TIC Travel Insurance - Emergency Hospital & Medical Insurance

MULTI-TRIP - SELECT
EMERGENCY HOSPITAL & MEDICAL INSURANCE FOR CANADIANS

IMPORTANT NOTICE

Please read your policy carefully before you travel.

What am I covered for?
Please read the section titled 'Benefits'. Travel insurance is intended to cover losses arising from sudden, unexpected, and unforeseeable circumstances.

What is not covered?
Travel insurance does not cover everything. Your insurance has exclusions, conditions and limitations. You should carefully read and understand your policy before you travel. Pre-existing medical conditions may be excluded. Any medical condition and/or symptoms you are aware of prior to the effective date, whether diagnosed or not, may not be covered.

Does this insurance cover my trip arrangements?
Your trip arrangements are covered up to the sum insured. Check with your travel supplier or agent at the time you book your trip, to understand the amounts that are non-refundable. The benefits payable under this policy are limited to the amounts that are non-refundable, as assessed by the travel supplier or agent, at the occurrence date of the 'Insured Risk' that was the cause for cancellation, regardless of the date the trip is cancelled. It is important to read this carefully and to notify your travel supplier or agent on the day (or the next business day) that the cause of cancellation occurs.

What if I have an emergency or claim?
You must notify TIC Emergency Assistance (toll free 1-800-995-1662 or worldwide collect 416-340-0049) prior to any surgery being performed or within 24 hours of admission to a hospital. Failure to do so, without reasonable cause, will result in the reduction of eligible benefit amounts payable by 20%. To apply for benefits, complete the claim form and include all original bills. Incomplete forms will cause delay.

Is my personal information protected?
We are committed to protecting the privacy, confidentiality and security of the personal information we collect, use and disclose. Your personal information, including your medical history, will be collected, used and disclosed only for the purpose of providing you with the requested insurance services. For a copy of TIC's privacy policy, please contact us or visit our website www.travelinsurance.ca.

I want to stay longer. Can I purchase further coverage?
This plan offers you 35 days of coverage per trip. If you want coverage for a longer trip, you can purchase more days subject to policy terms and conditions. Just call your agent or TIC (during business hours) before your policy expires. When you call, be sure to advise your agent if you have already left on a trip that is longer than 35 days. You must be in good health and not have incurred any losses during the period of coverage. Fees will be charged.

Travel Assistance
TIC or Co-operators Life Insurance Company will use their best efforts to provide assistance for a medical emergency arising anywhere in the world. They or their agents will not be responsible for the availability, quantity, quality, or results of any medical treatment received, or for failure to obtain medical service.

Extended Absence from Canada
Each provincial and territorial government health insurance plan has limitations on how long you can be out of the country and still remain eligible for coverage. Check your health plan for details.

Note: Words in italics indicate they are defined.

RIGHT TO EXAMINE POLICY

Please review this policy before you travel to ensure it meets your needs. You have 10 days after purchase to return this policy for a full refund, provided your coverage has not begun. Please refer to the sections of the policy that explain when coverage begins. For refunds after coverage has begun, refer to our refund policy also explained in this document.

MULTI-TRIP SELECT EMERGENCY HOSPITAL & MEDICAL INSURANCE FOR CANADIANS POLICY

ELIGIBILITY

To be eligible for coverage a person must:

be at least 15 days old; and
be insured for benefits under a Canadian government health insurance plan during the entire period of coverage; and
be currently in good health and know of no reason to seek medical consultation during the period of coverage; and
not reside in a nursing home, convalescent home, or rehabilitation centre; and
not require assistance with daily living activities.

For Option 2:

be scheduled to travel on a trip from or within Canada; and
purchase this coverage within 48 hours of paying the non-refundable deposit to the travel supplier or agent for the trip and before any cancellation penalties are applicable.

Coverage Begins
When an application has been made and the premium has been paid for a specific plan of insurance, coverage begins on the latest of the date and time:

the completed application is accepted by TIC or its representative; or
indicated as the effective date on the application; or
each time the insured departs from their province or territory of residence to begin each insured trip; and
indicated as the application date for Trip Cancellation & Interruption benefits when covered under Option 2.

Coverage Ends
Coverage ends on the earliest of the date:

and time the insured returns to their province or territory of residence at the end of each insured trip, or
indicated as the expiry date on the confirmation of coverage; or
the 35 trip days indicated on the confirmation of coverage ends; or
of occurrence of the Insured Risk which results in the cancellation of the insured's trip prior to the scheduled departure date, for Trip Cancellation & Interruption benefits when covered under Option 2.

DESCRIPTION OF COVERAGE

The insurer agrees to pay up to $2 million for reasonable and customary costs incurred unexpectedly by an insured Canadian resident during the period of coverage. Costs are paid for acute emergency hospital, emergency medical, or other covered costs as provided in the 'Benefits' section, due to sickness or injury occurring during the period of coverage.
For Canadian residents not insured under a government health insurance plan, the maximum sum insured is $3,000.
Amounts payable under this plan are in excess of any amounts available or collectible under the government health insurance plan of the province or territory in which the insured is covered, or would be covered, or those amounts payable or collectible under any other policy or plan. Refer to 'General Provisions' on page 6.
Coverage is world-wide.

