GENERAL TERMS OF COVERAGE

ELIGIBILITY

This Policy provides coverage to non-US citizens who reside outside the USA and are traveling outside of Their Home Country to visit solely the United States, or to visit a combination of the United States and other countries worldwide. The Insured must arrive in the USA before traveling to other countries. Coverage in countries outside the USA and your Home Country is available for up to 180 days during your Policy Period.

This Policy is not available to any individual who has been residing within the United States for more than 365 days prior to their Effective Date.

We maintain Our right to investigate to verify that the eligibility requirements have been met. If and whenever We discover that the eligibility requirements have not been met, Our only obligation is refund of premium.

CONTINUATION OF TREATMENT PERIOD

If a covered Sickness or Injury requires continuing Treatment after the expiration of the Policy Period, a Covered Person may receive continuing  Treatment for the covered Sickness or Injury for up to six (6) months per Sickness or Injury, subject to the following: if the Policy Period expires while  the Covered Person is outside the Home Country, a covered Sickness or Injury incurred while outside and prior to returning to the Home Country, and that covered Sickness or Injury requires continuing Treatment, the Company will review and determine the date of initial Treatment for the covered Sickness or Injury, and if such date is prior to the expiration of the Policy Period, Eligible Medical Expenses for the covered Sickness or Injury  will continue to be reimbursed until there has been at least the minimum number of days of continuous Treatment for the covered Sickness or  Injury, subject to the limits set forth in the Schedule of Benefits/Limits, and all other Terms of the insurance plan. In order to be eligible for coverage  under the Continuation of Treatment Period provision, the Covered Person must be covered by an insurance policy, benefit plan, or Other Coverage  for expenses or charges incurred by the Covered Person, and the Other Coverage remains in effect during the duration of coverage with the Company.

EFFECTIVE DATE

An eligible person will be insured on the latest of the following dates: 1. the Covered Person’s departure from Their Home Country; 2. the date and  time the Covered Person completed enrollment form and Their correct premium is received; or 3. the effective date requested and shown on the certificate.

TERMINATION DATE

Coverage will end on the earliest of the date: 1. the Covered Person’s return to Their Home Country, except as provided under Return to Home  Country Benefit, if eligible; or 2. the termination date shown on the certificate for which premium has been paid; or 3.the date the Maximum Benefit for the loss has been paid.

EXTENSION PROCEDURES

An extension notice will be sent to the Covered Person before the Policy Period ends and includes links to extend prior to the termination date.  The Covered Person is subject to the following rules at extension: If it is initially purchased for a minimum of 5 days. If available, additional periods  are charged at the premium rate in force at the time of extension. 5 days premium is the minimum acceptable extension premium and 364 days premium is the maximum. There are no grace periods for extension. Once the policy has lapsed, reapplication isrequired. Please note, upon application for a new policy, the Pre-Existing Condition exclusion, deductible and

co-insurance start over.

"Automobile" means a self-propelled, private passenger motor vehicle with four or more wheels that is a type both designed and required to be licensed for use on the highway of any state or country. Automobile includes,

but is not limited to, a sedan, station wagon, sport utility vehicle, or a motor vehicle of the pickup, van, camper, or motor-home type. Automobile does  not include a mobile home or any motor vehicle that is used in mass or public transit.

“Common Carrier" means any public conveyance that is operated via a published schedule and to which a fare is paid. This is inclusive of Bus, Rail, Air and Sea transportation.

“Company” means Crum & Forster SPC.

“Covered Accident” means an Accident that occurs while coverage is in force for a Covered Person and results ina loss or Injury covered by the Policy for which benefits are payable.

“Covered Expenses” means expenses actually incurred by or on behalf of a Covered Person for treatment, services and supplies covered by the Policy.  Coverage under the Policy must remain continuously in force from the date of the Accident or Sickness until the date treatment, services or supplies  are received for them to be a Covered Expense. A Covered Expense is deemed to be incurred on the date such treatment, service or supply, that gave rise to the expense or the charge, was rendered or obtained.

“Covered Loss” or “Covered Losses” means an accidental death, dismemberment or other Injury covered under the Policy.

“Covered Person” means any Insured and Dependent for whom the required premium is paid (herein also referred to as “ You” or “Your” or “They” or “Their”).

"Deductible" means the dollar amount of Covered Expenses that must be incurred as an out of-pocket expense by each Covered Person on a per  incidence basis. The deductible must be met, by the Covered Person before Medical Expense Benefits can be paid or reimbursed. The deductible is applied to the first eligible claim processed.

“Dependent” means an Insured’s lawful spouse or domestic partner; or an Insured’s unmarried child, from the moment of birth to age 21, who is chiefly  dependent on the Insured for support. A child, for eligibility purposes, includes an Insured’s natural child; adopted child, beginning with any waiting `

period pending finalization of the child’s adoption; or a stepchild who resides with the Insured or depends chiefly on the Insured for financial support. A Dependent may also include any person related to the Insured by blood or marriage and for whom the Insured is allowed a deduction under the Internal Revenue Code. Insurance will continue for any Dependent child who reaches the age limit and continues to meet the following conditions: 1. the child is  handicapped, 2. is not capable of self-support and 3. depends chiefly on the Insured for support and maintenance. The Insured must send Ussatis factory proof that the child meets these conditions, when requested. We will not ask for proof more than once a year.

"Diagnosis" means the result of examination or test by a licensed physician providing a specific international CPT or ICD10 code. Failure to obtain a covered Diagnosis will result in the denial of the claim.

