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DEFINITIONS

Description of Coverage 24-Hour Emergency (Capitalized terms within this Description of Coverage are defined
Assistance Telephone Numbers herein)
Continental USA………1.877.653.2516 “Actual Cash Value” means purchase price less depreciation.
Business Traveler “Baggage” means luggage, travel documents, and personal
International.………1.715.345.0505
possessions whether owned, borrowed, or rented, taken by the
Be sure to use the appropriate country Insured on the Trip.
SCHEDULE OF BENEFITS
and city codes when calling. “Business Partner” means a person who: (1) is involved with
This is an annual travel insurance program which provides coverage for
- KEEP THESE NUMBERS WITH YOU WHEN YOU TRAVEL - the Insured or the Insured’s Traveling Companion in a legal
all Trips taken and completed within 365 days of the date plan cost is
partnership; and (2) is actively involved in the daily management
of the business.
paid. The maximums shown below are aggregate amounts which will
IMPORTANT “Caregiver” means an individual employed for the purpose of
diminish in value per paid claim during the insurance period.
This coverage is valid only if the appropriate plan cost has been providing assistance with activities of daily living to the Insured or
to the Insured’s Family Member who has a physical or mental
paid. Please keep this document as Your record of coverage
All coverages are per person. MAXIMUM LIMIT impairment. The Caregiver must be employed by the Insured or
under the plan. the Insured’s Family Member. A Caregiver is not a babysitter;
Trip Interruption--Return Air Only ......................................$2,500
childcare service, facility or provider; or persons employed by
Trip Delay (Maximum of $150 per day).................................... $1,500 any service, provider or facility to supply assisted living.
Missed Connection...............................................................$500 PLEASE READ THIS DOCUMENT CAREFULLY! “Children”/“Child” means, with respect to Medical Expense
Baggage & Personal Effects Loss ....................................$2,500 and Emergency Evacuation benefits, unmarried children of the
Baggage Delay (Maximum of $200 per day).........................$1,000 The Policy will contain reductions, limitations, exclusions and Insured, including natural children from the moment of birth, and
termination provisions. Full details of coverage are contained in step, foster or adopted children from the moment of placement in
Medical Expense.............................................................$50,000 the Policy. If there are any conflicts between the contents of this the Insured’s home, under age 25 and primarily dependent on
Dental................................................................................$500 document and the Policy (form series T30337NUFIC), the Policy the Insured for support and maintenance. However, the age limit
Emergency Evacuation will govern in all cases. Insurance is underwritten by National does not apply to a child who: (1) otherwise meets the definition
Union Fire Insurance Company of Pittsburgh, Pa., with its principal of Children; and (2) is incapable of self-sustaining employment
and Repatriation of Remains.........................................$500,000 place of business in New York, NY.
(Limit of two evacuations per year) by reason of mental or physical incapacity.
“City” means an incorporated municipality having defined
Security Evacuation ......................................................$100,000 — Coverage may not be available in all states. — borders and does not include the high seas, uninhabited areas or
Accidental Death & Dismemberment ..............................$25,000 airspace.
“Common Carrier” means an air, land, or sea conveyance
Optional Coverage operated under a license for the transportation of passengers for
The following will be included if elected and appropriate hire.
cost has been paid. “Complications of Pregnancy” means conditions whose
diagnoses are distinct from pregnancy but are adversely affected
Trip Cancellation ..........................Maximum of $2,500 or $5,000
by pregnancy or are caused by pregnancy. These conditions
include acute nephritis, nephrosis, cardiac decompensation,
The following non-insurance services are provided missed abortion and similar medical and surgical conditions of
by Travel Guard. comparable severity. Complications of Pregnancy also include
nonelective cesarean section, ectopic pregnancy which is
Travel Medical Assistance
terminated and spontaneous termination of pregnancy, which
Worldwide Travel Assistance occurs during a period of gestation in which a viable birth is not
Concierge Services possible.
