Eligibility

Liaison® provides coverage as outlined in this Certificate of Insurance for You while traveling outside of Your Home Country. For United States Citizens, “Home Country” is always the United States. Eligible individuals may also purchase coverage for their Spouse, Traveling Companions, and Child(ren). It is Your responsibility to maintain all records regarding travel history and age and to provide any documents to the Administrator necessary to verify eligibility requirements.

Effective Date of Coverage

The date coverage for You begins under the terms of the Certificate, which begins at the later of the following times:

(i) 12:00 a.m. United States Eastern Time on the date after the Company receives Your application and correct premium payment if application and payment is made online or by fax;

(ii) 12:00 a.m. United States Eastern Time on the day after the postmark date of Your application and correct premium payment if application and payment is made by mail;

(iii) The moment You depart Your Home Country; or

(iv) 12:00 a.m. United States Eastern Time on the date You request on Your application. Expiration Date of Coverage

(i) The moment You return to Your Home Country except as provided under Sections 3.8 and 3.9;

(ii) 11:59 p.m. United States Easter Time on the date of attainment of the Maximum Period of Coverage;

(iii) 11:59 p.m. United States Eastern Time on the date shown on Your ID card;

(iv) 11:59 p.m. United States Eastern Time on the date that is the end of the period for which the Plan premium has been paid; or

(v) The moment You fail to be eligible

INSURANCE COMPANY

Physical Examination and Autopsy

The Company at its own expense will have the right and opportunity to examine the person of any Insured Person whose Injury or Illness is the basis of a claim when and as often as the Company may reasonably require during the pendency of a claim hereunder and to make an autopsy in case of death where it is not forbidden by law.

Assignment

No transfer or assignment of any of Your rights, benefits, or interests under this Certificate will be valid, binding upon, or enforceable against the Company unless agreed to in writing by the Company.

Subrogation

To the extent the Company pays for a loss suffered by You, the Company will take over the rights and remedies You had relating to the loss. This is known as subrogation. You must help the Company to preserve its rights against those responsible for the loss. This may involve signing any papers and taking any other steps the Company may require. If the Company takes over Your rights, You must sign an appropriate subrogation form supplied by the Company.

Misrepresentation and Fraud.

The Company explicitly relies on Your Application and the information contained in it in order to determine whether such individual meets the eligibility requirements for the issuance of a Certificate. Any misstatement, misrepresentation, concealment, omission, or fraud in Your Application will render Insurance for each Insured Person null and void from issuance, and no coverage will be afforded to such Insured Person under any circumstances.

The Company explicitly relies on statements made You in connection with all claims under this Certificate in order to determine whether or not and to what extent benefits under this Insurance are payable. Any misstatement, misrepresentation, concealment, omission, or fraud by You relating to any claim hereunder shall render the Insurance for each Insured Person null and void from issuance, and no coverage will be afforded to such Insured Person under any circumstances.

Nothing in this Section 9.14 shall in any way effect any other remedies available to the Company with respect to any misstatement, misrepresentation, concealment, omission, or fraud by an Insured Person.

Patient Protection and Affordable Care Act (“PPACA”).

THE INSURANCE PROVIDED HEREUNDER IS NOT SUBJECT TO, IS NOT INTENDED TO COMPLY WITH, AND DOES NOT PROVIDE ALL BENEFITS REQUIRED BY PPACA. THIS INSURANCE IS NOT QUALIFYING HEALTH COVERAGE (“MINIMUM ESSENTIAL COVERAGE”) THAT SATISFIES THE HEALTH CARE COVERAGE REQUIREMENT OF PPACA. IF AN INSURED PERSON DOE NOT HAVE MINIMUM ESSENTIAL COVERAGE, HE OR SHE MAY OWE AN ADDITIONAL PAYMENT WITH HIS OR HER TAXES. INSURED PERSONS ARE RESPONSIBLE FOR DETERMINING IF AND HOW PPACA IS APPLICABLE TO HIM OR HER AND SHOULD CONSULT HIS OR HER OWN TAX ADVISORS. NEITHER THE COMPANY NOR THE ADMINISTRATOR SHALL HAVE LIABILITY WHATSOVER FOR AN INSURED PERSON’S FAILURE TO OBTAIN PPACA-COMPLIANCE COVERAGE.

SCHEDULE OF BENEFITS

All benefits listed in this Schedule of Benefits are in UNITED STATES Dollar amounts. All Medical and Dental benefits are subject to Deductible and Coinsurance. Also, all benefits except Loss of Checked Baggage are per Person per Period of Coverage.

Benefit or Service Choice
COVERAGE LENGTH 5 days to 364 days
Coverage Area Worldwide "Excluding" the United States Worldwide "Including" the United States
Medical Maximum Options

Worldwide “Including” the United States as indicated on the attached rate sheets:

Ages     Available Benefit Maximums

14 days to 69 :    $50,000; $100,000; $500,000; $1,000,000; $2,000,000; $5,000,000

70-79:     $50,000

Ages 80+:     $15,000

Worldwide “Excluding” the United States as indicated on the attached rate sheets:

Ages     Available Benefit Maximums

14 days to 69 :    $50,000; $100,000; $500,000; $1,000,000; $2,000,000; $5,000,000

70-79:     $50,000 or $100,000

Ages 80+:     $15,000

Deductible Options (You Pay) $0; $100; $250; $500; $1,000; $2,500; $5,000
Coinsurance Options (The plan pays) Outside the United States: 100% Inside the United States In PPO Network: 90% of the first $5,000, then 100% up to the Medical Maximum Out of PPO Network: 80% of the first $5,000, then 100% to the Medical Maximum
Hospital Room & Board URC Up to Plan Maximum
Inpatient Hospital Services URC Up to Plan Maximum
Outpatient Hospital / Clinical Services URC Up to Plan Maximum
Emergency Room Services URC Up to Plan Maximum
Doctor's Office Visits URC Up to Plan Maximum
Prescription Drugs URC Up to Plan Maximum
Home Healthcare $2,500
Local Ambulance Benefit: $10,000
Hospital Indemnity (Outside the United States & Canada) $150 per day to a maximum of 30 days
Coma Benefit $25,000 (separate from the Medical Maximum)
Precertification – 25% penalty Required in the United States Penalty does not apply to emergency
Extension of Benefits to Home Country $10,000
Incidental Trips to Home Country $10,000
Waiver of Pre-existing Condition: United States Residents outside of the United States Age 0-69: $50,000 Age 70 & over: $10,000
Acute Onset of a Pre-existing Condition: Non-United States Residents traveling to the United States Age 0-69: $30,000 Age 70 & over: $5,000
Dental - Sudden Relief of Pain: $200
Dental - Accident: $5,000
Emergency Medical Evacuation & Repatriation: $500,000 (separate from the Medical Maximum)
Emergency Medical Reunion: Up to $200 per day / $50,000 maximum limit
Return of Child(ren): $50,000
Return of Mortal Remains $50,000
Local Burial or Cremation $50,000
Natural Disaster Evacuation $50,000
Natural Disaster Daily Benefit $100 per day, 5-day limit
Political Evacuation & Repatriation $10,000
Felonious Assault $10,000 (separate from the Medical Maximum)
Terrorism $50,000
24/7 TRAVEL ASSISTANCE SERVICES Included
Accidental Death and Dismemberment (AD&D) $25,000 Primary Insured or Travel Companion $5,000 Child Aggregate Limit of $250,000 for Total Number of Insureds on Plan
Common Carrier Accidental Death and Dismemberment $50,000 Primary Insured or Travel Companion $10,000 Child Aggregate Limit of $250,000 for Total Number of Insureds on Plan
Loss of Checked Luggage Up to $50 per article / $500 per occurrence maximum
Trip Interruption $5,000
Personal liability $50,000
Hazardous Activities (Optional) Up to Plan Maximum
Benefit Period 180 Days

BENEFIT PERIOD AND HOME COUNTRY COVERAGE

Benefit Period: The amount of time You have as set forth in the Schedule of Benefits from the date of Your Injury or Illness to receive Treatment. If Your Period of Coverage ends during your Benefit Period, You can still receive Treatment if You are outside Your Home Country. If You have returned to Your Home Country, there is limited coverage under Extension of Benefits in Home Country.

Extension of Benefits in Home Country. The Company will reimburse You for Covered Expenses incurred in Your Home Country, including those incurred in Your Home Country following an Emergency Medical Evacuation or an Emergency Medical Repatriation, up to the amount set forth in the Schedule of Benefits for one hundred and eighty days (180) from the onset of a new, covered Injury or Illness that begins while You are traveling and is first diagnosed and treated outside Your Home Country. The Deductibles and the selected Coinsurance option set forth in Section 3.1 apply to this coverage and will be Your responsibility. This coverage does not apply for Pre-Existing Conditions. The exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 3.8.

