|
Extraordinary Vacation Protection
TERMS AND
CONDITIONS:
|
|
The following
describes all of the terms, conditions and
definitions of the membership and service contract you have purchased.
Please read it carefully.
Should you decide to cancel this service
contract you may do so in writing within ten (10) days of the date of
purchase unless your trip has departed. If canceled as described, you
will receive a complete refund.
To be eligible for this service you must be
a citizen or resident of the United States or Canada.
Services begin only when full payment has
been received and your enrollment is accepted at our office in
Tennessee. Membership is non-transferable and once accepted,
non-refundable unless canceled as described above. If trip cancellation
is included in your plan, that benefit is in force for you at 12:01 am
the day following receipt of full payment and acceptance by Us. All
other services and benefits begin on the date of your departure and end
on the earlier of the actual date of your return or the scheduled date
of your return as reported to us on your application for membership
services. Under no circumstances will reimbursement be made to you if
you are traveling to receive medical care, medication or treatment if
the travel dates you submitted on your application do not reflect your
actual departure and return dates, if your tickets do not indicate the
travel dates, if you give incorrect data or facts or if your request for
service is not submitted to us within 30 days from the date of loss
except as otherwise prohibited by law.
Trip
Cancellation/Interruption:
This benefit is
provided up to the amount purchased for unused, non-refundable prepaid
expenses for travel arrangements if you are prevented from taking your
trip for any of the following reasons that occur after this plan
is in effect for you:
-
If you or a traveling
companion (who has also purchased this plan) or an immediate family
member suffers an injury, sickness, or death,
-
Is hijacked,
quarantined,
-
Required to serve on
a jury,
-
Called to active duty
in the military,
-
Subpoenaed as a
witness in a legal action in which you or your traveling companion are
not a party.
-
Have a home made
uninhabitable by fire, flood, earthquake or other natural disaster,
-
Are directly involved
in a documented traffic accident while en route to point of departure,
-
The filing of
bankruptcy and complete cessation of service by your travel supplier
provided you purchase this plan within 14 days of your initial trip
deposit and that the bankruptcy filing occurs more than 15 days after
full payment and acceptance of your enrollment by Us. In the event of
bankruptcy we reserve the right to substitute a trip of similar value
in lieu of cash payment,
-
Terrorism in a
country which is part of your trip which causes the United States
Department of State to issue a Travel Warning that you should not
travel to that country for a period of time that would include your
trip.
-
The additional cost
you may incur as a result of a change in the per person occupancy rate
should your traveling companion cancel their trip for a covered reason
and you do not.
Benefits will be paid up to the total trip
cost not to exceed the maximum benefits purchased provided the
total cost of the trip has been included in the cost of the plan.
You must be medically capable of travel
on the date you purchased your trip and the date you purchase this plan.
If canceling for a medical reason, it must be the written opinion of the
treating Physician, that the event causing cancellation was unforeseen,
occurred after the purchase of this plan and is so disabling as to cause
a trip to be canceled or interrupted. Unforeseeable sickness or injury
requires that you be examined by a licensed medical doctor prior to the
cancellation or interruption of your trip.
Trip interruption benefits include unused,
non-refundable land or sea expenses prepaid to your travel supplier for
your trip and/or the airfare paid, less the value of applied credit from
an unused return travel ticket to return to your departure city
Additional benefits also include the cost of reasonable additional
accommodations and transportation expenses incurred to remain near a
traveling companion who is hospitalized during your trip not to exceed
$l00) per day or the total amount you prepaid for your trip.
You must advise your travel supplier and
Us within 72 hours or as soon as reasonably possible of an event that is
likely to cause a request for service. Under no circumstances will
benefits be paid for additional charges incurred as a result of your
failure to notify these parties. If your travel plans involve air
tickets purchased in addition to your tour or cruise, you must notify
the airline of your cancellation as well.
"Cancel for Any Reason":
In the event you or a traveling companion
are prevented from taking your trip for any reason and have purchased
this option you will receive a voucher for the value of all
non-refundable cancellation charges imposed by your travel supplier,
cruise line or airline minus a twenty (20%) percent processing fee.
(If purchased within 14 days of travel, the payment increases to
the value of all non-refundable cancellation charges imposed by your
travel supplier, cruise line or airline minus a fifteen (15%) percent
processing fee in this case.)