"Effective Date" means the program shall become effective at 12:01 AM North American Central Time on the latest of the following dates: 1. The Insured  Person’s Departure from their Home Country. 2. The date the application and premium are received by the Administrator; or 3. The date the application  and premium are accepted by the Administrator; or 4. The date requested on the application.

"Event" means any one incident in which the Covered Person requires care for acute, sudden and unforeseen Medical and Accidental Emergencies and the direct consequence of the Event. Maximum coverage is limited toamounts specified in the Schedule of Benefits. Multiple Events independent of each  other are covered to the Event maximum with no limits on the number of Events.

"Home Country" means a country from which the Insured Person holds a passport. If the Insured Person holds passports from more than one country, his or  her Home Country will be that country which the Insured Person has declared to Us in writing as his or her Home Country.

“Hospital” means an institution that: 1. operates as a Hospital pursuant to law for the care, treatment, and providing of in-patient services for sick or injured  persons; 2. provides 24-hour nursing service by Registered Nurses on duty or call; 3. has a staff of one or more licensed physicians available at all times; 4.  provides organized facilities for diagnosis, treatment and surgery, either: (i) on its premises; or (ii) in facilities available to it, on a pre-arranged basis; 5. is not  primarily a nursing care facility, rest home, convalescent home, or similar establishment, or any separate ward, wing or section of a Hospital used as such;  and 6. is not a place solely for drug addicts, alcoholics, or the aged or any separate ward of the Hospital.

“Hospital Confined” means an overnight stay as a registered resident bed-patient in a Hospital.

“Host Country” means any country, otherthan an OFAC excluded country, in which the Covered Person is traveling while covered under the Policy.

“Immediate Family Member” means the spouse, parent, parent-in-law, grandparent, child, grandchild, brother, sister, fiancé, such person being related to the Covered Person.

"Incident" Any situation in which the terms and conditions of the policy are activated for either a Sickness,Accident or Injury.

"Injury" means accidental bodily harm sustained by a Covered Person that results, directly and independently from all other causes, from a Covered Accident. All injuries sustained by one person in any one Accident, including all related conditions and recurrent symptoms of these injuries, are considered a single Injury.

“Medical Emergency” means a condition caused by an Injury or Sickness that manifests itself by symptoms of sufficient severity that a prudent layperson  possessing an average knowledge of health and medicine would reasonably expect that failure to receive immediate medical attention would place the health  of the person in serious jeopardy.

“Medically Necessary” means a treatment, service or supply that is: 1. required to treat an Injury or Sickness; prescribed or ordered by a Physician or  furnished by a Hospital; 2. performed in the least costly setting required by the Covered Person’s condition; and 3. consistent with the medical and surgical practices prevailing in the area for treatment of the condition at the time rendered. Purchasing or renting 1. air conditioners; 2. air purifiers; 3. motorized transportation equipment; 4. escalators or elevators in private homes; 5. eye glass frames or lenses; 6. hearing aids; 7. swimming pools or supplies for them; 

and 8. general exercise equipment are not considered Medically Necessary. A service or supply may not be Medically Necessary if a less intensive or more  appropriate diagnostic or treatment alternative could have been used. We may, at Our discretion, consider the cost of the alternative to be the Covered Expense.

“Missing Bag Report” means a formal report of loss as filed with the common carrier commonly known as a PIR (Passenger Irregularity Report) or PAWOB  (Passenger Arriving With Out Baggage). This must include the 6-digit Claim Number or the World Tracer Record Number as provided by the carrier.

“Missing Person” means a Covered Person who disappeared for an unknown reason and whose disappearance was reported to the appropriate authority(ies).

“Natural Disaster” means storm (wind, rain, snow, sleet, hail, lightning, dust or sand) earthquake, flood, volcaniceruption, wildfire or other similar event that: 1. is due to natural causes; and 2. results in such severe and

widespread damage that the area of damage is officially declared a disaster area by the government in which the Covered Person’s Trip occurs and the area is deemed to be uninhabitable or dangerous.

“Nearest Place of Safety” means a location determined by the Designated Security Consultant where: 1. the Covered Person can be presumed safe from the  Occurrence that precipitated the Covered Person’s Political Evacuation; and the Covered Person has access to Transportation; and 2. the Covered Person  has the availability of temporary lodging, if needed.

“Necessities” means personal hygiene items and clothing.

“Occurrence” means any of the following situations involving a Covered Person: 1. expulsion from a Host Country or being declared persona non-grata on the written authority of the recognized government of a Host Country; 2. political or military events involving a Host Country, if the Appropriate Authorities issue  an Advisory stating that citizens of the Covered Person’s Home Country or citizens of the Host Country should leave the Host Country; 3. deliberate physical  harm of the Covered Person confirmed by documentation or physical evidence or a threat against the Covered Person’s health and safety as confirmed by  documentation and/or physical evidence; 4. Natural Disaster in the area the Covered Person is traveling to and occurring after Their effective date; 5. the

Covered Person had been deemed kidnapped or a Missing Person by local or international authorities and, when found, his or her safety and/or well-being are in question within seven days of his or her being found.

“Physician/Doctor” means a licensed health care provider acting within the scope of his or her license and rendering care or treatment to a Covered Person  that is appropriate for the conditions and locality. It will not include a Covered Person or a member of the Covered Person’s Immediate Family or household.

“Policy Period” means the dates as shown on the Covered Person’s certificate for which premium has been paid.

“Political Evacuation” means the extrication of a Covered Person from the Host Country due to an Occurrence which could result in grave physical harm or death to the Covered Person and is certified by a governing authority via declaration or warning.

