BROCHURE & ONLINE APPLICATION
Wander Frequent
Traveler
Annual Medical & Evacuation Insurance
Underwritten by The Insurance
Company of the State of Pennsylvania,
a member of Chartis
Insurance, and is rated A "Excellent" by the A.M. Best Company.
Best for: Frequent Travelers
looking for evacuation and medical coverage, when outside of their fixed
permanent residence. Take as many trips as you want throughout the year, as
long as the trips are less than 30 days.
Coverage Period:12 months
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on the Banner Below for Free Instant Quotes & Online Application
Please read the Benefits & Exclusions of this plan carefully before submitting your application.
| Medical
maximum |
$60,000,
$125,000, $600,000, or $1,000,000 |
| Emergency medical
evacuation/ repatriation |
Up to $300,000 (in
addition to the Medical Maximum) |
| Accidental death &
dismemberment (AD&D) |
50,000 Principal Sum
for Insured or Insured Spouse, $5,000 for Dependent Child(ren) |
| Home country coverage |
Incidental Trips to The
Home Country: $50,000 |
| Emergency reunion |
Up to $50,000 |
| Terrorism |
Usual, reasonable and
customary to the selected Medical Maximum |
| Interruption of trip |
Up to $5,000 |
| Waiver of pre-existing
conditions |
Up to $20,000-
See exclusion #1 in the
Brochure
below for full details |
| Travel Assistance
Services |
Included- Available
24/7/365 |
Eligibility
Wander. Frequent Traveler provides coverage as outlined in this brochure for
individuals and families (including unmarried dependent children over 14
days and under 19 years of age) while traveling outside of their Home
Country. Home Country is defined as - The country where an Insured Person(s)
has his/her true, fixed and permanent home and principal establishment. In
order to be considered eligible under Wander. Frequent Traveler, each
insured person must have primary health insurance coverage.
Effective Date of Individual Insurance
Your coverage will begin on the latest of the following: 1) The date and
time the Application and full plan cost is received and accepted by Seven
Corners; or 2) The date requested on the Application.
Termination Date of Individual Insurance
Individual coverage will end on the earlier of the following: 1) 12 months
after the effective date; or 2) The date shown on the ID Card, for which
plan cost has been paid; 3) The date you are no longer eligible under this
plan.; 4) The 30th day of any one trip.
Follow Me Home Coverage
Follow Me Home Coverage: This plan shall pay for Covered Expenses incurred
in your Home Country up to $5,000 for conditions that are first diagnosed
and treated outside Your Home Country (Does not apply for Emergency Medical
Evacuation or Repatriation).
Refund of Premium
Seven Corners realizes that there is uncertainty in international travel.
Refund of total plan cost will only be considered if written request is
received by Seven Corners 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 Seven Corners for reimbursement.
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Please read the Benefits & Exclusions of this plan carefully before submitting your application.
DESCRIPTION
OF BENEFITS
ACCIDENTAL DEATH & DISMEMBERMENT (AD&D)
The Company shall pay an indemnity determined from the Table if an Insured
Person sustains a Loss stated therein resulting from Injury and subject to
the limitations contained in PART IV - EXCLUSIONS, provided that: (a) such
Loss occurs within 365 days after the date of Accident causing such Loss;
and (b) the indemnity payable for any such Loss shall be the Principal Sum
stated on the ID Card, as applicable to such Insured Person and this
Insurance; and (c) if more than one Loss stated in said Table of Losses is
sustained as the result of one Accident, only one of the amounts, the
largest, shall be payable.
For Loss of: Insured or Spouse Each Child
| |
Insured
or Spouse |
Each Child |
|
Loss of Life |
100% of Principal Sum |
$5,000 |
|
Loss of two members |
100% of Principal Sum |
$5,000 |
|
Loss of one member |
50% of Principal Sum |
$2,500 |
|
Quadriplegia |
100% of Principal Sum |
$5,000 (total paralysis of both upper and lower
limbs) |
|
Paraplegia |
75% of Principal Sum |
$3,750 (total paralysis of both lower limbs) |
|
Hemiplegia |
50% of Principal Sum |
$2,500 (total paralysis of both upper & lower
limbs of one side of the body) |
| Uniplegia |
25% of the Principal Sum |
$1,250 (total paralysis
of one limb) |
The term "Loss", in reference to quadriplegia, paraplegia, hemiplegia and
uniplegia, shall mean the complete and irreversible paralysis of such limbs
and with regard to hands and feet, actual severance through or above the
wrist or ankle joints, and with regard to eyes, entire irrecoverable Loss of
sight. The term “Principal Sum” as used herein shall mean the amount stated
on the ID Card. “Member” means hand, foot or eye. Only one amount, the
largest to which you are entitled is payable for all losses resulting from
one accident.
Common Carrier Benefit Benefits will be paid to you as per the schedule of benefits if you sustain
an Accidental Death. Death must occur during the period of coverage while
the Insured Person is riding as a passenger (but not a pilot, operator or
member of the crew) in or on a Common Carrier.
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Please read the Benefits & Exclusions of this plan carefully before submitting your application.