Incidental Trips to Home Country. If the Period of Coverage is greater than thirty (30) days, the Company will reimburse You for Covered Expenses up to the amount set forth in the Schedule of Benefits for a new covered Injury or Illness that begins while You are on an incidental trip to Your Home Country. You must first depart Your Home Country before utilizing this benefit, and it does not apply to the final trip to Your Home Country. You may be required to provide proof of your travel intentions. Additionally, this coverage will not apply (i) if the Illness began or Injury occurred while You were outside Your Home Country or (ii) for Pre-Existing Conditions. Under this Section 3.9, You will receive five (5) days of coverage per month of coverage purchased up to a maximum of sixty (60) days per three hundred and sixty-four (364) days of purchased coverage. This coverage will apply separately for each three hundred sixty-four (364) day period, which means that any unused days of coverage from the prior three hundred sixty-four (364) day period(s) will not carry over to the any subsequent three-hundred sixty-four (364) day period, but, instead, you will start earning days of coverage over again. The exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 3.9.

The limit for this coverage is that amount shown on the Schedule of Benefits under “Incidental Trips to Home Country,” not that amount shown for “Medical Maximum Options.” The Deductibles and the Coinsurance option set forth in Section 3.1 apply to this coverage and will be Your responsibility.

MEDICAL

Deductibles and Coinsurance

Subject to Section 1.4, the Deductible and Coinsurance are per person and per Period of Coverage. They are applied to Covered Expenses and must be paid by You prior to receiving payment or reimbursement of benefits under this Certificate. In no event will the Company's maximum liability exceed the amount set forth in the Schedule of Benefits.

Deductible

The Deductible is set forth in the Schedule of Benefits. It is separate from and does not include Coinsurance.

Coinsurance Inside the United States:

See the Schedule of Benefits.

Coinsurance Inside the United States:

See the Schedule of Benefits.

Medical Covered Expenses

Subject to the terms of the Certificate, the Company will reimburse You for Covered Expenses up to the Medical Maximum shown in the Schedule of Benefits for the following medical Expenses that are incurred as the result of and within the Benefit Period:

(a) Hospital Expenses for room and board that do not exceed the Hospital’s average charge for semiprivate accommodations, Inpatient Treatment, Surgery, operating room, Intensive Care, nursing services, and services and supplies routinely provided by the Hospital to Inpatients;

(b) Outpatient Treatment or Surgery;

(c) Administration of anesthetics;

(d) Medication, x-ray services, laboratory tests and services, use of radium and radioactive isotopes, oxygen, blood transfusions, and iron lungs;

(e) Dressings, drugs, and medicines that can only be obtained upon a written prescription of a Physician or Surgeon;

(f) Physical therapy if recommended by a Physician for the Treatment of a specific Disablement and if administered by a licensed physical therapist;

(g) Hotel room when the Insured Person, otherwise necessarily confined in a Hospital, is under the care of a duly-qualified Physician in a hotel room due to unavailability of a Hospital room due to capacity or distance or to any other circumstances beyond the reasonable control of the Insured Person;

(h) Artificial limbs, eyes, larynx, and orthotic appliances other than for replacement of such items;

(i) Home Health Care up to the amount set forth in the Schedule of Benefits per Period of Coverage; and

(j) Care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital. The exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 3.2.

Local Ambulance. The Company will reimburse You up to the amount set forth in the Schedule of Benefits for the Period of Coverage for local ambulance service from within the metropolitan area to the nearest Hospital having facilities required for Medically Necessary Treatment. Other than in an emergency, a licensed air ambulance transportation may be substituted for a ground ambulance if You are in a rural area and unreachable by ground ambulance. The exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 3.3.

Hospital Daily Indemnity. The Company will pay You the amount set forth in the Schedule of Benefits for the Period of Coverage if You are an Inpatient in a Hospital while traveling outside the United States. Payment will be for each day for which You were an Inpatient up to a maximum of thirty (30) days. This payment is not related to the actual Hospital charges and is paid directly to You. You may use these funds for incidentals or as you like. The exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 3.4.

Coma. If Injury renders You Comatose within ninety (90) days of the date of the Accident that caused the Injury and if the Coma continues for a period of thirty (30) consecutive days, the Company will pay a monthly benefit equal to one percent (1%) of the amount set forth in the Schedule of Benefits as long as You remain Comatose due to that Injury. This benefit will cease on the earliest of (i) the date You cease to be Comatose due to that Injury; (ii) the date You die; or (iii) the date the total amount of monthly benefits paid for all Injuries caused by the same accident equals the amount set forth in the Schedule of Benefits. The Company will pay this benefit calculated at a rate of 1/30th of the monthly benefit for each day for which the Company is liable when You are Comatose for less than a full month. No Coma benefit is provided for the first thirty (30) days of the Coma. Only one benefit is provided for any one month of Coma regardless of the number of Injuries causing the Coma.

The Company reserves the right at the end of the first thirty (30) consecutive days of Coma and as often as it may reasonably require thereafter to determine, based on all the facts and circumstances, that You are Comatose including, but not limited to, requiring an independent medical examination provided at the expense of the Company.

The exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 3.5

Network Procedures. The Administrator has extensive networks of providers both in the United States and globally. While You may seek treatment at any facility, You may use one of the methods set forth on page 6 of this Certificate of Insurance to locate a hospital or Physician in these networks. By using networks in the United States, You may receive discounts and out-of-pocket savings for any Covered Expenses. Outside the United States, the Administrator has direct pay agreements with many of its global providers. Utilizing these networks does not guarantee benefits and does not ensure that the providers will bill the Administrator directly.

Pre-Certification Requirements. Pre-certification is required in the United States only and for the following:

a) Outpatient surgeries or procedures;

(b) Inpatient surgeries, procedures, or stays including those for rehabilitation;

(c) Diagnostic procedures including MRI, MRA, CT, and PET Scans;

(d) Chemo therapy;

(e) Radiation therapy;

(f) Physical and occupational therapies;

(g) Home infusion therapy; or

(h) Home Health Care;

To obtain pre-certification, You must:

(a) Contact Seven Corners Assist as soon as possible before the Expense is incurred;

(b) Comply with Seven Corners Assist’s instructions and submit any information or documents required; and

(c) Notify all Physicians, Surgeons, Hospitals, and other providers that this Insurance contains precertification requirements and request that they fully cooperate with Seven Corners Assist.

If You do not comply with the pre-certification requirements:

(a) Covered Expenses will be reduced by twenty-five percent (25%);

(b) The Deductible will be subtracted from the remaining seventy-five percent (75%); and

(c) The Coinsurance will be applied.

Pre-certification does not guarantee coverage, payment, or reimbursement. Eligibility, coverage, and payment or reimbursement remains subject to all the terms, conditions, provisions, and exclusions herein. For Inpatient stays of any kind in the United States, the Administrator initially will pre-certify a limited number of days of confinement. Notify all Physicians, Surgeons, Hospitals, and other providers that this Insurance requires them to receive prior approval for additional days of confinement following the precertification requirements.

DENTAL

Dental Emergency - Sudden Relief of Pain

If the Certificate has a Period of Coverage thirty (30) days or more, the Company will reimburse You up to the amount set forth in the Schedule of Benefitsfor Covered Expenses exceeding the Deductible and Coinsurance for emergency Treatment for the relief of pain to Sound Natural Teeth. The exclusions set forth in Section 8 apply to the coverage provided by this Certificate under this Section 4.1.

Dental Emergency - Accident Coverage

The Company will reimburse You up to the amount set forth in the Schedule of Benefits for Covered Expenses exceeding the Deductible and Coinsurance for emergency Treatment to repair or replace Sound Natural Teeth damaged as the result of an Accidental Injury caused by external contract with a foreign object. Coverage does not apply if You break a Sound Natural Tooth while eating or biting into a foreign object. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 4.2.

EMERGENCY SERVICES AND ASSISTANCE

Emergency Medical Evacuation and Repatriation. The Company will pay transportation and related medical Expenses incurred during such transportation up to the amount set forth in the Schedule of Benefits if any covered Injury or Illness commences while You are outside Your Home Country during the Period of Coverage and results in Your Medically Necessary (i) Emergency Medical Evacuation or (ii) Emergency Medical Repatriation. All transportation arrangements must be by the most direct and economical route. The Emergency Medical Evacuation or Emergency Medical Repatriation must be arranged by Seven Corners Assist in consultation with Your local attending Physician. Failure to utilize Seven Corners Assist will result in the denial of benefits. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 5.1.