Personal Security Assistance Complications of Pregnancy do not include false labor,
Identity Theft Assistance (Not available in NY) occasional spotting, Physician-prescribed rest during the period
of pregnancy, morning sickness, hyperemesis gravidarum,
Business Assistant Services preeclampsia and similar conditions associated with the
management of a difficult pregnancy not constituting a
nosologically distinct complication of pregnancy.
“Deductible” means the amount of charges that must be
PRODUCT NUMBER: 008366 P1 2/10 incurred by an Insured before benefits become payable. The
amount of the Deductible is shown in the Schedule for each
coverage to which a Deductible applies.
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T30337NUFIC-TG-DOC
“Departure Date” means the date on which the Insured is "Host At Destination" means the person with whom the or motor home type. Owned or Rented Vehicle does not include
originally scheduled to leave on his/her Trip. This date is Insured is sharing prearranged overnight accommodations in the a mobile home or any motor vehicle which is used in mass or
specified in the travel documents. host's home. public transit.
“Destination” means any place where the Insured expects to “Inclement Weather” means any severe weather condition “Physician” means a licensed practitioner of the healing arts
travel to on his/her Trip other than Return Destination as shown which delays the scheduled arrival or departure of a Common including accredited Christian Science Practitioners, medical,
on the travel documents. Carrier or prevents the Insured from reaching his/her Destination surgical, or dental, services acting within the scope of his/her
“Domestic Partner” means an opposite or a same-sex partner when traveling by an Owned or Rented Vehicle. license. The treating Physician may not be the Insured, a
who is at least 18 years of age and has met all of the following “Individual Coverage Term” means the period of time Traveling Companion, a Family Member, or a Business Partner.
requirements for at least 6 months: (1) resides with the Insured; beginning on the date insurance coverage begins and ending on “Primary” means the Insurer will pay first but reserves the right
(2) shares financial assets and obligations with the Insured; The the date insurance coverage ends as specified in the Effective to recover from any other insurance carrier with which the
Insurer may require proof of the Domestic Partner relationship in and Termination Dates section. Insured may be enrolled.
the form of a signed and completed Affidavit of Domestic “Initial Trip Payment” means the first payment made to the “Primary Residence” means a person's fixed, permanent and
Partnership. Insured’s Travel Supplier toward the cost of the Insured’s Trip. principal home for legal and tax purposes.
“Eligible Person” means a person who is a member of an “Injury/Injured” means a bodily injury caused by an accident “Reasonable Additional Expenses” means expenses for
eligible class of persons as described in the Description of occurring while the Insured’s coverage under the Policy is in meals, lodging, taxi fares, and essential telephone calls which
Eligible Persons section of the Master Application. force, and resulting directly and independently of all other were necessarily incurred as the result of a Trip Delay and which
“Experimental or Investigative” means treatment, a device or causes of Loss covered by the Policy. The injury must be verified are not provided by the Common Carrier or any other party free
prescription medication which is recommended by a Physician, by a Physician. of charge.
but is not considered by the medical community as a whole to be “Insured” means an Eligible Person for whom: (a) any required “Reasonable and Customary Charges” means an expense
safe and effective for the condition for which the treatment, enrollment form has been completed; (b) any required plan cost which:
device or prescription medication is being used. This includes has been paid; (c) while covered under the Policy. (1) is charged for treatment, supplies, or medical services
any treatment, procedure, facility, equipment, drugs, drug usage, “Insurer” means National Union Fire Insurance Company of Medically Necessary to treat the Insured’s condition;
devices, or supplies not recognized as accepted medical Pittsburgh, Pa. (2) does not exceed the usual level of charges for similar
practice, and any of those items requiring federal or other “Key Employee” means an employee of an employer who is treatment, supplies or medical services in the locality where
governmental agency approval not received at the time services responsible for policy and decision making. the expense is incurred; and
are rendered. “Loss” means Injury or damage sustained by the Insured as a (3) does not include charges that would not have been made if
“Family Member” means the Insured’s or Traveling consequence of one or more of the events against which the no insurance existed. In no event will the Reasonable and
Companion’s spouse, Domestic Partner, Child, daughter-in-law, Insurer has undertaken to compensate the Insured. Customary Charges exceed the actual amount charged.