BENEFIT SUMMARY

PLAN BENEFITS

SAFE TRAVELS ELITE ECONOMY

SAFE TRAVELS ELITE BASIC

SAFE TRAVELS ELITE SILVER

SAFE TRAVELS ELITE GOLD

SAFE TRAVELS ELITE PLATINUM

SAFE TRAVELS ELITE DIAMOND

SAFE TRAVELS ELITE DIAMOND PLUS

Policy Maximum

$25,000 Max per Incident

$50,000 Max per Incident

$75,000 Max per Incident

$100,000 Max per Incident

$175,000 Max per Incident

$50,000 Annual Max.

$100,000 Annual Max.

Deductible per Incident

$0

$0

$0

$0

$0

$100, $200

$100, $200

Ages

Ages 0-69

Ages 0-69

Ages 0-69

Ages 0-69

Ages 0-69

Ages 70-89

Ages 70-89

INPATIENT HOSPITAL EXPENSE

Hospital Room and Board Expenses

$1,400 per day to a maximum of 30 days

$2,000 per day to a maximum of 30 days

$2,000 per day to a maximum of 30 days

$2,000 per day to a maximum of 30 days

$3,000 per day to a maximum of 30 days

$1,500 per day to a maximum of 30 days

$1,500 per day to a maximum of 30 days

Inpatient Ancillary Hospital Services

Included under Hospital Room and Board

Included under Hospital Room and Board

Included under Hospital Room and Board

Included under Hospital Room and Board

Included under Hospital Room and Board

Included under Hospital Room and Board

Included under Hospital Room and Board

Hospital Intensive Care Unit Expenses

$2,100 per day to a maximum of 10 days

$2,500 per day to a maximum of 8 days

$2,500 per day to a maximum of 8 days

$3,000 per day to a maximum of 8 days

$4,500 per day to a maximum of 8 days

$2,300 per day to a maximum of 8 days

$2,300 per day to a maximum of 8 days

Physician's Surgical Treatment

$3,500 per Incident

$5,000 per Incident

$5,000 per Incident

$6,000 per Incident

$7,500 per Incident

$3,500 per Incident

$3,500 per Incident

Anesthesiologist Expense

$850 per Incident

$850 per Incident

$1,200 per Incident

$1,400 per Incident

$1,800 per Incident

$850 per Incident

$850 per Incident

Assistant Physician’s Surgical Expenses

$850 per Incident

$850 per Incident

$1,200 per Incident

$1,400 per Incident

$1,800 per Incident

$850 per Incident

$850 per Incident

Physician’s Non-Surgical Visits

Limited to $55 per visit, one visit per day and 30 visits per Policy Period

Limited to $75 per visit, one visit per day and 30 visits per Policy Period

Limited to $75 per visit, one visit per day and 30 visits per Policy Period

Limited to $100 per visit, one visit per day and 30 visits per Policy Period

Limited to $130 per visit, one visit per day and 30 visits per Policy Period

Limited to $75 per visit, one visit per day and 30 visits per Policy Period

Limited to $75 per visit, one visit per day and 30 visits per Policy Period

Consulting Physician

$450 per Incident

$450 per Incident

$550 per Incident

$550 per Incident

$700 per Incident

$450 per Incident

$450 per Incident

Private Duty Nurse

$450 per Incident

$450 per Incident

$550 per Incident

$550 per Incident

$700 per Incident

$450 per Incident

$450 per Incident

Pre-Admission Test within 7 days of Admission

$1,100 per Incident

$1,100 per Incident

$1,100 per Incident

$1,200 per Incident

$1,500 per Incident

$1,100 per Incident

$1,100 per Incident

OUTPATIENT - Maximum Daily Benefit All Services $10,000 – Up to the selected Policy Maximum

Outpatient Surgical Facility

$1,000 per Incident

$1,100 per Incident

$1,150 per Incident

$1,275 per Incident

$1,400 per Incident

$1,100 per Incident

$1,100 per Incident

Physician's Surgical Treatment

$3,500 per Incident

$5,000 per Incident

$5,000 per Incident

$6,000 per Incident

$7,500 per Incident

$3,500 per Incident

$3,500 per Incident

Anesthesiologist Expense

$850 per Incident

$850 per Incident

$1,200 per Incident

$1,400 per Incident

$1,800 per Incident

$700 per Incident

$700 per Incident

Assistant Physician’s Surgical Expenses

$850 per Incident

$850 per Incident

$1,200 per Incident

$1,400 per Incident

$1,800 per Incident

$700 per Incident

$700 per Incident

Physician’s Visits/ Urgent Care

Limited to $55 per visit, one visit per day and 30 visits per Policy Period

Limited to $75 per visit, one visit per day and 30 visits per Policy Period

Limited to $75 per visit, one visit per day and 30 visits per Policy Period

Limited to $100 per visit, one visit per day and 30 visits per Policy Period

Limited to $130 per visit, one visit per day and 30 visits per Policy Period

Limited to $130 per visit, one visit per day and 30 visits per Policy Period

Limited to $75 per visit, one visit per day and 30 visits per Policy Period

Diagnostic X-rays and Lab Services

$450 per Incident

$750 per Incident

$750 per Incident

$750 per Incident

$1,000 per Incident

$750 per Incident

$750 per Incident

Chemotherapy &/or radiation therapy

$1,100 per Incident

$1,100 per Incident

$1,225 per Incident

$1,350 per Incident

$1,750 per Incident

$700 per Incident

$1,100 per Incident

Scans, PET scan or MRI

$650 per Incident

$650 per Incident

$875 per Incident

$1,050 per Incident

$1,300 per Incident

$650 per Incident

$650 per Incident

Emergency Room Illness with no direct Hospital Admission

$350 and an additional $200 Deductible per visit - Only applies when receiving care in an Emergency room for an Illness that does not result in a hospital admittance.

