Please read this Insurance Certificate/brochure carefully, as
it is your evidence of coverage under the policy (once you have paid
the appropriate premium). If you have any questions about the
coverages offered or to repor t a claim, please contact Trip Mate
at 1-888-411-5378. Claims may also be
reported online and claim forms downloaded at
www.tripmate.com
Plan Number: 925i
TRAVEL INSURANCE CERTIFICATE
Who is Eligible for Coverage
A person who has arranged to take a Trip and pays the required premium,
and is a citizen or resident of the United States of America.
When Coverage Begins
All coverages (except Pre-Departure Trip Cancellation and Post-Departure
Trip Interruption) will take effect on the later of: 1) the date the premium
has been received; 2) the date and time you start your Trip; or 3) 12:01
A.M. Standard Time on the Scheduled Departure Date of your Trip.
The Pre-Departure Trip Cancellation Benefit is effective on the earlier of:
- at 12:01 A.M. Standard Time on the day after the date the premium is
received by TravelSafe; or
- if mailed, at 12:01 A.M. Standard Time on the day after the postmark date.
Post-Departure Trip Interruption coverage will take effect on the Scheduled
Departure Date.
When Coverage Ends
Your coverage automatically ends on the earlier of: 1) the date the Trip is
completed; 2) on the Scheduled Return Date; 3) on your arrival at the return
destination on a round trip, or the destination on a one-way trip; 4) cancellation
of the Trip covered by the policy. Termination of the policy will not affect a claim
for loss which occurs after premium has been paid. All coverage under this policy
will be extended if your entire Trip is covered by the policy and your return is
delayed by unavoidable circumstances beyond your control. If coverage is
extended for the above reasons, coverage will end on the earlier of the date you
reach your originally scheduled return destination or seven (7) days after the
Scheduled Return Date.
Summary of Coverages
Pre-Departure Trip Cancellation
We will pay a Pre-Departure Trip Cancellation Benefit, up to the amount in the
Schedule if you are prevented from taking your Trip due to your, an Immediate
Family Members, Traveling Companions, or Business Partners Sickness,
Injury, or death that occurs before departure on your Trip. The Sickness or
Injury must: a) commence while your coverage is in effect under the policy;
b) require the examination and treatment by a Physician at the time the Trip
is canceled; and c) in the written opinion of the treating Physician, be so
disabling as to prevent you from taking your Trip.
We will pay a benefit if you are prevented from taking your Trip due to Other
Covered Events, as defined, (see Page 3) that occur before departure on
your Trip.
Please refer to the Policy Definitions, page 3, for an explanation
of Pre-Existing Conditions which are excluded under the Trip
Cancellation/Interruption Coverage.
BENEFITS: Pre-Departure Cancellation
We will reimburse you, up to the amount in the Schedule for the amount of prepaid,
forfeited, non-refundable Payments or Deposits that you paid for your Trip if your
Trip is canceled. We will pay your additional cost as a result of a change in the per
person occupancy rate for prepaid travel arrangements if a Traveling Companion's
Trip is canceled and your Trip is not canceled.
Post-Departure Trip Interruption
We will pay a Post-Departure Trip Interruption Benefit, up to the amount in
the Schedule, if: 1) your arrival on your Trip is delayed beyond the Scheduled
Departure Date or 2) you are unable to continue on your Trip after you have
departed on your Trip due to your, an Immediate Family Members, Traveling
Companions, or Business Partners Sickness, Injury, or death.
For item 1) above, the Sickness or Injury must: a) commence while your
coverage is in effect under the policy; b) for item 2) above, commence while
you are on your Trip and your coverage is in effect under the policy; and c)
for both items 1) and 2) above, require the examination and treatment by a
Physician, at the time the Trip is interrupted or delayed; and d) in the written
opinion of the treating Physician, be so disabling as to delay your arrival on
your Trip or to prevent you from continuing your Trip.
We will pay a benefit if: 1) your arrival on your Trip is delayed beyond the
Scheduled Departure Date or 2) you are unable to continue on your Trip after
you have departed on your Trip due to Other Covered Events, as defined (see Page 3).