son-in-law, brother, sister, mother, father, grandparents, “Medically Necessary” means that a treatment, service, or “Return Date” means the date on which the Insured is
grandchild, step-child, step-brother, step-sister, step-parents, supply: scheduled to return to the point where the Trip started or to a
parents-in-law, brother-in-law, sister-in-law, aunt, uncle, niece, (1) is essential for diagnosis, treatment, or care of the Injury or different specified Return Destination. This date is specified in
nephew, legal guardian, Caregiver, foster child, ward, or legal Sickness for which it is prescribed or performed; the travel documents.
ward, or spouse or Domestic Partner of any of the above. (2) meets generally accepted standards of medical practice; “Return Destination” means the place to which the Insured
“Financial Default” means the total cessation of operations due (3) is ordered by a Physician and performed under his or her expects to return from his/her Trip.
to insolvency, with or without the filing of a bankruptcy petition by care, supervision, or order; and “Schedule” means the Schedule of Benefits.
a tour operator, cruise line, or airline. (4) is not primarily for the convenience of the Insured, “Sickness” means an illness or disease diagnosed or treated
“Hospital” means a facility that: (1) is operated according to Physician, other providers, or any other person. by a Physician.
law for the care and treatment of sick or Injured people; (2) has “Mental, Nervous or Psychological Disorder” means a “Strike” means a stoppage of work:
organized facilities for diagnosis and surgery on its premises or mental or nervous health condition including, but not limited to: (1) announced, organized, and sanctioned by a labor union and
in facilities available to it on a prearranged basis; (3) has 24 hour anxiety, depression, neurosis, phobia, psychosis; or any related (2) which interferes with the normal departure and arrival of a
nursing service by registered nurses (R.N.’s); and (4) is physical manifestation. Common Carrier.
supervised by one or more Physicians available at all times. “Natural Disaster” means a flood, hurricane, tornado, This includes work slowdowns and sickouts. The Insured’s Trip
A Hospital does not include: earthquake, fire, wildfire, volcanic eruption, or blizzard that is cancellation coverage must be effective prior to when the Strike
(1) a nursing, convalescent or geriatric unit of a hospital when a due to natural causes. is foreseeable. A Strike is foreseeable on the date labor union
patient is confined mainly to receive nursing care; (2) a facility “Necessary Personal Effects” means items such as clothing members vote to approve a Strike.
that is, other than incidentally, a clinic, a rest home, nursing and toiletry items, which were included in the Insured’s Baggage “Terrorist Incident” means an act of violence, that is deemed
home, convalescent home, home health care, or home for the and are required for the Insured’s Trip. terrorism by the United States Government other than civil
aged; nor does it include any ward, room, wing, or other section “Owned or Rented Vehicle” means a self-propelled private disorder or riot (that is not an act of war, declared or undeclared)
of the hospital that is used for such purposes; or (3) any military passenger motor vehicle with four or more wheels which is of a that results in Loss of life or major damage to property, by any
or veterans hospital or soldiers home or any hospital contracted type both designed and required to be licensed for use on the person acting on behalf of or in connection with any organization
for or operated by any national government or government highways of any state or country that is rented or owned by the which is generally recognized as having the intent to overthrow
agency for the treatment of members or ex-members of the Insured. Owned or Rented Vehicle includes, but is not limited to, or influence the control of any government.
armed forces. a sedan, station wagon, jeep-type vehicle pickup, van, camper

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“Transportation” means any land, sea or air conveyance Coverage Effective Date: (c) participation in professional athletic events, motor sport, or
required to transport the Insured during an Emergency Trip Cancellation coverage will be effective for an Insured at motor racing, including training or practice for the same;
Evacuation. Transportation includes, but is not limited to, air 12:01 a.m. Standard Time on the date following receipt by (d) mountaineering where ropes or guides are normally used.