$500 and an additional $200 Deductible per visit - Only applies when receiving care in an Emergency room for an Illness that does not result in a hospital admittance.

$500 and an additional $200 Deductible per visit - Only applies when receiving care in an Emergency room for an Illness that does not result in a hospital admittance.

$600 and an additional $200 Deductible per visit - Only applies when receiving care in an Emergency room for an Illness that does not result in a hospital admittance.

$800 and an additional $200 Deductible per visit - Only applies when receiving care in an Emergency room for an Illness that does not result in a hospital admittance.

$500 and an additional $200 Deductible per visit - Only applies when receiving care in an Emergency room for an Illness that does not result in a hospital admittance.

$500 and an additional $200 Deductible per visit - Only applies when receiving care in an Emergency room for an Illness that does not result in a hospital admittance.

Emergency Room injury/Accident or Illness with direct Hospital Admission

$350 per Incident

$500 per Incident

$500 per Incident

$600 per Incident

$800 per Incident

$500 per Incident

$500 per Incident

Prescription drugs and medications

$250 per Incident

$350 per Incident

$350 per Incident

$350 per Incident

$350 per Incident

$250 per Incident

$250 per Incident

ADDITIONAL MEDICAL TREATMENT AND SERVICES

Acute Onset of Pre-Existing Condition(s) per Policy Period Subject to the sub limits for each benefit listed

Up to Policy Maximum Coverage related to Cardiac Conditions or Stroke are limited to $25,000

Up to Policy Maximum Coverage related to Cardiac Conditions or Stroke are limited to $25,000

Up to Policy Maximum Coverage related to Cardiac Conditions or Stroke are limited to $25,000

Up to Policy Maximum Coverage related to Cardiac Conditions or Stroke are limited to $25,000

Up to Policy Maximum Coverage related to Cardiac Conditions or Stroke are limited to $25,000

For ages 70-79, up to $25,000. For ages 80 and above, up to $15,000 /Coverage related to Cardiac Conditions or Stroke are limited to $15,000

For ages 70-79, up to $25,000. For ages 80 and above, up to $15,000 /Coverage related to Cardiac Conditions or Stroke are limited to $15,000

Cardiac Conditions

$25,000 per Policy Period

$25,000 per Policy Period

$25,000 per Policy Period

$25,000 per Policy Period

$25,000 per Policy Period

$15,000 per Policy Period

$15,000 per Policy Period

COVID-19 Expenses

Covered as any other Sickness

Covered as any other Sickness

Covered as any other Sickness

Covered as any other Sickness

Covered as any other Sickness

Covered as any other Sickness

Covered as any other Sickness

Well Doctor Visit

Pays $125 - One Visit per person per Policy Period. To be eligible you must purchase at least 30 days of coverage initially and the visit must occur within the first 21 days of your effective date.

Dental Treatment for Injury to sound natural teeth

$600 per Incident

$750 per Incident

$750 per Incident

$750 per Incident

$750 per Incident

$750 per Incident

$750 per Incident

Mental or Nervous Disorder

$5,000 per Incident

$5,000 per Incident

$5,000 per Incident

$5,000 per Incident

$5,000 per Incident

$5,000 per Incident

$5,000 per Incident

Physiotherapy Physical Medicine/Chiropractic Expenses

$40/visit, 1/day, 12 visits max per Policy Period

Limited to $50 per visit, one visit per day and 12 visits per Policy Period

Limited to $50 per visit, one visit per day and 12 visits per Policy Period

Limited to $60 per visit, one visit per day and 12 visits per Policy Period

Limited to $60 per visit, one visit per day and 12 visits per Policy Period

Limited to $50 per visit, one visit per day and 12 visits per Policy Period

Limited to $50 per visit, one visit per day and 12 visits per Policy Period

Initial Orthopedic Prosthesis/brace

$1,100 per Incident

$1,100 per Incident

$1,225 per Incident

$1,350 per Incident

$1,750 per Incident

$1,100 per Incident

$1,100 per Incident

Return to Home Coverage

Up to 30 days per 12 months Max $2,000

Up to 30 days per 12 months Max $2,000

Up to 60 days per 12 months Max $2,500

Up to 60 days per 12 months Max $2,500

Up to 90 days per 12 months Max $7,500

N/A

N/A

TRANSPORTATION EXPENSES

Ambulance Service Benefits

$500 per Incident

$650 per Incident

$650 per Incident

$650 per Incident

$750 per Incident

$650 per Incident

$650 per Incident

*Emergency Medical Evacuation

$100,000 per Policy Period

$100,000 per Policy Period

$100,000 per Policy Period

Unlimited

Unlimited

$50,000 per Policy Period and $25,000/Lifetime Maximum for Acute Onset over age of 80

$50,000 per Policy Period and $25,000/Lifetime Maximum for Acute Onset over age of 80

