The Diplomat International provides Accident and Sickness Medical Coverage, Travel Assistance, and Accidental Death and Dismemberment benefits to Individuals while traveling outside their Home Country, but not to the United States. Coverage is available for you, a second adult, unmarried dependent Children, or Children traveling alone. The minimum period of coverage that can be purchased is 5 days, the maximum is 364 days.
Coverage will begin at 12:00 A.M. Eastern Standard Time on the latest of the following: 1) The date the Company receives a completed application or enrollment form; or 2) The moment Plan Participant exits their Home Country airspace; or 3) The Date the Company approves the Application; or 4) The Date requested by the Plan Participant.
Coverage will end at 11:59 P.M. Eastern Standard Time on the earliest of the following: 1) The date Plan Participant is no longer in an Eligible Class; or 2) The date the Plan Participant returns to his or her Home Country unless otherwise covered under the Plan Document; or; 3) The expiration of 364 days from the Effective Date of Coverage; or 4) The date shown on the Schedule of Insurance issued by the Company.
Maximum: Plan A - $50,000, Plan B - $100,000, Plan C -$250,000, Plan D -$500, 000, Plan E -$1,000,000; Persons age 70 –79 are eligible for plans A and B; Persons age 80+ are eligible for a maximum benefit of $20,000.
Deductible Choices: $0, $50, $100, $250, $500, $1,000, $2,500, $5,000 per person/plan period
Co - Insurance : After you pay your selected deductible this plan will pay 100% of Covered Expenses outside your Home Country up to the selected plan maximum.
Pre - Existing Condition Exclusion: 12 Months prior to the start date of coverage
Emergency Medical Evacuation and Repatriation: $500,000
Return of Mortal Remains: $50,000
Emergency Medical Reunion: $50,000
Return of Minor Child: $50,000
Interruption of Trip: $5,000
Loss of Baggage: $50 per article; up to a maximum of $250
Emergency Dental Treatment : $100
Accidental Death and Dismemberment: $25 ,000 (Enhanced Benefit Amounts available) with paralysis and coma, seat belt and airbag, felo nious assault and home alteration and vehicle modification benefits.
In - Hospital Indemnity (US Citizens only): $100 per day to a maximum of 10 days
Unexpected Recurrence of a Pre - existing Condition (US Citizens only): up to $20,000; ($2,500 for age 65 and older)
Optional Plan Enhancements:
- Athletic & Hazardous Activity Benefit
- Home Country Coverage
- War Risk Coverage Available, call for a quote.
Political and Natural Disaster Evacuation: $50,000
Exclusions - The Plan Document does not cover any loss resulting from any of the following unless otherwise covered under the Plan Document by Additional Benefits:
1) Suicide, attempted suicide (including drug overdose) self-destruction, attempted self-destruction or intentional self-inflicted Injury while sane or insane;
2) War or any act of war, declared or undeclared; Unless War Risk Rider is purchased;
3) Any Covered Loss which occurs while the Plan Participant is on Active Duty Service in any Armed Forces, National Guard, military, naval or air service or organized reserve corps;
4) Any Covered Loss sustained while in the service of the armed forces of any country. When the Plan Participant enters the armed forces of any country, We will refund the unearned pro rata premium upon request;
5) Voluntary, active participation in a riot or insurrection;
6) Medical expenses resulting from a motor vehicle accident in excess of that which is payable under any other valid and collectible insurance;
7) Medical Treatment related to organ transplants, whether as donor or recipient; this includes expenses incurred for the evaluation process, the transplant surgery, post operative treatment, and expenses incurred in obtaining, storing or transporting a donor organ. In relation to a bone marrow or stem cell transplant this exclusion would include harvesting & mobilization charges;
8) For any Covered Losses resulting from the Plan Participant's intoxication or use of illegal drugs or any drugs or medication that is intentionally not taken in the dosage recommended by the manufacturer or for the purpose prescribed by the Plan Participant's Physician;
9) Commission or attempt to commit an assault or felony, or that occurs while being engaged in an illegal occupation;
10) Eligible Expenses for which the Plan Participant would not be responsible in the absence of the Policy;
11) Treatment of acne;
12) Charges which are in excess of Usual, Reasonable and Customary charges;
