TRAVEL MEDICAL EMERGENCY INSURANCE

Once the appropriate premium is paid and a policy confirmation number is issued, this document becomes your insurance policy.

SECTION 1 - IMPORTANT NOTICE

Your Safe Trip Begins Here...

What safer way to begin your trip than by purchasing travel insurance?
Insurance is designed to guard against the financial consequences of unexpected and unforeseen events. Still, no single coverage can protect against every risk. That is why it is important for you to understand the nature of the insurance you have purchased.

Read your policy
Please read this policy carefully, particularly the sections relating to the insurance coverage(s) you have purchased. Some of the terms may limit the benefits payable to you.

Check the exclusion for pre-existing medical conditions
A pre-existing medical condition exclusion applies to medical conditions and/or symptoms that existed prior to your trip. Check to see how this applies in your policy and how it relates to your date of purchase or date of departure.

Medical history review
In the event of an accident, injury or sickness, your prior medical history may be reviewed when a claim is reported.

Definitions
Throughout this policy, words in italics have a specific meaning and are defined in the "Definitions" section.

Currency
All amounts are in Canadian currency, unless indicated otherwise.

What To Do in an Emergency

In the event of an emergency during a covered trip, you must call Global Excel immediately, prior to seeking treatment:

24-HOUR EMERGENCY MEDICAL ASSISTANCE
1-800-715-8833. . . . . . (toll free from the USA and Canada)
001-800-514-1518. . . . . . . . . . . . . (toll free from Mexico)
1-800-002-554. . . . . . . . . . . . . . . (toll free from Australia)
1-888-751-4335. . . (toll free from the Dominican Republic)
(819)566-8839 . . . . . . . . . . . . . . (collect from anywhere)

If it is not reasonably possible for you to contact Global Excel prior to seeking treatment, due to the nature of your emergency, you must have someone else call on your behalf or you must call as soon as medically possible. Failure to do so limits benefits (see Section 5 - Limitations and Restrictions - Paragraph 3).

Why are you required to call Global Excel?

If Global Excel is not notified, you may receive medical treatment or services which are not covered under this policy.

Pre-Approval Requirement - Global Excel must approve in advance any surgery, invasive procedure, diagnostic testing or treatment (including, but not limited to, cardiac catheterization), prior to the insured undergoing such surgery, procedure, testing or treatment. It remains your responsibility to inform your attending physician to call Global Excel for approval, except in extreme circumstances where such action would delay surgery required to resolve a life-threatening medical crisis. Global Excel will work closely with you to:

Another important fact you should know

Direct Payment - Direct payment of eligible medical expenses approved in advance is part of our service, but if it is not possible for the Insurer to pay directly, you may be required to provide payment yourself and submit a claim supported by proper documentation.

SECTION 2 - ELIGIBILITY

  1. This insurance shall be null and void if purchased in a manner other than as stated in this Section and the Insurer's liability shall be limited to the refund of the insurance premium paid.
  2. This insurance:
    1. must be issued in Canada; and
    2. must be applied for prior to the date of departure.
  3. The applicant must not be travelling:
    1. against the advice of a physician;
    2. while he requires kidney dialysis; or
    3. after being diagnosed with a terminal illness. Terminal Illness means the applicant has a medical condition that is cause for a physician to estimate that he has less than 6 months to live or for which palliative care has been received.
  4. The applicant must be a Canadian resident or a landed immigrant to apply for this insurance. If you apply for this insurance without being covered under a provincial or territorial government health plan in Canada your benefits are limited. Please refer to Section 5 - Limitations and Restrictions - Paragraph 2, for the applicable coverage limitation.
  5. To purchase the Single Trip Daily Plan Worldwide, the applicant must be:
    1. 59 years of age or under on the date of application and be travelling on a covered trip of 183 days (212 for Ontario Residents) or less; or
    2. between 60 and 74 years of age inclusively on the date of application and be travelling on a trip of 23 days or less.
  6. To purchase the Single Trip Daily Plan Canada, the applicant must be travelling on a covered trip of 365 days or less.

SECTION 3 - INSURANCE AGREEMENT

  1. The Contract

    Note that this Policy, the Application and the Policy Confirmation all form part of your insurance contract and must be read as a whole. The Insurer will pay benefits specified in the Policy upon payment of the required premium, submission of a correct and complete application form and occurrence of an emergency, subject to the terms, conditions, limitations, exclusions, definitions and other provisions of this Policy.

  2. Trip Duration

    Plans Available

    Age

    Maximum Trip Duration

    Single Trip Worldwide

    0-59

    183 days*
    (212 days* for Ontario Residents)

    60-74

    23 days

    Single Trip Canada

    All ages

    365 days
    * Coverage can be purchased up to 365 days provided you receive written permission from your government to maintain your Canadian government health insurance plan. In the event of a claim, you will be requested to provide such written permission.

  3. Period of Coverage

    1. Single Trip Daily Plan
      1. Effective Date - Coverage begins on the later of the following:
        1. the date of departure; or
        2. the effective date indicated on the Policy Confirmation.
      2. Expiry Date - Coverage terminates on the earlier of the following:
        1. the date you return to your province or territory of residence, except in the circumstances noted below; or
        2. the date of termination indicated on the Policy Confirmation.