*Medically Necessary Repatriation

$15,000 per Policy Period

$15,000 per Policy Period

$15,000 per Policy Period

$15,000 per Policy Period

$15,000 per Policy Period

$15,000 per Policy Period

$15,000 per Policy Period

*Political Evaluation

$500 per Policy Period

$500 per Policy Period

$500 per Policy Period

$500 per Policy Period

$500 per Policy Period

$500 per Policy Period

$500 per Policy Period

EXCLUSIONS

We will not pay benefits or expenses for any loss, treatment or services that is caused by, contributed by or that results from:
1)  Pre-Existing Conditions as defined.
2) Chronic or recurrent Illnesses.
3) Services, supplies or treatment, including any period of Hospital confinement, which were not recommended, approved and certified as necessary and reasonable by a Physician.
4) Costs related to medical examination, treatment and surgical intervention which are not administered in a licensed healthcare institution.
5) Costs related to medical examination where no Sickness has been diagnosed or Accident has been ascertained; for non-specified pain; or preventative or routine exams, except as specifically provided for in this policy.
6) Any visit to a medical provider that does not result in a covered Diagnosis code after medical review or testing.
7) Payment for any subsequent medical services incurred for an illness or injury of the Covered Person leaving a medical facility against the medical advice of the attending Physician will not be covered for 90 days following the date the Covered Person left against medical advice of the Physician.
8) Any treatment by a family member/family associate or any type of direct relationship.
9) In respect of accidental damage to Natural Teeth, no benefit is payable for Injury caused by eating or drinking (even if it contains a foreign body), normal wear and tear, tooth brushing or any other oral hygiene procedure or any means other than extra-oral impact, any form of restorative or remedial work, the use of precious metals, orthodontic treatment of any kind or dental treatment performed in a hospital unless dental surgery is the only treatment available.
10) Suicide or attempted suicide, intentional self-injury, the effect of intoxicating liquors or drugs.
11) Treatment of hernia; Osgood-Schlatters Disease; osteochondritis; osteomyelitis; congenital weakness whether or not caused by a Covered Accident.
12) Evacuation costs where the Insured Person is not being admitted to a Hospital for Treatment or where costs have not been approved by Company prior to travel commencing.
13) Any form of treatment or surgery which in the opinion of the Doctors(s) in attendance and the Assistance Provider that can be delayed until your return to your home country.
14) Any cost resulting in a Sickness, Injury or death from the misuse of drugs or being under the influence or effect of alcohol (other than a legally prescribed medication by a licensed medical professional).
15) Needless self-exposure to peril except in an attempt to save human life.
16) Intentional or fraudulent acts on the Insured Person's part or their consequences.
17) Trips specifically made for the purpose of obtaining medical treatment.
18) Cosmetic surgery or remedial surgery, removal of fat or other surplus body tissue and any consequences of such treatment, weight loss or weight problems/eating disorders, whether or not for psychological purposes, unless required as a direct result of an Accident which occurs during the Policy Period.
19) elective treatment, surgery, health treatment or examination that
a)  can be postponed until the Covered Person returns to his or her Home Country,
b)  is deemed by Us to be Experimental or Investigational, or
c)  are not recognized and generally accepted medical practices in the United States.
20) Treatment for alcoholism, narcotics, drug and substance abuse/dependency or any addictive condition of any kind and any Injury or Sickness arising from the Insured Person being under the influence of alcohol, drugs or any other intoxicating substance.
21) Pregnancy, childbirth whether normal or complicated, including the transfer of a pregnant woman to hospital to give routine childbirth or air travel when the Insured Person is more than 20 weeks pregnant and was NOT a result of an accident or onset of complications relating from an accident.
22) 22. Any sexually transmitted or venereal disease; and/or any testing for the following: HIV, Vaccine induced seropositivity to the AIDS virus, AIDS related Illnesses, ARC Syndrome, AIDS.
23) Treatment for transitional life Events, homesickness, fatigue, jetlag or work-related stress.
24) Any loss as the result of the use of any type of firearm(s) (Defined as any device that discharges a projectile of any type).
25) Any expenses relating to search and rescue operations to find an Insured Person in mountains, at sea, in the desert, in the jungle and similar remote locations, including air/sea rescue charges for evacuation to shore from a vessel or from the sea.
26) Charges or fees incurred for the completion of Medical Claim Forms.
27) Any loss as the result of the use of a Motorcycle or two or three wheeled device of any kind.
28) The radioactive, toxic, explosive or other hazardous or contaminating properties of any nuclear installation, reactor or other nuclear assembly or nuclear component thereof.