When a planned trip extends beyond the expiry date, a new Multi-trip Plan must be purchased prior to departure from the insured's province or territory of residence. Coverage will be in effect for the maximum number of days for each trip as selected under the new Multi-trip Plan. The maximum period of coverage per trip is 35 days.

BENEFITS for Plan Option 1 and Option 2

Benefits are payable for the following costs:

Emergency Hospital
The insurer agrees to pay for semi-private hospital accommodation and for reasonable and customary services and supplies necessary for the emergency care of the insured during confinement as a resident in-patient.
Emergency Medical
The insurer agrees to pay for:
1. The services of a legally licensed physician, surgeon, anaesthetist or registered graduate nurse (all of whom are not related by blood or marriage to the insured).
2. The services of a legally licensed physiotherapist (who is not related by blood or marriage to the insured) when ordered by the attending physician as treatment for a covered injury. Not to exceed $500 for out-patient treatment.
3. The services of a legally licensed doctor of chiropractic (who is not related by blood or marriage to the insured) for treatment of a covered injury. Not to exceed $500.
4. When performed at the time of the initial emergency, lab tests and/or X-ray examination as ordered by a physician for the purpose of diagnosis.
5. The use of a licensed local air, land, or sea ambulance (including mountain or sea evacuation), to the nearest hospital when reasonable and necessary.
6. Rental of crutches or hospital-type bed, not exceeding the purchase price; and the cost of splints, trusses, braces or other approved prosthetic appliances.
7. Emergency out-patient services provided by a hospital.
8. Drugs or medications that require a physician's written prescription, not exceeding a one-month supply, to a maximum $500 per insured unless hospitalized as an in-patient.
Meals and Accommodation
Up to a maximum of $3,000 will be reimbursed for additional reasonable living costs, child care costs (under age 18, or physically or mentally handicapped travelling companions who rely on the insured for assistance), essential telephone calls and taxi fares incurred by the insured or any insured persons remaining with the insured while hospitalized as an inpatient during the period of coverage.
Transportation of Family or Friend
Reimbursement of up to $3,000 for one round-trip economy class transportation by the most direct route, and up to $1,000 for reasonable costs incurred after arrival by a family member or close friend of the insured if:
1. The insured is hospitalized due to a covered sickness or injury and the attending physician advises the necessary attendance by such persons.
2. The local authorities legally require the attendance of such persons to identify the insured's remains in the event of death due to a covered sickness or injury.
Return of Travelling Companion
Pays the extra cost of a one-way economy class airfare, to return the insured's travelling companions (under age 18, or physically or mentally handicapped travelling companions who rely on the insured for assistance) and one of the insured's accompanying family members to their province or territory of residence, when an insured is transported to Canada by air ambulance or commercial stretcher, as a result of a covered emergency sickness or injury that necessitates immediate ongoing care. Must be pre-approved by TIC.
Return of Vehicle or Watercraft
Up to $3,000 will be reimbursed for a commercial agency to return the vehicle or watercraft used for the journey, to the insured's home or to the rental agency, if the insured is unable to return to Canada with that vehicle or watercraft, due to a covered sickness or injury.
Pet Return
Up to $300 will be reimbursed for the cost of returning the insured's accompanying dog or cat to Canada, if the insured is returned to Canada under the Emergency Transportation benefit or hospitalized due to a covered sickness or injury.
Return of Deceased
In the event of death due to a covered sickness or injury, up to $10,000 will be reimbursed for the costs incurred to return the insured in a standard transportation container, to their permanent residence in Canada; or up to $4,000 for cremation or burial at the place of death.
Accidental Dental
Up to $3,000 will be reimbursed for emergency treatment or services to whole or sound natural teeth (including capped or crowned teeth) caused by an accidental blow to the face. These costs cannot exceed the minimum fee specified in the Canadian Dental Association schedule of fees of the province or territory where the insured resides.
Dental Emergencies
Up to $500 will be reimbursed for the immediate relief of acute dental pain caused by other than a blow to the face. Dental conditions for which the insured has previously received treatment or advice are not covered.
Treatment relating to any dental claim must begin within 48 hours from the onset of the emergency and must be completed within the period of coverage and prior to the insured's return to their province or territory of residence.
Emergency Transportation
The insurer agrees to transport the insured to the nearest appropriate medical facility or to a Canadian hospital following a covered emergency sickness or injury. Any emergency transportation such as air ambulance, one-way economy airfare, stretcher and/or a medical attendant, must be pre-approved and arranged by TIC.
Attendant
Pays the cost of an attendant (not related to the insured by blood or marriage) plus the attendant's return economy class airfare, to travel with the insured's accompanying insured travelling companions (under age 18, or physically or mentally handicapped travelling companions who rely on the insured for assistance), to their province or territory of residence if an insured has been returned to Canada under the 'Emergency Transportation' benefit. This benefit is payable only when approved in advance and arranged by TIC.
Act of Terrorism
When an act of terrorism directly or indirectly causes a loss that would otherwise be payable under this plan, subject to all other policy limits, coverage will be provided as follows:
1. As a result of any one or a series of acts of terrorism occurring within a 72-hour period, the aggregate limit payable shall be limited to $2.5 million for all eligible insurance policies issued and administered by TIC, including this policy.
2. As a result of any one or a series of acts of terrorism occurring in any calendar year, the aggregate limit payable shall be limited to $5 million for all eligible policies issued and administered by TIC including this policy.
The amount payable for each eligible claim under (a) and (b) above are in excess of all other sources of recovery and shall be reduced on a pro rata basis, so that the total amount paid for all such claims shall not exceed the respective aggregate limit which will be paid after the end of the calendar year and after completing the adjudication of all claims relating to the act(s) of terrorism.
Return to Original Trip Destination
If the insured is returned to their province or territory of residence under the 'Emergency Transportation' benefit, and the attending physician determines that the treatment received in Canada resolved the emergency, a maximum aggregate limit of $5,000 will be paid, only when pre-approved and arranged by TIC, for a one-way economy flight to return the insured and one insured travelling companion to the original trip destination. The return must occur within the period of coverage originally provided by this benefit. A subsequent recurrence or complication of the condition that resulted in the insured being returned home is excluded under this policy.
Flight Accident
The insurer agrees to pay up to a maximum sum insured of $100,000 as indicated on the confirmation of coverage, for loss of life, limb or sight directly resulting from accidental injury occurring worldwide during the period of coverage.
1. Coverage is for all flights ticketed and arranged prior to the effective date.
2. The total aggregate limit for accidental injury resulting from a Risk Insured under the Flight Accident benefit is $10 million.
Benefits
Benefits are payable according to the following schedule:
1. 100% of sum insured resulting from the same accidental injury for loss of:
  1. life; or
  2. entire sight of both eyes; or
  3. both hands; or
  4. both feet; or
  5. one hand and entire sight of one eye; or
  6. one foot and entire sight of one eye
2. 50% of sum insured resulting from the same accidental injury for loss of:
  1. sight of one eye; or
  2. one hand; or
  3. one foot.
  Loss of hand or hands, or foot or feet means severance through or above the wrist joint or ankle joint, respectively.
  Loss of eye or eyes means total and irrecoverable loss of the entire sight.
  Only one amount is payable (the largest) if the insured suffers more than one of these losses.
Exposure and Disappearance
If the insured is exposed to the elements or disappears as a result of a flight accident, a loss will be covered if:
1. as a result of such exposure, the insured suffers one of the losses specified in the schedule of losses above, or
2. the body of the insured has not been found within 52 weeks from the date of the flight accident. It will be presumed, subject to evidence to the contrary, that the insured suffered loss of life.
Insured Risks for Flight Accident Benefits
Benefits are limited to payment for losses occurring during the period of coverage while the insured is:
1. riding solely as a ticketed passenger in, or boarding or alighting from, a certified multi-engine transportation-type aircraft or passenger aircraft provided by a regularly scheduled airline on any regularly scheduled trip operated between licensed airports.
2. on airport premises immediately before boarding or immediately after alighting from an aircraft; or while riding as a passenger in an airport limousine or bus, or surface vehicle provided, and arranged for, by the airline or airport authority, when going to or after being at an airport for the purpose of boarding an aircraft or alighting from an aircraft.