Post-Departure Interruption Benefits
We will reimburse you, less any refund paid or payable, for unused land or water
travel arrangements, plus one of the following:
- the additional transportation expenses by the most direct route from the
point where you interrupted your Trip:
- to the next scheduled destination where you can catch up to
your Trip; or
- to the final destination of your Trip; or
- the additional transportation expenses incurred by you by the most direct
route to reach your original Trip destination if you are delayed and leave
after the Scheduled Departure Date.
However, the benefit payable under (1) and (2) above will not exceed the
cost of a one-way economy air fare (or first class, if the original tickets
were first class) by the most direct route less any refunds paid or payable
for your unused original tickets.
- your additional cost as a result of a change in the per person occupancy rate
for prepaid travel arrangements if a Traveling Companion's Trip is interrupted
and your Trip is continued.
Please refer to the Policy Definitions, page 3, for an explanation
of Pre-Existing Conditions which are excluded under the Pre-
Departure Trip Cancellation and Post-Departure Trip Interruption
Coverages.
Travel Delay
If your Trip is delayed for 12 hours or more, we will reimburse you, up to the
amount shown in the Schedule for reasonable additional expenses incurred by
you for hotel accommodations, meals, telephone calls and local transportation
while you are delayed. We will not pay benefits for expenses incurred after
travel becomes possible.
Travel Delay must be caused by or result from: 1) Common Carrier delay;
or 2) loss or theft of your passport(s), travel documents, or money; or 3)
quarantine; or 4) hijacking; or 5) natural disaster or closure of public roadways
by government authorities due to adverse weather; or 6) Injury or Sickness of
you, an Immediate Family Member traveling with you, or a Traveling Companion;
or 7) death of an Immediate Family Member traveling with you, or a Traveling
Companion.
Medical Expense/Emergency Assistance
We will pay this benefit, up to the amount in the Schedule, for the following Covered
Expenses incurred by you, subject to the following:
- Covered Expenses will only be payable at the Usual and Customary level of
payment;
- benefits will be payable only for Covered Expenses resulting from a Sickness
that first manifests itself or an Injury that occurs while on a Trip;
- benefits payable as a result of incurred Covered Expenses will only be paid after
benefits have been paid under any Other Valid and Collectible Group Insurance
in effect for you. We will pay that portion of Covered Expenses which exceed
the amount of benefits payable for such expenses under your Other Valid and
Collectible Group Insurance.
Please refer to the Definitions, page 3, for an explanation of Pre-
Existing Conditions which are excluded under the Medical Expense/
Emergency Assistance Benefits.
Covered Expenses means:
- expenses for the following Physician-ordered medical services: services of
legally qualified Physicians and graduate nurses, charges for Hospital
confinement and services, local ambulance services, prescription drugs and
medicines, and therapeutic services, incurred by you within one year from
the date of your Sickness or Injury;
- expenses for emergency dental treatment incurred by you during a Trip;
- expenses incurred by you for Physician-ordered emergency medical
evacuation, including medically appropriate transportation and necessary
medical care en route, to the nearest suitable Hospital, when you
are critically ill or injured and no suitable local care is available, subject
to the Program Medical Advisors prior approval;
- expenses incurred for non-emergency medical evacuation, including
medically appropriate transportation and medical care en route, to a
Hospital or to your place of residence in the USA or Canada, when deemed
medically necessary by the attending Physician, subject to the Program
Medical Advisors prior approval;
- expenses for transportation, not to exceed the cost of one round-trip
economy class air fare, to the place of hospitalization for one person
chosen by you, provided you are traveling alone and are hospitalized for
more than 7 days;
- expenses for transportation, not to exceed the cost of one-way economy
class airfare, to your place of residence in the USA or Canada, including
escort expenses if you are 18 years of age or younger and left unattended
due to the death or hospitalization of an accompanying adult(s), subject
to the Program Medical Advisors prior approval;
- expenses for one-way economy class airfare (or first class, if your
original tickets were first class) to your place of residence in the USA
or Canada, from a medical facility to which you were previously
evacuated, less any refunds paid or payable from your unused
transportation tickets, if these expenses are not covered elsewhere in
the policy;
- repatriation expenses for preparation and air transportation of your remains
to your place of residence in the USA or Canada, or up to an equivalent amount
for a local burial in the country where death occurred, if you die while outside
the USA or Canada.