MEDICAL EXPENSE BENEFITS If the Insured Person is traveling inside the United States and Canada: When
a covered Injury or Illness is incurred by the Insured Person, the Company
will pay 90% of the first $5,000 of Reasonable and Customary medical charges
for Covered Expenses, excess of the Policy Period Deductible as stated on
the ID Card. Thereafter, the Company will pay 100% of Reasonable and
Customary medical charges for Covered Expenses up to the medical maximum as
stated on the ID Card.
If the Insured Person is traveling outside the United States and Canada: the
Company will pay 100% of Reasonable and Customary medical charges for
Covered Expenses, excess of the Policy Period Deductible as stated on the ID
Card, up to the medical maximum as stated on the ID Card. In no event shall
the Company's maximum liability exceed the medical maximum as stated on the
ID Card. The Deductible and Coinsurance amount consists of Covered Expenses
which would otherwise be payable under this Policy. These expenses must be
borne by each Insured Person. A maximum of 3 Policy Period deductibles per
family under the same application will apply. Only such expenses, incurred as the result of and within 180 days from a
Disablement, which are specifically enumerated in the following list of
charges, and which are not excluded in PART IV - EXCLUSIONS, shall be
considered as Covered Expenses:
1. Charges made by a Hospital for room and board, floor nursing and other
services inclusive of charges for professional service and (with the
exception of personal services of a non-medical nature); charges made for an
operating room.
Wander. Frequent Traveler 2 GLB-9129674 2. Charges made for Intensive Care or Coronary Care charges and nursing
services. 3. Charges made for diagnosis, treatment and Surgery by a Physician; charges
made for the cost and administration of anesthetics. 4. Charges made for Outpatient treatment, same as any other treatment
covered on an Inpatient basis. This includes ambulatory Surgical centers,
Physicians’ Outpatient visits/examinations, clinic care, and Surgical
opinion consultations. 5. Charges for medication, x-ray services, laboratory tests and services,
the use of radium and radioactive isotopes, oxygen, blood transfusions, iron
lungs, and medical treatment; dressings, drugs, and medicines that can only
be obtained upon a written prescription of a Physician or Surgeon. 6. Charges for physiotherapy, if recommended by a Physician for the
treatment of a specific Disablement and administered by a licensed
physiotherapist. 7. Ground ambulance (within the metropolitan area, up to a $ 5,000 maximum)
to and from the nearest Hospital with facilities for required treatment. If
the Insured Person is in a rural area, then licensed ground ambulance
transportation to the nearest metropolitan area shall be considered a
Covered Expense. 8. Hotel room charge, when the Insured Person, otherwise necessarily
confined in a Hospital, shall be under the care of a duly qualified
Physician in a hotel room due to unavailability of a Hospital room by reason
of capacity or distance or to any other circumstances beyond control of the
Insured Person. 9. Charges made for artificial limbs, eyes, larynx, and orthotic appliances,
but not for replacement of such items.
The charges enumerated herein shall in no event include any amount of such
charges which are in excess of Reasonable and Customary charges. If the
charge incurred is in excess of such average charge, such excess amount
shall not be recognized as a Covered Expense. All charges shall be deemed to
be incurred on the date such services or supplies which give rise to the
expense or charge are rendered or obtained.
PreNotification / Referral –
Seven Corners Assist must be contacted prior to: (1) any medical treatment
being received in the United States; or (2) hospital admissions worldwide;
or (3) inpatient or outpatient surgeries worldwide. Additionally, the
Company’s appointed network provider must be utilized for medical expenses
incurred inside the United States (when available – contact Seven Corners
Assist with questions).
Pre-notification does not guarantee that benefits will be
paid. Failure to follow Pre-Notification / Referral will result in a 20%
reduction of Eligible Benefits. (For Emergency admissions and situations,
Seven Corners Assist must be contacted within 48 hours, or as soon as
reasonably possible.)
COMA BENEFIT Maximum Benefit Amount: $50,000 If Injury renders an Insured Comatose within 90 days of the date of the
accident that caused the Injury, and if the Coma continues for a period of
30 consecutive days, the Company will pay a monthly benefit equal to 1% of
the Maximum Amount. No benefit is provided for the first 30 days of the
Coma. The benefit is payable monthly as long as the Insured remains Comatose
due to that Injury, but ceases on the earliest of: (1) the date the Insured
ceases to be Comatose due to that Injury; (2) the date the Insured dies; or
(3) the date the total amount of monthly Coma benefits paid for all Injuries
caused by the same accident equals the Maximum Amount. The Company will pay
benefits calculated at a rate of 1/30th of the monthly benefit for each day
for which the Company is liable when the Insured is Comatose for less than a
full month. 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 30 consecutive days
of Coma and as often as it may reasonably require thereafter, to determine,
on the basis of all the facts and circumstances, that the Insured is
Comatose, including, but not limited to, requiring an independent medical
examination provided at the expense of the Company.
Coma/Comatose - as used in this Rider, means a profound state of
unconsciousness from which the Insured cannot be aroused to consciousness,
even by powerful stimulation, as determined by a Physician.