ambulances, land ambulances and private motor vehicles. the Insurer or the Insurer’s authorized representative of any The ascent or descent of a mountain requiring the use of
“Travel Supplier” means the tour operator, rental company, required plan cost. specialized equipment, including but not limited to pick-axes,
cruise line, and/or airline that provides pre-paid travel All other coverages will begin on the later of: anchors, bolts, crampons, carabineers, and lead or top-rope
arrangements for the Insured’s Trip. (a) 12:01 a.m. Standard Time on the scheduled Departure anchoring equipment;
“Traveling Companion” means a person or persons with whom Date shown on the travel documents for a Trip or (e) war or act of war, whether declared or not, civil disorder, riot,
the Insured has coordinated travel arrangements and intends to (b) the date and time the Insured starts a Trip, taken during or insurrection;
travel with during the Trip. A group or tour leader is not the Individual Coverage Term provided any required plan (f) operating or learning to operate any aircraft, as student,
considered a Traveling Companion, unless the Insured is cost has been paid. pilot, or crew;
sharing room accommodations with the group or tour leader. Insurance Termination Date: (g) air travel on any air-supported device, other than a regularly
“Trip” means a period of travel away from home to a Destination Insurance elected by or provided for an Insured will end on the scheduled airline or air charter company;
outside the Insured’s City of residence; the purpose of the Trip is earliest of: (h) loss or damage caused by detention, confiscation, or
business or pleasure and is not to obtain health care or treatment of 1. The Policy termination date, unless the Insured purchased destruction by customs;
any kind; the Trip does not exceed 60 days; and the Insured’s this insurance prior to the date of termination; (i) any unlawful acts, committed by the Insured, a Family
Destination is not to another home. Travel must be more than 100 2. the end of the period for which any required premium has Member, or a Traveling Companion, or Business Partner
miles from the Insured’s Primary Residence. For annual plans, any been paid; whether insured or not;
Trip taken during the Individual Coverage Term. 3. the premium due date if premiums are not paid when due; (j) Mental, Nervous or Psychological Disorder;
“Trip Cost” means the dollar amount of Trip payments or 4. 365 days from the date of the Insured’s Effective Date of (k) if the Insured’s tickets do not contain specific travel dates
deposits reflected on any required enrollment form which are insurance; or (open tickets);
subject to cancellation penalties or restrictions paid by the 5. the date the Insured requests, in writing, that his or her (l) use of drugs, narcotics, or alcohol, unless administered
Insured prior the Insured’s Trip Departure Date. Trip Cost will insurance be terminated. upon the advice of a Physician;
also include the cost of any subsequent pre-paid payments or Coverage Termination Date: All coverage other than Trip (m) any failure of a provider of travel related services (including
deposits paid by the Insured for the same Trip, after enrollment Cancellation ends on the earlier of: any Travel Supplier) to provide the bargained-for travel
for coverage under this plan provided the Insured amends their (a) the scheduled Return Date for a Trip; services or to refund money due the Insured;
enrollment form to add such subsequent payments or deposits (b) the Insured’s arrival at the Return Destination on a round (n) Experimental or Investigative treatment or procedures;
and pays any required additional plan cost prior to the Insured’s Trip, or the Destination on a one-way Trip; (o) any loss that occurs at a time when this coverage is not in
Departure Date. (c) the date the Insured’s Insurance terminates. effect;
“Unforeseen” means not anticipated or expected and occurring Extension of Coverage: (p) traveling for the purpose of securing medical treatment;
after the effective date of the coverage. All coverage (except Trip Cancellation) will be extended, if: (q) care or treatment which is not Medically Necessary;
“Uninhabitable” means (1) the building structure itself is (a) the Insured's entire Trip is covered by the plan; and (r) any Trip taken outside the advice of a Physician;
unstable and there is a risk of collapse in whole or in part; (2) (b) the Insured's return is delayed by one of the Unforeseen (s) PRE-EXISTING MEDICAL CONDITION EXCLUSION:
there is exterior or structural damage allowing elemental reasons specified under Trip Cancellation or Trip Delay. The Insurer will not pay for any Loss or expense incurred as
intrusion, such as rain, wind, hail or flood; (3) immediate safety This extension of coverage will end on the earlier of: the result of an Injury, Sickness or other condition of an