13) Charges that are not Medically Necessary;
14) Charges provided at no cost to the Plan Participant;
15) Expenses incurred for treatment while in Your Home Country; except as provided under the Home Country Coverage Benefit;
16) Expenses incurred for an Accident or Injury or Sickness after the Benefit Period shown in the Schedule of Benefits or incurred after the termination date of coverage;
17) Regular health checkups; routine physical, immunizations or other examination where there are no objective indications or impairment in normal health;
18) Services or treatment rendered by a Physician, Registered Nurse or any other person who is employed or retained by the Policyholder; or an Immediate Family member of the Plan Participant;
19) Duplicate services actually provided by both a certified nurse midwife and Physician;
20) Any Covered Loss paid under Workers’ Compensation, Employer’s liability laws or similar occupational benefits or while engaging in an occupation for monetary gain from sources other than the Policyholder;
21) Benefits for enrolling solely for the purpose of obtaining medical treatment, while on a waiting list for a specific treatment, or while traveling against the advice of a Physician;
22) Aggravation or re-injury of a prior Injury that the Plan Participant suffered prior to his or her coverage Effective Date, unless We receive a written medical release from the Plan Participant’s Physician;
23) Pre-existing conditions (This exclusion does not apply to Emergency Evacuation/Repatriation or Return of Mortal Remains);
24) Treatment of a hernia, including sports hernia, whether or not caused by a Covered Accident;
25) Pregnancy or childbirth, elective abortion; elective cesarean section; or any complications of any of these conditions; pregnancy or childbirth of a dependent when dependent child of a Plan Participant;
26) Drug, treatment or procedure that either promotes or prevents conception, or prevents childbirth, including but not limited to: artificial insemination, treatment for infertility or impotency, sterilization or reversal thereof, or abortion;
27) Charges incurred for Surgery or treatments which are, Experimental/Investigational, or for research purposes;
28) Expense incurred for treatment of temporomandibular joint (TMJ) disorders or craniomandibular joint dysfunction and associated myofacial pain;
29) Dental care or treatment other than care of sound, natural teeth and gums required on account of Injury resulting from an Accident or emergency pain relief treatment to natural teeth while the Plan Participant is covered under the Policy, and rendered within 6 months of the Accident;
30) Eyeglasses, contact lenses, hearing aids braces, appliances, or examinations or prescriptions therefore;
31) Weak, strained or flat feet, corns, calluses, or toenails;
32) Private-duty nursing services;
33) The cost of the Plan Participant’s unused airline ticket for the transportation back to the Plan Participant’s Home Country, where an Emergency Medical Evacuation or Repatriation and/or Return of Mortal Remains benefit is provided;
34) Expenses payable under any prior policy which was in force for the person making the claim;
35) For the cost of a one way airplane ticket used in the transportation back to the Insured's country where an air ambulance benefit is provided and medically necessary;
36) Treatment paid for or furnished under any other individual or group policy, or other service or medical prepayment plan arranged through the employer to the extent so furnished or paid, or under any mandatory government program or facility set up for the treatment without cost to any individual;
37) Travel in or upon: (a) A snowmobile; (b) A water jet ski; (c) Any two or three wheeled motor vehicle, other than a motorcycle registered for on-road travel; (d) Any off-road motorized vehicle not requiring licensing as a motor vehicle; when used for recreation or competition. Unless the Hazardous Activity Benefit is purchased.
38) Injury sustained while taking part in: mountaineering; hang gliding; parachuting; bungee jumping; racing by horse, motor vehicle or motorcycle; snowmobiling; motorcycle/motor scooter riding; scuba diving, involving underwater breathing apparatus, water skiing; snow skiing; spelunking; parasailing; white water rafting; surfing, unless part of a school credit course; and snowboarding. Unless the Hazardous Activity Benefit is purchased.
39) Practice or play in any amateur, club, intramural, interscholastic, intercollegiate, sports contest or competition. Unless Athletic Sports Rider is purchased.
