DEFINITIONS
“Actual Cash Value” means purchase price less depreciation.
“Baggage” means luggage and personal possessions, whether owned,borrowed, or rented, taken by the Insured on the Trip.
“Business Partner” means an individual who: (a) is involved with the Insured or the Insured’s Traveling Companion in a legal partnership; and (b) is actively involved in the daily management of the business.
“Common Carrier” means any conveyance operated under a license for the transportation of passengers for hire.
“Complication of Pregnancy” means a condition whose diagnosis is distinct from pregnancy but adversely affected or caused by pregnancy. It does not include any condition associated with the management of a difficult pregnancy not consisting of a classifiable distinct Complication of Pregnancy.
“Deductible” means the amount of charges that must be incurred by the Insured before benefits become payable. The amount of the Deductible is the Deductible shown in the Schedule of Benefits for each coverage to which a Deductible applies.
“Destination” means the place where the Insured expects to travel on his/her Trip, as shown on the Enrollment Form.
“Domestic Partner” means an opposite or a same-sex partner who is at least 18 years of age and has met all of the following requirements for at least 6 months: (1) resides with the Insured; (2) shares financial assets and obligations with the Insured; the Insurer may require proof of the Domestic Partner relationship in the form of a signed and completed Affidavit of Domestic Partnership.
“Exotic Vehicle” means any vehicle with an original manufacturer’s suggested retail price greater than $50,000 and antique cars meaning cars that are over 20 years old or have not been manufactured for 10 or more years.
“Experimental or Investigative” means treatment, a device or prescription medication which is recommended by a Physician, but is not considered by the medical community as a whole to be safe and effective for the condition for which the treatment, device, or prescription medication is being used, including any treatment, procedure, facility, equipment, drugs, drug usage, devices, or supplies not recognized as accepted medical practice, and any of those items requiring federal or other governmental agency approval not received at the time services are rendered.
“Felonious Assault” means an act of violence against the Insured or a Traveling Companion requiring medical treatment in a Hospital. A Felonious Assault may not be inflicted by the Insured, an Immediate Family Member, Traveling Companion, or Traveling Companion’s Immediate Family Member.
“Hospital” means a facility that: (1) is operated according to law for the care and treatment of injured people; (2) has organized facilities for diagnosis and surgery on its premises or in facilities available to it on a prearranged basis; (3) has 24-hour nursing service by registered nurses (R.N.’s); and (4) is supervised by one or more Physicians. A Hospital does not include: (1) a nursing, convalescent, or geriatric unit of a hospital when a patient is confined mainly to receive nursing care; (2) a facility that is, other than incidentally, a rest home, nursing home, convalescent home, or home for the aged; nor does it include any ward, room, wing, or other section of the hospital that is used for such purposes; or (3) any military or veterans hospital or soldiers home or any hospital contracted for or operated by any national government or government agency for the treatment of members or ex-members of the armed forces.
“Immediate Family Member” means the Insured’s or Traveling Companion’s spouse or Domestic Partner, child, spouse’s child, daughterin-law, son-in-law, brother, sister, mother, father, grandparents, grandchild, step-brother, step-sister, step-parents, parents-in-law, brother-in-law, sister-in-law, aunt, uncle, niece, nephew, legal guardian, caregiver, legal ward, or Domestic Partner of any of the above.
“Inclement Weather” means any severe weather condition which delays the scheduled arrival or departure of a Common Carrier. With respect to an Insured who is traveling via private/non-commercial automobile transportation, any severe weather condition which prevents an Insured from reaching the Destination.
“Injury” means a bodily injury caused by an accident occurring while the Insured’s coverage under the Policy is in force, and resulting directly and independently of all other causes of loss covered by the Policy. The injury must be verified by a Physician.
“Insured” means the person(s) named on the individual Enrollment Form and for whom the plan cost has been paid.
“Insurer” means National Union Fire Insurance Company of Pittsburgh, PA.
“Medically Necessary” means that a treatment, service, or supply: (1) is essential for diagnosis, treatment, or care of the Injury or Sickness for which it is prescribed or performed; (2) meets generally accepted standards of medical practice; (3) is ordered by a Physician and performed under his or her care, supervision, or order; and (4) is not primarily for the convenience of the Insured, Physician, other providers, or any other person.