Emergency Medical Reunion. When an Emergency Medical Evacuation is occurring or has occurred or when an Emergency Medical Repatriation is to occur and provided, in each such case, that an Emergency Medical Reunion is recommended by Your attending Physician, the Company will arrange and pay up to the amount set forth in the Schedule of Benefits for (i) a round-trip economy-class airfare for one individual from Your Home Country selected by You to travel to and from the location where You are hospitalized and (ii) reasonable travel and accommodation expenses up to the amount set forth in the Schedule of Benefits. The period of Emergency Medical Reunion cannot exceed ten (10) days including travel days. The Emergency Medical Reunion must be arranged by Seven Corners Assist. Failure to utilize Seven Corners Assist will result in the denial of benefits. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 5.2.

Return of Child(ren). If You are traveling alone with a Child(ren) who is left unattended because You became hospitalized as a result of a covered Illness or Injury, the Company will arrange and pay up to the amount set forth in the Schedule of Benefits for (i) one-way economy airfare(s) for the Child(ren) to his or her Home Country and (ii) services of an attendant or escort if necessary to ensure the safety and welfare of the Child(ren). Meals and lodging are not included in this benefit. The return of the Child(ren) must be arranged by Seven Corners Assist. Failure to utilize Seven Corners Assist will result in the denial of benefits. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 5.3.

Return of Mortal Remains. Provided that You have not elected the benefit provided under Section 5.5, the Company will pay up to the amount set forth in the Schedule of Benefits for the reasonable expenses incurred for embalming, a minimally-necessary container appropriate for transportation, shipping costs, and the necessary government authorizations to return Your remains to Your Home Country if You die while outside Your Home Country during the Period of Coverage from an Illness or Injury covered under this Insurance. This benefit applies regardless of whether the death is related to a Pre-Existing Condition. The return of mortal remains must be arranged by Seven Corners Assist. Failure to utilize Seven Corners Assist will result in the denial of benefits. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 5.4.

Local Burial or Cremation. Provided that You have not elected the benefit provided under Section 5.4, the Company will pay up to the amount set forth in the Schedule of Benefits for the reasonable expenses incurred for preparation and either Your local burial or Your cremation if You die while outside Your Home Country during the Period of Coverage from an Illness or Injury covered under this Insurance. This benefit applies regardless of whether the death is related to a Pre-Existing Condition. This Insurance does not include the expenses for the religious practitioners performing the service, flowers, music, food, or beverages. The local burial and cremation must be arranged by Seven Corners Assist. Failure to utilize Seven Corners Assist will result in the denial of benefits. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 5.5.

Natural Disaster Evacuation and Repatriation. If You require an emergency evacuation due to a Natural Disaster, the Company will arrange and pay up to the amount set forth in the Schedule of Benefits for reasonable and necessary expenses incurred for (i) Your Natural Disaster Evacuation; (ii) reasonable lodging up to the maximum number of days set forth in the Schedule of Benefits if You are delayed at the safe location; (iii) and Your Natural Disaster Repatriation by means of a one-way economy airfare. The Natural Disaster Evacuation or Natural Disaster Repatriation must be arranged by Seven Corners Assist. Failure to utilize Seven Corners Assist will result in the denial of benefits.

The Company’s security personnel will determine the need for the Natural Disaster Evacuation in consultation with local governments and security analysts. It may use any appropriate resources to evacuate You including, but not limited to, charter aircraft, ground, transportation, and sea transportation in such circumstances where the point of departure may not be an international airport. You may be required to release the Company or any provider from liability during this Natural Disaster Evacuation. If a Natural Disaster Evacuation is impossible due to hostile conditions, the Company will use security resources to maintain contact with You to the greatest extent allowed by circumstance until a Natural Disaster Evacuation becomes possible or the emergency is resolved.

The Company will not be responsible for failure to provide services or for delays caused by conditions beyond its control including, but not limited to, weather conditions, flight availability, strikes, unforeseen changes to airport regulations or restrictions, Your failure to comply with the Company’srecommendations, or where rendering of service is prohibited by local laws or regulatory agencies. Further, if You can leave the Host Country location by normal means, such as changing a commercial airline ticket, no coverage applies, but the Company will assist in rebooking flights or other transportation.

The coverage provided by the Certificate under this Section 5.6. excludes Expenses that are for, resulting from, related to, or incurred for the following:

(a) Your Natural Disaster Evacuation or Your Natural Disaster Repatriation (i) while in the United States; (ii) while You are traveling within fifty (50) miles of Your primary residence; (iii) when the Natural Disaster situation directly giving rise to these benefits precedes Your arrival in the effected location; (iv) when the evacuation notice issued by the United States or Host Country Government has been posted for a period of more than sixty (60) days; or (v) when You elect not to depart in a timely manner or with evacuation arrangements coordinated by Seven Corners Assist, in which case the coverage under this Section 5.6 is immediately terminated;

(b) Medical expenses incurred by You;

(c) Expenses not related to the Natural Disaster Evacuation or Natural Disaster Repatriation including expenses for transportation from the Host Country by normal commercial means;

(d) Kidnap or ransom of You; and

(e) any services or other arrangements not arranged by Seven Corners Assist. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 5.6.

Natural Disaster Daily Benefit. The Company will reimburse You for replacement accommodations up to the amount set forth in the Schedule of Benefits if You are Displaced from planned, paid accommodations due to an evacuation from a forecasted Natural Disaster or following a Natural Disaster. To receive reimbursement, You must provide proof of payment for the original planned, paid accommodations.

Political Evacuation and Repatriation. The Company will arrange and pay up to the amount set forth in the Schedule of Benefitsfor reasonable and necessary expenses incurred for (i) Your Political Evacuation and/or (ii) Your Political Repatriation by means of a one-way economy airfare. Political Evacuation and/or Political Repatriation must occur within ten (10) days of the events causing the necessity for such action. The means of transportation will be the most appropriate and economical under the circumstances for Your health and safety. Such expenses will be paid once for You per occurrence. If You fail to heed a Level 3 Terrorism, Level 3 Civil Unrest, or any Level 4 Travel Advisory issued by the United States Department of State or similar warnings issued by other appropriate authorities of either Your Host Country or Your Home Country recommending that travelers avoid a certain country, region, or specific areas or locations within a country, benefits are not covered and will be denied. Additionally, the Political Evacuation or Political Repatriation must be arranged by Seven Corners Assist. Failure to utilize Seven Corners Assist will result in the denial of benefits.

The coverage provided by the Certificate under this Section 5.8 excludes Expenses:

(a) Recoverable under any other insurance or through an employer;

(b) Arising from or attributable to:

(i) Dishonest or criminal acts committed or attempted by You;

(ii) Alleged violation of the laws of the Host Country by You unless the Company, in its sole discretion, determines such allegations to be fraudulent;

(iii) Your failure to maintain required documents or visas;

(iv) Debt, insolvency, commercial failure, or the repossession of any property; and

(v) Your non-compliance with a contract or license; implementation of illegally contributed exchange rates.

(c) Due to liability assured or assumed by You under any contract; or

(d) For arrangements not made by Seven Corners Assist. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 5.8.

Felonious Assault. The Company will reimburse You up to the amount set forth in the Schedule of Benefits when You suffer losses for which benefits are payable under the Accidental Death Benefit, Accidental Dismemberment Benefit, or Coma Benefit resulting from a Felonious Assault (i) that is not a moving violation as defined under the applicable government’s motor vehicle laws and (ii) that is not an act of an Immediate Family Member or another Insured Person. Only one benefit is payable for all losses resulting from the same Felonious Assault.

Terrorist Activity. The Company will reimburse You up to the amount set forth in the Schedule of Benefits for Your Covered Expenses incurred resulting from Terrorist Activity provided (i) You have no direct or indirect involvement in the Terrorist Activity; (ii) the Terrorist Activity is not in a country or location where the United States government has issued a Level 3 Terrorism, Level 3 Civil Unrest, or any Level 4 Travel Advisory or the appropriate authorities of either Your Host Country or Your Home Country have issued similar warnings, any of which have been in effect within the six (6) months prior to Your date of arrival; and (iii) You failed to depart the country or location following the date a warning to leave that country or location is issued by the United States government or the appropriate authorities of either Your Host Country or Your Home Country.

OTHER COVERAGES AND SERVICES

Travel Assistance Services. Upon enrollment, You are eligible to use any of the assistance services provided by Seven Corners Assist. These services are available 24 hours per day, 365 days per year. Multi-lingual personnel, physicians, and nurses are on staff and can assist with, among other things, emergency situations and locating local facilities. Call toll free at 1-800-690-6295 or collect at 1-317-818-2808.