40) Practice or play in any professional or semiprofessional sports contest or competition;
41) Rest cures or custodial care;
42) Treatment of Mental and Nervous Disorders;
43) Weight reduction programs or surgical treatment of obesity;
44) Treatment of venereal disease;
45) Elective or Cosmetic surgery and Elective Treatment or treatment for congenital anomalies (except as specifically provided), except for reconstructive surgery on a diseased or injured part of the body (Correction of a deviated nasal septum is considered cosmetic surgery unless it results from a covered Injury or Sickness);
46) Travel or flight in or on any vehicle for aerial navigation, including boarding or alighting from:
a) While riding as a passenger in any Aircraft not intended or licensed for the transportation of passengers; or
b) While being used for any test or experimental purpose; or c) While piloting, operating, learning to operate or serving as a member of the crew thereof; or d) while traveling in any such Aircraft or device which is owned or leased by or on behalf of the Policyholder of any subsidiary or affiliate of the Policyholder, or by the Plan Participant or any member of his household.
e) A space craft or any craft designed for navigation above or beyond the earth's atmosphere; or
f) An ultra light, hang-gliding, parachuting or bungi-cord jumping; Unless the Hazardous Activity Benefit is purchased.
Except as a fare paying passenger on a regularly scheduled commercial airline or as a passenger in a non-scheduled, private aircraft used for business or pleasure purposes.
47) Ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste, from combustion of nuclear fuel, the radioactive, toxic, explosive or other hazardous properties of any nuclear assembly or nuclear component of such assembly.
48) Plan Participant being exposed to the Utilisation of nuclear, chemical or biological weapons of mass destruction.
49) Treatment of HIV infection, HIV related illness and AIDS (acquired immune deficiency syndrome) in excess of a lifetime maximum of $7,500;
50) Expenses incurred for services, testing and treatment of Sleep Apnea.
51) This Insurance does not cover any claim in any way caused by or resulting from:
a) Coronavirus disease (COVID-19);
b) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2);
c) any mutation or variation of SARS-CoV-2;
d) any fear or threat of a), b) or c) above
In addition to any of the exclusions listed above, for Eligible Expenses under Trip Interruption, this Insurance also does not cover the following:
1) The Plan Participant or Traveling Companion or Traveling Companion’s family making changes to personal plans; having business or contractual obligations; being unable to obtain necessary travel documents (passports, visas, etc.); being detained or having property confiscated by customs authorities; carrier caused delays (including bad weather);
2) Prohibition or regulatory by any government; default of yacht charter companies; default of the organization from which the Plan Participant purchased their trip arrangements;
3) A Pre-Existing Condition existing prior to the Plan Participant’s departure from their Home Country.
In addition to any of the exclusions listed above, for Eligible Expenses under Baggage Loss, this Insurance also does not cover the following: (1) Animals; (2) Artificial teeth or limbs, hearing aids; (3) Sunglasses, contact lenses or eyeglasses; (4) Professional or occupational equipment or property, whether or not electronic business equipment or; (5) Telephones or PDA devices, computer hardware or software.
Acute Pre-Ex Coverage
Pre-Existing Condition means an Injury, Sickness, disease, or other condition during the 12 month period immediately prior to the date the Plan Participant’s coverage is effective for which the Plan Participant 1) received medical advice or received a recommendation for a test, examination, or Medical Treatment for a condition which first manifested itself, worsened or became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment or 2) took or received a prescription for drugs or medicine
Coverage under this Plan is not renewable. If additional coverage time is needed, a new application must be completed and correct Premium submitted to Global Underwriters Agency. A new Deductible, Coinsurance, and Pre-existing Condition Exclusion will apply at each succeeding or subsequent Period of Coverage.
Premiums will be refunded in full if cancellation request is received prior to the certificate effective date.
- $25 cancellation fee will apply for administrative costs incurred by us; and
- Only the unused portion of the plan cost will be refunded; and
- You cannot have filed any claims to be eligible for premium refund.
After the Effective Date of Individual coverage, premium is considered fully earned and non-refundable. Partial refunds are not available.
The Company, upon receipt of a written 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 15 days after the giving of such notice, the claimant shall be deemed to have complied with the requirements of this Plan by submitting, within the time fixed in this Plan for filing proofs of loss, written proof showing the occurrence, nature and extent of the loss for which claim is made. Claim forms can be obtained by calling 800-513-2981 or online at www.globalunderwriters.com. One claim form is needed for each Injury or Illness for which a claim is being made.
The Company is liable and in case of claim for any other loss within 90 days after the date of such loss. Failure to furnish proof within the time required shall not invalidate nor reduce any claim if it is not reasonably possible to give proof within such time, provided proof is furnished as soon as reasonably possible.