    NOTE: If you return to your province or territory of residence for a temporary visit prior to your expiry date and provided you have not incurred a claim, your coverage may resume with no additional premium once you leave your province or territory of residence to resume your trip. The number of days of your temporary return will not be refunded or reissued. If during your temporary visit you are treated or you receive medical treatment for a medical condition (other than a minor ailment), your policy will terminate and you may be eligible for a refund.

  4. Plans Offered

    1. Single Trip Daily Plan
      1. All benefits are available under the Single Trip Daily Plan and the Top Up Plan.
      2. Provides coverage for a single trip.
    2. Family Coverage (available up to age 59)
      1. The Single Trip Daily Plan is available under family coverage.
      2. The family coverage option covers the spouse and the children of the insured person.
      3. The required premium for the family coverage must be paid prior to departure.

  5. Automatic Extension of Coverage

    Your coverage will be extended automatically without additional premium upon notifying Global Excel, if your return to your province or territory of residence is delayed beyond the expiry date of this insurance solely due to one of the following reasons:
    1. Your return from the trip is delayed beyond the expiry date of this insurance due to the delayed arrival or departure of a common carrier aboard which you are scheduled to travel, until the earliest of:
      1. the date you return to your province or territory of residence; or
      2. five consecutive days from the date the insurance coverage would otherwise terminate were it not for the automatic extension.
    2. The vehicle in which you are travelling is involved in an accident or mechanical breakdown that prevents you from returning to your province or territory of residence on or before your expiry date of this insurance provided the return journey commences prior to the expiry date of your policy, until the earlier of:
      1. the date you return to your province or territory of residence; or
      2. five consecutive days from the date the insurance coverage would otherwise terminate were it not for the automatic extension.
    3. You or your travel companion must remain hospitalized for medical treatment of a sickness or injury beyond the expiry date of this insurance, to a maximum of 365 days or until you or your travel companion are stable for discharge in the opinion of the Insurer, whichever is earlier, plus five consecutive days thereafter.
    4. You or your travel companion's return is delayed beyond the expiry date of this insurance as a direct result of sickness or injury for which you or your travel companion are not hospitalized, until the earlier of:
      1. the date you return to your province or territory of residence; or
      2. five consecutive days from the date the insurance coverage would otherwise terminate were it not for the automatic extension.

  6. Optional Extension Procedures

    Coverage under the Single Trip Daily Plan can be extended by contacting Global Excel provided that:
    1. a claim has not been made under this policy;
    2. you remain eligible for this insurance;
    3. the extension is requested by phone not more than 10 days prior to the expiry date of your coverage;
    4. the total time outside your province or territory of residence (including the extension) does not exceed the maximum trip duration for which you are eligible;
    5. the required premium is charged to your credit card.

    Note: The cost of the additional days of insurance will be calculated based on the total trip duration less the initial premium paid.

  7. Premium Payment

    1. The required premium is due and payable at the time of application and will be determined according to the schedule of premium rates then in effect.
    2. If the premium is insufficient for the period of coverage selected, we will:
      1. charge and collect any underpayment; or
      2. shorten the policy period by written endorsement if an underpayment in premium cannot be collected.
    3. We will refund any overpayment of premium.

  8. Refunds

    Contact Global Excel to request premium refunds:
    1. A full refund of the premium paid will be made if you must cancel the trip prior to the effective date.
    2. A partial refund (less an administration fee of $25 per policy) of the premium paid will be made if you return early, provided that you contact Global Excel upon early return and that no claim has been received or is pending. Satisfactory proof of the return date must be received. Requests for refunds must be made in writing within 90 days of the expiry date of this insurance to Global Excel. If Global Excel receives satisfactory proof (e.g. airline ticket or customs/immigration stamps) of your actual return date to your province or territory of residence, your refund will be calculated from that date. Otherwise, calculation of such refunds will be based on the date of the postmark of your written request. Minimum refund is $10 per insurance policy.

  9. Coverage Offered

    This insurance provides payment for the reasonable and customary costs incurred by you (less any applicable deductible) in case of an emergency occurring while you are travelling outside of your province or territory of residence on a covered trip for the benefits set out below. The Insurer will pay such eligible expenses, to a maximum of $5 million* per insured, only in excess of those reimbursable under any group, individual, private or public plan or contract of insurance, including any auto insurance plan and your Canadian provincial or territorial government health insurance plan.


    10. * Limitations may apply. Please refer to Section 5 - Limitations and Restrictions - Paragraph 2.
SECTION 4 - BENEFITS
  1. Hospital Accommodation: Charges up to the semi-private room rate (or an intensive or coronary care unit where medically necessary).

  2. Physician Fees: Medical treatment by a physician.

  3. Diagnostic Services: Laboratory tests and x-rays prescribed by the attending physician due to an emergency. Note: This policy does not cover magnetic resonance imaging (MRI), cardiac catheterization, computerized axial tomography (CAT) scans, sonograms, ultrasounds and biopsies unless such services are approved in advance by Global Excel.