Accidental Death & Dismemberment. The Company will pay indemnity determined from the table below if You sustain a Loss stated therein resulting from Injury suffered from an Accident during the Period of Coverage and subject to the exclusions set forth in Section 8, provided that (i) such Loss occurs within three hundred sixty-five (365) days after the date of Accident causing such Loss; (ii) the indemnity payable for any such Loss shall be the Principal Sum stated on the ID Card as applicable to You and this Insurance; and (iii) if more than one Loss stated in the table of Losses is sustained as the result of one Accident, only one of the amounts, the largest, will be paid.

For: Insured or Travel Companion Child(ren)
Loss of life Principal Sum See Schedule of Benefits
Loss of two members Principal Sum $5,000
Loss of one member 50% of Principal Sum $2,500
Quadriplegia Principal Sum $5,000 (total paralysis of both upper and lower limbs
Paraplegia 75% of the Principal Sum $3,750 (total paralysis of both lower limbs)
Hemiplegia 50% the Principal Sum  
Uniplegia 25% of the Principal Sum $1,250 (total paralysis of one limb)

The total amount payable under this Section 6.2 when there are multiple Insured Persons covered by the Certificate is the Aggregate Limit as set forth in the Schedule of Benefits. If the total of such indemnity exceeds the Aggregate Limit, the Company will not be liable to any Insured for a greater proportion of such Insured’s indemnity afforded by the Accidental Death & Dismemberment Benefit than their proportionate share.

For loss of life, the benefit will be paid to the beneficiary designated in writing by You. If no beneficiary is designated or if the beneficiary is no longer living, the benefit will be paid to Your closest living Relative in the following order: (i) Spouse; (ii) Child(ren); (iii) issued of deceased Child(ren); (iv) parent(s); (v) siblings; (vi) issue of deceased siblings; (vii) grandparents; (viii) siblings of parents; or (ix) Your estate.

If benefits are paid for You under Section 6.3, Common Carrier Accidental Death and Dismemberment, no benefits will be paid under this Section 6.2. The coverage under this Section 6.2 excludes and does not cover Expenses that are for, resulting from, related to, or incurred in connection with the following:

(a) Disease or sickness of any kind;

(b) Bacterial infections except pyogenic infection that occurs through an Accidental cut or wound; or

(c) Hernia of any kind.

Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 6.2.

Common Carrier Accidental Death and Dismemberment. The Company will pay an indemnity up to the amount set forth in the Schedule of Benefits if You die as the result of an Injury suffered from an Accident while You were traveling on a Common Carrier. Death must occur during the Period of Coverage and while You are riding as a passenger on a Common Carrier and not as a pilot, operator, or member of the crew. The benefit will be paid to the person determined by application of the relevant provisions of Section 6.2.

The total amount payable under this Section 6.3 when there are multiple Insured Persons covered by the Certificate is the Aggregate Limit as set forth in the Schedule of Benefits. If the total of such indemnity exceeds the Aggregate Limit, the Company will not be liable to any Insured for a greater proportion of such Insured’s indemnity afforded by the Common Carrier Accidental Death and Dismemberment Benefit than their proportionate share.

Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 6.3.

Loss of Checked Baggage. The Company will reimburse You up to the amount set forth in the Schedule of Benefits for lost baggage and personal effects owned by You and checked with a Common Carrier provided You have taken all reasonable measures to protect, save, and recover the property at all times. Also, You must submit a copy of the Common Carrier’s claim form and such other documentation as the Company may reasonably require. Reimbursement will be for the least of (i) the actual cash value (cost less proper deduction for depreciation at the time of loss); (ii) the cost to repair or replace the article with material of a like kind and quality; or (iii) per article limited set forth in the Schedule of Benefits. This coverage is secondary to any coverage provided by the Common Carrier, and You will be required to furnish proof to the Company that the Common Carrier has paid the full amount that it is legally required to pay.

The coverage provided by the Certificate under this Section 6.4 does not cover animals, automobiles or automobile equipment, boats, motors, motorcycles, other conveyances or their appurtenances except bicycles while checked as baggage with a Common Carrier, household furniture, eye-glasses or contact lenses, artificial teeth or dental bridges, hearing aids, prosthetic limbs, musical instruments, money or securities, tickets or documents, or sporting equipment if loss or damage results from the use thereof Trip Interruption.

The Company will reimburse You up to the amount set forth in the Schedule of Benefits for the cost of economy travel less the value of applied credit from an unused return travel ticket to return home to Your area of principal residence if You are unable to continue the Trip due to the death of a parent, Spouse, sibling, or Your Child(ren) or due to serious damage to Your principal residence from fire or Natural Disaster. The Trip Interruption benefits must be arranged by Seven Corners Assist. Failure to utilize Seven Corners Assist will result in the denial of benefits. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 6.5.

Personal Liability. The Company will pay or reimburse You up to the amount set forth in the Schedule of Benefits and subject to the condition, restrictions, and exclusions and contained in this Section 6.6 for eligible court-entered judgments or Company-approved settlements arising as a result of or in connection with the personal liability You incurred for acts, omissions, and other occurrences covered under this Certificate for losses or damages solely, directly, and proximately caused by Your negligent acts or omissions during the Period of Coverage that result in the following:

(a) Injury to a third person occurring during the Period of Coverage;

(b) Damage or loss to a third person’s personal property during the Period of Coverage; and

(c) Damage or loss to a Relative’s personal property during the Period of Coverage. The maximum payable under this Section 6.6 is up to the maximum stated in the Schedule of Benefits. With respect to covered and eligible personal liability claims, the Company will pay You for associated reasonable legal fees and out-of-pocket costs incurred by You with respect to the determination and settlement of such legal liability.

Conditions and Restrictions

(a) You must notify the Company within thirty (30) days of any act, omission, or occurrence that may create or impose any personal liability upon You and, also, within thirty (30) days of the initiation or receipt of service of any actual or threatened lawsuit, notice of claim, or proceeding filed or threatened to be filed against You with respect to same. Such notification(s) to the Company shall include a recitation of all circumstances, facts, and known or presumed causes of any loss or damage and a description of the nature and approximate amount of any damages suffered by any third person or Relative. In addition, immediately upon receipt thereof, You shall provide to the Company copies of any pleadings, complaints, lawsuits, petitions, demand letters, notices, orders, summonses, subpoenas, opinions, briefs, motions, letters from opposing counsel, and any other documents or papers with respect to any such lawsuit or proceeding that are received or issued by, addressed to or from, remitted to or by, or served by or upon You or Your counsel. Any failure to so notify or provide papers or documents to the Company in strict accordance with the foregoing shall be deemed to be and will result in a forfeiture and waiver of any and all benefits, claims, or coverages otherwise provided by this Insurance under this Section 6.6.

(b) The Company shall have the absolute right and authority without Your further consent or approval to intervene in its own name and on its own behalf as a party in interest with respect to any lawsuit, civil action, or other proceeding in which You are involved and for which the Company may have exposure for coverage or benefits under this Section 6.6 and shall be entitled to fully participate, receive due and proper notice of all matters, and have an opportunity to be heard with respect to all issues, controversies, and other proceedings or hearings of any kind.

(c) With respect to any personal liability for which You are or may be jointly or jointly and severally liable with other third persons or Relatives, the Company shall be fully subrogated to all rights of contribution, indemnity, recoupment, and recovery of proportional shares from other joint tortfeasors whose negligence contributed in whole or in part to the subject injury or loss and who are or may also be liable to You or the injured/damaged person.

(d) As a condition precedent to any liability or obligation of the Company to provide coverages or benefits for personal liability under this insurance, no settlement, compromise, accord, admission of fault or liability, default, default judgment, waiver, release, indemnity, hold harmless, or other concession of any kind shall be given, made, committed, allowed, granted, or agreed to by or on behalf of You to any third person or Relative without the prior express written approval and consent of the Company, and any failure to comply with this condition precedent shall void, waive, and forfeit all benefits and coverages for legal assistance, advancement of bail, or coverage for personal liability under this Section 6.6.

