Insured” means the Member who arranged to take the Covered Trip, completed
the application, paid the premium in full, and whose coverage under the Policy
has become effective and has not terminated.
“Locality” means an area large enough to represent a reasonable cross
section of providers giving the type of service or supplies for which the
charge was made.
“Member” means any person who belongs to the
Policyholder’s association.
“Necessary” means medical treatment that is vital and required for the
treatment of a covered Injury or Illness.
“Organized Labor Strike” means any stoppage of work: (a) as a result of a
combined effort of workers which was unannounced and unpublished at the time a
Covered Trip was purchased; and (b) which interferes with the normal departure
and arrival of a Common Carrier. An
Organized Labor Strike is no longer unannounced and unpublished beginning with
the first day of an announced “cooling off period.”
“Physician” means a person, other than You, a Travel Companion or a
Family Member, who is licensed as a medical doctor in the healing arts, and
acting within the scope of his or her license for the service or treatment
given.
“Policy” means the Group Travel
Insurance Policy issued to the Policyholder by Us. As the underwriting insurance carrier, We are solely liable and
responsible for the coverage and benefits provided under the Policy.
“Policyholder” means the National Small
Business Travel & Health Association.
“Pre-Existing
Condition” means an Injury or Illness
which manifests itself during the 60 days immediately before and including
the date Your coverage became effective, unless the condition is controlled
through the taking of prescription drugs or medication and remains controlled
throughout the 60 day period.
An Illness or Injury has manifested itself when:
1. Medical care or
treatment has been given; or
2. There exist symptoms
which would cause a reasonably prudent person to seek diagnosis, care, or
treatment; or
3. Prescription medication has been altered or changed.
“Reasonable Expenses” means the normal and customary charge of the
provider, incurred by You for a service or supply, but not more than the
prevailing charge in the Locality for a like service by a provider with similar
training or experience; or for a supply which is identical or substantially
equivalent.
“Return Date” means the scheduled date on which You are to arrive at Your
Return Destination as shown on the coverage verification letter for the
Certificate.
“Return Destination” means the place to which You are scheduled to return from a
Covered Trip.
“Scheduled Airline” (including scheduled charters) means an airline with a
license for civil scheduled air transport issued by the country in which its
aircraft are registered. Such airline
must file and publish schedules and fares for regular passenger service between
cities.
“Terrorist Incident” means any violent act or an act that is dangerous to human life,
property or infrastructure, that is committed, within 120 miles of a
Destination, by any person or persons who appear to be part of an effort to
coerce a civilian population or affect the conduct of any government by
coercion
“Travel
Companion” means a person who accompanies and shares accommodations with You
on a Covered Trip, and a physical cross-reference entry exists within a
computerized reservation system, a global distribution system or Travel
Supplier reservation system that references Travel Companions to each other.
“Travel Companion’s Family Member” means a Travel Companion’s spouse,
children, parents or grandparents.
“Travel Supplier” means a travel agent, Scheduled Airline, cruise line, tour
operator, bus line, or other licensed provider of travel.
“We, Us, Our” means Sirius America Insurance
Company.
“You or Your” means the Insured.
Subject to Our acceptance of Your application and payment of the
premium in full, coverage for all benefits except Trip Cancellation will begin
on the Departure Date. The Trip
Cancellation benefit will begin at 12:01 a.m. on the day after We receive Your
application.
All coverage for a Covered Trip ends on the earliest of:
1. Arrival at Your Return
Destination;
2.
The
Return Date;
3. The end of the Coverage
Term as indicated on the Certificate; or
4. Cancellation of the
Covered Trip.
Subject
to the limitations stated below, We will pay for non-refundable, unused
payments and deposits, not to exceed the lesser of the total trip protection
purchased, or the maximum benefit shown on the Schedule of Benefits, if Your
Covered Trip is cancelled or interrupted as a result of any one of the
following events which occurss after Your coverage is in effect and
before such coverage terminates:
1. Illness, Injury or death to:
a)
You;
b)
A Family
Member;
c)
A Business
Partner;
d)
A Travel
Companion; or
e)
A Travel
Companion’s Family Member.
The Illness or Injury must be so disabling as to reasonably cause a Covered Trip to be delayed, canceled or interrupted upon the written opinion of a treating Physician. For Trip Cancellation benefits, an actual examination by a Physician must take place before the cancellation is made. For Trip Interruption benefits, this examination must take place during the Covered Trip. If the Illness or Injury occurs to a Family Member or Travel Companion’s Family Member, that person must require Your care or the care of a Travel Companion.
We will not pay this benefit if Your Illness, Injury or
death is a result of a Pre-Existing Condition.