hazards have yet to be cleared, such as debris on roofs or (a) the date the Insured reaches his/her Return Destination; or Insured, Traveling Companion, Business Partner, or Family
downed electrical lines; or (4) the rental property is without (b) 7 days after the date the Trip was scheduled to be completed. Member which, within the 90 day period immediately
electricity or water. (c) the date the Insured’s insurance terminates. preceding and including the Insured’s coverage effective
Baggage Continuation of Coverage: If an Insured’s Baggage, date: (a) first manifested itself, worsened or became acute or
ELIGIBILITY, EFFECTIVE AND TERMINATION DATES passports, and visas are in the charge of a charter or Common had symptoms which would have prompted a reasonable
Eligibility Carrier and delivery is delayed, coverage for Baggage and person to seek diagnosis, care or treatment; (b) for which
Persons eligible for insurance under the policy are any business Personal Effects and travel documents will be extended until the care or treatment was given or recommended by a
traveler(s) who purchases insurance through or from a properly Common Carrier delivers the property to the Insured. This Physician; (c) required taking prescription drugs or
licensed agent/agency located in the U.S., who enrolls for coverage Extension does not include Loss caused by the delay. medicines, unless the condition for which the drugs or
and pays the premium, providing they have not already departed on medicines are taken remains controlled without any change
their business Trip. GENERAL EXCLUSIONS in the required prescription drugs or medicines.
Insurance Effective Date: This plan does not cover any loss caused by or resulting from:
Insurance elected or provided for an Insured will take effect on (a) intentionally self-inflicted Injury, suicide, or attempted suicide
the latest of: of the Insured, Family Member, Traveling Companion or
1. The Policy effective date; Business Partner while sane or insane;
2. the date of enrollment for insurance; (b) pregnancy, childbirth, or elective abortion, other than
3. the effective date specified on the enrollment form; or Complications of Pregnancy;
4. the day after any required plan cost has been paid.
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The following exclusions apply to Baggage/Personal The following exclusion applies to Accidental Death and (g) the Insured, or a Traveling Companion being subpoenaed,
Effects Loss: Dismemberment: required to serve on a jury, hijacked, or quarantined;
Benefits will not be provided for any loss or damage to or (a) the Insurer will not pay for loss caused by or resulting from (h) Insured or Traveling Companion is called to active military
resulting (in whole or in part) from: Sickness or disease of any kind. service or military leave is revoked or reassigned;
(a) animals, rodents, insects or vermin; (i) a Terrorist Incident in a City listed on the Insured’s itinerary
(b) bicycles (except when checked with a Common Carrier); EXCESS INSURANCE LIMITATION within 30 days of the Insured’s scheduled arrival;
(c) motor vehicles, aircraft, boats, boat motors, ATV’s and other The insurance provided by the Policy for all coverages except (j) the Insured or Traveling Companion is required to work
conveyances; Trip Cancellation and Interruption and Medical Expense shall be during his/her scheduled Trip. He/she must provide proof of
(d) artificial prosthetic devices, false teeth, any type of in excess of all other valid and collectible insurance or indemnity. requirement to work, such as a notarized statement signed
eyeglasses, sunglasses, contact lenses, or hearing aids; If at the time of the occurrence of any Loss payable under the by an officer of his/her employer; In the situation of self-
(e) tickets, keys, notes, securities, accounts, bills, currency, Policy there is other valid and collectible insurance or indemnity employment, proof of self-employment and a notarized
deeds, food stamps or other evidences of debt, credit cards, in place, the Insurer shall be liable only for the excess of the statement confirming that the Insured is unable to travel due
and other travel documents (except passports and visas); amount of Loss, over the amount of such other insurance or to his or her job obligations will be required;
(f) money, stamps, stocks and bonds, postal or money orders; indemnity, and applicable Deductible. (k) the Insured or Traveling Companion is directly involved in a
(g) property shipped as freight, or shipped prior to the Departure merger, acquisition, government required product recall, or
Date; OPTIONAL TRIP CANCELLATION bankruptcy proceedings and must be currently employed by
(h) contraband, illegal transportation or trade; The Insurer will pay a benefit, up to the Maximum Limit shown the company that is involved in said event;
(i) items seized by any government, government official or on the Schedule, if an Insured cancels his/her Trip or is unable (l) the Insured’s or Traveling Companion’s company is deemed