(e) The Company shall not be liable or obligated to provide any coverage or benefits or to pay or reimburse any claim, damage, or loss under this Section 6.6 for and no coverage or benefits shall be eligible or available under this Section 6.6 with respect to, any legal fees, legal costs or expenses, advancements of bail, or for any personal injury or property damage claims, liability awards or judgments in the event there exists any other insurance, insurance fund, membership benefits, workers’ or workplace compensation coverage program or other similar governmental program, reimbursement or indemnification coverage, right of contribution, recoupment or recovery, contract, or any other third-party obligation or liability for provision of benefits (“Primary Coverage”) which would or would, but for the existence of this Insurance, be available or obligated to provide such benefit or to pay or reimburse or provide indemnity for such claim, damage, or loss except in respect of any excess beyond the amount payable or provided under such Primary Coverage had this insurance not been effected. Further, the Company shall not be liable or obligated to provide any benefit or to pay or reimburse any claim for injury, loss, or damage to the extent coverage for same is furnished or provided by any program or agency funded or controlled by any government or government authority

(f) No third Person or Relative is intended to have, shall be deemed or construed to have, or shall have any rights or interest as a “third-party beneficiary” under the Master Policy of Insurance, and any allegation or assertion of any such status or any direct claim or other attempt to legally enforce alleged rights by such third person or Relative against the Company, the Administrator, or the Participating Organization based on any allegation or assertion of any such status, shall be subject to summary dismissal. Notwithstanding any law, statute, judicial decision, or rule to the contrary which may be or may purport to be otherwise applicable within the jurisdiction, locale or forum state of You, third person, or Relative or the situs of any alleged personal injury, property damage or other loss, no transfer or assignment of any of the Participating Organization’s rights, benefits or interests under this Certificate, and no transfer or assignment of any of Your rights, benefits, or interests under this Section 6.6 as a beneficiary thereof, shall be valid, binding on, or enforceable against the Company or the Administrator unless first expressly agreed and consented to in writing by the Company, which agreement and/or consent may be reused and/or withheld for any or no reason at the sole discretion of the Company. Any such purported transfer or assignment not in strict compliance with the foregoing provisions of this Section 6.6 shall be void ab initio and without effect as against the Company and the Administrator and any assertion or claim of same shall be subject to summary dismissal, and the Company and the Administrator shall have no liability of any kind under this Section 6.6 to any such purported transferee or assignee with respect thereto.

(g) The Company will consider paying or advancing, but without any obligation or contractual duty to do so, up to $2,500 to You or for Your benefit to settle and compromise an asserted claim against You arising from personal injury or property damage so long as (i) the asserted claim is one that may be eligible for coverage under this Insurance and is not expressly excluded; (ii) a lawsuit has not yet been filed, or, if already filed, an answer or other response has not yet been filed thereto; (iii) You obtain a full written release and/or covenant-not-to-sue upon such terms and conditions as are satisfactory to the Company in its sole discretion; (iv) a full proof of claim, medical bills, accident form, and such other documentation and/or Proof of Loss is provided to the Company in form and substance satisfactory to it; and (v) You first pay the deductible as stated in the Schedule of Benefits and limits for such injury or loss.

Exclusions. You shall have no benefits or coverages for and the Company shall have no liability or obligation of any kind to pay or reimburse You or any third person or Relative for, any changes, fees (including attorneys’ fees), costs, expenses, damages, losses, judgments, claims or other liabilities incurred or sustained by or assessed against You or any third person or Relative, if directly or indirectly relating to, arising from or in connection with any of the following acts, omissions, events, conditions, charges, consequences, occurrences or circumstances, all of which are expressly excluded from coverage under this Insurance and all of which the Company will provide no benefits or coverages for and shall have no liability or obligation for same, and the Company will not pay or reimburse You or any third person or Relative for any claims of any kind arising directly or indirectly from, happening through or as a consequence of:

(a) Any damages, losses or claims caused in whole or in part by You during any hunt or as a result of hunting;

(b) Any criminal, fraudulent, deceptive, willful, reckless, malicious, or other unlawful acts or omissions committed by You or any acts or omissions committed by You in connection with the violation or breach of any laws, statutes, ordinances, legal orders, rules or regulations to which You are subject or by which You are bound;

(c) Any loss, damage, or claim arising or resulting from the use of any firearms, fireworks, explosives, welding equipment, propane tanks, or other flammables, deadly weapons, or hazardous implements;

(d) The pursuit of any trade, business, profession, or employment activity;

(e) Ownership, possession, control, or occupation of any land or building;

(f) Ownership, possession, control, or use of any automobile, motorcycle, ATV, off-road vehicle, watercraft, aircraft, parachute, parasail, glider, or any other motorized, gravity-induced, or selfpropelled vehicle or craft of any kind;

(g) Resulting from any fire, flood, wind, hail, water leak, gas leak, explosion, or other catastrophe or loss occurring in or about the residence or premises of any Relative, or in or about the residence or any other premises of which You are the owner, lessee, invitee, licensee, occupant, or Resident, or in or about any residence or premises which are contiguous or adjacent to any of the foregoing residences or premises;

(h) The consequences of any breach, violation, or failure to perform any contractual undertakings or obligations of You, whether verbal or in writing;

(i) Criminal or disciplinary proceedings, charges, arrests, indictments, or arraignments of any kind;

(j) Shoplifting, vandalism, theft, conversion, misappropriation, public drunkenness, fighting or brawling, arson, or any malicious or intentional activity resulting in personal injury or destruction of property;

(k) Gross negligence, fraud, bad faith, assault and battery, domestic disputes, and all other intentional torts or actions based or sounding in tort without regard to how named or presented;

(l) Any collusion, conspiracy, deceit, or other fraudulent scheme or artifice to defraud or other fraudulent means or methods;

(m) Fines, penalties, assessments, or claims by any governmental authorities or regulatory bodies including traffic fines or traffic violations or parking tickets, and the costs, fees, or expenses incurred by You as a witness, custodian, or in any other non-party status in connection with responding to any order to appear in court, subpoena, subpoena duces tecum, notice of deposition, or any other nonparty legal or administrative proceeding or activity;

(n) All non-compensatory damages including, without limitation, damages imposed as a punishment, punitive or exemplary damages, consequential damages, lost profits, criminal damages, excessive damages, expectancy damages, incidental damages, liquidated damages, presumptive damages, prospective damages, special damages, speculative damages, statutory damages, double, treble or other multiples of damages, and/or unliquidated damages, and all claims and damages for pain and suffering, loss of consortium, physical discomfort, mental or emotional distress, trauma, disfigurement, dismemberment, loss of use, or scarring;

(o) Contractual or employer’s liability or workman’s compensation claims;

(p) Animals or pets belonging to You or any Relative, or in the care, custody, or control of You or any Relative;

(q) Intentionally committed acts caused or brought about by You;

(r) Arising or occurring while You are, to any extent, under the influence of alcohol or drugs or due to Your use of drugs, prescription medicines, narcotics, or tranquilizers not medically prescribed for You by a licensed physician;

(s) Caused by Your suicide or attempted suicide;

(t) Your participation in gambling, gaming, or betting of any kind;

(u) Your participation in any fights, brawls, criminal activity, or other unlawful activity;

(v) During the practice or participation of sports, recreational endeavors, or Athletics either as a professional, amateur or novice, unless performed solely for recreational purposes or during high school activities;

w) Hazardous Activities;

(x) Occurring when You are a passenger in an aircraft other than a commercial aircraft;

(y) War, Hostilities, and War-Like Operations;

z) Thermal, mechanic, radioactive, and other effects due to any modification of the atomic structure of matter or the artificial acceleration of atomic particles or due to radiation from radio-isotopes or the use of nuclear or chemical materials;

(aa) Judgments or damage awards that have not been ordered, declared, or entered within twelve (12) months from the date of the act, omission, occurrence, or event causing personal injury or property damage or within twelve (12) months from the date of termination of group coverage under the Certificate, whichever is earlier;

(bb) Any lawsuit, claim for benefits, enforcement action, complaint, or other civil or administrative proceeding of any kind brought by or on behalf of You or any third person or Relative against the Company, the Administrator, or the Participating Organization including, without limitation, any lawsuit or proceeding alleging breach of contract, bad faith, or any tortuous conduct of any kind, seeking equitable or declaratory relief, or otherwise seeking the recovery, enforcement or effectuation of any benefits or coverages under this Insurance;

(cc) Any loss, personal injury, property damage, or other claim arising or resulting from any act, omission, failure to act, event or other occurrence committed or occurring at any time prior to or subsequent to the Period of Coverage; or

(dd) Any personal injury, medical expense, damage or other loss suffered by a Relative except for damage to a Relative’s personal property, which shall be limited to a maximum of $2,500 and subject to the per Injury/Illness Deductible set forth in the Schedule of Benefits.