  4. Paramedical Services: Services of a licensed chiropractor, chiropodist, osteopath, podiatrist or physiotherapist, including x-rays, to a maximum of $300 per profession listed, when approved in advance by Global Excel.

  5. Prescription Drugs: Drugs, serums and injectables that can only be obtained upon medical prescription, that are prescribed by a physician and that are supplied by a licensed pharmacist when required as a result of an emergency. This benefit does not cover drugs, serums and injectables needed to stabilize a chronic condition or a medical condition which you had before your trip. Limited to a 30-day supply per prescription, unless you are hospitalized. To file a claim you must supply original receipts issued by the pharmacist, physician or hospital, indicating the total cost, prescription number, name of medication, quantity, date and name of the prescribing physician.

  6. Ambulance Services: When reasonable and medically necessary, licensed ground ambulance service (also covers taxi fare in lieu of ground ambulance) to the nearest hospital.

  7. Medical Appliances: When approved in advance by Global Excel, minor appliances such as crutches, casts, splints, canes, slings, trusses, braces, walkers and/or the temporary rental of a wheelchair when prescribed by the attending physician and required due to a covered emergency.

  8. Private Duty Nursing: The professional services of a registered private nurse (other than an immediate family member) as the result of a covered emergency, when medically necessary and while hospitalized, to a maximum of $5,000 per insured person, when approved in advance by Global Excel.

  9. Emergency Air Transportation: When approved and arranged in advance by Global Excel (see Section 5 - Limitations and Restrictions, #4):
    1. air ambulance to the nearest appropriate medical facility or to a Canadian hospital for medical treatment;
    2. transport on a licensed airline with an attendant (when required) for emergency return to your province or territory of residence for immediate medical attention;
    3. the fare for additional airline seats to accommodate a stretcher to return you to your province or territory of residence; or
    4. up to the cost of a one-way economy airfare to your province or territory of residence.

  10. Qualified Medical Attendant: Fees for a qualified medical attendant (other than an immediate family member) to accompany you to your province or territory of residence when recommended by the attending physician and approved in advance and arranged by Global Excel. This includes return economy airfare and overnight lodging and meals (where necessary).

  11. Transportation to Bedside: When approved in advance by Global Excel, a round-trip economy airfare from Canada and up to $150 per day to a maximum of $1,500 per policy for the cost of meals and commercial accommodation (original receipts are required) will be provided for a person of your choice to:
    1. be with you when you are travelling alone and have been hospitalized for at least seven consecutive days outside your province, territory of residence or Canada. You must provide written certification from the attending physician that the situation is serious enough to warrant the visit. This benefit is provided immediately if you are 20 years of age or less; or
    2. identify the deceased insured prior to the release of the body, where necessary.

    Furthermore, the person required at bedside, or mandated to identify the deceased will be covered under the same terms and limitations of your policy.

  12. Return of Insured Travel Companion: When approved in advance by Global Excel, the cost of a one-way economy airfare to return your insured travel companion to your province or territory of residence if you are returned under the Emergency Air Transportation or Preparation and Return of Remains benefit.

  13. Treatment of Dental Accidents: Emergency dental treatment at trip destination to a maximum of $2,000 to repair or replace sound natural teeth or permanently attached artificial teeth injured as the result of an accidental blow to the face, provided you consult a physician or a dentist immediately following the injury. An accident report is required from the physician or dentist for claims purposes. This benefit excludes crowns and root canals.

  14. Emergency Relief of Dental Pain: Up to $350 per insured person for emergency relief of dental pain at trip destination. This benefit excludes crowns and root canals.

  15. Out-of-Pocket Expenses: When approved in advance by Global Excel, reasonable, necessary expenses incurred by you or an insured travel companion for commercial lodging and meals, commercial automobile rental, or taxi transportation and parking fee to a maximum of $1,500 per policy, subject to a limit of $150 per day if a covered emergency causes you to miss your scheduled return or requires that you be relocated for treatment. To file a claim, you must supply original receipts from commercial organizations and a certificate from the attending physician to the effect that you were unable to travel.

  16. Vehicle Return: Up to $3,000 if neither you, nor someone travelling with you, is able to operate your owned or rented vehicle during your trip due to sickness or injury. Arrangements and payment will be made for the return of the vehicle to your home in your province or territory of residence or the nearest appropriate rental agency. Benefits will only be payable for one person to return the vehicle when approved and arranged in advance by Global Excel. This benefit does not cover wages lost by the person driving your vehicle. Original receipts are required.

  17. Preparation and Return of Remains: In the event of your death, up to a maximum benefit of $5,000 towards the actual cost incurred for preparation of remains, homeward transportation of the deceased insured person to his province or territory of residence; or cremation and/or burial at the place of death of the insured person. The cost of the casket or urn is not covered by this benefit.