“Natural Disaster” means a flood, hurricane, tornado, earthquake, or blizzard that is due to natural causes.
“Physician” means a licensed practitioner of the healing arts including accredited Christian Science Practitioners, acting within the scope of his/her license. The treating Physician may not be the Insured, Immediate Family Member, or a Traveling Companion.
“Reasonable Additional Expenses” means any expenses for meals, taxi fares, essential telephone calls, and lodging which were necessarily incurred as the result of a Trip Delay and which are not provided by the Common Carrier or any other party free of charge.
“Reasonable and Customary Charges” means an expense which: (a) is charged for treatment, supplies, or medical services Medically Necessary to treat the Insured’s condition; (b) does not exceed the usual level of charges for similar treatment, supplies, or medical services in the locality where the expense is incurred; and (c) does not include charges that would not have been made if no insurance existed. In no event will the Reasonable and Customary Charges exceed the actual amount charged.
“Return Destination” means the place to which the Insured expects to return from his/her Trip.
“Sickness” means an illness or disease diagnosed or treated by a Physician.
“Strike” means a stoppage of work (a) announced, organized, and sanctioned by a labor union and (b) which interferes with the normal departure and arrival of a Common Carrier. This includes work slowdowns and sickouts.
“Traveling Companion” means a person or persons with whom you have coordinated travel arrangements and intend to travel with during the Trip. A group or tour leader is not considered a Traveling Companion, unless you are sharing room accommodations with the group or tour leader.
“Trip” means a period of travel away from home to a Destination outside the Insured’s city of residence; the purpose of the Trip is business or pleasure and is not to obtain health care or treatment of any kind; the Trip has defined departure and return dates specified when the Insured applies; the Trip does not exceed 365 days; travel is primarily by Common Carrier and only incidentally by private conveyance.
“Unforeseen” means not anticipated or expected and occurring after the effective date of the policy.
“Uninhabitable” means (1) the building structure itself is unstable and there is a risk of collapse in whole or in part; (2) there is exterior or structural damage allowing elemental intrusion, such as rain, wind, hail, or flood; (3) immediate safety hazards have yet to be cleared, such as debris on roofs or downed electrical lines; or (4) the rental is without electricity or water. An Insured's Destination is inaccessible if he or she cannot reach the property by the original mode of transportation.
INDIVIDUAL ELIGIBILITY,
EFFECTIVE & TERMINATION DATES
Persons eligible for insurance under the policy are any traveler(s) who purchases his/her insurance through or from a properly licensed agent/agency located in the U.S., who enrolls for coverage and pays the plan cost no later than final trip payment.
Effective Date: Trip Cancellation Benefit will be effective 12:01 a.m. Standard Time on the date after becoming enrolled and plan cost is paid. All other coverages will begin on the later of: (a) the date and time the Insured starts his/her Trip, or (b) the scheduled departure date shown on the Enrollment form.
Termination Date: The Trip Cancellation coverage ends on the earliest of: (a) the cancellation of the Insured’s Trip; or (b) the date and time the Insured starts on his/her Trip. All other coverage ends on the earlier of: (a) the date the Trip is completed; (b) the scheduled return date; or (c) the Insured’s arrival at the Return Destination on a round Trip, or the Destination on a one-way Trip.
Extension of Coverage: All coverage (except Trip Cancellation) under the policy will be extended, if: (a) the Insured's entire Trip is covered by the policy; and (b) the Insured's return is delayed by one of the Unforeseen events specified under Trip Cancellation and Interruption or Trip Delay. This extension of coverage will end on the earlier of: (a) the date the Insured reaches his/her Return Destination; or (b) seven (7) days after the date the Trip was scheduled to be completed.