This Pre-Existing Condition exclusion is waived if You are under the age
of 70 and coverage is purchased within 14 days from the date Your initial
deposit for the Covered Trip was paid to the Travel Supplier, and all Insureds
are medically able to travel on the date coverage is purchased.
2. Financial Default of a Travel Supplier (other than the Travel
Supplier from whom You purchased the Covered Trip) which stops service more
than 30 days after the date Your coverage became effective. Financial Default
of a Travel Supplier before or on the date Your coverage became effective or
within 30 days after the date Your coverage became effective is excluded. This
coverage must be purchased within 14 days from the date of initial deposit for
the Covered Trip.
3. A Terrorist Incident, if You are scheduled to arrive at a Destination within 10
days following the Terrorist Incident and the Travel Supplier is not offering a
substitute itinerary. Travel to any Destination for which travel warnings have
been issued by the U.S. State Department at the time this coverage is purchased
is excluded. Travel to any Destination in which such a Terrorist Incident has occurred
in the 12 months prior to the date this coverage was purchased is excluded.
4. Organized Labor Strike, natural disasters or bad weather resulting in the
complete cessation of services by a Travel Supplier for at least 24 consecutive
hours.
5.
You or a Travel Companion being hijacked
or medically quarantined by order of a governmental health authority.
6. You or a Travel Companion being summoned to serve on a jury or served with a court
order issued after the date Your coverage became effective, which mandates the
appearance in court during the time period of the Covered Trip.
7. Your home or the home of a Travel Companion is made uninhabitable by fire, windstorm,
vandalism or flood.
8. A traffic Accident directly involving either You or a Travel
Companion, substantiated by a police report, while en route to a scheduled
departure point for the Covered Trip.
9. You or a Travel Companion is on active military duty in the United States
Armed Forces or is an active duty police officer or fire fighter, whose personal leave is
revoked within 10 days before Your Departure Date. Such revocation must be in
writing by a superior officer and must not be due to a base or unit
mobilization, unit or personal reassignment for any reason (whether temporary
or permanent), or disciplinary action.
10.
Employer termination or Your layoff. You must have been employed with the same employer for at least
one year, and You must have worked at least 30 hours per week, excluding time
off for paid vacation and holidays, for the entire period of employment.
Subject to the limitations stated below, We will pay up to the maximum benefit shown on the
Schedule of Benefits for additional reasonable traveling expenses that are
incurred by You on a Covered Trip because of a travel delay of at least 24
hours, and are not otherwise paid by a Travel Supplier or Common Carrier. You must make every reasonable effort to
avoid additional expenses. This benefit
is payable for only one delay per Covered Trip.
Travel Delay must be caused by:
1.
Travel Supplier delay;
2.
Lost
or stolen passport, travel documents or money;
3.
Medical quarantine;
4.
Natural disaster; or
5.
Injury or Illness of You
or a Travel Companion.
Any
benefit payable under this coverage will be reduced by all amounts credited or
refunded to You by any other source.
We will also pay for additional reasonable
transportation costs to help You join (catch up to) a covered cruise, up to
the amount shown on the Schedule of Benefits, if You missed a cruise departure
because the airline flight was canceled or delayed for at least 6 hours due
to bad weather. Any benefit payable under this coverage will be reduced by any amount
paid by a Common Carrier towards additional transportation costs.
Subject to the limitations stated below, We will pay up to
the maximum benefit shown on the Schedule of Benefits for damage to or loss or
theft of Your checked or stored Baggage on a Covered Trip when such Baggage is
lost or damaged by a Common Carrier or stored with a hotel or motel in which
You are registered as a guest.
The following limitations will apply:
1. We will not pay for damage to or loss of or theft of Baggage which has been paid by a Common Carrier, hotel, Travel Supplier, or is otherwise payable under any other insurance.
2. We will pay no more than $500 for the first item of Baggage and, thereafter, no more than $250 per item of Baggage up to the maximum benefit shown on the Schedule of Benefits.
3. We will not pay for damage to or loss of:
a) Animals;
b) Property used in trade,
business or for the production of income;
c) Motor vehicles,
aircraft, and other conveyances or equipment or parts pertaining to such
conveyances;
d) Artificial limbs, false
teeth, any type of eyeglasses or contact lenses;
e) Tickets, except for
administrative fees required to reissue tickets;
f)
Money, stamps, stocks and bonds, postal or money orders;
g) Property shipped as
freight, or shipped prior to the Departure Date;
h) Credit cards;
i)
Contraband; or
j)
Hearing aids.
4. We will not pay for loss due to:
a) Defective materials or craftsmanship;
b) Normal wear and tear;
c) Deterioration; or
d) Rodents, animals or insects.