29) War Insurrection and Terrorism related to the following: Nuclear, and Weapons of mass destruction means the use of any explosive nuclear weapon or device or the emission, discharge, dispersal, release or escape of fissile material emitting a level of radioactivity capable of causing incapacitating disablement or death amongst people or animals. Chemical Weapons: mass destruction means the emission, discharge, dispersal, release or escape of any solid, liquid or gaseous chemical compound which, when suitably distributed, is capable of causing incapacitating disablement or death amongst people or animals. Utilization of Biological weapons of mass destruction means the emission, discharge, dispersal, release or escape of any pathogenic (disease producing) micro-organism(s) and/or biologically produced toxin(s) (including genetically modified organisms and chemically synthesized toxins) which are capable of causing incapacitating disablement or death amongst people or animals. Terrorism: Terrorist activity means an act, or acts, of any person, or group(s) of persons, committed for political, religious, ideological or similar purposes with the intention to influence any government and/or to put the public, or any section of the public, in fear. Terrorist activity can include, but not be limited to, the actual use of force or violence and/or the threat of such use. Furthermore, the perpetrators of terrorist activity can either be acting alone, or on behalf of, or in connection with any organization(s) or governments(s).
30) Any infection of the urinary tract (including, without limitation, infection of the kidney, ureter, bladder, prostate or urethra) and any complication, medical condition or other Illness directly or indirectly arising therefrom, that occurs within 90 days of the Effective Date of this Insurance and that requires Treatment of the Insured Person in a Hospital as an inpatient.
31) Injury while participating in a named hazards: Abseiling, Aviation (except when traveling as a passenger in a commercial aircraft), BASE Jumping, Bobsleigh, BMX, Bungee Jumping, Canopying, Canyoning, Caving, High Diving, Hang Gliding, Heli-skiing, Hot Air Ballooning, Inline Skating, Jet Skiing, Kayaking, Luge, Motocross, Motorcycling, Moto-X, Mountaineering, Mountain Biking, Mountain Climbing, Paragliding, Parasailing, Parascending, Piloting any Aircraft, Racing of any kind, Rock Climbing, Rodeo Activities, Rappelling, Scuba Diving, Ski Jumping, Skydiving, Snow Skiing, Snowboarding, Snowmobiling, Spelunking, Surfing, Trekking, Water Skiing, Wind Surfing, White Water Rafting, Zip Lining, Zorbing.
32) Injury sustained while participating in a professional, semi-professional, amateur, club, intramural, interscholastic, intercollegiate sport, or any other sport related activity. Inclusive of any condition that arises out of sport activity including but not limited to Cardiac, Respiratory, or Orthopedic conditions.
33) The Covered Person did not exercise reasonable care to prevent accident, Injury, loss or damage and at all times, act as if uninsured.
34) Complications arising from or treatment of an Injury or Illness that is not covered under this Policy.
35) Extreme Sports.
We will not pay Political Evacuation benefits for expenses and fees:
1) payable under any other provision of the Policy.
2) that are recoverable through the Covered Person’s emp
3) arising from or attributable to an actual fraudulent, dishonest or criminal act committed or attempted by the Covered Person, acting alone or in collusion with other persons.
a) arising from or attributable to an alleged:
b) violation of the laws of country in which the Covered Person is traveling while covered under the Policy; or
c) violation of the laws of the Covered Person’s Home County.
4) due to the Covered Person’s failure to maintain and possess duly authorized and issued required travel documents and visas.
5) for repatriation of remains expenses.
6) for common or endemic or epidemic diseases or global pandemic diseases as defined by the World Health Organization.
7) for medical services.
8) for monies payable in the form of a ransom, if a Missing Person case evolves into a kidnapping.
9) arising from or attributable, in whole or in part to a) a debt, insolvency, commercial failure, the repossession of any property by any title holder or lien holder or any other financial cause; b) non- compliance by the Covered Person with regard to any obligation specified in a contract or license.
10) due to military or political issues if the Covered Person’s Security Evacuation request is made more than 30 days after the Appropriate Authority(ies) Advisory was issued
We will not pay Natural Disaster benefits for expenses and fees:
1) If You do not evacuate an area due to a potential Natural Disaster, when evacuation notice (mandatory or voluntary) has been issued or posted by the local, state or country government of Your Home Country or the Host Country for a period of more than three (3) days prior to the Natural Disaster Event.
2) The benefits and services described herein are provided to You only if authorized, arranged and coordinated by Us or Our designated Assistance Provider;
3) We will not pay for any loss or expense recoverable under any other valid and collectible insurance or through an employer;
4) We or Our designated Assistance Provider has sole discretion regarding the means, methods and timing of a Natural Disaster Evacuation. However, the decision to travel is Your sole responsibility;
5) We are not responsible for the availability, timing, quality, results of, or failure to provide any service caused by conditions beyond Our control. This includes Our inability to provide You an evacuation or any additional services when United States of America law, local laws or regulatory agencies prohibit the rendering of such evacuation or service. We will not cover a Natural Disaster Evacuation from OFAC designated countries;
6) the actual or threatened use or release of any nuclear, chemical or biological weapon or device, or exposure to nuclear reaction or radiation, regardless of contributory cause;
7) We will not pay for more than one (1) Natural Disaster Evacuation from a country or territory per Policy Period;
8) We will not pay for any loss or expense arising from or attributable to a) fraudulent or criminal acts committed or attempted by You; b) alleged violation of the laws of the country You are visiting, unless We determine such allegations to be fraudulent; or c) failure to maintain required documents or visas;
9) We will not pay any costs or expenses arising from: a) Natural Disaster Evacuation from Your Home Country; b) Natural Disaster Evacuation when the Natural Disaster Event precedes Your arrival in the Host Country.