Benefits will be paid up to a $10,000 maximum.
Your travel voucher is payable for a period
of one year (12 months) from the date of your original trip
cancellation, is not transferable or refundable and must be used with
the travel supplier from whom you originally purchased your canceled
trip.
Trip Delay/Missed Connection:
We will provide reimbursement up to the
Maximum Benefit Amount for:
a) Additional Transportation Cost to join
the Trip or return home, including up to $150 per day for reasonable
accommodations and meals, if Your delay requires an unplanned overnight
stay; and/or
b) unused, non-refundable portion of the
prepaid expenses as long as the expenses are supported by proof of
purchase and are not reimbursable by any other source.
Delay must be 10 hours or more and
certified due to the following reasons: 1) Delay of Common Carrier
(which is certified by the Common Carrier); 2) A traffic accident in
which You were not directly involved (substantiated by a police report);
3) Documented weather condition preventing You from getting to the point
of departure; 4) Organized Labor Strike, natural disaster, Terrorist
Incident, riot, or You or Your Traveling Companion being hijacked or
quarantined.
You must notify us as soon as you know
your trip is going to be delayed more than 10 hours. Failure to do so
may affect reimbursement.
Medical Expense:
We will provide reimbursement up to the
Maximum Benefit Amount for: Expenses incurred as a result of an Injury
which occurs or a Sickness which first manifests itself during the Trip.
Benefits will include expenses for emergency dental treatment for injury
to sound natural teeth not to exceed $750 only during your trip. No
reimbursement will be provided for any dental treatment or expenses
incurred after you reach your return destination regardless of the
reason. Coverage for this benefit is primary for all care received
outside of the United States and secondary to all other valid and
collectible coverage for care received within the 50 United States.
Medical
Evacuation/Repatriation:
You are covered up to the Maximum Benefit
Amount purchased for:
Medical Evacuation which is determined by a
Legally Qualified Physician and the authorized Assistance Company’s
medical director that an Injury or Sickness is acute or life threatening
and adequate treatment is not available at a local Hospital.
Transportation will be to the closest Hospital or medical facility
capable of providing adequate treatment
Medical Repatriation when it is deemed
Medically Necessary by a Legally Qualified Physician and the authorized
Assistance Company for You to return home or to a Hospital near Your
home for continued treatment. Transportation Expense incurred will be
paid for You; a) to return to Your permanent residence or b) to be moved
to a Hospital or medical facility closest to Your permanent place of
residence capable of providing that treatment; via one-way, Economy
Transportation; or commercial upgrade, based on Your condition as
recommended by the local attending Legally Qualified Physician and the
authorized Assistance Company;
Repatriation of Remains: In the event
of covered death of You, occurring during the Trip, the Company will pay
either the cost of the actual expense incurred for preparation, standard
container and transportation of the body or ashes of You to the outbound
point of departure or for the reasonable cost for burial or cremation
abroad, in either case not to exceed $ 5,000.
Transportation for the return trip home via
Economy Transportation for any dependent children under age 18 who are
accompanying You if You are confined to a Hospital for more than 7
consecutive days. If You are traveling alone and are confined to a
Hospital for more than 7 consecutive days, this benefit will provide,
upon request by You or next of kin, one round-trip Economy
Transportation for a person of Your choice to visit You in the Hospital.
These benefits provide Economy
Transportation which must be by the most direct route. Covered land or
air transportation includes, but is not limited to, commercial
stretcher, medical escort, or the Usual and Customary Charges for air
ambulance, provided such transportation has been pee approved and
arranged by the authorized Assistance Company.
Benefits are paid less the value of an
unused return travel ticket. If benefits are payable under this coverage
and You have other insurance that may provide benefits for this same
loss, Extraordinary Vacation Protection reserves the right to recover from
such other insurance.
If benefits are payable under MEDICAL
EVACUATION I REPATRIATION and You have other insurance that may provide
benefits for this same loss, Extraordinary Vacation Protection (Company)
reserves the right to recover benefits from such other insurance. You
shall: I) notify the Company of any other insurance; 2) cooperate with
the Company to exercise the Company’s rights in any reasonable way that
the Company may request, including the filing and assignment of other
insurance benefits; 3) not do anything after the loss to prejudice the
Company’s rights; and 4) reimburse to the Company, to the extent of any
payment the Company has made, for benefits received from such other
insurance.