FELONIOUS ASSUALT BENEFIT Maximum Benefit Amount: $10,000 The Company will pay 100% of the Maximum Amount when the Insured suffers one
or more losses for which benefits are payable under the Accidental Death
Benefit, Accidental Dismemberment Benefit or Coma Benefit provided by the
Policy as a result of a Felonious Assault:
1. That is not a moving violation as defined under the applicable government
motor vehicle laws; and 2. That is not an act of an Immediate Family Member, another Insured or an
individual who resides with the Insured on a permanent basis. Only one benefit is payable for all losses as a result of the same Felonious
Assault. Felonious Assault - as used, means any willful or unlawful use of force upon
the Insured: (1) with the intent to cause bodily Injury to the Insured; and
(2) that results in bodily harm to the Insured; and (3) that is a felony or
a misdemeanor in the jurisdiction in which it occurs.
HOSPITAL INDEMNITY Should the Insured Person be hospitalized while traveling outside the United
States or Canada, and the hospitalization is considered a Covered Expense,
the Company will indemnify the Insured $150 for each night spent in the
hospital up to a maximum of 30 days. This benefit is in addition to any
other covered expenses of the program.
EMERGENCY MEDICAL EVACUATION/REPATRIATION Maximum Benefit Amount: $300,000 The Company shall pay benefits for Covered Expenses incurred up to $300,000,
if any covered Injury or Illness commencing during the Period of Coverage
results in the Medically Necessary Emergency Medical Evacuation or
Repatriation of the Insured Person. The Emergency Medical Evacuation or
Repatriation must be ordered by the Assistance Company in consultation with
the Insured Person’s local attending Physician.
Emergency Medical Evacuation or Repatriation means: (a) the Insured Person's
medical condition warrants immediate transportation from the place where the
Insured Person is located to the nearest adequate medical facility where
medical treatment can be obtained; or (b) after being treated at a local
medical facility as a result of a Emergency Medical Evacuation, the Insured
Person's medical condition warrants transportation with a qualified medical
attendant to his/her Home Country to obtain further medical treatment or to
recover; or (c) both (a) and (b) above. All transportation arrangements must
be by the most direct and economical route.
REPATRIATION OF REMAINS Maximum Benefit Amount: $50,000 The Company will pay the reasonable Covered Expenses incurred up to $50,000
to return the Insured Person's remains to his/her then Home Country, if he
or she dies. Covered Expenses include, but are not limited to, cremation,
expenses for embalming, a minimally necessary container appropriate for
transportation, shipping costs, and the necessary government authorizations.
POLITICAL EVACUATION AND REPATRIATION OF REMAINS Maximum Benefit Amount: $50,000 If due to political or military events in a host country, a formal
recommendation from the appropriate authorities is issued for the Insured to
leave the host country or the Insured is expelled or declared persona
non-grata by the host country, all reasonable expenses incurred for
transportation to the nearest place of safety or for repatriation to the
Insured's home country or country of residence are covered up to a maximum
of $50,000. Evacuation must occur within 10 days of any such event. Coverage
will apply to the most appropriate and economical means consistent under the
circumstances with your health & safety. Evacuation costs will be paid once
per Insured per occurrence.
In the event this benefit is needed,
arrangements must be made by the assistance services provider.
For Political Evacuation and Repatriation, this insurance does not cover: 1)
Losses recoverable under any other insurance or through an employer; 2)
Losses arising from or attributable to a) dishonest or criminal acts
committed or attempted by the Insured, b) alleged violation of the laws of
the host country, unless the company determines such allegations to be
fraudulent, or c) failure to maintain required documents or visas; 3) Losses
attributable to a ) debt, insolvency, commercial failure, or the
repossession of any property, b) Insured's non-compliance with a contract or
license or c) implementation of illegally contributed exchange rates; 4)
Losses due to liability assured by the Insured under any contract.
Wander. Frequent Traveler 3 GLB-9129674
EMERGENCY MEDICAL REUNION Maximum Benefit Amount: $50,000 When Emergency Medical Evacuation or Repatriation occurs, the Company will
arrange and pay, up to $50,000, for round trip economy-class transportation
for one individual selected by the Insured Person, from the Insured Person’s
Home Country to the location where the Insured Person is hospitalized and
return to the Home Country. Emergency Medical Reunion must be recommended by
the attending Physician. The benefits payable will include: (1) The cost of
a round trip economy air fare; (2) Reasonable travel and accommodation
expenses (not to exceed $200 per day) incurred in relation to the maximum of
$50,000. (3) The period of Emergency Medical Reunion is not to exceed 10
days, including travel.
RETURN OF MINOR CHILD(REN) Maximum Benefit Amount: $50,000 Should the Insured Person be traveling alone with a Minor Child(ren) and is
hospitalized because of a covered Illness or Injury and the Minor Child(ren),
under age 19, is left unattended, the Company will arrange and pay, up to
$50,000, for one way economy fares to their Home Country. These arrangements
will be made at no cost to the Insured Person. Meals and lodging are the
responsibility of the Insured Person. If an attendant/escort is necessary to
insure the safety and welfare of Minor Child(ren), the Company will arrange
and pay for these services to the limit stated in the Schedule of Benefits.