OPTIONAL COVERAGES

Hazardous Activities

The definition of “Hazardous Activities” set forth in Section 8 does not apply to this Section 7. If You elect and pay the required premium for this optional Insurance, the Company will reimburse You for Covered Expenses up to the amount set forth in the Schedule of Benefits resulting from an Injury sustained while participating in bungee jumping; caving; hang gliding; jet skiing; motorcycle or motor scooter riding whether as a passenger or a driver; Parachuting; parasailing; scuba diving only to a depth of 10 meters with a breathing apparatus provided that You are SSI, PADI or NAUI certified; snowmobiling; spelunking; wakeboard riding; water skiing; windsurfing; or zip lining. You must purchase this optional coverage if you wish to be covered while riding a motorcycle, motor scooter, or similar transportation when such transportation is an established and accepted routine means of public transportation for hire in the specific geographic area where You are located in the Host Country. Except as otherwise specifically set forth and enumerated in this Section 7, the exclusions set forth in Section 8 apply to coverage provided by the Certificate under this Section 7.

EXCLUSIONS

Unless otherwise specifically provided for therein, the coverage provided by the Certificate under Sections 3.2 through 3.5, 3.8, 3.9, 4.1, 4.2, 5.1 through 5.6, 5.8, 6.2, 6.3, 6.5, and 7 excludes Expenses that are for, resulting from, related to, or incurred for the following:

a) Pre-Existing Condition(s) except as waived under Sections 3.10 and 3.11 above.

(b) Claims not received by the Company or Administrator within ninety (90) days of the date of service:

(c) Treatment that (i) exceeds Usual, Reasonable, and Customary Expenses; (ii) is Investigational, Experimental, or for research purposes; or (iii) received in a Hospital emergency room visit that is not a Medical Emergency;

(d) Treatment, services, or supplies that are not administered by or under the supervision of a Physician or Surgeon and products that can be purchased without a Physician’s or Surgeon’s prescription;

(e) Routine physicals, inoculations, or other examinations or tests conducted when there is no objective indications or impairments in normal health;

(f) Chiropractic care or acupuncture;

(g) Services, supplies, medications, testing, or Treatment prescribed, performed, or provided by a Relative or Immediate Family Member;

(h) Durable medical equipment;

(i) False teeth, dentures, dental appliances, dental expenses, normal ear or hearing tests, hearing aids, hearing implants, eye refractions, eye examinations for prescribing corrective lenses or eyeglasses unless caused by Accidental Injury, eyeglasses, contact lenses, or eye surgery when the primary purpose is to correct nearsightedness, farsightedness, or astigmatism;

(j) Replacement of artificial limbs, eyes, larynx, and orthotic appliances;

(k) Custodial Care, Educational or Rehabilitative Care, or any Treatment in any establishment for the care of the aged;

(l) Vocational, occupational, sleep, speech, recreational, or music therapy;

(m) Pregnancy, Illness or complications from Pregnancy, childbirth, abortion, miscarriage including that resulting from an Accident, postnatal care, preventing conception or childbirth, artificial insemination, infertility, impotency, sexual dysfunction, or sterilization or reversal thereof;

(n) Sleep apnea or other sleep disorders;

(o) Mental and Nervous Disorder, Rest Cures, learning disabilities, attitudinal disorders, or disciplinary problems;

(p) Congenital abnormalities and conditions arising out of or resulting therefrom.

(q) Temporomandibular joint;

(r) Occupational Diseases;

(s) Exposure to non-medical nuclear radiation or radioactive materials;

(t) Sexually-transmitted diseases, venereal diseases, and conditions and any consequences thereof;

(u) Acquired Immune Deficiency Syndrome (AIDS), AIDS-Related Complex (ARC), or the Human Immunodeficiency Virus (HIV);

(v) Human organ or tissue transplants.

(w) Exercise programs whether prescribed or recommended by a Physician or therapist;

(x) Weight reduction programs or the surgical Treatment of obesity including, but not limited to, wiring of the teeth and all forms of intestinal bypass Surgery;

(y) Cosmetic or plastic Surgery including deviated nasal septum; modifications of Your physical body intended to improve Your psychological, mental, or emotional well-being including, but not limited to, sex-change Surgery;

(z) Acne, moles, skin tags, disease of sebaceous glands, seborrhea, sebaceous cyst, unspecified disease of the sebaceous glands, hypertrophic and atrophic conditions of skin, nevus;

(aa) Hazardous Activities unless You purchase optional hazardous activities coverage and then only for the activities covered under that option under Section 7;

(bb) Injuries sustain while participating in professional Athletics, amateur Athletics, or interscholastic Athletics including, but not limited to, events, games, matches, practice, training camps, sport camps, conditioning, and any other activity related thereto but excluding non-competitive, recreational, or intramural activities;

(cc) Abuse, misuse, illegal use, overuse, dependency upon, or being under the influence of alcohol, drugs, chemicals, or narcotic agents unless administered under the advice of a Physician and taken in accordance with the proper dosing as directed by the Physician;

(dd) Suicide or any attempt thereof; self-destruction or any attempt thereof; or any intentionally selfinflicted Injury or Illness;

(ee) Terrorist Activity except as provided under Section 5.10; War, Hostilities, or War-Like Operations;

(ff) Commission of a criminal offense or any other criminal or illegal activity as defined by the local governing body;

(gg) You unreasonably fail or refuse to depart a country or location following the date a warning to leave that country or location is issued by the United States government or similar warnings issued by other appropriate authorities of either Your Host Country or Your Home Country;

(hh) Service in the military, naval, coast guard, or air service of any country or while on duty as a member of a police force or unit;

(ii) Treatment paid for or furnished under any other individual, government, or group policy or Expenses incurred at no cost to You;

(jj) You while in Your Home Country unless covered under Section 3.8 or 3.9;

(kk) Conditions for which travel was undertaken to seek Treatment after Your Physician has limited or restricted travel;

(ll) Travel accommodations;

(mm) Injury sustained while You are riding as a pilot, student pilot, operator, or crew member, in or on, boarding or alighting, from any type of aircraft;

(nn) Injury sustained while You are riding as a passenger in any aircraft (i) not having a current and valid Airworthy Certificate and (i) not piloted by a person who holds a valid and current certificate of competency for piloting such aircraft;

(oo) Flying in any aircraft being used for acrobatic or stunt flying, racing, endurance tests, rocketpropelled aircraft, crop dusting or seeding or spraying, firefighting, exploration, pipe or power line inspection, any form of hunting or herding, aerial photography, banner towing, or any experimental purpose; and

(pp) Participating in contests of speed or riding or driving in any type of competition.

(qq) Loss of life;

(rr) Long-term disability; or

(ss) Financial guarantee, financial default, bankruptcy, or insolvency risks.

When seeking treatment in the United States, a network provider can be located by visiting our website www.sevencorners.com/findproviders or by contacting Seven Corners Assist. Contact information for Seven Corners Assist will be provided on your virtual ID Card.

Acute Onset of Pre-existing Conditions  

Age 0-69: $30,000

Age 70 & over: $5,000

Emergency Services & Assistance Limited to $25,000

Acute Onset of Pre-Existing Condition(s). If you are a non-United States resident under the age of 70, the exclusion set forth in Section 8(a) is waived for the eligible medical expenses for the first Acute Onset of a Pre-Existing Condition(s) during the Period of Coverage up to the amount set forth in the Schedule of Benefits for eligible medical expenses incurred in the United States. The same waiver applies for persons age 70 and over for the amount set forth for them in the Schedule of Benefits. These waivers apply subject to Your payment of the Deductible and selected Coinsurance option. This waiver does not include coverage for known, scheduled, required, or expected medical care, drugs, or Treatments existent or necessary prior to arrival in the United States and prior to the Effective Date of Coverage; coverage for Treatment for which You have traveled, or coverage for conditions for which travel was undertaken after Your Physician has limited or restricted travel. Coverage ceases on the earliest of (i) the condition no longer being considered acute or (ii) Your discharge from the Hospital. As set forth in the Schedule of Benefits, there is no waiver for persons age 70 and over.

Acute Onset of a Pre-existing Condition(s): Sudden and unexpected outbreak or recurrence of a Pre-Existing Condition(s) that occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms and requires urgent care. The Acute Onset of a Pre-existing Condition(s) must occur after the Effective Date of Coverage and prior to the age shown in the Schedule of Benefits. Treatment must be obtained within twenty-four (24) hours of the sudden and unexpected outbreak or recurrence. A Pre-Existing A condition that is Congenital or that gradually becomes worse over time is not Acute Onset of a Pre-Existing Condition. A Pre-Existing Condition will not be considered an Acute Onset of a Pre-existing Condition(s) if, during the thirty (30) days prior to the acute event, You had a change in prescription or treatment for a diagnosis related to the acute event. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs, or Treatments existent or necessary prior to arrival in the United States and prior to the Effective Date of Coverage.