All medical transportation services must
be authorized in advance and organized by our designated assistance
provider. In the event that the medical transportation services are not
authorized in advance and organized by our designated assistance
provider, no reimbursement will be provided for this benefit.
Travel Assistance Services are provided by
an independent organization and not by Extraordinary Vacation Protection.
There may be times when circumstances beyond the assistance provider’s
control hinder their endeavors to provide Travel Assistance Services.
They will however make all reasonable efforts to provide Travel
Assistance Services and help You resolve Your emergency situation.
Travel Assistance provides a variety of travel related services.
Baggage and Personal Effects:
You are covered up to the Maximum Benefit
Amount for lost, stolen. or damaged baggage or personal items with a
maximum reimbursement of up to $250 per article. A combined maximum of
$500 will be paid for jewelry, watches, articles consisting in whole or
in part of silver, gold or platinum, articles trimmed with fur, cameras
and their accessories and related equipment. In addition. the following
reimbursements will apply: 1) lost or stolen passport or visa ($50
maximum); 2) lost or stolen credit cards ($50 maximum for the cost
associated with unauthorized use subject to verification that You has
complied with all conditions of the credit card company).
The lesser of the following amounts will be
paid: 1) the actual cash value (coat less proper deduction for
depreciation) at the time of loss, theft or damage; 2) the cost to
repair or replace the article with material of a like kind and quality;
or 3) $250 per article.
Benefits will not be paid for any expenses
which have been reimbursed or for any services which have been provided
by the Common Carrier, hotel or Travel Supplier; nor will benefits be
paid for loss or damage to property specifically scheduled under any
other insurance.
Baggage Delay:
If Your checked baggage is delayed or
misdirected by a Common Carrier while on Your Trip for more than 24
hours from Your time of arrival at the destination other than Your
residence, You are covered for the expense of necessary purchases of
personal items up to the Maximum Benefit Amount as long as the expense
is substantiated by receipts for purchases. The Common Carrier must
certify the delay.
For Baggage & Baggage Delay: Benefits
are not payable for animals; automobile and automobile equipment, boats
or other vehicles or conveyances, trailers, motors, aircraft, bicycles
(except when checked as baggage with a Common Carrier); household
effects and furnishings, antiques and collector’s items; sunglasses or
glasses (prescription or non-prescription), contact lenses; artificial
teeth, dental bridges; hearing aids; prosthetic limbs; prescribed
medications; keys; money, credit cards, tickets and documents (except as
coverage is otherwise specifically provided herein), securities; stamps;
professional or occupational equipment or property whether or not
electronic business equipment, telephones, computer hardware or
software.
Exclusions:
No benefits will be paid for Sickness,
Injuries or losses of You and Your Traveling Companion caused by or
resulting from:
a) Suicide, attempted suicide, or any
intentionally self-inflicted Injury while sane or insane (in Missouri,
sane only);
b) Resulting from a Terrorist Incident
(except as specifically provided elsewhere in the policy), hostilities
or an act of declared or undeclared war;
c) While participating in maneuvers or
training exercises of an armed service;
d) While riding, driving or participating in
races, or speed or endurance contests;
e) While mountaineering (engaging in the
sport of scaling mountains generally requiring the use of picks, ropes
or other special equipment);
f) While participating as a member of a team
in an organized sporting competition;
g) While participating in skydiving, hang
gliding, bungee cord jumping, scuba diving or deep sea diving;
h) While piloting or learning to pilot or
acting as a member of the crew of any aircraft;
i) Received as a result or consequence of
being Intoxicated or under the influence of any controlled substance
unless administered on the advice of a Legally Qualified Physician;
j) To which a contributory cause was the
commission of or attempt to commit a felony or being engaged in an
illegal occupation;
k) Resulting from a governmental regulation
or prohibition;
1) Unless medically fit to travel at the
time of purchase of this plan;
m) Relating to a diagnosed Sickness from
which no recovery is expected and for which only palliative treatment is
provided and which carries a prognosis of death within 12 months of the
policy Effective Date;
n) Resulting from non-physical Sickness such
as mental, nervous, emotional or psychological disorders in any form
whatsoever.
o) Due to normal childbirth, normal
pregnancy or voluntarily induced abortion;
p) For dental treatment (except as coverage
is otherwise specifically provided herein);
q) Where coverage has been purchased for
travel to or through countries for which travel warnings have been
issued by the United States Department of State at the time this plan
was purchased; or a) resulting from the intentional release of a
biological material.
