Plan Administrator: USI Affinity Travel Insurance Services | AM Best Rating: A+ "Superior" | Underwriter: Lloyd's of London
Age and Policy Maximum |
Age 0-65 :3,00,000 |
Doctor Visit | Up to the overall maximum limit |
Surgical Treatment | Up to the overall maximum limit |
Hospital Room and Board | Average semi-private room rate, including nursing services. |
Ambulance | Up to $350 per injury or illness, when covered illness or injury results in hospitalization as inpatient. - not subject to coinsurance |
Prescription | Generic Drugs: $10 deductible per prescription Brand Name Drugs: $20 deductible per prescription |
Complete details are given in certificate of insurance.
Complete details are given in certificate of insurance.
Any (1) condition for which medical advice, diagnosis, care, or treatment (includes receiving services and supplies, consultations, diagnostic tests or prescription medicines) was recommended or received during the 12 months immediately preceding the Certificate Effective Date; (2) condition that had manifested itself in such a manner that would have caused a reasonably prudent person to seek medical advice, diagnosis, care, or treatment (includes receiving services and supplies, consultations, diagnostic tests or prescription medicines) within the 12 months immediately preceding the Certificate Effective Date; (3) injury, illness, sickness, disease, or other physical, medical, mental, or nervous conditions, disorder or ailment (whether known or unknown) that, with reasonable medical certainty, existed at the time of application or within the 12 months immediately preceding the Certificate Effective Date.
To comply with the United States Preferred Provider Organization requirements, the Member must receive medical treatment from PPO providers while in the United States. If the Member chooses to comply with the PPO requirements, and the expenses are incurred in a PPO provider, Underwriters will waive the Coinsurance applicable to the expenses.Members may review a listing of Hospitals, Physicians and other medical service providers included in the PPO Network for the area where the Member will be receiving treatment by accessing the Internet website for HCC Medical Insurance Services.
When Underwriters receive notice of claim, they will provide the Member with forms for filing Proof of Claim. The following is considered to be Proof of Claim:
The Member shall have 60 days beginning on the last day of the Certificate Period to submit Proof of Claim to Underwriters, unless medical services were rendered after the Certificate Termination Date, in which case the Member shall have 60 days from the date the claim is incurred to submit Proof of Claim to Underwriters.
Time Limit – In the event Underwriters deny all or part of a claim under this insurance, the Member shall have 90 days from the date notice
Appeal Procedure – Within 60 days of Underwriters’ receipt of the appeal, Underwriters’ will review the claim. A written response will be forwarded to the Member.