ADDITIONAL BENEFITS for Plan Option 2

Trip Cancellation & Interruption
The insurer agrees to pay up to the sum insured of $1,000, for Trip Cancellation prior to departure and up to $2,000 for Trip Interruption after departure, for losses resulting from an Insured Risk occurring during the period of coverage. Coverage is provided worldwide for trips, from or within Canada. Benefits are limited to the non-refundable amounts assessed by the travel supplier as of the date of occurrence of the Insured Risk, injury or the ultimate diagnosis of a sickness that was the cause of the cancellation, regardless of the date the trip is cancelled.

Benefits
Benefits are payable for the following costs:
1. Prior to Departure
  1. The non-refundable, non-recoverable portion of prepaid airfare and/or pre-paid travel arrangements.
  2. The single supplement charged as the result of a travelling companion or accompanying family member who is unable to travel due to an Insured Risk.
2. After Departure
  1. The extra cost of economy transportation by the most direct route to continue with the insured trip if the insured misses a portion of his/her trip due to sickness or injury of the insured, a travelling companion or accompanying family member;
  2. The non-refundable portion of unused, pre-paid, insured travel arrangements for the trip (excluding partially used airline tickets) booked prior to departure, and the extra cost of economy airfare by the most direct route, to return to the point of departure.
3. Prior To or After Departure:
  In the event that a delay of the connecting carrier or automobile at the departure point causes a missed connection, provided the connecting carrier or automobile was scheduled to arrive not less than two hours prior to the scheduled connection time due to:
  - weather conditions or mechanical failure of the connecting carrier (airline, bus, train or government-operated ferry system); or
  - traffic accident or emergency police road closure (police report required) causes the delay of a private or commercial automobile;
  The insurer agrees to pay:
  1. the extra cost of economy transportation to the ticketed destination;
  2. the unusable pre-paid, insured travel arrangements and;
  3. an out-of-pocket allowance of up to $200 per day to a maximum of $600 for commercial accommodation and meals, essential telephone calls and taxi fares.