PLAN BENEFITS

SAFE TRAVELS ELITE ECONOMY

SAFE TRAVELS ELITE BASIC

SAFE TRAVELS ELITE SILVER

SAFE TRAVELS ELITE GOLD

SAFE TRAVELS ELITE PLATINUM

SAFE TRAVELS ELITE DIAMOND

SAFE TRAVELS ELITE DIAMOND PLUS

Acute Onset of Pre-Existing Condition(s) per Policy Period Subject to the sub limits for each benefit listed

Up to Policy Maximum Coverage related to Cardiac Conditions or Stroke are limited to $25,000

Up to Policy Maximum Coverage related to Cardiac Conditions or Stroke are limited to $25,000

Up to Policy Maximum Coverage related to Cardiac Conditions or Stroke are limited to $25,000

Up to Policy Maximum Coverage related to Cardiac Conditions or Stroke are limited to $25,000

Up to Policy Maximum Coverage related to Cardiac Conditions or Stroke are limited to $25,000

For ages 70-79, up to $25,000. For ages 80 and above, up to $15,000 /Coverage related to Cardiac Conditions or Stroke are limited to $15,000

For ages 70-79, up to $25,000. For ages 80 and above, up to $15,000 /Coverage related to Cardiac Conditions or Stroke are limited to $15,000

ACUTE ONSET OF PRE-EXISTING CONDITION: Benefits are payable for an Acute Onset of a Pre-Existing Condition up to the maximum as stated in the Schedule of Benefits provided the condition or event:

  1. occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent and immediate medical care;
  2. occurs a minimum of 48 hours after the Effective Date of the Policy; and
  3. treatment is obtained within 24 hours of the sudden and unexpected outbreak or recurrence. Any repeat/reoccurrence within the same Policy Period will no longer be considered Acute Onset of a PreExisting Condition and will not be eligible for additional coverage. This benefit covers only one (1) Acute Onset episode of a Pre-Existing Condition. Sudden and Acute Onset of a Pre-Existing Condition Coverage expires upon medical advice that the condition and onset is no longer acute, or the Covered Person is discharged from a medical facility.

Any repeat/reoccurrence within the same Policy Period will no longer be considered Acute Onset of a Pre-Existing Condition and will not be eligible for additional coverage. This benefit covers only one (1) Acute Onset episode of a Pre-Existing Condition. Sudden and Acute Onset of a Pre-Existing Condition Coverage expires upon medical advice that the condition and onset is no longer acute, or the Covered Person is discharged from a medical facility.

CARDIAC CONDITIONS: Treatment for Cardiac Conditions up to the maximum as stated in the Schedule of Benefits.

 If you are visiting the US and you have First Health Network logo on your ID Card:


Find a provider in the USA at www.firsthealthinternational.com

Please note

Click Start Now then choose the provider type and the zip code. You may need to contact a few to find an appointment right away.

  • Both Dental Providers and Pharmacies are Out of Network, and any Out of Network Deductible will apply to eligible claims.
  • Medical Providers may decide not to offer you an appointment for a sick visit. It may be better to find an Urgent Care Center, clinic at a drug store or use the telemedicine benefit in your plan to get an appointment right away.
  • Medical providers participate in various networks which is how a provider recognizes and accepts your insurance to bill the insurance company directly. If you mistakenly say “I am covered by Trawick International Insurance” your provider will not likely recognize the name and say they don't accept your insurance coverage. This does NOT mean that your insurance is not valid and it does NOT mean that insurance will not pay. It might mean that you have to pay for services and submit a claim to be reimbursed or continue the search for a provider.
  • For info on how/where to file a claim see Claim Information on the drop-down above. Some plans have different benefits if you use an In-Network provider versus one that is Out of Network. Please see your plan document for details.

 

Click here for PPO Network

An extension notice will be sent to the Covered Person before the Policy Period ends and includes links to extend prior to the Termination Date. The Covered Person is subject to the following rules at extension: In order to extend, the Policy Period must be initially purchased for a minimum of 5 days. If available, an extension period can be purchased

  1. at the premium rate in force at the time of the extension;
  2. for a minimum of 5 days;
  3. for up to a maximum of 364 days, provided the Covered Person’s Policy Period does not exceed 364 days in total.

There are no grace periods for extension. Once the policy has lapsed, reapplication is required.
Please note, upon application for a new policy, the Pre-Existing Condition exclusion, deductible and coinsurance start over.

Full cancellation and refund will only be considered if We receive written request prior to or on the Effective Date of the coverage. If We receive a written request for cancellation and refund after the Effective Date of coverage, a partial cancellation and refund may be allowed.

The following conditions apply

  1. If any claims have been filed with Us, the premium is fully earned and is non-refundable. If no claims have been filed with the Company, then (i) a cancellation fee of US $25 will be charged; and (ii) only unused days
  2. premiums will be considered as refundable; and
  3. If after a refund is made, it is determined that a claim was presented to Us on a Covered Person’s behalf, the Covered Person will be fully responsible for that claim in its entirety.


DISCLOSURES Client must notify the Plan Administrator within 30 days of a change of address or domicile.

 

All claims must be submitted within 90 days of the date of service. All claims MUST BE ON A FULLY COMPLETED claim form including medical history sections. A claim form must be completed and provided for each medical condition.

Governing Jurisdiction: All claims arising under this insurance shall be governed by the Laws of Cayman Islands whose courts alone shall have jurisdiction in any dispute arising hereunder.


Notice of Claim: A claimant must give Us or Our authorized representative written (or authorized electronic or telephonic) notice of claim within 90 days after any loss covered by the Policy occurs. If the claimant or Covered Person is incapacitated within the 90 days after the loss, must be given as soon as reasonably possible. This notice should identify the Covered Person and the Policy Number. All claims must be submitted within 90 days from date of incident, or they will be denied. Circumstances may exist in which this is not always possible. Any submissions after 90 days will be considered based on those circumstances.


Claim Forms: Upon receiving written notice of claim, We will provide claim forms to the claimant within 15 days. If We do not furnish such claim forms, the claimant will satisfy the requirements of written proof of loss by sending the written (or authorized electronic or telephonic) proof as shown below. The proof must describe the occurrence, extent and nature of the loss and give authorization to release medical records.


Proof of Loss: Written (or authorized electronic or telephonic) proof of loss must be sent to the agent authorized to receive it. Written (or authorized electronic or telephonic) proof must be given within 90 days after the date of loss. If it cannot be provided within that time, it should be sent as soon as reasonably possible. In no event, except in the absence of legal capacity, will proof of loss be accepted if it is sent later than one year from the time proof is otherwise required.


