If an Insured Person is not eligible, this Certificate is void ab initio and all premium paid will be refunded. In order to be eligible and qualified for coverage under this insurance, a person must:

1. be a Full-Time Student or Scholar, the Spouse of the Full-Time Student or Scholar, or a Dependent traveling with the Full-Time Student or Scholar, and residing outside their Home Country for the purpose of pursing international educational activities including, but not limited to college course work, research, or teaching for a temporary period of time; and
2. at the time of the Effective Date, be physically residing in Host Country with the intent to reside there for at least thirty days; and
3. complete and sign an Application as the Insured Person (or be listed thereon by proxy as an applicant and proposed Insured Person), and/or as the Insured Person’s spouse and/or Child; and
4. pay the required Premium on or before the Effective Date of Coverage; and
5. receive written acceptance of his/her Application or renewal from the Company; and
6. be at least thirty one (31) days old but not yet sixty-five (65) years old; and
7. not be Hospitalized or Disabled on the Initial Effective Date; and
8. not be HIV+ on the Initial Effective Date.

Maximum Limit	Student: $500,000; Dependent: $100,000
Maximum Limit per Illness or Injury	Student: $300,000; Dependent: $100,000
Deductible	$100 per illness or injury Student health center: $5 copay per visit
Coinsurance	Outside of the U.S.: Company pays 100% In PPO network or student health center within the U.S.: Company pays 100% Out of PPO network if within the U.S.: Company pays 80% of eligible expenses up to $5,000; then 100% thereafter
Hospital Room and Board	Average semi-private room rate, including nursing service
Intensive Care	After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally
Emergency Room Injury	After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally
Emergency Room Illness resulting in Hospitalization	After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally
Emergency Room Illness without Inpatient Admission	After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally; Subject to additional $250 deductible
Mental or Nervous / Substance Abuse	Outpatient: $50 per day; $500 maximum limit; Inpatient: After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally up to $10,000 maximum limit; Student health center treatment: $0
Prescription Drugs	Inpatient: After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally Outpatient: 50% of actual charges 90 day dispensing maximum
Physical Therapy (Medical order or treatment plan required)	After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally; limit one visit per day
Local Ambulance	$350 per illness resulting in an inpatient hospitalization or injury
Dental	Non-emergency treatment at a dental provider due to an accident - $500 period of coverage limit per injury; Unexpected pain to sound, natural teeth - $350 period of coverage limit
Eligible Medical Expenses	After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally
Interfacility Ambulance Transfer (For services rendered in the U.S.)	Company pays 100%. Transfer must be a result of an inpatient hospital admission
Emergency Medical Evacuation	$500,000 maximum limit
Emergency Reunion	$50,000 maximum limit
Return of Mortal Remains	$50,000 maximum limit
Political Evacuation and Repatriation	$10,000 maximum limit
Intercollegiate/Interscholastic/Intramural or Club Sports	$5,000 period of coverage limit per illness or injury
Incidental Trip Coverage	Up to a cumulative 14 days (available for non-U.S. residents only)
Pre-existing Conditions	Charges excluded until after 12 months of continuous coverage
Terrorism	$50,000 maximum limit
AD&D	Student: $25,000 principal sum; Spouse: $10,000 principal sum; Dependent child: $5,000 principal sum Accidental dismemberment percentage of principal sum
Personal Liability (Secondary to any other insurance)	$10,000 combined maximum limit Injury to third person: subject to a $100 per injury deductible Damage to third person’s property: subject to a $100 per damage deductible

Maternity & Pre-Existing Condition Rider (Standard Plan Only):

Charges excluded until after 12 months of continuous coverage

Pre-Existing Condition Rider(Platinum Plan Only):

Charges excluded until after 6 months of continuous coverage

The Maternity & Pre-Existing Condition Rider is available for eligible participants. Under this rider, eligible medical expenses for pre-natal care, delivery, post-natal care, and care of newborns can be covered after the insured has maintained coverage continuously for 10 months and the pregnancy is a result of natural insemination. Eligible medical expenses relating to a pre-existing condition can be covered after the insured has maintained coverage continuously for 6 months.

Renewal of Coverage

Subject to the Terms of the Termination of Master Policy and Termination of Coverage for Insured Persons sections, an Insured Person whose initial Period of Coverage is at least three (3) months can request coverage under this insurance plan to be renewed monthly for up to 12 month periods and a maximum of sixty (60) continuous months in accordance with and subject to the Terms of the plan then in effect (including the Terms of the then applicable Master Policy) and so long as renewal Premium is paid when due and the Insured Person otherwise continues to meet the applicable eligibility requirements of the plan.

The Company’s commitment and the Insured Person’s ability to renew is also subject to termination upon thirty (30) days written notice to the other party prior to the expiration date of the then existing Period of Coverage. The Company reserves the right in its sole discretion to make changes, additions and/or deletions to the Terms of the Master Policy, this Certificate, renewals or replacements of either, and/or to the insurance plan (including the issuance of Riders to effectuate same) at any time or from time to time after the Effective Date of Coverage of this Certificate, upon no less than ninety (90) days prior written notice to the Assured and the Insured Person (“Notice of Amendment”). The Notice of Amendment shall include a complete description of the changes, additions and/or deletions to be made, the effective date thereof (the “Change Date”), and notice of the Insured Person’s cancellation rights as set forth below, and shall be sent first class mail, postage pre-paid, to the last known residence or mailing address of the Insured Person. Upon issuance of the Notice of Amendment, the Assured and/or the Insured Person shall have the right to request cancellation of this Certificate above, at any time prior to the Change Date; provided, however that cancellation under this section shall be at the option of the Insured Person, and coverage under this insurance shall terminate with effect from the cancellation date specified by the Insured Person (subject to the provisions of the Termination of Coverage for Insured Persons section. If the Insured Person does not elect to cancel this Certificate in accordance with the foregoing, the changes, additions and/or deletions as made by the Company and specified in said Notice of Amendment shall take effect as of the Change Date specified in the Company’s Notice, and this insurance shall thereafter continue in effect in accordance with its Terms, as so amended and modified.