RENEWAL

Extension of Coverage. Coverage may be continued if the initial Period of Coverage is less than the Maximum Period of Coverage. If You elect to extend Your Trip beyond the initial Period of Coverage, You may extend the applicable Period of Coverage by a minimum of five (5) days and up to three hundred sixtyfour (364) days at a time provided that the total Period of Coverage may not exceed the Maximum Period of Coverage. Upon such extension and receipt of the appropriate Plan premium and applicable fee charged for each extension, the original Certificate’s Expiration Date of Coverage will be extended to the new Expiration Date of Coverage. For Liaison® Travel Economy and Liaison® Travel Choice Plans, the original Effective Date of Coverage will be used to calculate Your Deductible and Coinsurance; to determine whether maximum coverage amounts as set forth in the Schedule of Benefits have been obtained; and to determine any Pre-Existing Conditions. For Liaison® Travel Elite Plans, a new Deductible and new Coinsurance will apply beginning the 365th day and beginning again on the 729th day, if applicable, during the Period of Coverage, but the original, beginning Effective Date of Coverage (day 1) will continue to be used to determine whether maximum coverage amounts as set forth in the Schedule of Benefits have been obtained and to determine any Pre-Existing Conditions.

Extensions, if offered by the Company, will be subject to the definitions, benefits, and conditions in force at the time of each renewal.

Cancel

CANCELLATION

Refund of Premium. Refund of the premium will only be considered if written request is received by the Administrator prior to the Effective Date of Coverage. If written request is received after the Effective Date of Coverage, the unused portion of the Plan cost may be refunded minus a cancellation fee provided no claim has been submitted to the Administrator for reimbursement. Additionally, no refund will be made after a claim has been denied or not paid. Upon refund, neither the Company nor You shall have any further rights, liabilities, or obligations under this Certificate.

Claims

Claims must be submitted within 90 days of the date of service. See Section 10 on page 26 for claims procedures.

Email: Claims@sevencorners.com

Website: https://www.sevencorners.com/claims

FAX: 317-575-2256

Mail: Seven Corners, Inc.

303 Congressional Blvd.

Carmel, Indiana 46032

United States of America

For additional assistance with claims, phone Seven Corners:

United States and Canada - Toll free: 800-335-0477

All Other Countries – Collect: 317-575-2652.

Claim Forms

The Company, upon receipt of a notice of claim, will furnish to the claimant such forms as are usually furnished by it for filing Proofs of Loss. If such forms are not furnished within fifteen (15) days after the giving of such notice, the claimant shall be deemed to have complied with the requirements of the plan as to Proof of Loss upon submitting, within the time fixed in the Certificate for filing Proofs of Loss, written proof covering the occurrence, the character, and the extent of the Disablement for which claim is made.

Proof of Loss

Written Proof of Loss must be furnished to the Company at its said office in case of claim for loss for which this Certificate provides any periodic payment contingent upon continuing loss within ninety (90) days after the termination of the period for which the Company is liable and in case of claim for any other loss within ninety (90) days after the date of such loss. Failure to furnish such Proof of Loss within the time required shall not invalidate nor reduce any claim if it was not reasonably possible to give Proof of Loss within such time, provided such Proof of Lossis furnished as soon as reasonably possible. The Company at its option may pend resolution and adjudication of submitted claims and/or deny coverage for Proof of Loss submitted thereafter, or for incomplete Proof of Loss and/or failure to submit Proof of Loss.

Time of Payment of Claims

Indemnities payable under the Certificate for any loss other than loss for which the Certificate provides any periodic payment will be paid immediately upon receipt of due written Prooof Loss. Subject to due written Proof of Loss, all accrued indemnities for loss for which the Certificate provides periodic payment will be paid at the expiration of each four (4) weeks during the continuance of the period for which the Company is liable, and any balance remaining unpaid upon the termination of liability will be paid immediately upon receipt of due written proof.

Payment of Claims

Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment. If no such designation or provision is then effective, such indemnity shall be payable to Your estate. Any other accrued indemnities unpaid at Your death may, at the option of the Company, be paid either to such beneficiary or to such estate. All other indemnities will be payable to You. If any indemnity of the Certificate shall be payable to Your estate or to an Insured Person who is a under the age of eighteen (18) or otherwise not competent to give a valid release, the Company may pay such indemnity, up to an amount not exceeding $1,000, to any Relative by blood or connection by marriage of the Insured Person who is deemed by the Company to be equitably entitled thereto. Any payment made by the Company in good faith pursuant to this provision shall fully discharge the Company to the extent of such payment. Subject to any written direction of You, all or a portion of any indemnities provided by this Certificate on account of Hospital, nursing, medical or Surgical service may, at the Company's option and unless You request otherwise in writing not later than the time for filing Proof of Loss, be paid directly to the Hospital or person rendering such services, but it is not required that the service be rendered by a particular Hospital or person.

Notice of Claim

Written notice of claim must be given to the Company within ninety (90) days after the occurrence or commencement of any Disablement covered by the plan. Notice given by or on behalf of the claimant to the Administrative Offices of the Company or to any authorized agent of the Company, with information sufficient to identify You shall be deemed notice to the Company.

Appeal of Claims.

If the Company denies all or any part of a claim, You will have a maximum of two (2) appeals for review of the claim and determination, and You must file two (2) appeals before bringing any legal action hereunder. You will have sixty (60) days from the date of the notice of denial within which to file an appeal. You may submit written comments, documents, records, or other information with the notice of appeal. The Company will respond in writing to an appeal as soon as reasonably possible but, in any event, within ninety (90) days from receipt of the notice of appeal.

Physical Examination and Autopsy

The Company at its own expense will have the right and opportunity to examine the person of any Insured Person whose Injury or Illness is the basis of a claim when and as often as the Company may reasonably require during the pendency of a claim hereunder and to make an autopsy in case of death where it is not forbidden by law.

Cooperation

You and Your healthcare and medical services providers and suppliers, Physicians, and Hospitals must cooperate fully with the Company and the Administrator in reviewing, investigating, adjudicating, and administering any claims under this Certificate. This includes, but is not limited to, access to all relevant, pertinent, or related records, medical documentation, medical histories, reports, lab or test results, x-rays, and other available evidence. The Company may suspend or pend adjudication of a claim or deny benefits or coverage for refusal to cooperate or delay in cooperation or for any act or omission by the above-referenced persons or entities that hinders, delays, impairs, or otherwise prejudices the performance of the Company’s obligations hereunder.

Subrogation

To the extent the Company pays for a loss suffered by You, the Company will take over the rights and remedies You had relating to the loss. This is known as subrogation. You must help the Company to preserve its rights against those responsible for the loss. This may involve signing any papers and taking any other steps the Company may require. If the Company takes over Your rights, You must sign an appropriate subrogation form supplied by the Company.

Other Insurance

All coverages except Accidental Death & Dismemberment are in excess of all other insurance or similar benefit programs and shall apply only when such benefits thereunder are exhausted. This Plan is secondary coverage to any other insurance. Such other insurance or similar benefit programs may include, but are not limited to, membership benefit; workers’ compensation benefits or programs; government programs; group or blanket coverage; prepayment coverage; union, labor, or employee plans; socialized insurance program or program otherwise required by law or statute; automobile insurance; or third-party liability insurance.

Misrepresentation and Fraud

The Company explicitly relies on Your Application and the information contained in it in order to determine whether such individual meets the eligibility requirements for the issuance of a Certificate. Any misstatement, misrepresentation, concealment, omission, or fraud in Your Application will render Insurance for each Insured Person null and void from issuance, and no coverage will be afforded to such Insured Person under any circumstances.

The Company explicitly relies on statements made You in connection with all claims under this Certificate in order to determine whether or not and to what extent benefits under this Insurance are payable. Any misstatement, misrepresentation, concealment, omission, or fraud by You relating to any claim hereunder shall render the Insurance for each Insured Person null and void from issuance, and no coverage will be afforded to such Insured Person under any circumstances.

Nothing in this Section 9.14 shall in any way effect any other remedies available to the Company with respect to any misstatement, misrepresentation, concealment, omission, or fraud by an Insured Person.

Legal Actions

No actions at law or in equity shall be brought to recover on the Certificate prior to the expiration of sixty (60) days after written Proof of Loss has been furnished in accordance with requirements of this Certificate. All legal actions, whether in law or equity, arising under this Certificate shall be barred unless written notice thereof is received by the Company or the Administrator within one (1) year from the date of the event giving rise to such legal action. No such action shall be brought after expiration of three (3) years after that time written Proof of Loss is required to be furnished. You further agree that no such actions will be taken to recover under the Certificate until after You have complied with Section 9.7.

You and the Company irrevocably agree and submit to the exclusive jurisdiction and venue of the state and federal courts located in the State of Indiana for any action brought under the Certificate. The Court will be the trier of fact for any dispute under this Certificate, and the parties expressly waive their rights to a jury trial.