Baggage & Personal Effects
We will reimburse you, less any amount paid or payable from any other valid
and collectible insurance or indemnity, up to the amount shown in the Schedule,
for direct loss, theft, damage or destruction of your Baggage, passports or
visas during your Trip. We will also pay for loss due to unauthorized use of
your credit cards, if you have complied with all of the credit card conditions
imposed by the credit card companies.
Items Subject to Special Limitations - We will not pay more than \$500 on all
losses to jewelry; watches; precious or semi-precious gems; decorative or
personal articles consisting in whole or in part of silver, gold, or platinum;
cameras, camera equipment; digital or electronic equipment and media; and
articles consisting in whole or in part of fur. Items not included above are
subject to a \$250 per item limit.
Items Not Covered - We will not pay for damage to or loss of: animals;
property used in trade, business or for the production of income, household
furniture, musical instruments, brittle or fragile articles, or sporting equipment
if the loss results from the use thereof; boats, motors, motorcycles, motor
vehicles, aircraft, and other conveyances or equipment, or parts for such
conveyances; artificial limbs or other prosthetic devices, artificial teeth, dental
bridges, dentures, dental braces, retainers or other orthodontic devices, hearing
aids, any type of eyeglasses, sunglasses or contact lenses; documents or
tickets, except for administrative fees required to reissue tickets; money, stamps,stocks and
bonds, postal or money orders, securities, accounts, bills, deeds,
food stamps or credit cards, except as noted above; property shipped as
freight or shipped prior to the Scheduled Departure Date; contraband.
Losses Not Covered - We will not pay for loss arising from: defective materials or
craftsmanship; normal wear and tear, gradual deterioration, inherent vice; rodents,
animals, insects or vermin; theft or pilferage from an unattended vehicle; mysterious
disappearance; or electrical current, including electric arcing that damages or
destroys electrical devices or appliances.
Continuation of Coverage - If the covered Baggage, passports or visas
are in the custody of a Common Carrier, and delivery is delayed, this coverage
will continue until the property is delivered to you. This continuation of
coverage does not include loss caused by or resulting from the delay.
Valuation and Payment of Loss - Payment of loss under the Baggage and
Personal Effects Benefit will be calculated based upon an Actual Cash Value
basis. For items without receipts, payment of loss will be calculated based
upon 75% of the Actual Cash Value at the time of loss. At our option, we may
elect to repair or replace your Baggage. We will notify you within 30 days
after we receive your proof of loss. We may take all or part of damaged
Baggage as a condition for payment of loss. In the event of a loss to a pair
or set of items, we will: 1) repair or replace any part to restore the pair or
set to its value before the loss; or 2) pay the difference between the value of
the property before and after the loss.
Baggage Delay
We will reimburse you up to the amount shown in the Schedule for the cost of
reasonable additional clothing and personal articles purchased by you, if your
Baggage is delayed for 24 hours or more during your Trip. We will also
reimburse you up to \$25 for expenses incurred during your Trip to expedite
the return of your delayed Baggage.
This coverage terminates upon your arrival at the return destination of your
Trip.
Accidental Death and Dismemberment
We will pay this benefit up to the amount on the Schedule if you are injured in
an Accident which occurs while you are on a Trip and covered under the
policy, and you suffer one of the losses listed below within 365 days of the
Accident. The Principal Sum is the benefit amount shown on the Schedule.
Life 100%
Both Hands; Both Feet or Sight of Both Eyes 100%
One Hand and One Foot 100%
One Hand and Sight of One Eye 100%
One Foot and Sight of One Eye 100%
One Hand; One Foot or Sight of One Eye 50%
If you suffer more than one loss from one Accident, we will pay only for the
loss with the larger benefit. Loss of a hand or foot means complete severance
at or above the wrist or ankle joint. Loss of sight of an eye means complete
and irrecoverable loss of sight.
Definitions
In this policy, "you", "your" or "yours" refer to the Insured. "We", "us" and "our"
refer to the company providing this insurance. In addition, certain words and
phrases are defined as follows:
"Actual Cash Value" means current replacement cost for items of like kind
and quality less depreciation.