Insured Risks For Trip Cancellation & Interruption Benefits
The Benefits listed above are payable if the insured's trip is cancelled prior to the scheduled departure date, curtailed prior to the scheduled return date, or delayed after the scheduled return date as the result of:

Health

Sickness, injury or death of the insured, or a family member, or a travelling companion, or travelling companion's family member or a key employee of the insured.
The death of a friend of the insured.
The death or hospitalization of the insured's host at the destination.
Sickness, injury or death of a person or persons with whom arrangements were made for the care of dependents living in the insured's household.

Legal

The insured has been called to jury duty, or been subpoenaed as a witness, and the court proceeding is scheduled to be heard during the period of the trip (excluding law enforcement officers).
The legal adoption of a child by the insured during the period of the trip, which necessitates cancellation of the trip.

External

The schedule change of the airline carrier that is providing transportation for a portion of the insured trip, causing the insured to miss a connection or resulting in the interruption of the insured travel arrangements.
The insured's failure to obtain a valid travel visa (excluding an immigration, student or employment visa) necessary to enter the country of destination of the trip, for reasons beyond the insured's control provided the insured is a Canadian resident and eligible to apply, and the failure to obtain valid documents is not the result of a late or previously denied application.
Default of a travel supplier ceasing operations as a result of bankruptcy.
A disaster which renders the insured's principal residence, in their country of permanent residence, uninhabitable.
A statement on terrorism or health risk made in the 'Travel Report' issued by the Canadian Department of Foreign Affairs or Public Health Agency of Canada after the application date, advising or recommending that Canadians should not travel to the booked destination for a period that would include the insured's scheduled trip.
Hijacking or quarantine of the insured.
Adverse weather which would prevent the insured from travelling for a period not less than 30% of the total duration of the insured trip when the insured chooses not to continue with the trip prior to departure from the point of origin.
Cancellation prior to departure, of a business meeting that the insured is required to attend as required by his/her employment or a conference arranged by the insured's professional association, and the cancellation is beyond the control of the insured, the insured's employer or association.
Rescheduling of an examination at an accredited Canadian or American university or college after the trip was booked and due to circumstances beyond the insured's control. A copy of the original official examination schedule and the notice of rescheduling must accompany any claim submission. The rescheduled examination must occur during the period of coverage.

Work

A job transfer within 30 days of the insured's scheduled departure date, by the insured's employer, that requires relocation of the insured's principal residence (not applicable to self-employed persons).

SPECIFIC CONDITIONS for Trip Cancellation & Interruption Benefits

Upon the occurrence of an Insured Risk that results in cancellation, curtailment or delay of the insured's trip, the travel supplier or agent must be notified on the same day or next business day that the cause of cancellation, injury or ultimate diagnosis of sickness occurs.
Benefits are limited to the non-refundable amounts assessed by the travel supplier as of the date of occurrence of the Insured Risk, injury or the ultimate diagnosis of a sickness.
When family members are travelling together, the total aggregate limit is twelve (12) insured persons, regardless of the number of policies issued, unless authorized by TIC.
When travelling companions are travelling together, the total aggregate limit is five (5) insured persons, regardless of the number of policies issued, unless authorized by TIC.
No benefits are payable when the insured's return to the point of origin is beyond 10 days from the expiry date specified in the confirmation of coverage, unless the insured or a travelling companion suffering the sickness or injury was confined in a hospital, or was certified as medically unfit to travel by the attending physician at the location treatment was provided.
Reimbursement of any eligible additional costs are limited to the lesser of:
1. the change-fee
2. a one-way economy class airfare or
3. a return economy class airfare,
all by the most direct route.
All claims due to sickness or injury must be supported by documentation from the attending physician at the location where sickness or injury leading to cancellation occurred.
General Provisions of this policy apply. Refer to page 6.

SPECIFIC CONDITIONS for Emergency Hospital & Medical Benefits

TIC must be notified prior to any surgery being performed or within 24 hours of admission to a hospital. Failure to do so, without reasonable cause, will result in the reduction of eligible amounts payable by 20%.
TIC reserves the right, as reasonably required, to transfer an insured to any hospital or to transport an insured to Canada following an emergency. If the insured refuses to be transferred or transported when declared medically fit to travel, any continuing costs incurred after the insured's refusal will not be covered and the payment of such costs becomes the sole responsibility of the insured. Coverage ceases upon the insured's refusal and no coverage will be provided to the insured for the remainder of the period of coverage.

EXCLUSIONS

Exclusions with EHM refers to Emergency Hospital &Medical Insurance, CANX refers to Trip Cancellation & Interruption benefits and FAC refers to Flight Accident Benefits.