Coverage Intent. This is not a general health insurance policy but an interim travel medical program intended for use while You are away from Your Home Country or country of residence. Complaints

Initial inquiries or complaints are to be addressed to the Administrator. If You are not satisfied with the way an inquiry or complaint has been managed by the Administrator, You may request in writing to the Complaints & Advisory Department of the Company a review of the case without prejudice to the Insured Person’s rights.

Complaints and Advisory Department of Lloyd's

1 Lime Street

London EC3M 7HA

United Kingdom

Selection of Providers

You and/or Your family members, guardians, Physicians, and other healthcare providers are solely responsible for making decisions regarding the selections of Physicians, Hospitals, or other healthcare or health service providers and regarding any medical Treatment decisions for or on Your behalf. Neither the Company nor the Administrator has the right, obligation, or authority to make such decisions.

Coverage Intent

This is not a general health insurance policy but an interim travel medical program intended for use while You are away from Your Home Country or country of residence.

Modification and Waiver

No modification to or waiver of the terms of the Master Policy of Insurance, this Certificate, the Declaration, or the Plan is binding unless expressly set forth in writing and signed by an authorized agent or representative of the Company. Failure of the Company or the Administrator to enforce Your obligation hereunder is not a waiver. No statement made by an agent, employee, or representative of the Company or the Administrator will be deemed or construed as a modification, waiver, actionable representation, promise, or an estoppel or will create any liability against the Company or Administrator

Assignment

No transfer or assignment of any of Your rights, benefits, or interests under this Certificate will be valid, binding upon, or enforceable against the Company unless agreed to in writing by the Company.

Entire Agreement.

The Master Policy of Insurance, the Application, the Certificate, the Declaration, and any Riders constitute the entire Agreement between the Company and You. The coverage evidenced by this Certificate is subject to all the terms and conditions of the Master Policy of Insurance, the Application, the Declaration, and any Riders.

Office of Foreign Assets Control and Other Denied Party Lists.

Coverage will be immediately null and void if any Insured Person (i) appears on the like of Specially Designated Nationals and Blocked Persons administered by the UNITED STATES Treasury Department's Office of Foreign Assets Control ("OFAC") or other denied party lists maintained by the UNITED STATES Government, the European Union ("EU"), United Nations (“UN”), or the United Kingdom (“UK”); (ii) is resident or physically present in a country or territory subject to sanctions, prohibitions, or restrictions administered by OFAC, the EU, the UN, or the UK; or (iii) is a person who is otherwise the target of UNITED STATES, EU, UN, or UK sanctions, laws, or regulations such that the Company cannot deal or otherwise engage in business transactions with such person. Whenever any coverage provided hereunder would be in violation of any UNITED STATES, EU, UN, or UK sanctions, prohibitions, or restrictions, such coverage shall be immediately null and void. The Company may be compelled by law to seize premiums, deny services, or withhold claims payments if an Insured Person becomes subject to UNITED STATES, EU, UN, or UK sanctions while this Certificate is in effect. Any payment for services will only be made in full compliance with all United States’ economic or trade sanction laws or regulations including, but not limited to, sanctions, laws, and regulations administered and enforced by the OFAC. For more information, consult the OFAC website at www.treas.gov/offices/enforcement/ofac/

Patient Protection and Affordable Care Act (“PPACA”). THE INSURANCE PROVIDED HEREUNDER IS NOT SUBJECT TO, IS NOT INTENDED TO COMPLY WITH, AND DOES NOT PROVIDE ALL BENEFITS REQUIRED BY PPACA. THIS INSURANCE IS NOT QUALIFYING HEALTH COVERAGE (“MINIMUM ESSENTIAL COVERAGE”) THAT SATISFIES THE HEALTH CARE COVERAGE REQUIREMENT OF PPACA. IF AN INSURED PERSON DOE NOT HAVE MINIMUM ESSENTIAL COVERAGE, HE OR SHE MAY OWE AN ADDITIONAL PAYMENT WITH HIS OR HER TAXES. INSURED PERSONS ARE RESPONSIBLE FOR DETERMINING IF AND HOW PPACA IS APPLICABLE TO HIM OR HER AND SHOULD CONSULT HIS OR HER OWN TAX ADVISORS. NEITHER THE COMPANY NOR THE ADMINISTRATOR SHALL HAVE LIABILITY WHATSOVER FOR AN INSURED PERSON’S FAILURE TO OBTAIN PPACA-COMPLIANCE COVERAGE.

THIS INSURANCE IS ISSUED PURSUANT TO APPLICABLE SURPLUS LINES LAW. PERSONS INSURED BY SURPLUS LINES CARRIERS DO NOT HAVE THE PROTECTION OF STATE INSURANCE GUARANTY LAWS TO THE EXTENT OF ANY RIGHT OF RECOVERY FOR THE OBLIGATION OF AN INSOLVENT UNLICENSED INSURER.

LLOYD'S PRIVACY POLICY STATEMENT

Underwriters at Lloyd’s, London. The Company wants Insured Persons to know how it protects the confidentiality of their non-public personal information. The Company wantsInsured Personsto know how and why it uses and discloses the information that it has about them. The following describes the Company’s policies and practices for securing the privacy of Insured Persons: Information Underwriter Collects. The non-public personal information that Company collects about Insured Persons includes, but is not limited to:

(a) Information contained in applications or other forms that Insured Persons submit to the Company such as name, address, and social security number;

(b) Information about Insured Persons’ transactions with the Company’s affiliates or other thirdparties such as balances and payment history; and

(c) Information the Company receives from a consumer-reporting agency such as creditworthiness or credit history.

Information the Underwriter Discloses. The Company discloses the information that it has when it is necessary to provide its products and services. It may also disclose information when the law requires or permits it to do so.

Confidentiality and Security. Only the Company’s employees and others who need the information to service an Insured Person’s account have access to his or her personal information. The Company has measures in place to secure their paper files and computer systems.

Right to Access or Correct Personal Information. Insured Persons have a right to request access to or correction of their personal information that is in the Company’s possession. Contacting the Underwriter. If an Insured Person has any questions about this privacy notice or would like to learn more about how the Company protects privacy, the Insured Person should contact the agent or broker who handled this insurance. The Company can provide a more detailed statement of its privacy practices upon request

Signature Required. This Certificate is not valid unless signed by the Correspondent on the attached Declarations page.

Correspondent Not Insurer. The Correspondent is not an Insurer under this Certificate and is not liable for any loss or claim whatsoever. The Insurers are those Underwriters at Lloyd’s, London whose syndicate numbers can be ascertained from the Correspondent. As used in this Certificate, “Underwriters” includes incorporated as well as unincorporated persons or entities that are Underwriters at Lloyd’s, London.

Service of Suit. If the Underwriters fail to pay any amount claimed to be due hereunder, it is agreed that, Underwriters, at the request of the Assured, will submit to the jurisdiction of a court of competent jurisdiction within the United States. Nothing in this Clause constitutes or should be understood to constitute a waiver of Underwriters’ rights to commence an action in any court of competent jurisdiction in the United States, to remove an action to a United States District Court, or to seek a transfer of a case to another court as permitted by the laws of the United States or of any state in the United States. It is further agreed that service of process in such suit may be made upon Mendes and Mount; 750 Seventh Avenue; New York, NY 10019-6829 USA (For California Residents, contact Eileen Ridley, FLWA Service Corp., c/o Foley & Lardner LLP, 555 California Street, Suite 1700, San Francisco, CA 94104-1520 USA.), and that, in any suit instituted against any one of them upon this contract, Underwriters will abide by the final decision of such court or of any appellate court in the event of an appeal.

The above-named are authorized and directed to accept service of process on behalf of Underwriters in any such suit, or, upon request of the Assured, to give a written undertaking to the Assured that they will enter a general appearance upon Underwriters’ behalf in the event such a suit shall be instituted.

Further, pursuant to any statute of any state, territory, or district of the United States that makes provision therefor, Underwriters hereby designate the Superintendent, Commissioner, or Director of Insurance or other officer specified for that purpose in the statute or his successors in office as their true and lawful attorney upon whom may be served any lawful process in any action, suit, or proceeding instituted by or on behalf of the Assured or any beneficiary hereunder arising out of this contract of Insurance and hereby designate the above-mentioned as the person to whom the said officer is authorized to mail such process or a true copy thereof Assignment. This Certificate shall not be assigned either in whole or in part without the written consent of the Correspondent endorsed hereon.

Attached Conditions Incorporated. This Certificate is made and accepted subject to all the provisions, conditions, and warranties set forth herein, attached or endorsed, all of which are to be considered as incorporated herein.