"Air Carrier" means any air conveyance operated under a license for the
transportation of passengers for hire.
"Baggage" means luggage, personal possessions and travel documents
taken by you on the Trip.
"Business Partner" means an individual who is involved, as a partner, with
you in a legal general partnership and shares in the management of the business.
"Common Carrier" means any land, water, or air conveyance operated under
a license for the transportation of passengers for hire, not including taxi cabs, or
rented, leased, or privately owned motor vehicles.
"Domestic Partner" means a person who is at least 18 years of age and you
can show: 1) evidence of financial interdependence, such as joint bank accounts
or credit cards, jointly owned property, and mutual life insurance or pension
beneficiary designations; 2) evidence of cohabitation for at least the previous 6
months; and 3) an affidavit of domestic partnership if recognized by the
jurisdiction within which they reside.
"Elective Treatment and Procedures" means any medical treatment or
surgical procedure that is not medically necessary including any service, treatment,
or supplies that are deemed by the federal, or a state or local government
authority, or by us to be research or experimental or that is not recognized as a
generally accepted medical practice.
"Financial Insolvency" means the total cessation of operations due to
insolvency, with or without the filing of a bankruptcy petition, or the total cessation
of operations following the filing of a bankruptcy petition, by a tour operator,
cruise line or airline, other than the person, organization, agency or firm from
whom you directly purchased or paid for your Trip provided the Financial Insolvency
occurs more than 15 days following your effective date for the Trip Cancellation
Benefits.
"Home" means your primary or secondary residence.
"Hospital" means an institution which meets all of the following requirements: 1)
it must be operated according to law; 2) it must give 24-hour medical care, diagnosis
and treatment to the sick or injured on an inpatient basis; 3) it must provide
diagnostic and surgical facilities supervised by Physicians; 4) registered nurses
must be on 24-hour call or duty; and 5) the care must be given either on the
hospitals premises or in facilities available to the hospital on a pre-arranged basis.
A Hospital is not: a rest, convalescent, extended care, rehabilitation, or other
nursing facility; a facility which primarily treats mental illness, alcoholism, or drug
addiction (or any ward, wing or other section of the hospital used for such
purposes); or a facility which provides hospice care (or wing, ward or other section
of a hospital used for such purposes).
"Immediate Family Member" includes your or the Traveling Companions,
spouse, child, spouses child, son-daughter-in-law, parent(s), sibling(s),
grandparent(s), grandchild, step brother-sister, step-parent(s), parent(s)-inlaw,
brother-sister-in-law, aunt, uncle, niece, nephew, guardian, Domestic
Partner, foster-child, or ward.
"Injury" means bodily harm caused by an accident which 1) occurs while
your coverage is in effect under the policy and 2) requires examination and
treatment by a Physician. The injury must be the direct cause of loss and
must be independent of all other causes and must not be caused by, or
result from, Sickness.
"Insured" means an Eligible Person who takes a Trip, completes any required
enrollment form, and pays any required premium.
"Insurer" means Stonebridge Casualty Insurance Company.
"Other Covered Events" means only the following unforeseeable events or their
consequences which occur while coverage is in effect under this policy:
- Air Carrier delays resulting from inclement weather, mechanical breakdown of
the aircraft on which you are scheduled to travel, or organized labor strikes
that affect public transportation;
- arrangements canceled by an airline resulting from inclement weather,
mechanical breakdown of the aircraft on which you are scheduled to travel,
or organized labor strikes that affect public transportation.
Items #1 & #2 above apply only to Post-Departure Trip Interruption
Benefits and are subject to a maximum limit of \$500.
- arrangements canceled by an airline, cruise line, or tour operator, resulting
from Financial Insolvency as defined.
Item #3 above is subject to your premium being received by or
before the final payment due date for your Trip.