Benefits are not payable for costs incurred due to:

EHM1 Any sickness, injury or medical condition, that exhibited symptoms for which a diagnosis need not have been made or required any or all of, medical consultation, prescription medication, medical treatment or hospitalization, within the 180 days immediately prior to the effective date. This exclusion applies to persons up to age 70 on the effective date, travelling for periods of 36 days or longer and persons age 71 and over for trips of any duration.
EHM2 (CANX2) Any sickness, injury or medical condition for which a diagnosis need not have been made or state of health which, prior to the effective date of coverage, was such as to render expected medical treatment or hospitalization.
EHM3 (FAC1, CANX3) Losses while sane or insane due to: emotional, mental or nervous disorders resulting from any cause, including but not limited to anxiety or depression; suicide, attempted suicide; or intentional self-inflicted injury.
EHM4 (FAC2, CANX4) Act of war, kidnapping, act of terrorism caused directly or indirectly by nuclear, chemical or biological means, (Trip Cancellation & Interruption and Flight Accident benefits do not cover acts of terrorism by any means) riot, strike or civil commotion, unlawful visit in any country, participation in protests, participation in armed forces activities or a commercial sexual transaction or the commission or attempted commission of any criminal offence, contravention of any statutory law or regulation in the area where the loss occurred by the insured, a family member or travelling companion.
EHM5 (CANX6) Any sickness, injury or medical condition for which a diagnosis need not have been made where a trip is undertaken for the purpose of securing medical treatment or advice.
EHM6 (FAC3, CANX5) Loss, death or injury, if at the time of the loss, death or injury, evidence supports the insured was affected by, or the medical condition causing the loss was in any way contributed to by, the use of alcohol, prohibited drugs, or any other intoxicant; the non-compliance with prescribed treatment or medical therapy; or the misuse of medication.
EHM7 (CANX7) Any medical consultation that is non-emergency, elective or the consequence of a prior elective procedure.
EHM8 (CANX8) Travelling against the advice of a physician or any loss resulting from a sickness or medical condition that was diagnosed by a physician as terminal prior to the effective date of this policy.
EHM9 Any treatment, investigation or hospitalization which is a continuation of, or subsequent to, emergency treatment of a sickness or injury, or treatment which can be reasonably delayed until the insured returns to Canada (whether or not they intend to return) by the next available means of transportation, unless approved in advance by TIC.
EHM10 A recurrence or complication of the sickness, injury or medical condition that resulted in the insured being returned home if the insured elects to resume their trip after being returned to Canada.
EHM11 Any rehabilitation or convalescent care.
EHM12 (CANX9) Injury resulting from training for or participating in speed contests usually and customarily in excess of 60 km per hour, professional sport activities, or organized motor sport contests.
EHM13 (CANX11) Routine or elective treatment for pregnancy within the first 32 weeks of the pregnancy.
EHM14 (CANX10) Pregnancy within 8 weeks of the expected delivery date.
EHM15 Sickness or injury resulting from a motor vehicle accident where the insured is entitled to receive benefits pursuant to any policy or legislative plan of motor vehicle insurance.
EHM16 Dental or cosmetic surgery unless such emergency surgery is a result of a covered injury.
EHM17 Treatment or services that contravene, or are prohibited by, legislation under a provincial or territorial hospital/medical plan.
EHM18 Naturopathic, holistic or acupuncture treatment.
EHM19 Costs that exceed the reasonable and customary rate for the area where the treatment or services are being performed.
EHM20 (FAC4, CANX21) Any nuclear occurrence, however caused.
EMH21 Any loss resulting from an act of terrorism on a trip while at a destination where, prior to the insured's departure to that destination, a statement regarding terrorism is made in the 'Travel Report' issued by the Canadian Department of Foreign Affairs advising or recommending that Canadians should not travel to that destination during the period of coverage.
CANX12 A trip undertaken for the purpose of visiting or attending to an ailing person whose medical condition or ensuing death is the cause of cancellation or curtailment of the insured trip or delays the insured's return home.
CANX13 Loss for any event prior to departure, which might reasonably have been expected to necessitate the immediate return or delay the return of the insured.
CANX14 Loss for any event which, on the application date could reasonably have been expected to prevent the insured from traveling as booked.
CANX15 Losses recovered or which are recoverable from any other source, including trustees or any government compensation fund.
CANX16 Loss arising as a consequence of the bankruptcy or insolvency of a retail travel agent, agency or broker, whether or not otherwise entitled to the benefit of this insurance.
CANX17 Losses arising as a result of a default of the travel supplier if, at the time of booking and/or application, the travel supplier is bankrupt, insolvent, in receivership, or has sought protection from creditors under any bankruptcy or related legislation.
CANX18 Losses arising as a result of default of an American travel supplier if the services to be provided by the American travel supplier are not part of a package tour sold to the insured by an appointed representative of TIC.
CANX19 Losses arising from default of a travel supplier for travel services purchased by the insured direct from the travel supplier, or from other than an appointed representative of TIC.
CANX20 Any amounts assessed by the travel supplier that are non-refundable after the date of the occurrence of an Insured Risk, injury or ultimate diagnosis of a sickness that was the cause of the cancellation, regardless of the date the trip was cancelled.