Quality Guarantee

Your satisfaction is very important to IMG. If you are not pleased with this product for any reason, you may submit a written request, prior to your effective date, for cancellation and refund of your premium. You may cancel your plan after your effective date if you do not have any claims filed with IMG, however, the following conditions will apply:

1. you will be required to pay a $50 cancellation fee and
2. only full month premiums will be considered for refunds (e.g., if you choose to cancel your coverage two months and two weeks prior to the date your coverage ends, IMG will only consider the two full months for a refund). If you have filed claims, your premium is non-refundable.

Please send cancellation request at: cancel@imglobal.com and copy that email to us. Our email is given on Contact Us page.

PROOF OF CLAIM

When the Company receives notice of a claim for benefits under this insurance from or on behalf of an Insured Person it will provide the Insured Person with Claimant’s Statement and Authorization Forms (“Claim Forms”) for filing Proof of Claim. The following items must be submitted by or on behalf of the Insured Person to be considered a complete Proof of Claim eligible for consideration of coverage under this insurance (“Proof of Claim”):

1. a duly completed, timely submitted, and signed Claim Form and authorization for release of information; and
2. all original itemized bills and statements of services rendered from all Physicians, Hospitals and other healthcare or medical service providers involved with respect to the claim; and
3. all original receipts for any costs, fees or expenses that have been incurred or paid by or on behalf of the Insured Person with respect to the claim, including without limitation all original receipts for any cash and/or credit card payments.

The Insured Person and/or Physician, Hospital and other healthcare and medical service providers and suppliers shall have ninety (90) days from the date a claim is incurred to submit a complete Proof of Claim, and the Company at its option may pend resolution and adjudication of submitted claims and/or may deny coverage: for Proofs of Claim submitted thereafter; or for incomplete Proofs of Claim; and/or for failure to submit a Proof of Claim; provided, however, that the Company at its option may waive the requirements regarding submission of a new Claim Form for subsequent claims incurred by an Insured Person relating to a continuing Illness, Injury or other medical condition for which a properly completed and signed Claim Form has previously been submitted and received.

APPEALING A CLAIM

In the event the Company denies all or part of a claim, the Insured Person shall have a maximum of two mandatory appeal levels to appeal the denial under which there will be a review of the claim and the determination. Insured Persons shall have sixty (60) days from the date that the notice of denial was mailed to the Insured Person's last known residence or mailing address within which to appeal the determination, and shall have the opportunity to submit written comments, documents, records, and other information relating to the claim. The Company’s review will take into account all comments, documents, records, and other information submitted by the Insured Person relating to the claim, without regard to whether such information was submitted or considered in the initial claim determination. Insured Persons must file two (2) appeals of a claim denial prior to bringing any legal action under the contract of insurance. Upon receipt of a written appeal, the Company shall have an opportunity for further reasonable investigation and/or review as set forth in the Explanation or Verification of Benefits section, and will respond in writing as soon as reasonably practicable, and in any event within ninety (90) days from receipt thereof.

CLAIM SETTLEMENT:

Eligible and covered claims for ELIGIBLE MEDICAL EXPENSES or other benefits under this insurance that have previously been paid by or on behalf of the Insured Person at the time of the Company’s favorable adjudication thereof will be reimbursed by the Company directly to the Insured Person, by check, at his/her last known residence or mailing address. While this insurance is in effect, in order to effectuate proper administration the Insured Person shall undertake to promptly notify the Company of any change in such addresses. Eligible and covered claims for ELIGIBLE MEDICAL EXPENSES or other benefits under this insurance that have not been paid by or on behalf of the Insured Person at the time of adjudication will be paid by the Company by check or electronic funds transfer to the Insured Person at his/her last known residence or mailing address, or, at the sole option and discretion of the Company (but without obligation to do so), and as an accommodation to the Insured Person, directly to the provider(s), as applicable. All claim settlements, payments and reimbursements are subject to the insurance plan shown in the Declaration and all other Terms of this insurance. No healthcare or medical service provider or supplier, or any other third-party, shall have any direct or indirect interest, claim or right of action against the Company under this Certificate, the Declaration or the Master Policy, whether by purported assignment of benefits, subrogation of interests or otherwise, unless first expressly agreed and consented to in writing by the Company, and notwithstanding the Company’s exercise or failure to exercise any option or discretion under this provision regarding the method of claim payment. No such provider, supplier or other third-party is intended to have or shall have any rights as a third-party beneficiary under this Certificate, the Declaration, or the Master Policy.

FRAUDULENT CLAIMS:

A person who knowingly and with intent to defraud the Company files a statement of claim containing any false, incomplete, or misleading information commits a felony. If any claim or request for benefits under this insurance shall knowingly be in any respect false, incomplete, misleading, concealing, fraudulent or deceitful, or if the Insured Person or anyone acting for or on his/her behalf under this insurance knowingly uses any false, incomplete, misleading, concealing, fraudulent or deceitful statements regarding the Insured Person, the insurance contract and all coverage thereunder may be cancelled, voided, rescinded and terminated by the Company in its sole and absolute discretion, and the Company shall have no obligation or liability for any such benefits, coverage or claims.