For residents of California, benefits are
not payable if during the 60 days prior to Your Effective Date, a
Legally Qualified Physician advised You or Your Traveling Companion not
to travel due to a Sickness or injury.
r) Business, contractual or educational
obligations.
s) Elective treatment or procedures.
General
Plan Provisions:
Plan Costs and Fees: All protection plan
costs and fees are non-refundable. In the event the plan cost paid for
coverage is less than the required plan cost for coverage, benefits may
be paid in direct proportion of the actual amount paid to the required
plan cost due.
Medical Records: In the event of a claim,
the Company reserves the right to review any and all of Your medical
records, whether or not the contents of such records were made known to
You.
Duplicate Coverage: If You have two
or more Protection Plans with the Company that duplicate benefits, You
will be paid up to the highest benefit amount under only one plan for
each Covered Trip.
Coordination of Benefits: If a member
is entitled to similar benefits through any other
insurer the benefits payable under this plan
shall be coordinated so that total benefits from all insurers shall not
exceed the actual loss incurred.
Errors or Mis-payments: If any
benefit is paid in error or payment is made in excess of the amount
allowed under the provisions of this plan, the Company reserves the
right to recover the excess or ineligible payment from You, Your estate,
any institution, insurer or person to whom the payment was made.
Currency: All monies described in
this plan are expressed in United States of America
Notice to Residents of Florida: The Benefits
of the Plan are governed primarily by the law of a state other than
Florida. Your homeowners policy, if any, may provide coverage for loss
of personal effects provided by the Baggage and Personal Effects
coverage.
Note: This plan contains health insurance
benefits that only apply during your Trip. You may have coverage from
other sources that already provide You with these benefits. You should
review Your existing policies. If you have any questions about Your
current coverage, call Your insurer or health plan provider.
Protection Plan Definitions:
“Additional Transportation Cost”
means the actual cost incurred for one-way. Economy Transportation by
Common Carrier reduced by the value of an unused travel ticket.
“Baggage and Personal Effects” means
goods being used by You during a Covered Trip. (See WHAT IS NOT
COVERED.)
“Business Partner” means an
individual who: a) is involved in a legal general partnership with You;
and b) is actively involved in the day-to-day management of Your
business.
“Common Carrier” means any public
land, air or water conveyance operating under a valid license providing
for the transportation of passengers for hire.
“Covered Expense” means expense
incurred for services and supplies: a) listed below; and b) ordered or
prescribed by a Legally Qualified Physician as Medically Necessary for
diagnosis or treatment; which are limited to: the services of a Legally
Qualified Physician; Hospital or ambulatory medical-surgical center
services (this will also include expenses for a cruise ship cabin or
hotel room, not already included in the cost of Your Covered Trip, if
recommended as a substitute for a hospital room for recovery of an
Injury or Sickness); transportation furnished by a professional
ambulance company to and/or from a Hospital; and prescribed drugs,
prosthetics and therapeutic services and supplies.
“Covered Trip” means scheduled trips,
tours or cruises for which: a) coverage is requested; and b) the
required plan cost is paid prior to final payment.
“Economy Transportation” means the
lowest published available transportation rate for a ticket on a Common
Carrier matching the original class of transportation that You purchased
for the Covered Trip, reduced by the value of an unused return travel
ticket.
“Eligible Person” means a resident of
the United States or a person who purchases this plan within the United
States.
“Family Member” means You or Your
Traveling Companion’s: legal spouse or common-law spouse (where legal),
legal guardian, legal ward, son or daughter (adopted, foster, step or
in-law), brother or sister (includes step or in-law), parent (includes
step or in-law), grandparent (includes in-law), grandchild, aunt, uncle,
niece, nephew provided the Family Member resides in the United States,
Canada or Mexico.
“Hospital” means: a) a place which is
licensed or recognized as a general hospital by the proper authority of
the state in which it is located; b) a place operated for the care and
treatment of resident inpatients with a registered graduate nurse (RN)
always on duty and with a laboratory and an x-ray facility; c) a place
recognized as a general hospital by the Joint Commission on the
Accreditation of Hospitals. Not included is a Hospital or institution
licensed or used principally: 1) for treatment or care of drug addicts
or alcoholics; or 2) as a clinic, continued or extended care facility,
skilled nursing facility, convalescent home, rest home, nursing home or
home for the aged.