DEFINITIONS

Accident(al) means a sudden, unexpected, unforeseeable, unavoidable external event.
Act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof or commission or threat of a dangerous act, of any person or group(s) or government(s), committed for political, religious, ideological, social, economic or similar purposes including the intention to intimidate, coerce or overthrow a government (whether defacto or de jure) or to influence, affect or protest against any government and/or to put the civilian population, or any section of the civilian population, in fear.
Act of war means any loss or damage arising directly or indirectly from, occasioned by, happening through or in the consequence of war, invasion, acts of foreign enemies, hostilities or warlike operations (whether war is declared or not) by any government or sovereign, using military personnel or other agents, civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power.
Aggregate limit means the total number or the maximum value of insured losses resulting from any one accident or event causing loss.
Application date means the date the insured applies and pays for this insurance in conjunction with the initial non-refundable costs associated with booking their trip. The insured must purchase this insurance within 48 hours of paying the non-refundable deposit for the trip and before any non-refundable amounts assessed by the travel supplier apply.
Business meeting means a meeting scheduled before the application date between companies with unrelated ownership, pertaining directly to the insured's full-time employment or professional association, and required by the insured's employment.
Canadian resident means a landed immigrant or Canadian citizen who maintains a permanent residence in Canada to which they will return after their trip.
Default means a complete cessation of operations as a result of a bankruptcy of a contracted travel supplier.
Effective date means the date and time coverage begins as provided for in the section titled 'Coverage Begins' for the specific plan purchased.
Emergency means a sudden, unforeseen sickness or injury occurring during the period of coverage, which requires immediate intervention by a physician or legally licensed dentist and cannot reasonably be delayed. An emergency is deemed to no longer exist when medical evidence indicates that the insured is able to continue the trip or return to their place of ordinary residence in Canada.
Expected medical treatment means medical consultation or hospitalization, which has been shown, by prior medical history, as probable or certain to occur.
Expiry date means the date coverage ends as indicated in the section titled 'Coverage Ends' for the specific plan purchased.
Family member means the insured's legal or common-law spouse, parent, brother, sister, legal guardian, step-parent, step-child, step-brother, step-sister, aunt, uncle, niece, nephew, grandparent, grandchild, in-law, ward, natural or adopted child.
Hospital means a facility incorporated or licensed as a hospital by the jurisdiction where such services are provided and which has accommodation for resident in-patients, a laboratory, a registered graduate nurse and physician always on duty and an operating room where surgical operations are performed by a physician. In no event shall this include a convalescent or nursing home, home for the aged, health spa, or an institution for the care of drug addicts, alcoholics or persons suffering from mental or nervous disorders.
Injury means sudden bodily harm, which is directly caused by or resulting from an accident, being a sudden and unforeseen event, excluding bodily harm that results from deliberate or voluntary action, and independent of sickness and all other causes.
Insured means an eligible person named on the application, who has been accepted by TIC or its authorized representative, and has paid the required premium for a specific plan of insurance.
Insurer means Co-operators Life Insurance Company.
Key employee means a business partner or an employee whose continued presence is critical to the ongoing affairs of the business during the insured's absence.
Medical consultation means any medical services obtained from a licensed medical practitioner for an ailment, sickness or medical condition, including but not limited to any or all of: history taking, medical examination, investigative testing, advice or treatment, and for which a diagnosis of the condition need not have been definitively made. This does not include regular medical checkups where no medical signs or symptoms existed or were found during the check-up.
Nuclear, chemical or biological means the use of any nuclear weapon or device or the emission, discharge, dispersal, release or escape of any solid, liquid or gaseous chemical agent and/or biological agent, including the resultant contamination where:

Nuclear means any occurrence causing bodily injury, sickness, disease, or death or loss of or damage to property, or for loss of use of property, arising out of or resulting from the radioactive, toxic, explosive, or other hazardous properties of source, special nuclear, or by-product material.
Chemical agent means any compound which, when suitably disseminated, produces incapacitating, damaging or lethal effects on people, animals, plants or material property.
Biological agent means any pathogenic (disease-producing) micro-organism(s) and/or biologically produced toxin(s) (including genetically modified organisms and chemically synthesized toxins) which cause illness and/or death in humans, animals or plants.

Period of coverage means the period from the effective date to the expiry date as indicated in this policy and for which premium has been paid.
Physician means a person other than the insured, who is legally qualified and licensed to practice medicine or perform surgery in the location where the services are performed, and is not related to the insured by blood or marriage.
Professional means an activity engaged in by the insured who earns the majority of their income from such activity.
Reasonable and customary means the services customarily provided or the costs customarily incurred for covered losses, which are not in excess of the standard practice or fee in the geographical area where the services are provided or costs are incurred for comparable treatment, services or supplies for a similar sickness or injury.
Sickness means any illness or disease.
Spouse means a person who is legally married to the insured, or has been living in a common-law relationship (either opposite sex or same sex) with the insured for a continuous period of at least one year and who resides in the same household as the insured.
Terminal means a sickness or medical condition for which a physician gave a prognosis of eventual death or for which palliative care was received, prior to the effective date.
Travelling companion means a person who has prepaid shared accommodation or transportation with the insured. (Maximum of 5 persons including the insured.)
Trip means the period of travel contracted by the insured and for which coverage is in effect.