INTERRUPTION OF TRIP Maximum Benefit Amount: $5,000 If the Insured is unable to continue the Trip due to the death of a parent,
spouse, sibling or child; or due to serious damage to the Insured’s
principal residence from fire, flood or similar natural disaster (tornado,
earthquake, hurricane, etc.), the program will reimburse (up to $5,000), the
Insured for the cost of economy travel, less the value of applied credit
from an unused return travel ticket, to return home to their area of
principal residence.
LOSS OF CHECKED LUGGAGE Maximum Benefit Amount: $250 If the Insured's checked luggage is permanently lost by the airline, the
program will reimburse the Insured for the replacement of clothing and
personal hygiene items lost to a maximum per article limit of $50. This
benefit is secondary to any other (including airline) coverage available.
The Insured must furnish proof to the Company that full reimbursement has
been obtained from the airline. This policy will reimburse the Insured up to
a maximum benefit of $250 under this provision.
DENTAL - EMERGENCY ONLY Maximum Benefit Amount: $500 Emergency Dental treatment necessary to resolve acute, spontaneous and
unexpected inception of pain to sound natural teeth (up to a maximum of
$100) or Dental treatment necessary to restore or replace sound natural
teeth lost or damaged in an Accident which is covered under the program (up
to a maximum of $500). The Deductible and Coinsurance amounts apply to the
dental benefit.
NOTE: In the event of an Emergency Medical Evacuation/Repatriation, Return
of Mortal Remains, Emergency Medical Reunion, Return of Minor Child(ren), or
Interruption of Trip benefit is needed, arrangements must be made by the
Assistance Company. Failure to utilize the Assistance Company (Seven Corners
Assist) for these benefits will void any payment by the Company. Complete
details about required notification of the Assistance Company are listed
below.
ASSISTANCE SERVICES Pre-Trip Assistance - Telephone information about passports, visas;
Telephone information about health hazards in remote areas; Telephone
information about inoculations; Help in arranging special medical treatment
facilities needed while traveling. Medical Assistance While Traveling - 24-Hour telephone contact for travel
medical emergencies, with assistance in locating medical care; Arranging
telephone conferences between your attending and home physicians; Arranging
second medical opinions in hospital cases; Relaying emergency messages to
family and employer during medical emergencies; Guarantee or payment of
medical bills using your available financial resources; 24-hour ticketing
service to arrange family visits; Arranging Emergency Medical Evacuation
from medically underserved areas; Arranging evacuation for catastrophic
claims; Arranging medical transportation home after treatment; Arranging
escorts and transportation for unaccompanied children; Arranging transfer of
medical records; Arranging Repatriation of Remains for deceased travelers;
Notify your health insurer of a claim.
General Travel Assistance - 24 hour telephone contact for baggage and other
travel problems; Advice on handling losses and delays; Follow-up contact
with airlines regarding baggage; Help with lost passports, ticket and
documents; Guarantee or payment of emergency expenses using your available
financial resources; Arranging shipments of forgotten, lost or stolen items;
Relaying emergency messages.
ID Theft Restoration Service - 24/7 toll-free telephone access to highly
trained identity theft specialists; Theft Recovery Kit to help determine if
identity theft has occurred and provide gudiance in restoring good name and
credit; Assignment of a personal case manager who will do most of the
identity recovery and follow-up work, if identity theft has occurred; Notify
the three major credit bureaus, and the Eligible Person's affected
creditors, financial institutions, and utility providers of the identity
fraud (US Only); Provide assistance with filing a police report; Research
and investigate potential damage to Eligible Person's identity.
Concierge Services - Restaurant referrals and reservations; Event Ticketing;
Ground transportation coordination; Golf tee time reservations and
referrals; Wireless device assistance; Latest worldwide weather and ski
reports; Floral Services - Coordination of flower delivery for birthdays,
anniversaries, holidays and other special occasions; Local activity
recommendations.
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Please read the Benefits & Exclusions of this plan carefully before submitting your application.
PART III - DEFINITIONS The term “Accident” or “Accidental” shall mean an event, independent of
Illness or self inflicted means, which is the direct cause of bodily Injury
to an Insured Person.
The term “Airworthiness Certificate” shall mean the “Standard” Airworthiness
Certificate issued by the Federal Aviation Agency of the United States or
its foreign equivalent issued by the government authority having
jurisdiction over civil aviation in the country of its registry.
The term “Company” shall mean The Insurance Company of the State of
Pennsylvania.
The term “Coinsurance” shall mean the percentage amount of eligible Covered
Expenses, after the Deductible, which are the responsibilities of the
Insured Person and must be paid by the Insured Person. The Coinsurance
amount is stated in Section II, Schedule of Benefits, under each stated
benefit.
The term "Common Carrier" shall mean any public air conveyance operating
under a valid license providing for the transportation of passengers for
hire.
The term “Covered Expense” shall mean “Eligible Benefit”.