- a change in plans by you, an Immediate Family Member traveling with you,
or Traveling Companion resulting from one of the following events:
- being directly involved in a documented traffic accident while en route to
departure;
- being hijacked, quarantined, required to serve on a jury, or required
by a court order to appear as a witness in a legal action, provided you,
an Immediate Family Member traveling with you or a Traveling Companion
is not 1) a party to the legal action, or 2) appearing as a law
enforcement officer;
- your Home is made uninhabitable by fire, flood, volcano, earthquake,
hurricane or other natural disaster;
- being called into active military service to provide aid or relief in the event
of a natural disaster;
- a documented theft of passports or visas;
- a transfer of employment of 250 miles or more;
- a terrorist act which occurs in your departure city or in a city which is a
scheduled destination for your Trip provided: 1) the terrorist act occurs
within 30 days of the Scheduled Departure Date for your Trip; and 2) your
premium is received by or before the final payment due date for your Trip.
"Other Valid and Collectible Group Insurance"means any group policy
or contract which provides for payment of medical expenses incurred because
of Physician, nurse, dental or Hospital care or treatment; or the performance
of surgery or administration of anesthesia. The policy or contract providing
such benefits includes group or blanket insurance policies; service plan
contracts; employee benefit plans; or any plan arranged through an employer,
labor union, employee benefit association or trustee; or any group plan created
or administered by the federal or a state government or its agencies. In the
event any other group plan provides for benefits in the form of services in lieu
of monetary payment, the Usual and Customary value of each service rendered
will be considered a Covered Expense.
"Payments or Deposits" means the cash, check, or credit card amounts
actually paid for your Trip. Payments made in the form of a certificate, voucher
or discount are not Payments or Deposits as defined herein.
"Physician" means a person licensed as a medical doctor by the jurisdiction
in which he/she is resident to practice the healing arts. He/she must be
practicing within the scope of his/her license for the service or treatment given
and may not be you, a Traveling Companion or an Immediate Family Member
of yours.
"Policy" means the contract issued to the Policyholder providing the benefits
specified herein.
"Policyholder" means the legal entity in whose name this Policy is issued, as
shown on the Declarations.
"Pre-Existing Condition" means an illness, disease, or other condition
during the 60 day period immediately prior to your effective date for which
you or your Traveling Companion, Business Partner or Immediate Family
Member scheduled or booked to travel with you: 1) received, or received
a recommendation for, a diagnostic test, examination, or medical treatment;
or 2) took or received a prescription for drugs or medicine.
Item (2) of this definition does not apply to a condition which is treated or
controlled solely through the taking of prescription drugs or medicine and
remains treated or controlled without any adjustment or change in the required
prescription throughout the 60 day period before coverage is effective under
this policy.
"Program Medical Advisors" means individuals appointed by MEDEX Assistance Corporation.
"Scheduled Departure Date" means the date on which you are originally
scheduled to leave on your Trip.
"Scheduled Return Date"means the date on which you are originally
scheduled to return to the point where the Trip started or to a different final
destination.
"Scheduled Trip Departure City" means the city where the scheduled trip
on which you are to participate originates.
"Sickness"means an illness or disease of the body which: 1) requires
examination and treatment by a Physician, and 2) commences while the
insurance is in effect. An illness or disease of the body which first manifests
itself and then worsens or becomes acute prior to the effective date of this
insurance is not a Sickness as defined herein and is not covered by the policy.
"Terrorist Act" means an act of violence, other than civil disorder or riot,
(that is not an act of war, declared or undeclared) that results in loss of life
or major damage to property, by any person acting on behalf of or in
connection with any organization which is generally recognized as having the
intent to overthrow or influence the control of any government.
"Traveling Companion" means up to six (6) persons whose names appear
with yours on the same Trip arrangement and who, during the Trip, will
accompany you.
"Trip" means a scheduled trip for which coverage is elected and premium paid,
and all travel arrangements are arranged prior to the Scheduled Departure Date
of the Trip.
"Usual and Customary Charge" means those charges for necessary
treatment and services that are reasonable for the treatment of cases of
comparable severity and nature. This will be derived from the mean charge based
on the experience in a related area of the service delivered and the MDR (Medical
Data Research) schedule of fees valued at the 90th percentile.
Policy Exclusions
The following exclusion applies to the Accidental Death and
Dismemberment coverage:
- We will not pay for loss caused by or resulting from Sickness of any kind.