  18. Escort of Children: When approved in advance by Global Excel:
    1. organization, escort and payment up to the cost of a one-way economy airfare for the return of your insured children or grandchildren, provided they are under 21 years of age; or
    2. reimbursement of up to $1,000 for the services of a caregiver (other than an immediate family member) contracted by you for your insured children or grandchildren, provided they are under 21 years of age, in the event an insured parent or legal guardian (on the trip) must be medically repatriated or hospitalized.

  19. Pet Return: The return to Canada of your accompanying cat or dog, in the event that you are hospitalized or repatriated during a covered emergency, to a maximum of $500.

  20. Remote Evacuation: Your emergency evacuation from a mountainous area, the sea, or other such remote location to the nearest, most reasonably accessible medical facility or hospital, to a maximum of $5,000.

  21. Return to Trip Destination: A one-way economy airfare for you to be returned to your trip destination after you are returned to your province or territory of residence for immediate medical treatment provided your attending physician determines that you require no further treatment for your emergency, when approved in advance by the Insurer. Once you return to your trip destination, a recurrence of the sickness or injury, which caused the initial emergency, or any problems or complications related thereto, will not be covered under this policy.

Note: This benefit is valid only if you were returned to Canada with the Emergency Air Transportation benefit and your insurance policy is still effective.

SECTION 5 - LIMITATIONS AND RESTRICTIONS

  1. Pre-Approval of Surgery, Invasive Procedure, Diagnostic Testing and Treatment - Global Excel must approve in advance any surgery, invasive procedure, diagnostic testing or treatment (including, but not limited to, cardiac; catheterization), prior to the insured undergoing such surgery, procedure, testing or treatment. It remains your responsibility to inform your attending physician to call Global Excel for approval, except in extreme circumstances where such action would delay surgery required to resolve a life-threatening medical crisis.

  2. Benefits Limited to $20,000 - Only Canadian residents and landed immigrants covered under a Canadian government health insurance plan (GHIP) are eligible for the complete coverage maximum of $5 million.

    Exception: If you have no coverage under GHIP or if you lose such coverage during your trip, then this insurance is limited to a total of $20,000 for all eligible expenses.

  3. Failure to Notify Global Excel - In the event of an emergency during a covered trip, you must call Global Excel immediately, prior to seeking treatment. If it is not reasonably possible for you to contact Global Excel prior to seeking treatment, due to the nature of your emergency, you must have someone else call on your behalf or you must call as soon as medically possible. Failure to do so limits benefits payable to you to:
    1. in the event of hospitalization, 70% of eligible expenses, based on reasonable and customary costs; and
    2. in the event of an out-patient medical consultation, a maximum of one visit per sickness or injury.

    You will be responsible for payment of any remaining charges.

  4. Transfer or Medical Repatriation - During an emergency (whether prior to admission, during a hospitalization or after your release from the hospital), the Insurer reserves the right to:
    1. transfer you to one of its preferred health care providers; and/or
    2. return you to your province or territory of residence, for the medical treatment of your sickness or injury without danger to your life or health. If you choose to decline the transfer or return when declared medically stable by the Insurer, the Insurer will be released from any liability for expenses incurred for such sickness or injury after the proposed date of transfer or return. Global Excel will make every provision for your medical condition when choosing and arranging the mode of your transfer or return and, in the case of a transfer, when choosing the hospital.

  5. Limitation of Benefits - Once you are deemed medically stable to return to your province or territory of residence (with or without a medical escort) either in the opinion of the Insurer or by virtue of discharge from hospital, your emergency is considered to have ended, whereupon any further consultation, treatment, recurrence or complication related to the medical emergency will no longer be eligible for coverage under this policy.

  6. Availability and Quality of Care - The Insurer is not responsible for the availability, quality or results of any medical treatment or transportation, or your failure to obtain medical treatment or hospitalization.

  7. Benefits Limited to Incurred Expenses - The total benefits paid to you from all sources cannot exceed the actual expenses which you have incurred.
SECTION 6 - EXCLUSIONS
  1. Pre-existing Medical Condition Exclusions

    Pre-existing Key:
    PTA = Prior to Application Date     PTD = Prior to Departure

    Your Plan Your Age Maximum Trip Duration Your pre-existing exclusion Your pre-existing period
    Single Trip Worldwide 0-54 183 days 1 90 days (PTA)
    55-59 183 days 2 90 days (PTD)
    60-74 23 days 2 90 days (PTD)
    Single Trip Canada All ages 365 days None None

    This insurance does not cover losses or expenses caused directly or indirectly, in whole or in part, by:

    Pre-existing Medical Exclusion 1

    1. Any sickness, injury or medical condition (other than a minor ailment) that was not stable at any time during the applicable pre-existing period required by your plan.
    2. Your heart condition if any heart condition was not stable at any time during the applicable pre-existing period required by your plan.
    3. Your lung condition, if:
      1. any lung condition was not stable; or
      2. you have been treated with home oxygen or taken oral steroids (e.g., Prednisone) for any lung condition,
      at any time during the applicable pre-existing period required by your plan.