GENERAL EXCLUSIONS
In addition to any exclusions which apply to a particular benefit (called “Additional Exclusions”), the policy does not cover any loss caused by: (a) intentionally self-inflicted Injury or any attempt at an intentionally self inflicted Injury, suicide, or attempted suicide by the Insured, Immediate Family Member, Traveling Companion, or Business Partner; (while sane, in Colorado and Missouri); (b) pregnancy or childbirth, or elective abortion, other than the Complications of Pregnancy; (c) participation in professional athletic events, motor sport, or motor racing, including training or practice for the same; (d) Mountain Climbing (meaning the ascent or descent of a mountain requiring the use of specialized equipment, including but not limited to pick-axes, anchors, bolts, crampons, carabineers, and lead or top-rope anchoring equipment); (e) war or act of war, whether declared or not, civil commotion, riot, or insurrection; (f) operating or learning to operate any aircraft, as student, pilot, or crew; (g) air travel on any air-supported device, other than a regularly scheduled airline or air charter company; (h) loss or damage caused by detention, confiscation, or destruction by customs; (i) any unlawful acts, committed by the Insured, Immediate Family Member, or a Traveling Companion, whether insured or not (not applicable in Florida); (j) mental, psychological, or nervous disorders including, but not limited to, anxiety, depression, neurosis, or psychosis; (k) if the Insured’s tickets do not contain specific travel dates (open tickets); (l) alcohol or substance abuse or treatment for same; or (m) an Injury or Sickness which occurs at a time when this coverage is not in effect; (n) elective or non-emergency treatment or surgery, except for any necessary treatment or surgery due to covered Injury or Sickness; (o) Experimental or Investigative treatment or procedures.
EXCESS INSURANCE LIMITATION
The insurance provided for all coverages except Trip Cancellation, Trip Interruption, and Car Rental Collision Coverage shall be in excess of all other valid and collectible insurance or indemnity. If at the time of the occurrence of any loss payable under the Policy there is other valid and collectible insurance or indemnity in place, the Insurer shall be liable only for the excess of the amount of loss, over the amount of such other insurance or indemnity, and applicable Deductible.
TRIP CANCELLATION & INTERRUPTION
The Insurer will reimburse the Insured, as described below, if a Trip is canceled or interrupted for the Insured due to any of the following Unforeseen circumstances: (a) Sickness, Injury, or death of an Insured, Immediate Family Member, Traveling Companion, or Business Partner. Injury or Sickness must be so disabling as to reasonably cause a Trip to be canceled or interrupted. If the Insured must cancel or interrupt his/her Trip due to Injury or Sickness of an Immediate Family Member or Business Partner, it must be because their condition is life-threatening, or because the Immediate Family Member requires the Insured’s or Traveling Companion’s care; (b) Inclement Weather causing delay or cancellation of travel; (c) Strike resulting in complete cessation of travel services at the point of departure or Destination. A Strike is foreseeable on the date labor union members vote to approve a Strike and is not covered under the policy; (d) the Insured’s principal residence or Destination being made Uninhabitable by fire, flood, or similar Natural Disaster, vandalism, or burglary; (e) the Insured or a Traveling Companion being subpoenaed, required to serve on a jury, hijacked, or quarantined; (f) being involved in or delayed due to an automobile accident en route to departure; (g) Termination of employment or layoff affecting the Insured or his/her Traveling Companion; must have been with the same employer for at least
five continuous years; (h) the Insured or a Traveling Companion being the victim of a Felonious Assault within 10 days prior to his/her departure date; or (i) the Insured or Traveling Companion being called into active military service or having leave revoked or being reassigned.
Trip Cancellation Benefits:
The Insurer will reimburse the Insured for the following up to the Maximum Limit shown on the Schedule of Benefits for Trips that are canceled before the scheduled departure date due to the Unforeseen events shown at the beginning of this section: (a) forfeited, non-refundable prepaid deposits or payments, (b) the charge for a single supplement if the Insured’s Traveling Companion Trip is cancelled but the Insured’s is not.
Trip Interruption Benefits:
The Insurer will reimburse the Insured for the following up to the Maximum Limit shown on the Schedule of Benefits for Trips that have been interrupted due to the Unforeseen events shown at the beginning of this section.
(a) forfeited, non-refundable, unused prepaid payments, made prior to your departure date; or (b) additional non-airline transportation expenses incurred by the Insured, either (i) to the Return Destination; or (ii) from the place that the Insured left the Trip to the place that the Insured may rejoin the Trip; or (c) additional transportation expenses incurred by the Insured to reach
the original Trip Destination if the Insured is delayed, and leaves after the departure date. However, the benefit payable under (b) and (c) above will not exceed the cost of economy airfare (or first class if the Insured’s original tickets were first class) by the most direct route, less any refunds paid or payable; (d) the Insured’s additional cost as a result of a change in the per-person occupancy rate for prepaid travel arrangements if a Traveling Companion’s Trip is interrupted, and the Insured’s Trip is continued.