GENERAL PROVISIONS

Assignment
Any benefits payable or which may become payable under this policy cannot be assigned by the insured, and the insurer is not responsible for and will not be bound by any assignment entered into by the insured.

Automatic Extension of Coverage

This coverage shall be automatically extended for up to 72 hours if, during the period of coverage, the conveyance in which the insured is riding or is scheduled to ride as a passenger, scheduled to arrive at destination during the period of coverage is delayed due to circumstances beyond their control.
Coverage will be automatically extended for up to 5 days, if medical evidence supports that the insured is medically unfit to travel due to a covered sickness or injury on or before the coverage expiry date.
If an insured is hospitalized at the end of the period of coverage, as a result of a covered injury or sickness, this coverage will be extended to the insured and an insured travelling companion remaining with the insured when reasonable and necessary, during the period of hospital confinement, plus 72 hours after release to travel home.

Benefit Payments

Unless otherwise stated, all provisions in this policy apply to each insured during one period of coverage. Benefits are only payable under one policy, for each insured during the period of coverage. If more than one TIC policy is in effect at the same time benefits will only be paid under one insurance policy, the one with the greatest sum insured. Benefits are only payable for the plans and the specific sum insured selected, paid for and accepted by TIC at the time of application. Any benefits payable do not include interest charges.

Claim Submission

The insured or the claimant, if other than the insured, shall be responsible for the verification of:

Any medical costs incurred; and shall obtain itemized accounts of all medical services which have been provided.
Any payment made by a provincial or territorial hospital/medical plan, or, if the insured is not covered or is not eligible for coverage, verification of any payment that would have been made.
Any payment made by any other insurance plan or contract.
Providing substantiating medical documentation from their province, territory or country of residence, at the request of TIC. Failure to provide substantiating documents shall invalidate all claims under this insurance.

Contract
The application, completed medical questionnaire, confirmation of coverage, this policy, any document attached to this policy when issued, and any amendment to the policy agreed upon in writing after it is issued, constitute the entire contract. Each policy or term of coverage is considered a separate contract. TIC reserves the right to decline any application or any request for extensions of coverage. No condition of this policy shall be deemed to have been waived, either in whole or in part, unless the waiver is clearly expressed in writing and signed by TIC.

Coordination of Benefits
Coverage under this policy is in excess of all or any existing coverage concurrently in force held by the insured, including but not limited to homeowners, tenants, multi-risk, any credit card, third-party liability, group or individual basic or extended health insurance or any private or legislative plan of motor vehicle insurance providing hospital, medical or therapeutic coverage. TIC will coordinate all benefits in accordance with the Canadian Life and Health Insurance Association guidelines. Reimbursement will not be made for any costs, services or supplies that are payable to the insured under a motor vehicle insurance policy or legislative plan pursuant to the 'no-fault' benefits schedule under any insurance act, or for which the insured receives benefits from any other party pursuant to any policy or legislative plan of motor vehicle insurance.
The insured may not claim or receive in total, more than 100% of the loss caused by the insured event.
If the insured named in this policy is retired with an extended health plan provided by a former employer, with a lifetime limit of up to $50,000, TIC will not coordinate benefits with that provider.

Currency
All amounts stated in the policy including premium are in Canadian currency. At the option of TIC, benefits may be paid in the currency of the country where the loss occurred.

Governing Law
This policy will be governed by the laws of the Canadian province or territory in which the insured normally resides.

Limit on Liability
It is a condition precedent to liability under this policy that at the time of application, the insured is in good health and knows of no reason to seek medical attention.

Misrepresentation or Nondisclosure
A failure to disclose or misrepresentation of any material fact by the insured, or fraud, either at the time of application or at the time of claim, shall render the entire contract null and void, and any claim submitted thereunder shall not be payable.

Premiums
The total premium amount is due and payable at the time of application. The premium is calculated using the most current rates for the insured's age on the effective date.

Rights of Examination
The claimant shall provide TIC with the opportunity to examine the insured when and so often as it reasonably requires while a claim is pending. In the case of an insured's death TIC may require an autopsy, subject to any laws of the applicable jurisdiction relating to autopsies.

Subrogation (Right of Recovery)
In the event of any payment of benefits under this policy, TIC shall be subrogated to all the rights of the insured including without limitation, the right to proceed in the insured's name, but at the insurer's cost, against any third party that may be responsible for giving rise to a claim under this policy. The insured shall execute all documents required and shall co-operate fully with the insurer to secure such rights. The insured shall do nothing after the loss to prejudice the insurer's right of recovery.

Time
Expiry time of coverage is the time within the time zone where the insured was residing when the application was made.

PREMIUM REFUNDS

Refunds are not payable after the effective date indicated on the application.