Proof of Eligibility: A claimant must provide Us or Our authorized representative with written proof of eligibility as outlined in this policy, at time of Claim. Proof of Eligibility is required prior to any payment of a Claim.


Claimant Cooperation Provision: Failure of a claimant to cooperate with Us in the administration of a claim may result in the delay or termination of a claim. Such cooperation includes, but is not limited to, providing any information or documents needed to determine whether benefits are payable or the actual benefit amount due.


Time Payment of Claims: Benefits for loss covered by the Policy, other than benefits that require periodic payment, will be paid not more than 60 days after We receive proper written proof of such loss.


Payment of Claims: If the Covered Person dies, any death benefits or other benefits unpaid at the time of the Covered Person’s death will be paid to the beneficiary. If no beneficiary is on record with Us or Our authorized agent, payment will be made to the first surviving class of the following to the Covered Person’s: 1. spouse; 2. children, in equal shares (If a child is a minor, benefits will be paid to the legal guardian); 3. mother or father;
4. estate. All other benefits due and not assigned will be paid to the Covered Person if living. Otherwise, the benefits may, at our option, be paid: 1. according to the beneficiary designation; or 2. to the Covered Person’s estate. If a benefit due is payable to: 1.the Covered Person’s estate; or 2. the Covered Person or a beneficiary who is either a minor or is not competent to give a valid release for the payment, We may pay any amount due to some other person. The other person will be one who we believe is entitled to the payment and who is related to the Covered Person or the beneficiary by blood or marriage. We will be relieved of further responsibility to the extent of any payment made in good faith. We may pay benefits directly to any Hospital or person rendering covered services unless the Covered Person requests otherwise in writing. The Covered Person must make the request no later than the time he or she files a written proof of loss.


Recovery of Overpayment or Error: If benefits are overpaid, or paid in error, We have the right to recover the amount overpaid, or paid in error, by any or all of the following methods: 1. a request for lump sum payment of the amount overpaid or paid in error. 2. Reduction of any proceeds payable under the Policy by the amount overpaid or paid in error. 3. Taking any other action available to Us. We may at Our own expense take proceedings in the name of the Covered Person to recover compensation or secure an indemnity from any third party in respect of any loss, damage or expense covered by this Insurance and any amount so recovered or secured shall belong to Us.
Assignment: At the request of the Covered Person or his or her parent or guardian, if the Covered Person is a minor, medical benefits may be paid to the provider of service. Any payment made in good faith will end our liability to the extent of the payment.


Beneficiary: The Insured may designate a beneficiary. The Insured has the right to change the beneficiary at any time by written (or electronic and telephonic) notice. If the Insured is a minor, his or her parent or guardian may exercise this right for him or her. The change will be effective when We or Our authorized agent receive it. When received, the effective date is the date the notice was signed. We are not liable for any payments made before the change was received. We cannot attest to the validity of a change. The Insured is the beneficiary for any covered Dependent.


Physical Examinations and Autopsy: We have the right to have a Physician of Our choice examine the Covered Person as often as is reasonably necessary. This section applies when a claim is pending or while benefits are being paid. We also have the right to request an autopsy in the case of death, unless the law forbids it. We will pay the cost of the examination or autopsy.


Legal Actions: No lawsuit or action in equity can be brought to recover on the Policy: 1. before 60 days following the date proof of loss was given to Us; or 2. After 3 years following the date proof of loss is required. Conformity with State Laws: On the effective date of the Policy, any provision that is in conflict with the laws in the state where it is issued is amended to conform to the minimum requirements of such laws.


Not in Lieu of Workers’ Compensation: The Policy is not a Workers’ Compensation Policy. It does not provide Workers’ Compensation benefits.


Economic or Trade Sanctions: Any payments under this policy will only be made in full compliance with all United States of America economic or trade sanction laws or regulations, including, but not limited to, sanctions, laws, and regulations administered and enforced by the U.S. Treasury Department’s Office of Foreign Assets Control (“OFAC”). Therefore, any expenses incurred, or claims made involving travel that is in violation of such sanctions, laws and regulations will not be covered under this policy. For more information, You may consult the OFAC internet website at

https://www.treasury.gov/about/organizational-structure/offices/Pages/Office-of-Foreign-Assets-Control.aspx.

Electronic Communication: 1. Consent to receive insurance related documents and communications, including but not limited to, your policy documents, disclosures, notices, explanation of benefits (EOB), claims documentation, as well as termination and cancellation or non-renewal notices, electronically to the email address you provide to us through the online application process instead of receiving these records in a paper format from us. 2. Agree and acknowledge that your consent is provided and/or obtained in connection with a transaction affecting interstate commerce subject to the Electronic Signatures in Global and National Commerce Act and the Uniform Electronic Transactions Act, or a similar electronic transactions law, as adopted by state law. 3. Agree that the document(s) delivered to you electronically shall have the same meaning and effect as if you were provided a paper document, whether or not you choose to view the document(s), unless you previously withdrew your consent to receive documents via electronic means as provided below. Electronic document(s) are considered received by you at the time you complete your purchase, unless we receive notice that the email notification was not delivered to you at the email address you provided.

Fraud Warning: If the Covered Person or any person acting on his/her behalf shall make any claim or statement knowing the same to be false or fraudulent as regards to amount or otherwise, then this Insurance shall become void and all claims here under shall be forfeited without refund of premium.