Trip Interruption – Return Air Only:
The Insurer will reimburse the Insured for the additional airline transportation expenses incurred by the Insured to reach the Return Destination if the Insured's Trip must be interrupted due to one of the Unforeseen events shown at the beginning of this section, up to the Maximum Limit shown on the Schedule of Benefits.
The Insured must:
Contact LiveTravel (1.800.826.8597) as soon as he/she knows the Trip is going to be cancelled or interrupted. Failure to do so may affect coverage.
In addition to the General Exclusions, coverage is not provided for
losses caused by or as a result of:
(i) travel arrangements cancelled by an airline, cruise line, or tour operator, except as provided elsewhere in the policy; (ii) changes in plans by the Insured, an Immediate Family Member, or Traveling Companion, for any reason; (iii) financial circumstances of the Insured, an Immediate Family Member, or a Traveling Companion; (iv) any business or contractual obligations of the Insured, an Immediate Family Member, or Traveling Companion; (v) Default by the person, agency, or tour operator from whom the Insured bought his/her coverage and purchased his/her travel arrangements; (vi) any government regulation or prohibition; (vii) an event
which occurs prior to the Insured’s coverage Effective Date for Trip Cancellation coverage, whether known to the Insured or not; (viii) financial default.
The Insured’s Duties in the Event of Loss:
The Insured must provide the Insurer documentation of the cancellation or interruption, and proof of the expenses incurred. The Insured must provide proof of payment for the Trip such as cancelled check or credit card statements, proof of refunds received, copies of applicable tour operator or Common Carrier cancellation policies, and any other information reasonably required to prove the loss. Claims involving loss due to Sickness, Injury, or death require signed patient (or next of kin) authorization to release medical information and an attending physician’s statement. The Insured must provide the Insurer with all unused air, rail, cruise, or other tickets if he/she is claiming the value of those unused tickets.
TRIP DELAY
The Insurer will reimburse up to $150 a day to the Maximum Limit shown on the Schedule of Benefits if the Insured’s Trip is delayed for more than 5 hours for Reasonable Additional Expenses until travel becomes possible. Incurred expenses must be accompanied by receipts. This benefit is payable for only one delay per Insured, per Trip. Trip Delay must be caused by reasons listed under Trip Cancellation & Interruption, in addition to: (a) carrier-caused delay; (b) lost or stolen passports, travel documents, or money; (c) quarantine; or (d) Natural Disaster that causes a complete cessation of travel services at the point of departure or Destination.
The Insured Must:
Contact LiveTravel (1.800.826.8597) as soon as he/she knows his/her Trip is going to be delayed more than 5 hours. Failure to do
so may affect coverage.
MISSED CONNECTION
The Insurer will reimburse this benefit up to the Maximum Limit shown on the Schedule of Benefits if Inclement Weather or Common Carrier causes cancellation or a delay of all regularly scheduled airline flights for three to less than five hours to your point of departure. You can collect up to $250, for additional transportation costs to join the Trip (must be same class of original tickets purchased). Reasonable accommodations and meals (up to $150 per day), and/or the non-refundable, unused portion of the prepaid expenses as long as the expense is supported by a proof of purchase and is not reimbursable by another source. Common Carrier must certify the delay of the regularly scheduled airline flight.
LOSS OF BAGGAGE & PERSONAL EFFECTS
The Insurer will reimburse the Insured, up to the Maximum Limit shown on the Schedule of Benefits for loss, theft, or damage to the Insured’s Baggage and travel documents during the Insured’s Trip.
Continuation of Coverage:
If the Insured has checked his or her property with a Common Carrier, and delivery is delayed, coverage for Baggage and travel documents will continue until such property is delivered to the Insured. This coverage does not include loss caused by the delay.