The term “Deductible” shall mean the amount of eligible Covered Expenses
which are the responsibility of each Insured Person and must be paid by each
Insured Person before benefits under the Policy are payable by the Company.
The term "Disablement" as used with respect to medical expenses shall mean
an Illness or an Accidental bodily Injury necessitating medical treatment by
a Physician as defined in this Policy.
The term “Eligible Benefit(s)” shall mean benefits payable by the Company to
reimburse expenses which are for Medically Necessary services, supplies,
care, or treatment; due to Illness or Injury; prescribed, performed or
ordered by a Physician; Reasonable and Customary charges; incurred while
insured under this program and which do not exceed the maximum benefit.
The term “Emergency” shall mean a medical condition manifesting itself by
acute signs or symptoms which could reasonably result in placing the Insured
Person’s life or limb in danger if medical attention is not provided within
24 hours.
The term “Experimental / Investigational” means all services or supplies
associated with: 1) treatment or diagnostic evaluation which is not
generally and widely accepted in the practice of medicine in the United
States of America or which does not have evidence of effectiveness
documented in peer reviewed articles in medical journals published in the
United States. For the treatment or diagnostic evaluation to be considered
effective such articles should indicate that it is more effective than
others available: or if less effective than other available
treatments or diagnostic evaluations, is safer or less costly; 2) A drug
which does not have FDA marketing approval; 3) A medical device which does
not have FDA marketing approval; or has FDA approval under 21 CFR 807.81,
but does not have evidence of effectiveness for the proposed use documented
in peer reviewed articles in medical journals published in the United
States.
For the device to be considered effective, such articles should
indicate that it is more effective than other available devices for the
proposed use; or if less effective than other available devises, or is safer
or less costly. The company will make the final determination as to whether
a service or supply is Experimental/Investigational.
The term "Hospital" as used in this Policy shall mean except as may
otherwise be provided, a Hospital (other than an institution for the aged,
chronically ill or convalescent, resting or nursing homes) operated pursuant
to law for the care and treatment of sick or Injured persons with organized
facilities for diagnosis and Surgery and having 24-hour nursing service and
medical supervision.
The term "Home Country" shall mean the country where an Insured Person has
his or her true, fixed and permanent home and principal establishment.
The term "Host Country" shall mean any country other than the country where
an Insured Person has his or her true, fixed and permanent home and
principal establishment.
The term "Illness" wherever used in this Policy shall mean sickness or
disease of any kind.
The term "Injury" wherever used in this Policy shall mean bodily Injury
caused solely and directly by violent, Accidental, external, and visible
means occurring while this Policy is in force and resulting directly and
independently of all other causes in Disablement covered by this Policy.
The term “Insured” or “Insured Person” shall mean a person eligible for
benefits under the Policy who has applied for coverage and is named on the
application and for whom the company has accepted premium.
The term “Intensive Care” shall mean a cardiac care unit or other unit or
area of a Hospital which meets the required standards of the Joint
Commission on Accreditation of Hospitals for Special Care Units.
The term “Loss” in reference to quadriplegia, paraplegia, hemiplegia, and
uniplegia, shall mean the complete and irreversible paralysis of such limbs
and with regard to hands and feet, actual severance through and above the
wrist or ankle joints, and with regard to eyes, entire irrecoverable Loss of
sight.
The term “Medically Necessary” shall mean services and supplies received
while insured that are determined by the Company to be: (1) appropriate and
necessary for the symptoms, diagnosis, or direct care and treatment of the
Insured Person’s medical conditions; (2) within the standards the organized
medical community deems good medical practice for the Insured Person’s
condition; (3) not primarily for the convenience of the Insured Person, the
Insured Person’s Physician or another Service Provider or person; (4) not
Experimental/Investigational or unproven, as recognized by the organized
medical community, or which are used for any type of research program or
protocol; and (5) not excessive in scope, duration, or intensity to provide
safe and adequate, and appropriate treatment. For Hospital stays, this means
that acute care as an Inpatient is necessary due to the kinds of services
the Insured Person is receiving or the severity of the Insured Person’s
condition, in that safe and adequate care cannot be received as an
Outpatient or in a less intensified medical setting. The fact that any
particular Physician may prescribe, order, recommend, or approve a service,
supply, or level of care does not, of itself, make such treatment Medically
Necessary or make the charge of a Covered Expense under this Policy.
The term “Mental Illness” shall mean any condition or disease listed in the
most recent edition of the International Classification of Diseases as a
mental disorder, which clinically significant behavioral or psychological
disorder marked by a pronounced deviation from a normal healthy state and
associated with a present painful symptom or impairment in one or more
important areas of functioning. This disease must not be merely an
expectable response to a particular stimulus. Mental Illness does not mean
learning disabilities, attitudinal disorders or disciplinary problems.
The term “Outpatient” shall mean an Insured Person who receives care in a
Hospital or another institution, including; ambulatory surgical center;
convalescent/skilled nursing facility; or Physician’s office, for an Illness
or Injury, but who is confined and is not charged for room and board.
The term “Policy Period” or “Period of Coverage” shall mean the Period of
Coverage issued by the Company to the Insured Person, typically beginning
with the Effective Date and ending with the Termination Date or the date
coverage is renewed by the Company.