    Pre-existing Medical Exclusion 2

    1. Any sickness, injury or medical condition (other than a minor ailment) that was not stable at any time during the applicable pre-existing period required by your plan.
    2. Your heart condition if, for any heart condition:
      1. you have been hospitalized;
      2. you have been prescribed a medication (including prescribed as needed);
      3. you have taken medication; or
      4. you have undergone a medical or surgical procedure,
      at any time during the applicable pre-existing period required by your plan.
    3. Your lung condition if, for any lung condition:
      1. you have been hospitalized;
      2. you have been prescribed a medication (including prescribed as needed);
      3. you have taken medication;
      4. you have undergone a medical or surgical procedure; or
      5. you have been treated with home oxygen or taken oral steroids (e.g., Prednisone),
      at any time during the applicable pre-existing period required by your plan.

  2. General Exclusions

    This insurance does not cover losses or expenses caused directly or indirectly, in whole or in part, by:
    1. Expenses for which no charge would normally be made in the absence of insurance.
    2. Committing or attempting to commit an illegal act or criminal act.
    3. Your participation in and/or voluntary exposure to any risk from: war or act of war, whether declared or undeclared; invasion or act of foreign enemy; declared or undeclared hostilities; civil war, riot, rebellion; revolution or insurrection; act of military power; or any service in the armed forces.
    4. Medication, drugs or toxic substance abuse or overdose (whether or not you are sane); alcohol abuse, alcoholism or an accident while being impaired by drugs or alcohol or having an alcohol concentration that exceeds 80 milligrams in 100 milliliters of blood.
    5. Suicide (including any attempt thereat) or self-inflicted injury whether or not you are sane.
    6. Radiotherapy or chemotherapy.
    7. A disorder, disease, condition or symptom that is emotional, psychological or mental in nature unless hospitalized.
    8. Treatment or surgery during a trip when the trip is undertaken for the purpose of securing or with the intent of receiving medical or hospital services, whether or not such trip is taken on the advice of a physician; or a sickness, injury or related condition for which it was reasonable to expect treatment or hospitalization during your covered trip.
    9. Treatment or hospitalization of mother or child(ren) as a result of pregnancy, miscarriage, childbirth or complications of any of these conditions occurring in the nine weeks before and/or after the expected delivery date.
    10. Sickness or injury which first appeared, was diagnosed or received treatment after the date of departure and prior to the effective date of the insurance extension.
    11. Treatment, surgery, medication, services or supplies that are not required for the immediate relief of acute pain or suffering, or that you elect to have provided outside your province or territory of residence when medical evidence indicates that you could return to your province or territory of residence to receive such treatment. The delay to receive treatment in your province or territory of residence has no bearing on the application of this exclusion.
    12. Cardiac catheterization, angioplasty, and/or cardiovascular surgery including any associated diagnostic test(s) or charges unless approved by Global Excel prior to being performed, except in extreme circumstances where such surgery is performed on an emergency basis immediately upon admission to a hospital.
    13. Magnetic resonance imaging (MRI), computerized axial tomography (CAT) scans, sonograms or ultrasounds and biopsies unless such services are authorized in advance by Global Excel.
    14. Hospitalization or services rendered in connection with general health examinations for "check-up" purposes, treatment of an ongoing condition, regular care of a chronic condition, home health care, investigative testing, rehabilitation or ongoing care or treatment in connection with drugs, alcohol or any other substance abuse.
    15. Noncompliance with any prescribed medical therapy or medical treatment (as determined by the Insurer) or failure to carry out a physician's instructions.
    16. Treatment of a sickness or injury after the initial medical emergency has ended (as determined by the Insurer).
    17. Emergency air transportation and/or car rental unless approved and arranged in advance by Global Excel.
    18. Treatment not performed by or under the supervision of a physician or licensed dentist.
    19. Expenses incurred as a result of symptomatic or asymptomatic HIV infection, HIV-related conditions and AIDS (Acquired Immune Deficiency Syndrome), including any associated diagnostic tests or charges.
    20. Participation in:
      1. any sports as a professional athlete (person who engages in an activity as one's main paid occupation);
      2. any competitive motorized sporting events, racing or speed contests.
    21. The purchase replacement cost (prescribed or not) loss or damage to hearing devices, eyeglasses, sunglasses, contact lenses or prosthetic teeth, limbs or devices and resulting prescription therefrom.
    22. Services provided by an optometrist or for cataract surgery.
    23. The replacement of an existing prescription, whether by reason of loss, renewal or inadequate supply, or the purchase of drugs and medication (including vitamins) which are commonly available without a prescription or which are not legally registered and approved in Canada or which are not required as a result of a medical emergency.
    24. Upgrading charges and cancellation penalties for airline tickets, unless approved in advance by Global Excel.
    25. Elective and/or cosmetic surgery or treatment whether or not for psychological reasons.
    26. Sickness, injury or medical condition you suffer or contract in a specific country, region or area for which the Department of Foreign Affairs and International Trade of the Canadian Government has issued a travel advisory or formal notice, before your departure date, advising Canadians not to travel to that specific country, region or area. If the Canadian Government issues a travel advisory or formal notice to leave that specific country, region or area, after your departure date, your coverage for sickness, injury or medical condition is limited to a period of 10 days from the date the advisory was issued, or to a period that is reasonably necessary to safely evacuate the country, region or area. In this exclusion "sickness, injury or medical condition" means any sickness, injury or medical condition that is attributable to the reason for which the travel advisory or formal notice was issued or complications arising from such "sickness, injury or medical condition".
    27. Crowns and root canals.
    28. Flight accident (unless you are travelling as a fare-paying passenger on a commercial airline).
    29. A trip outside your province or territory of residence on a commercial vehicle for the purpose of delivering goods or carrying a load. This exclusion applies to the driver, the operator, a co-driver, a crew-member and any other passenger of the commercial vehicle.