CLAIMS PROCEDURES

Important Notes

In the event of a medical emergency, TIC must be notified prior to any surgery being performed or within 24 hours of admission to a hospital. Failure to do so, without reasonable cause, will result in the reduction of eligible benefit amounts payable by 20%. To make your claim, fill out the claim form completely and include all original bills. Incomplete information will cause delay.
Claims must be reported within 30 days of occurrence.
Written proof of claim must be submitted within 60 days of occurrence.
Any costs incurred for documentation or required reports are the insured's or claimant's responsibility.

When submitting an Emergency Hospital & Medical claim please include:

A fully completed and signed claim form with all original bills and receipts. Incomplete forms will delay your claim.
Medical records including an emergency room report and diagnosis from the medical facility or a Medical Certificate completed by the treating physician. Any fee for completing the certificate is not a benefit under this insurance.
For physiotherapy visits, a letter from the referring physician recommending a referral to the physiotherapist.
Completed appropriate provincial government health insurance plan forms; see claim form for details.
For Multi-trip Plans, include proof of original departure from and return to your province or territory of residence.
Any other documentation that may be required and/or requested by TIC.

When submitting a Flight Accident claim please include:

Fully completed and signed claim form (completed by either the insured person, or in the case of death, by the appointed executor/executrix).
Copy of flight itinerary.
Copy of incident report from airline or airport.
Medical certificate completed by the attending physician or hospital medical records.
Death certificate (in the event of death).

When submitting a Trip Cancellation & Interruption claim please include:

Trip Cancellation, Interruption and Delay
1. A fully completed and signed claim form. Incomplete forms will be returned and will delay processing of your claim.
2. Both the insured and the claimant (if other than the insured) must sign the Authorization and Certification.
3. A medical certificate completed by the treating physician. A copy of the patient's/deceased's medical records may be required.
4. If cancellation is due to death, copy of death certificate.
5. If cancellation is due to any reason other than sickness, injury or death, please contact the TIC Claims Department for detailed claims requirements.
Prior to Departure (in addition to the requirements for item a) above)
1. Itemized copy of the invoice confirming the amount paid for your trip, including the cost of airfare, hotel, taxes, service fees and any other expenses.
2. Proof of payment such as: a credit card statement, a copy of a cancelled cheque, or copy of the official receipt issued by the travel agency.
3. Statement of refund from the travel supplier or agent if applicable.
4. Original unused airline tickets and any other original travel documentation (if you did not get a refund from any other source).
After Departure (in addition to the requirements for item a) above)
1. Original unused airline ticket and passenger coupon of the new replacement ticket purchased to return home.
2. If only a change fee was charged, receipt showing the amount charged.
3. For an unused tour, provide a copy of the original invoice, breakdown of unused tour cost, and a copy of the travel itinerary.
4. Any original receipts for out-of-pocket expenses incurred due to interruption or delayed return.
5. Any other documentation to support your claim.

All claims forms are available online at www.travelinsurance.ca or by calling TIC Claims Department.

SUBMIT CLAIMS TO:

For Provinces Manitoba and West
TIC Claims Department
125 - 4400 Dominion Street
Burnaby, BC, Canada V5G 4G3
Collect worldwide: 604-639-8849
Toll free Canada/U.S.A.: 1-800-882-5246

For Provinces Ontario and East
TIC Claims Department
1200 - 438 University Avenue
Toronto, ON, Canada M5G 2K8
Collect worldwide: 416-340-8809
Toll free Canada/U.S.A.: 1-800-869-6747

STATUTORY CONDITIONS

Notwithstanding any other provisions herein contained, this contract is subject to the Statutory Conditions in the Insurance Act respecting contracts of Accident and Sickness Insurance. For Québec residents, notwithstanding any other provisions herein contained, this contract is subject to the mandatory provisions of the Civil Code of Québec respecting contracts of Accident and Sickness Insurance.

In witness whereof, CO-OPERATORS LIFE INSURANCE COMPANY has caused this policy to be signed by its COO and Senior Vice President

Administered by:
TIC Travel Insurance Coordinators Ltd.
300 - 2609 Westview Drive
North Vancouver, BC
Canada V7N 4M2

Underwritten by:
Co-operators Life Insurance Company
1920 College Avenue
Regina, Saskatchewan
Canada S4P 1C4

EMERGENCY PROCEDURES
In the event of a medical emergency, TIC Emergency Assistance must be notified prior to any surgery being performed or within 24 hours of admission to a hospital. Failure to do so, without reasonable cause, will result in the reduction of eligible benefit amounts payable by 20%. We are here to help. Our service is available 24 hours a day, 7 days a week. TIC Emergency Assistance also provides support and recommendations for non-medical emergencies, providing you with access to resources to help resolve any unexpected difficulties you encounter during your trip.

TIC EMERGENCY ASSISTANCE
Toll free Canada/U.S.A.: 1-800-995-1662
Toll free worldwide: 800-842-08420 or 00-800-842-08420
If unable to contact us through the toll free numbers call collect: 416-340-0049
Contact us at www.travelinsurance.ca and initiate your claim and we will contact you.