The following exclusion applies to the Medical Expense / Emergency
Assistance, Pre-Departure Trip Cancellation, Post-Departure Trip Interruption
and Travel Delay coverages:
- We will not pay for loss or expense caused by or incurred as a result of a
Pre-Existing Condition, as defined in the policy, including death that results
therefrom. This exclusion does not apply to benefits under Covered
Expenses item #3 (emergency medical evacuation) or item #8 (return of
remains) of the Medical Expense/Emergency Assistance Benefits coverage.
Exclusion #2 will be waived if: 1) the premium for the coverage is received
by or before the final payment due date for your Trip; 2) you
insure all prepaid Trip costs that are subject to cancellation penalties or
restrictions; and 3) are not disabled from travel at the time you pay your
premium.
The following exclusions apply to all Coverages:
- We will not pay for any loss under the policy, caused by, or resulting from:
- suicide, attempted suicide, or intentionally self-inflicted injury of you, a
Traveling Companion, Immediate Family Member, or Business Partner booked
to travel with you, while sane or insane (while sane in CO & MO);
- mental, nervous or psychological disorders;
- being under the influence of drugs or intoxicants unless prescribed by
a Physician;
- normal pregnancy or resulting childbirth or elective abortion;
- participation as a professional in athletics;
- participation in organized amateur and interscholastic athletic or sports
competition or events;
- riding or driving in any motor competition;
- declared or undeclared war, or any act of war;
- civil disorder (does not apply to Travel Delay);
- service in the armed forces of any country;
- nuclear reaction, radiation or radioactive contamination;
- operating or learning to operate any aircraft, as pilot or crew;
- mountain climbing, bungee cord jumping, parachuting, hang gliding,
parasailing or travel on any air supported device, other than on a
regularly scheduled airline or air charter company;
- any unlawful acts, committed by you or a Traveling Companion (whether
insured or not);
- any amount paid or payable under any Worker's Compensation, Disability
Benefit or similar law;
- loss or damage caused by detention, confiscation or destruction by
customs;
- Elective Treatment and Procedures;
- medical treatment during or arising from a Trip undertaken for the
purpose or intent of securing medical treatment;
- Financial Insolvency of the person, organization or firm from whom you
directly purchased or paid for your Trip, Financial Insolvency which
occurred before your effective date for the Trip Cancellation Benefits, or
Financial Insolvency which occurs within 15 days following your effective
date for the Trip Cancellation Benefits;
- failure of any tour operator, Common Carrier, or other travel supplier,
person or agency to provide the bargained-for travel arrangements
for other than Financial Insolvency;
- business, contractual or educational obligations of you, an Immediate
Family Member, Business Partner, or Traveling Companion;
- a loss that results from an illness, disease, or other condition, event
or circumstance which occurs at a time when the policy is not in effect
for you.
Note: Exclusion 3, Item v) above, applies to you, an Immediate Family
Member, Traveling Companion or Business Partner.
Notice to Florida Residents
Your homeowners policy, if any, may provide coverage for loss of personal effects.
You are not required to purchase baggage insurance in connection with purchase
of tickets or in connection with the lease or rental of a motor vehicle.
Insurance Company
The Travel Insurance is Underwritten By:
Stonebridge Casualty Insurance Company, Columbus, OH.
Notice: If you are a resident of one of the following states (IL, IN, KS, LA, OK, OR, VT, WA, WY) your coverage is provided on an individual policy form. Your policy number is your complete
Name plus 925i. Additional forms complete your policy and are available at
www.tripmate.com. You can also request these forms by calling TravelSafe at 1-888-
-885-7233.
In Canada: Life Investors Insurance Company of America (except Baggage
& Personal Effects and Baggage Delay) & Legacy General Insurance
Company, Markham, Ontario (Baggage & Personal Effects and Baggage Delay).