SECTION 7 - HOW TO FILE A CLAIM

  1. Claims Procedure
    1. You must substantiate your claim by providing all required documents for the applicable insurance coverage. Failure to do so may result in non-payment of your claim. (The Insurer is not responsible for charges levied in relation to any such documents.) Note that incomplete documentation will be returned to you for completion.

    2. Notice and Proof of Claim - The insured or a beneficiary entitled to make a claim, or the agent of any of them shall:
      1. give written notice of claim to Global Excel by delivery thereof or by sending it by registered mail to Global Excel not later than 30 days from the date the claim arises under the contract on account of an accident or sickness;
      2. within 90 days from the date a claim arises under the contract on account of an accident or sickness, furnish Global Excel such proof of claim as is reasonably possible in the circumstance of the happening of the accident or the commencement of the sickness and the loss occasioned thereby, the right of the claimant to receive payment, his or her age, and the age of the beneficiary, if relevant; and
      3. if so required by Global Excel, furnish a satisfactory certificate as to the cause or nature of the accident or sickness for which a claim may be made under the contract.

    3. Failure to Give Notice or Proof - Failure to give notice of claim or furnish proof of claim within the prescribed period above does not invalidate the claim if the notice or proof is given or furnished as soon as is reasonably possible, and in no event later than one year from the date of emergency if it is shown that it was not reasonably possible to give notice or furnish proof within the time so prescribed.

  2. When Money Payable - All money payable under this contract shall be paid by the Insurer within 60 days after it has received proof of claim.

  3. Payment of Benefits
    1. All benefits are payable to you on your behalf.
    2. In case of death of the insured person, benefits are payable to the estate.
    3. Any claims paid to you will be payable in Canadian funds.
    4. Where claims are payable in foreign currency, the rate of exchange is based on the rate effective on the date when the claim payment is made to you.
    5. No sum payable shall bear interest.

  4. You must submit the following documents:


    1. A completed claim form (available by contacting Global Excel).
    2. Original itemized bills from the licensed medical provider(s) stating the patient's name, diagnosis, date and type of treatment, and the name, address and telephone number of the provider, as well as the original transaction documents proving that payment was made to the provider. (Copies of itemized bills are accepted only if the insured has already dealt directly with his government health insurance plan.)
    3. Original prescription drug receipts from the pharmacist, physician or hospital indicating the name of the prescribing physician, prescription number, name of preparation, date, quantity and total cost.
    4. For out-of-pocket expenses: an explanation of expenses accompanied by the original receipts.
    5. If you are covered by other insurance:
      1. the full name and address of your employer;
      2. the policy number, name and address of any other insurance company.

Note: This policy will not cover associated costs of any additional medical documents requested.

PLEASE SEND ALL DOCUMENTS FOR YOUR CLAIM TO:

Global Excel Management Inc.
73 Queen Street
Sherbrooke, Quebec
J1M 1J3
Telephone: 1-800-715-8833 toll-free or (819) 566-8839 collect 566-8839 collect

Section 8 - International Assistance Services

Global Excel answers your questions 24 hours a day, 7 days a week.

  1. Emergency Call Centre

    No matter where you travel, professional assistance personnel are ready to take your call. We can also provide you with Canada Direct instructions and codes so that you deal only with Canadian telephone operators.

  2. Referrals

    Global Excel can refer you to the preferred medical providers (hospitals, clinics and physicians) that are closest to where you are staying. With a referral, it is less likely that you will have to pay for services out-of-pocket.

  3. Benefit Information

    Explanation of your policy is available to you and to the medical providers who are treating you.

  4. Case Management

    Our team of medical professionals, available 24 hours a day, will monitor the services given in the event of a serious emergency. If necessary, we will help you to return to Canada for the care you need.

  5. Urgent Message Relay

    In the event of an emergency, we will contact your travel companion to keep him apprised of your medical situation, and we will help you exchange important messages with your family.

  6. Interpretation Service

    We can connect you to a foreign language interpreter when required for emergency services in foreign countries.

  7. Direct Billing

    Whenever possible, we will instruct the hospital or clinic to bill Global Excel directly.

  8. Claims Information

    We will answer any questions you may have about the eligibility of your claim, our standard verification procedures and the way that your policy benefits are administered.