The term "Physician" as used in this Policy shall mean a doctor of medicine
or a doctor of osteopathy licensed to render medical services or perform
Surgery in accordance with the laws of the jurisdiction where such
professional services are performed, however, such definition will exclude
chiropractors and physiotherapists.
The term “Reasonable and Customary” shall mean the maximum amount that the
Company determines is Reasonable and Customary for Covered Expenses the
Insured Person receives, up to but not to exceed charges actually billed.
The Company’s determination considers: (1) amounts charged by other Service
Providers for the same or similar service in the locality where received,
considering the nature and severity of the bodily Injury or Illness in
connection with which such services and supplies are received; (2) any usual
medical circumstances requiring additional time, skill or experience; and
(3) other factors the Company determines are relevant, including but not
limited to, a resource based relative value scale. For a Service Provider
who has a reimbursement agreement, the Reasonable and Customary charge is
equal to the amount that constitutes payment in full under any reimbursement
agreement with the Company.
The term “Relative” shall mean spouse, parent, sibling, child, grandparent,
grandchild, step-parent, step-child, step-sibling, in-laws (parent, son,
daughter, brother and sister), aunt, uncle, niece, nephew, legal guardian,
ward, or cousin of the Insured Person.
The term “Service Provider” shall mean a Hospital, convalescent/skilled
nursing facility, ambulatory surgical center, psychiatric Hospital,
community mental health center, residential treatment facility, psychiatric
treatment facility, alcohol or drug dependency treatment center, birthing
center, physician, dentist, chiropractor, licensed medical practitioner,
nurse, medical laboratory, assistance service company, air/ground ambulance
firm, or any other such facility that the Company approves.
The term “Surgery” shall mean an invasive diagnostic procedure; or the
treatment of Illness or Injury by manual or instrumental operations
performed by a Physician while the patient is under general or local
anesthesia. The term “Traveling Companion” shall mean spouse, parent, sibling, child,
grandparent, grandchild, step-parent, step-child, step-sibling, in-laws
(parent son, daughter, brother, or sister), aunt, uncle, niece, nephew,
legal guardian, ward, or business partner of the Insured Person.
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Please read the Benefits & Exclusions of this plan carefully before submitting your application.
PART IV – EXCLUSIONS For Medical benefits, this Insurance does not cover:
1. Any Injury or Illness which meets the following criteria: (a) condition(s)
that would have caused a person to seek medical advice, diagnosis, care or
treatment during the 36 months prior to the Effective Date of coverage under
this Policy; (b) condition(s) for which manifestation, medical advice,
diagnosis, care or treatment was recommended, received, or noticed during
the 36 months prior to the Effective Date of coverage under this Policy;
For Insured Persons traveling outside the United States and Canada, the
period is 12 months instead of 36 months. If you are a United States citizen and the United States is your Home
Country, this exclusion is waived for the first $20,000 in eligible medical
expenses incurred outside the United States and Canada (for persons age 65
and over, the amount is $2,500). This waiver does not include coverage for
known, scheduled, required, or expected medical care, drugs, or treatments
existent or necessary prior to the effective date of this program.
If you are a non-United States citizen and suffer a Myocardial Infarction or
Stroke and are admitted to a Hospital, this exclusion is waived in order to
pay a $200 per night benefit for each night spent in the Hospital, up to a
maximum benefit of $3,000. The term “Myocardial Infarction” shall mean an
acute and emergent onset of any of the conditions and/or diseases described
and coded in the International Coding of Diseases version 9 (ICD9), code
sequences 410.0 – 410.9 and 414.1 – 419.9. The term “Stroke” shall mean an
acute and emergent onset of any of the conditions and/or diseases described
and coded in the International Coding of Diseases version 9 (ICD9), code
sequence 430-438.9.