“Inclement Weather” means any weather
condition which delays the scheduled arrival or departure of a Common
Carrier.
“Injury” or “Injuries” mean
accidental bodily Injuries received while covered under this plan and
prior to Your scheduled return date and resulting in loss independently
of Sickness and all other causes and certified by a Legally Qualified
Physician.
“Intoxicated” means a blood alcohol
level which equals or exceeds the legal limit for operating a motor
vehicle in the state or jurisdiction where You are located at the time
of an incident.
“Legally Qualified Physician” means a
physician or a Christian Science Practitioner: a) other than You, a
Traveling Companion or a Family Member; b) practicing within the scope
of his or her license; and c) recognized as a physician in the place
where the services are rendered.
“Maximum Benefit Amount” means the
maximum amount payable for each coverage as shown on the Schedule of
Benefits.
“Medical Treatment” means treatment,
advice or consultation by a Legally Qualified Physician.
“Medically Necessary” means a service
or supply which: a) is recommended by the attending Legally Qualified
Physician; b) is appropriate and consistent with the diagnosis in
accordance with accepted standards of community practice; c) could not
have been omitted without adversely affecting Your condition or quality
of medical care; d) is delivered at the most appropriate level of care
and not primarily for the sake of convenience; and e) is not considered
experimental unless coverage for experimental service or supplies is
required by law.
“Organized Labor Strike” means any
stoppage of work; a) as a result of a combined effect of workers which
was unannounced and unpublished at the time this plan was purchased; and
b) which interferes with the normal departure and arrival of a Common
Carrier.
“Scheduled Departure Date” means the
date on which You are originally scheduled to leave on Your Trip.
“Scheduled Return Date” means the
date You are originally scheduled to return to the point of origin or
the original final destination,
“Sickness” means an illness or
disease which is diagnosed or treated by a Legally Qualified Physician
after the Effective Date of Your plan and while You are covered under
this plan.
“Terrorist Incident” means the
unsanctioned and illegal use of violence which caused destruction of
property, injury or death by an individual or group for the express or
implied purpose of achieving a political, ethnic, or religious goal or
result. A Terrorist Incident does not include general civil disturbance,
rioting, an act of war (declared or undeclared) or the intentional
release of a biological material. The Terrorist Incident must be
documented in a travel warning issued by the United States Department of
State advising that one should not travel to Your country of destination
or, for U.S. cities, reported by the major news media.
“Transportation Expense” means: a)
the cost of the conveyance of You and any medical personnel (if
Medically Necessary); and b) Medically, Necessary services and supplies.
“Traveling Companion” means a person
or persons, up to a maximum of 4 people, with whom a covered person is
sharing the same room accommodations.
“Travel Supplier” means any entity or
organization that coordinates or supplies travel services for You.
“Unforeseen” means circumstances
occurring after the effective date of this plan.
“Usual and Customary Charges” means
those comparable charges for similar treatment, services and supplies in
the geographic area where treatment is performed.
“You” or “Your” means an individual
who has purchased a Trip and for whom the required rate for this
Protection Plan has been paid.
Filing a Claim is Simple:
To receive a claim
form: Within 30 days of your loss, call 1-888-707-0213, or send Your
name, address, travel dates, details of Your loss along with the ID# to:
Extraordinary Vacation Protection,
Services Department,
110 S. First Street,
Suite 1,
Dekalb, IL 60115
IMPORTANT:
To provide prompt reimbursement, you will be
asked to provide proof of your loss within 30 days after the date of
loss or as soon as is reasonably possible. Proof must however be
furnished no later than 6 months from the time of loss, except in the
absence of legal capacity. Benefits under this plan will not be paid for
expenses reimbursed or services provided by any other source. Benefits
cannot be duplicated under this Protection Plan.
All suits, actions or legal proceedings
arising from the programs, benefits, or services provided through the
programs (collectively “Controversies”) may be submitted to binding desk
arbitration in accordance with the rules then applying to the American
Arbitration Association. No demand for arbitration can be brought to
recover benefits until 60 days have elapsed following submission of Your
entire request for service to Extraordinary Vacation Protection.
|