SECTION 9 - GENERAL PROVISIONS

  1. Subrogation

    If an insured person suffers a loss covered under this policy, the Insurer is granted the right from the insured person to take action to enforce all the rights, powers, privileges and remedies of the insured person upon making payment or accepting the claim to the extent of the incurred losses, against any person, legal person or entity which caused such loss. Additionally, if No Fault benefits or other collateral sources of payment of expenses are available to the insured person, regardless of fault, the Insurer is granted the right to make a demand for, and recover those benefits. If the Insurer institutes an action, the Insurer may do so at its own expense, in the insured person's name, and the insured person will attend at the place of loss to assist in the action. If the insured person institutes a demand or action for a covered loss he shall immediately notify the Insurer so that it may safeguard its rights.

    The insured person shall take no action after a loss that will impair the rights of the Insurer set forth in this paragraph and shall do such things as are necessary to secure the Insurer's rights.

  2. Other Insurance

    This insurance is a second payor plan. For any loss or damage insured by, or for any claim payable under any other liability, group or individual basic or extended health insurance plan, or contracts including any private or provincial or territorial auto insurance plan providing hospital, medical, or therapeutic coverage, or any other insurance in force concurrently herewith, amounts payable hereunder are limited to those covered benefits incurred outside the province of residence that are in excess of the amounts for which an insured person is insured under such other coverage.

    All coordination with employee related plans follows Canadian Life and Health Insurance Association Inc. guidelines. In no case will the Insurer seek to recover against employment related plans if the lifetime maximum for all in-country and out-of-country benefits is $50,000 or less. If the lifetime maximum for all in-country and out-of-country benefits is over $50,000, the Insurer will coordinate benefits only above this amount.

  3. Misrepresentation and Non-Disclosure

    The entire coverage under this policy shall be voidable if the Insurer determines, whether before or after loss, you have concealed, misrepresented or failed to disclose any material fact or circumstance concerning this policy or your interest therein, or if you refuse to disclose information or permit the use of such information, pertaining to any of the insured persons under this contract of insurance.

  4. Arbitration

    Notwithstanding any clause in the present policy, the parties hereto undertake to submit to an arbitration procedure, to the exclusion of the courts, any present or future dispute relating to a claim. The arbitration proceedings shall be governed by arbitration laws in force in the Canadian province or territory of residence of the insured. The parties agree that any action will be referred to arbitration.

  5. Limitation of Actions

    An action, arbitration or similar proceeding against the Insurer for the recovery of a claim under this contract shall not be commenced more than one year (two years in the Northwest Territories, three years in the province of Quebec) after the date the insurance money became payable or would have become payable if it had been a valid claim. If this limitation is invalidly shorter than the limitation prescribed by the laws of your province or territory of residence an action, arbitration or similar proceeding against the Insurer shall not be commenced later than the shortest limitation period prescribed by the laws of that province or territory of residence. The limitation periods stated in this section apply to all plans and benefits of this policy and to all endorsements thereof.

  6. Applicable Law

    This contract of insurance is governed by the laws of your Canadian province or territory of residence. Any legal proceeding by you, your heirs or assigns shall be brought in the courts of the Canadian province or territory of residence of the insured.

  7. Notice of Statutory Conditions

    Despite any other provision of this contract, this contract is subject to the statutory conditions in the Insurance Act respecting contracts of accident and sickness insurance of the Canadian province or territory of residence of the insured.

  8. Safeguarding your Privacy

    The Insurer places great importance on the protection of your privacy. The Insurer collects your personal information when you apply for this insurance and in the event of a claim, to provide you with insurance services and to analyze your claim. This information remains confidential, as is required under applicable federal and provincial laws. In the event of a claim, the Insurer may collect your personal health information held by a third party. This information may be released to employees of Global Excel and the Insurer for claims analysis and to better serve you.

    In no case will the Insurer release this information to any person or organization that is not clearly entitled to it without first seeking your consent. For privacy information, please see www.royalsunalliance.ca, or call us at 1-800-716-4339.

SECTION 10 - DEFINITIONS

Accident means a fortuitous, sudden, unforeseen and unintentional event exclusively attributable to an external cause resulting in bodily injury.

Caregiver means a person you have entrusted with the care of your children on a permanent, full-time basis and whose services cannot reasonably be replaced.

Child(ren) means an unmarried child of the insured or his spouse who is, at the date of purchase, dependent on you for support and is under 21 years of age.

Common Carrier means a conveyance (bus, taxi, train, boat, airplane or other vehicle) which is licensed, intended and used to transport paying passengers.

Day means 24 consecutive hours.

Emergency means that you require immediate medical treatment for the relief of acute pain or suffering resulting from an unexpected and unforeseen sickness or injury occurring while on a covered trip and that such medical treatment cannot be delayed until your return to your province or territory of residence.

Global Excel means the company appointed by the Insurer to provide medical assistance and claims services.

Hospital means an institution which is designated as a hospital by law; which is continuously staffed by one or more physicians at all times; which continuously provides nursing services by graduate registered nurses; which is primarily engaged in providing diagnostic services and medical and surgical treatment of a sickness or injury in the acute phase, or active treatment of chronic conditions; which has facilities for diagnosis, major surgery and in-patient care. The term hospital does not include convalescent, nursing, rest or skilled nursing facilities, whether separate from or part of a regular general hospital, nor a facility operated exclusively for the treatment of persons who are mentally ill, aged, drug or alcohol abusers.