2. Charges for treatment which exceed Reasonable and Customary charges; or
Charges incurred for Surgeries or treatments which are Investigational,
Experimental, or for research purposes; expenses which are nonmedical in
nature; expenses for Vocational, Speech, Recreational or Music Therapy;
3. Expenses which were not recommended, approved and certified as Medically
Necessary and reasonable by a Physician;
4. Suicide or any attempt thereof, while sane or self destruction or any
attempt thereof, while insane; intentionally self-inflicted Injury or
Illness; or expenses as a result or in connection with the commission of a
felony offense; Wander. Frequent Traveler 5 GLB-9129674
5. Any consequence, whether directly or indirectly, approximately or
remotely occasioned by, contributed to by, or traceable to, or arising in
connection with war, invasion, act of foreign enemy hostilities, warlike
operations (whether war be declared or not), or civil war;
6. Injury sustained while participating in professional, sponsored and/or
organized Amateur or Interscholastic Athletics;
7. Routine physicals, inoculations, or other examinations where there are no
objective indications or impairment in normal health;
8. Treatment of the Temporomandibular joint;
9. Services or supplies performed or provided by a Relative of the Insured
Person, or anyone who lives with the Insured Person;
10. Treatment and the provision of false teeth or dentures, normal ear tests
and the provision of hearing aids, cosmetic or plastic Surgery (including
deviated nasal septum), routine dental expenses, eye refractions or eye
examinations for the purpose of prescribing corrective lenses for eye
glasses or for the fitting thereof, unless caused by Accidental bodily
Injury incurred while insured hereunder;
11. Treatment in connection with alcoholism and drug addiction, or use of
any drug or narcotic agent; any Mental and Nervous disorders or rest cures;
Injury sustained while under the influence of or Disablement due to wholly
or partly to the effects of intoxicating liquor or drugs;
12. Congenital abnormalities and conditions arising out of or resulting therefrom;
13. Expenses incurred during a hospital emergency room visit which is not of
an emergency nature;
14. Injury sustained while taking part in mountaineering, hang gliding,
parachuting, bungee jumping, racing by horse or motor vehicle or motorcycle
(whether as a passenger or driver), snowmobiling, motorcycle motor scooter
riding, scuba diving involving underwater breathing apparatus (unless PADI
or NAUI certified), water skiing, snow skiing and snow boarding (UNLESS
HAZARDOUS SPORTS RIDER IS PURCHASED, SEE PROVISION BELOW, AS THIS EXCLUSION
IS REPLACED FOR SOME SPORTS);* Mountaineering shall mean the sport, hobby or
profession of walking, hiking, and climbing up mountains either: 1)
utilizing harnesses, ropes, crampons or ice axes; or 2) ascending 4500
meters or above. Parachuting shall mean an activity involving the breaking
of a free fall from an airplane using a parachute.
15. Treatment paid for or furnished under any other individual, government,
or group policy or charges provided at no cost to the Insured Person;
16. Treatment of venereal or sexually transmitted disease;
17. Pregnancy expenses or Illness resulting from pregnancy, childbirth, or
miscarriage; or for miscarriage resulting from an Accident;
18. 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;
19. Expenses incurred while the Insured Person is in their Home Country
(except after approved Emergency Medical Evacuation / Repatriation or if
treatment is a follow-up to a covered disablement during coverage, see
Follow Me Home Coverage);
20. Expenses incurred for which travel was undertaken to seek medical
treatment for a condition; or incurred after the Insured Person’s physician
has limited or restricted travel.
With regards to Accidental Death and Dismemberment, Emergency Medical
Evacuation/Repatriation, Return of Mortal Remains, Emergency Medical
Reunion, and Return of Minor Child, this Insurance does not cover:
1. Suicide or attempt thereof by the Insured Person while sane or self
destruction or any attempt thereof by the Insured Person while insane; 2. Disease or sickness of any kind; (only applicable to AD&D) 3. Bacterial infections except pyogenic infection which shall occur through
an accidental cut or wound; (only applicable to AD&D) 4. Hernia of any kind; (only applicable to AD&D) 5. Injury sustained while the Insured Person is riding as a pilot, student
pilot, operator or crew member, in or on, boarding or alighting, from any
type of aircraft; 6. Injury sustained while the Insured Person is riding as a passenger in any
aircraft (a) not having a current and valid Airworthy Certificate and (b)
not piloted by a person who holds a valid and current certificate of
competency for piloting such aircraft; 7. Any consequence, whether directly or indirectly, proximately or remotely
occasioned by, contributed to by, or traceable to, or arising in connection
with: (a) war, invasion, act of foreign enemy hostilities, warlike operations
(whether war be declared or not), or civil war. (b) mutiny, riot, strike,
military or popular uprising insurrection, rebellion, revolution, military
or usurped power. (c) any act of any person acting on behalf of or in
connection with any organization with activities directed towards the
overthrow by force of the Government de jure or de facto or to the
influencing of it by terrorism or violence. (d) martial law or state of
siege or any events or causes which determine the proclamation or
maintenance of martial law or state of siege (hereinafter for the purposes
of this Exclusion called the “Occurrences”). Any consequence happening or
arising during the existence of abnormal conditions (whether physical or
otherwise), whether directly or indirectly, proximately or remotely
occasioned by, or contributed to by, traceable to, or arising in connection
with, any of the said Occurrences shall be deemed to be consequences for
which the Company shall not be liable under this Policy except to the extent
that the Insured Person shall prove that such consequence happened
independently of the existence of such abnormal conditions; 8. Service in the military, naval or air service of any country; 9. Flying in any aircraft being used for or in connection with acrobatic or
stunt flying, racing, endurance tests, rocket-propelled aircraft, crop
dusting or seeding or spraying, fire fighting, exploration, pipe or power
line inspection, any form of hunting or herding, aerial photography, banner
towing or any experimental purpose; 10. Being under the influence of alcohol or having taken drugs or narcotics
unless prescribed by a legally qualified physician or surgeon; 11. Injury occasioned or occurring while the Insured Person is committing or
attempting to commit a felony or to which a contributing cause was the
Insured Person being engaged in an illegal occupation; 12. Riding or driving in any kind of competition; 13. Pregnancy, childbirth, miscarriage or abortion; 14. Covered Expenses incurred after the Insured Person’s physician has
limited or restricted travel; or Covered Expenses incurred as a result of a
change in prescribed treatment during, or within the three months prior to
the effective date of coverage.