We may choose to replace, repair, or pay for the loss after making allowances for depreciation and wear and tear. We will pay the cost of repair or replacement of the damaged Baggage less depreciation. We may take all or part of the damaged Baggage at the appraised or agreed value.
In the event of a loss to Baggage that is a pair or set, We may, at Our option, repair or replace any part to restore the pair or set to its value before the loss; or pay the difference between the value of the property before and after the loss.
In the event of loss, theft or damage to Baggage, You must:
4.
Make necessary
reasonable and temporary repairs to the Baggage.
We will not pay for further damage if You fail to protect the Baggage.
This coverage does not include loss caused by Baggage delay.
In the event Your checked Baggage is delayed by a Common Carrier on a Covered Trip for 24 hours or more from the actual time of arrival at a Destination, subject to the limitations stated below, We will reimburse costs You incurred up to the maximum benefit shown on the Schedule of Benefits for reasonable additional clothing and essential personal articles You purchased. Verification of the delay by the Common Carrier and receipts for the necessary purchases must accompany any claim.
The following limitations will apply:
1. This benefit does not apply if Baggage is delayed after You have reached Your Return Destination.
2. We will cover only one Baggage Delay per Covered Trip.
3. This benefit is in excess of any reimbursable costs paid by a Common Carrier.
Subject
to the limitations stated below, We will pay up to
the maximum benefit shown on the Schedule of Benefits for Covered Expenses You
incurred for an Injury or Illness on a Covered Trip, provided initial treatment
is received during a Covered Trip. The first expense must be incurred within 48
hours from the date of the onset of the Injury or Illness, or, if the
Pre-Existing Condition Limitation is waived, the Injury or Illness must
re-occur while You are covered for Injury or Illness. This coverage is
secondary to any other coverage available to You. Coverage continues until Your
Covered Trip ends.
“Covered Expenses” means the Necessary and Reasonable Expenses for medical, surgical and Emergency dental services, treatments and supplies incurred during a Covered Trip. Covered Expenses also include expenses for professional nursing services, Hospital charges, X-rays, and ambulance services.
We will not pay for:
5. Benefits which are payable under any worker’s compensation or similar law;
Subject to the limitations stated below, We will pay up to the
maximum benefit shown on the Schedule of Benefits for Covered Expenses, and We
will arrange for Emergency assistance services You require as the result of
Illness or Injury occurring during a Covered Trip.
“Covered Expenses” means Reasonable Expenses for medical services required for evacuation to the nearest adequate medical facility from the place where the Injury or Illness occurred. Services and benefits will be arranged only if the treating Physician recommends such evacuation. Covered Expenses will be paid provided You are traveling on a Covered Trip and are more than120 miles away from Your primary place of residence. In addition to the above Covered Expenses, when You are confined in a medical facility more than 120 miles from Your primary residence and Your treating Physician and We determine it is feasible and medically Necessary to transfer You to a medical facility nearer to Your primary residence to recuperate in familiar surroundings, medical repatriation will be provided.
We will
not pay for any services or Covered Expenses incurred without Our prior consent
or approval. We will not pay for any services or Covered Expenses incurred as a
result of a Pre-Existing Condition. This Pre-Existing Condition exclusion is waived if You are
under the age of 70 and coverage is purchased within 14 days from the date Your
initial deposit for the Covered Trip was paid to the Travel Supplier, and all
Insureds are medically able to travel on the date the coverage is purchased.
Subject to the limitations stated below, We will either purchase or pay a total amount not to exceed the maximum benefit shown on the Schedule of Benefits for one or more of the following:
We will
not pay for any services or expenses incurred without Our prior consent or
approval.
Subject to the limitations stated below, We will cover Injury to You on a Covered Trip limited to riding as a passenger, getting in or out of, or being struck by a Common Carrier.
If Your Injury results in a loss shown below within one year after an Accident causing the loss, We will pay a percentage of the Principal Sum shown on the Schedule of Benefits as follows:
|
Loss of Life |
100% of the Principal Sum |
|
Loss of both Hands or both Feet or Sight of both eyes |
100% of the Principal Sum |
|
Loss of one Hand and one Foot |
100% of the Principal Sum |
|
Loss of one Hand or one Foot and Sight of one eye |
100% of the Principal Sum |
|
Loss of one Hand or one Foot or Sight of one eye |
50% of the Principal Sum |
“Loss of Hand or Foot” means the complete and permanent
severance through or above the wrist or ankle joint.
“Loss of Sight” means the total and permanent loss of
entire sight. Such loss correctable by surgery or lenses is not considered
total and permanent.
“Principal Sum” means the limit as specified in the
Schedule of Benefits.
If You suffer more than one loss from any one Accident, We will pay only
one amount which is determined to be the highest benefit payable not to exceed
the Principal Sum.