Hospitalized or Hospitalization means an insured who occupies a hospital bed for more than 24 hours for medical treatment and for which admission was recommended by a physician when medically necessary.

Immediate Family Member means your mother, father, sibling, child, spouse, grandparent, grandchild, aunt, uncle, niece, nephew, mother-in-law, father-in-law, daughter-in-law, son-in-law, brother-in-law and sister-in-law.

Injury means an unexpected and unforeseen harm to the body caused by an accident, occurring while on a covered trip and requiring immediate emergency treatment that is covered by this policy.

Insured, Insured Person, You, Your and Yourself refers to any eligible person who is named on the Policy Confirmation.

Medical Treatment means any reasonable procedure which is medical, therapeutic or diagnostic in nature, which is medically necessary and which is prescribed by a physician. Medical Treatment includes hospitalization, basic investigative testing, surgery, prescription medication (including prescribed as needed) or other treatment directly related to the sickness, injury or symptom.

Medically Necessary, in reference to a given service or supply, means such service or supply:

  1. is appropriate and consistent with the diagnosis according to accepted community standards of medical practice;
  2. is not experimental or investigative in nature;
  3. cannot be omitted without adversely affecting your condition or quality of medical care;
  4. cannot be delayed until your return to your province, territory of residence or Canada.

Minor Ailment means any sickness or injury which does not require the use of medication for a period greater than 15 days, more than one follow-up visit to a physician, hospitalization, surgical intervention, or referral to a specialist, and which ends at least 30 consecutive days prior to the departure date. However, a chronic condition or any complication of a chronic condition is not considered a minor ailment.

Physician means a medical practitioner whose legal and professional standing within his jurisdiction is equivalent to that of a doctor of medicine (M.D.) licensed in Canada, who is duly licensed in the jurisdiction in which he practices, who prescribes drugs and/or performs surgery and who gives medical care within the scope of his licensed authority. A physician must be a person other than yourself or an immediate family member.

Reasonable and Customary Costs means costs that are incurred for approved, eligible medical services or supplies that do not exceed the standard fee of other providers of similar standing in the same geographical area, for the same medical treatment of a similar sickness or injury.

Sickness means a disease or disorder of the body which results in loss while this coverage is in effect. The sickness must be sufficiently serious to prompt a reasonably prudent person to consult a physician for the purpose of medical treatment.

Spouse means the person to whom you are legally married or with whom you have been residing for at least the last 12 months.

Stable means any medical condition (other than a minor ailment) for which all the following statements are true:

  1. there has been no new diagnosis, treatment or prescribed medication;
  2. there has been no change in treatment or change in medication, including the amount of medication to be taken, how often it is taken, the type of medication or change in treatment frequency or type Exceptions: the routine adjustment of Coumadin, Warfarin, insulin or oral medication to control diabetes (as long as they are not newly prescribed or stopped) and a change from a brand name medication to a generic brand medication (insofar as the dosage is not modified);
  3. there has been no new symptom, more frequent symptom or more severe symptom;
  4. there have been no test results showing deterioration;
  5. there has been no hospitalization or referral to a specialist (made or recommended) and you are not awaiting results and/or further investigations for that medical condition.

Travel Companion means a person accompanying you on the covered trip, who shares accommodation and transportation with you and has paid such accommodation or transportation in advance of departure. A maximum of three persons will be considered your travel companions.

Treated means that you have been hospitalized, have been prescribed (including prescribed as needed), have taken or are currently taking medication, have undergone a medical or surgical procedure.

Vehicle means any automobile, station wagon, mini-van, sports utility vehicle (for on road use), motorcycle, boat, pick-up truck or a mobile home, camper truck or trailer home under 36 feet in length, used exclusively for the transportation of passengers other than for hire, in which you are a passenger or driver during your trip.

IDENTIFICATION OF THE INSURER

Underwritten by:             Administered by:

Royal & SunAlliance        etfs

TM The Royal & SunAlliance logo is a trademark owned by Royal & SunAlliance Insurance Group plc, licensed for use by Royal & Sun Alliance Insurance Company of Canada.

® The following is a registered trademark of Global Excel Management Inc.: the Global Excel logo.

TM The following are trademarks of Expert Travel Financial Security (E.T.F.S.) Inc.: the etfs logo and Travel & Healthcare Solutions.

Important Notice to the Insured

If you have to cancel or interrupt your covered trip, you must call the Global Excel Cancellation Desk immediately at 1-877-644-4215 toll free or (819) 566-4215.

REMEMBER TO:

  1. Keep all original invoices and/or receipts for payment and confirmation of your insurance in a safe place.
  2. Keep your policy with you at all times during your covered trip.
  3. Read your policy carefully.

The insured is requested to read this policy, and if incorrect, return it immediately for alteration. In the event of an occurrence likely to result in a claim under this insurance, immediate notice should be given to Global Excel.

THIS POLICY CONTAINS CLAUSES WHICH MAY LIMIT THE AMOUNT PAYABLE.




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