For Interruption of Trip, this insurance does not cover:
(1) war or any act
of war, whether declared or not; participation in a felony, riot or
insurrection; participation in contests of speed; a Pre-existing Condition
existing prior to the Insured’s departure from their Home Country that has
the likelihood of causing death; the Insured Person 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); prohibition or regulatory by any government; default of yacht
charter companies; default of the organization from which the Insured Person
purchased their trip arrangements.
For Loss of Checked Luggage, this insurance 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.
Hazardous Sports Coverage (when applicable) To cover motorcycle/motor scooter riding (whether as a passenger or driver),
mountaineering (4,500 meter limit), hang gliding, parachuting, bungee
jumping, water skiing, snow skiing, snowmobiling, and snow boarding.
Exclusion: Injury sustained while taking part in racing by horse or motor
vehicle or motorcycle, scuba diving involving underwater breathing apparatus
(unless PADI or NAUI certified);
Pre Notification / Referral – Seven Corners Assist must be contacted prior
to: (1) any medical treatment being received in the United States; or (2)
hospital admissions worldwide; or (3) inpatient or outpatient surgeries
worldwide. Additionally, the Company’s appointed network provider must be
utilized for medical expenses incurred inside the United States (when
available – contact Seven Corners Assist with questions). A listing of
network facilities can be found at www.sevencorners.com/findproviders on the
worldwide web. Pre Notification does not guarantee that benefits will be
paid. Failure to follow Pre Notification / Referral will result in a 20%
reduction of Eligible Benefits. (For Emergency admissions and situations,
Seven Corners Assist must be contacted within 48 hours, or as soon as
reasonably possible.)
Please be aware that this is not a general health insurance policy, but an
interim travel medical program intended for use while away from your Home
Country or Country of Residence. Wander. Frequent Traveler does not
guarantee payment to a facility or individual for medical expenses until the
Company determines that it is an eligible expense. Wander. Frequent Traveler 6 GLB-9129674
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on the Banner Below for Free Instant Quotes & Online Application
Please read the Benefits & Exclusions of this plan carefully before submitting your application.
PART V - POLICY PROVISIONS 1. 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 Policy, or as soon thereafter as is reasonably
possible. 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 the Insured Person shall be deemed notice
to the Company.
2. 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 Policy as to Proof of Loss upon submitting, within the
time fixed in the Policy for filing Proofs of Loss, written proof covering
the occurrence, the character and the extent of the Disablement for which
claim is made.
3. 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 Policy 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 within the time required shall not
invalidate nor reduce any claim if it was not reasonably possible to give
proof within such time, provided such proof is furnished as soon as
reasonably possible.
4. Time of Payment of Claims: Indemnities payable under the Policy for any
loss other than loss for which the Policy provides any periodic payment will
be paid immediately upon receipt of due written proof of such loss. Subject
to due written Proof of Loss, all accrued indemnities for loss for which the
Policy 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.
5. 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 the estate of the Insured Person. Any other
accrued indemnities unpaid at the Insured Person's 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 the Insured Person.
If any indemnity of the Policy shall be payable to the estate of an Insured
Person, or to an Insured Person who is a minor 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 the Insured Person all or a portion of
any indemnities provided by this Policy on account of Hospital, nursing,
medical or Surgical service may, at the Company's option and unless the
Insured Person requests otherwise in writing not later than the time for
filing proof of such 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.
6. Physical Examination and Autopsy: The Company at its own expenses shall
have the right and opportunity to examine the person of any individual whose
Injury or Illness is the basis of claim when and as often as it 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.
7. Legal Actions: No actions at law or in equity shall be brought to recover
on the Policy prior to the expiration of sixty (60) days after written Proof
of Loss has been furnished in accordance with requirements of this Policy.
No such action shall be brought after expiration of three (3) years after
that time written Proof of Loss is required to be furnished.
Subrogation To the extent the Company pays for a loss suffered by an Insured, the
Company will take over the rights and remedies the Insured had relating to
the loss. This is known as subrogation. The Insured 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 an Insured’s rights, the Insured must sign an
appropriate subrogation form supplied by the Company.
Pre-Notification and Network Information Many facilities inside the U.S. are not familiar with travel medical
insurance and this creates unnecessary problems for Insureds. Seven Corners
Assist must be contacted and Seven Corner’s provider network must be
utilized for treatment received in the United States. When contacted
properly, Seven Corners Assist is able to notify the network provider of
benefits, coverage, and conditions in advance of the Insured’s arrival.
While utilizing the network does not guarantee benefits or that the treating
facility will bill Seven Corners directly, it saves the Insured from many
administrative hassles and places the facility in contact with the Seven
Corners claims department.
Following these procedures are very important, failure to do so
will result in a 20% reduction of eligible benefits.
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on the Banner Below for Free Instant Quotes & Online Application
Please read the Benefits & Exclusions of this plan carefully before submitting your application.
If you have any questions or concerns, please contact us.
877-211-3654 or
559-294-0316
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