customs official; to continue on his/her Trip due to the following Unforeseen to be unsuitable for business due to burglary, or Natural
(j) defective materials or craftsmanship; events: Disaster and the Insured or Traveling Companion is directly
(k) normal wear and tear; (a) Sickness, Injury or death of an Insured, Family Member, involved as a Key Employee of the disaster recovery team;
(l) deterioration. Traveling Companion, or Business Partner. (m) mechanical/equipment failure of a Common Carrier that
The following exclusions apply to Trip Cancellation and Trip 1) Injury or Sickness of an Insured, Traveling Companion or occurs on a scheduled Trip and causes complete cessation
Interruption: Family Member traveling with the Insured must be so of the Insured’s travel and results of a Loss of 50% of the
Benefits will not be provided for any loss resulting (in whole or in disabling as to reasonably cause a Trip to be cancelled or Insured’s Trip length; or
part) from: interrupted, or which results in medically imposed (n) the Insured or Traveling Companion is involuntarily
(a) travel arrangements canceled by an airline, cruise line, or restrictions as certified by a Physician at the time of Loss terminated or laid off through no fault of his or her own,
tour operator, except as provided elsewhere in the plan; preventing your continued participation in the Trip. provided that he or she has been an active employee for the
(b) changes by the Insured, a Family Member, or Traveling 2) If the Insured must cancel or interrupt his/her Trip due to same employer for at least one year. Termination must occur
Companion, for any reason; Injury or Sickness of a Family Member not traveling with following the effective date of coverage. This provision is not
(c) financial circumstances of the Insured, a Family Member, or the Insured, it must be because their condition is life- applicable to temporary employment, independent
a Traveling Companion; threatening, as certified by a Physician or because they contractors or self-employed persons.
(d) any government regulation or prohibition; require the Insured’s care. SPECIAL NOTIFICATION OF CLAIM
(e) an event which occurs prior to the Insured’s coverage 3) Injury or Sickness of the Business Partner must be so The Insured must notify Travel Guard as soon as reasonably
Effective Date; disabling as to reasonably cause the Insured to cancel or possible in the event of a Trip Cancellation or Interruption claim.
(f) failure of any tour operator, Common Carrier, person or interrupt the Trip to assume daily management of the If the Insured is unable to provide cancellation notice within the
agency to provide the bargained-for travel arrangements. business. Such disability must be certified by a Physician. required timeframe, the Insured must provide proof of the
The following exclusions apply to the Medical Expense (b) Sickness Injury or death or hospitalization of the Insured's circumstance that prevented timely notification.
Benefit: Host at Destination. A Physician must certify the Injury or Trip Cancellation Benefits: The Insurer will reimburse the
Benefits will not be provided for any loss resulting (in whole or in Sickness. Insured for forfeited Trip Cost up to the Maximum Limit shown on
part) from: (c) Financial Default of an airline, cruise line, or tour operator the Schedule for Trips that are canceled prior to the scheduled
(a) routine physical examinations; provided the Financial Default occurs more than 14 days departure for their Trip due to the Unforeseen events shown
(b) mental health care; following an Insured's effective date for the Trip Cancellation above.
(c) replacement of hearing aids, eye glasses, contact lenses, or Trip Interruption Benefits. There is no coverage for the
and sunglasses; Financial Default of any person, organization, agency, or TRIP INTERRUPTION-RETURN AIR ONLY
(d) routine dental care; firm from whom the Insured purchased travel arrangements The Insurer will reimburse the Insured for the additional
(e) any service provided by the Insured, a Family Member, or supplied by others; transportation expenses incurred to reach the Return
Traveling Companion or Traveling Companion of Family (d) Inclement Weather causing delay or cancellation of travel; Destination due to one of the Unforeseen events listed in the Trip
Member; (e) Strike resulting in complete cessation of travel services at Cancellation section. However, the benefit payable will not
(f) alcohol or substance abuse or treatment for the same. the point of departure or Destination; exceed the cost of economy airfare (or the same class as the
(f) the Insured’s Primary Residence or Destination being made Insured’s original ticket) less any refunds paid or payable and
Uninhabitable by Natural Disaster, vandalism, or burglary; taken by the most direct route.