Property Not Covered:
The Insurer will not pay for damage or loss of: (a) animals; (b) bicycles (except when checked with a Common Carrier); (c)
motor vehicles and other conveyances; (d) prosthetic limbs, false teeth, hearing aids; (e) tickets, keys, money, notes or security accounts, bills, currency, deeds, food stamps or other evidences of debt, credit cards, stocks and bonds, postal or money orders; (f) property shipped as freight, or shipped prior to the departure date; or (g) contraband, illegal transportation or trade.
Special Limitations:
The Insurer will not pay more than $1,000 for the first item and thereafter, no more than $500 per item up to the Baggage and Personal Effects Loss Maximum Limit shown on the Schedule of Benefits. The Insurer also will not pay more than $500 aggregate on all losses of the following: jewelry, watches, furs, cameras and camera equipment, camcorders, sporting equipment, computers, and other electronic devices.
Additional Exclusions:
In addition to the General Exclusions, the Insurer will not pay for any loss due to: (a) defective materials or craftsmanship; (b) normal wear and tear; (c) gradual deterioration; or (d) rodents, vermin or insects.
Payment of Loss:
The Insured must: (a) report theft losses to police or other local authorities as soon as possible; (b) take reasonable steps to protect his/her Baggage from further damage and make necessary and reasonable temporary repairs. The Insurer will reimburse the Insured for those expenses. The Insurer will not pay for further damage if the Insured fails to protect his/her Baggage; (c) allow the Insurer to examine the damaged Baggage and/or the Insurer may require the damaged item to be sent in the event of payment; (d) send sworn proof of loss as soon as possible from date of loss, providing amount of loss, date, time, and cause of loss, and a complete list of damaged/lost items. Any items $150 or more must be accompanied by the original receipt. Excess Insurance Limitation applies
BAGGAGE DELAY
The Insurer will reimburse the Insured, up to the Maximum Limit shown on the Schedule of Benefits for the cost of necessary personal effects purchased by the Insured during the Trip, if the Insured’s Baggage is delayed or misdirected for more than 6 hours from the time the Insured arrives at the Destination (other than the Insured’s Return Destination) provided the Insured is a ticketed passenger on a Common Carrier and the delay or misdirection is verified by the Common Carrier.
Payment of Loss:
The Insured must provide documentation of the delay or misdirection of Baggage by the Common Carrier and receipts for the
necessary personal effects purchased.
MEDICAL EXPENSE BENEFIT
The Insurer will reimburse or pay the Reasonable and Customary Charges for Medically Necessary Covered Expenses incurred by the Insured due to an Injury or Sickness within one year from the date of Injury or Sickness provided initial treatment was received during the Trip up to the Maximum Limit shown in the Schedule of Benefits.
Covered Expenses: Means charges incurred for any of the following services, supplies or treatments: 1) Emergency dental treatment received during a Trip limited to a maximum of $500; 2) Services of a Physician or Registered Nurse (R.N.); 3) Hospital charges; 4) X-ray; 5) local ambulance services to or from the Hospital; 6) artificial limbs, eyes, teeth or other prosthetic appliances; 7) Physical therapy will be covered up to 90 days after the Insured reaches his/her Return Destination. Excess Insurance Limitation applies.
PRE-EXISTING MEDICAL CONDITION EXCLUSION:
The Insurer will not pay for any loss or expense incurred as the result of an Injury, Sickness, or other condition of you, traveling companion, business partner, or Immediate Family Member which, within the 180-day period immediately preceding and including your coverage effective date: first manifested itself or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment; or for which care or treatment was given or recommended by a Physician; or required the taking of prescription drugs or medicines, unless the condition for which the drugs or medicines are taken remains controlled without any change in the prescription drugs or medicines.
The Insurer will waive this exclusion if the Insured meets the following conditions:
1. You purchase the program within 15 days of making the initial Trip payment. Day one is the date the initial Trip payment is received; 2. The amount of Trip Cancellation coverage purchased at that time equals the full cost of all pre-paid non-refundable trip arrangements. The cost of any subsequent arrangement(s) added to the same Trip must be insured within 15 days of the date of payment or deposit for any subsequent Trip arrangement(s). Failure to do so may affect the pre-existing medical condition waiver coverage; 3. You must be medically able to travel when plan cost is paid; and 4. Applies to the first $100,000 of Trip cost per person. IMPORTANT — Exclusions apply to certain medical conditions.