Traveler PDQ Service is provided by:
Worldwide PDQ a division of Cargril Corporation
24 Hour Assistance Service is provided by:
MEDEX Assistance Corporation
FOR INSURANCE INQUIRIES CALL:
888-885-7233 OR
FAX TOLL FREE:
800-303-6015
Monday-Friday 8:30 AM to 5:00 PM (EST)
TO REPORT A CLAIM
888-411-5378
OR REPORT ONLINE AT:
WWW.TRIPMATE.COM
Your Duties in the Event of a Loss
In the event of a Medical or Dental Expense: You must provide us with
all bills and reports for medical and/or dental expenses claimed; you must
provide any requested information, including but not limited to, an explanation
of benefits from any other applicable insurance; and you must sign a
patient authorization to release any information required by us, to investigate
your claim.
In case of loss, theft or damage to Baggage and Personal Effects you
should: immediately report the situation to the hotel manager, tour guide or
representative, transportation official, local police or other local authorities and
obtain their written report of your loss; take reasonable steps to protect your
Baggage from further damage; and make necessary, reasonable and temporary
repairs. We will reimburse you for these expenses. We will not pay for further
damage if you fail to protect your Baggage.
Where to Present a Claim
All claims should be presented to the Program Administrator:
Trip Mate*
9225 Ward Parkway
Kansas City, Missouri 64114
1-888-411-5378 (Toll Free)
When calling, refer to Plan Number: 925i
*In CA, dba Trip Mate Insurance Agency
Claims may also be reported online and claim forms downloaded at
www.tripmate.com
MEDEX Travelers Assistance Service
24-hour Telephone Service- Multi-lingual professionals are available 24 hours a day to provide help and advice with a medical or legal emergency.
International Medical Assistance- If you are in need of medical attention, MEDEX will help you locate local physicians, dentists, or medical facilities. MEDEX will also monitor your condition and contact your personal physician and family, if requested.
Medical Evaluation*- If you need to be transported to a different hospital or treatment facility, or back home, MEDEX will arrange and pay for transportation and a special medical escort if required.
Telephone Interpretation Service- In a medical emergency, MEDEX provides interpretation services in major languages and will transmit urgent messages to family, friends, and businesses, if requested.
* Payment for these services is available only for covered claims and up to the amount of coverage provided in the policy.
Failure to call MEDEX may invalidate your Medical Expense and/or Trip Interruption or Delay claim.
The MEDEX Assistance Network extends worldwide. If you are outside the United States or Canada, call the local telephone operator for help in placing your collect call. Within the United States and Canada, use the toll free number.
Give MEDEX the following Plan Number: 925i
Within U.S.A & Canada: 1-800-527-0218
Outside U.S.A. & Canada: 1-410-453-6330*
From outside the United States & Canada, you will first have to enter the International Access Code of the country you are calling from.
NOW! Access Your Medical Records Online
With our exclusive Traveler PDQ Service, you can assure that your important medical records are available to you or any Physician chosen by you, anytime, anywhere in the world, quickly, wherever internet access is available. The registration process takes just a few minutes. Register at your convenience at www.travelerpdq.com* or call, toll free 1-800-379-9887. It's free during your insured Trip! *Program Code 925i
Plan Designed & Marketed by:
TravelSafe
P.O. Box 7050
Wyoming, PA 19610-9783
Call: 888-885-7233
Fax: 800-303-6015
SCHEDULE OF COVERAGES
TravelSafe
Protect-A-Group Plan Benefits
Pre-Departure Trip Cancellation, Amount Purchased* (Maximum \$10,000)
Post-Departure Trip Interruption, Up To 150% Of Amount Purchased (Maximum \$15,000)
Travel Delay (12 Hours or More), \$150 Per Day \$750 Maximum
Medical Expense/Emergency Assistance; \$25,000
Accident & Sickness Medical Expenses; Included
Emergency Medical Evacuation; Included
Repatriation of Remains; Included
MEDEX 24-Hour Assistance Service; Included
Baggage and Personal Effects; \$1,000
Baggage Delay (24 Hours or More), \$200
Accidental Death and Dismemberment; \$25,000
*If you insure an amount less than your total prepaid
Trip costs that are subject to cancellation penalties
or restrictions, the maximum benefit for Pre-Departure
Trip Cancellation and Post-Departure Trip Interruption
will be limited to the amount of coverage you
purchased.
Availability
Persons eligible for insurance under this policy are U.S. residents.
Not available for Family group travel.