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SINGLE OCCUPANCY BAGGAGE AND PERSONAL EFFECTS LOSS Covered Expenses:
The Insurer will reimburse the Insured, up to the Trip The Insurer will reimburse the Insured, up to the Maximum Limit The Insurer will pay for:
Cancellation Maximum Limit shown on the Schedule, for the shown in the Schedule subject to the special limitations shown • services of a Physician or Registered Nurse (R.N.);
additional cost incurred during the Trip as a result of a change in below, for Loss, theft or damage to the Insured’s Baggage, • Hospital charges;
the per person occupancy rate for prepaid, non-refundable travel personal effects, passports, travel documents and visas during • X-ray(s);
arrangements if a person booked to share accommodations with the Insured’s Trip. • local ambulance services to or from a Hospital;
the Insured has his/her Trip cancelled due to the Unforeseen Special Limitations: • artificial limbs, artificial eyes, artificial teeth, or other
events shown in the Trip Cancellation section and the Insured The Insurer will not pay more than: prosthetic devices;
does not cancel. • $500 for the first item and • the cost of emergency dental treatment only during a Trip
• thereafter, no more than $250 per each additional item limited to a Maximum Limit shown in the Schedule.
TRIP DELAY • $500 aggregate on all Losses to: jewelry, watches, furs, Coverage for emergency dental treatment does not apply if
The Insurer will reimburse the Insured up to the Maximum cameras and camera equipment, camcorders, computers, treatment or expenses are incurred after the Insured has
Limit(s) shown on the Schedule for Reasonable Additional and other electronic devices, including but not limited to: reached his/her Return Destination, regardless of the
Expenses until travel becomes possible if the Insured’s Trip is portable personal computers, cellular phones, electronic reason. The treatment must be given by a Physician or
delayed 5 or more consecutive hours from reaching their organizers and portable CD players. dentist.
intended Destination as a result of a cancellation or delay of a Items over $150 must be accompanied by original receipts. Advance Payment: If an Insured requires admission to a
regularly scheduled airline flight for one of the Unforeseen Hospital, Travel Guard will arrange advance payment, if
events listed below: The Insurer will pay the lesser of: required. Hospital confinement must be certified as Medically
(a) reasons listed under Trip Cancellation; (1) the cash value (original cash value less depreciation) as Necessary by the attending Physician.
(b) Common Carrier delay; determined by the Insurer or,
(c) the Insured’s or Traveling Companion’s lost or stolen (2) the cost of replacement. EMERGENCY EVACUATION
passports, travel documents, or money; & REPATRIATION OF REMAINS
(d) Natural Disaster; or The Insurer may take all or part of the damaged Baggage at the The Insurer will pay for Covered Emergency Evacuation
(e) the insured being involved in or delayed due to a traffic appraised or agreed value. In the event of a Loss to a pair or set Expenses incurred if an Insured suffers an Injury or Sickness
accident while en route to a departure as substantiated by a of items, the Insurer may at its option: while he or she is on a Trip that warrants his or her Emergency
police report. (1) repair or replace any part to restore the pair or set to its value Evacuation. Benefits payable are subject to the Maximum Limit
Incurred expenses must be accompanied by receipts. before the Loss; or shown on the Schedule for all Emergency Evacuations due to all
(2) pay the difference between the value of the property before Injuries from the same accident or all Sicknesses from the same
This benefit is payable for only one delay per Insured, per Trip. and after the Loss. or related causes.
Covered Emergency Evacuation Expenses are the
If the Insured incurs more than one delay in the same Trip the BAGGAGE DELAY Reasonable and Customary Charges for necessary
Insurer will pay for the delay with the largest benefit up to the If the Insured’s Baggage is delayed or misdirected by the Transportation, related medical services and medical supplies
Maximum Limits shown on the Schedule. Common Carrier for more than 12 hours while on a Trip, the incurred in connection with the Emergency Evacuation of the
Insurer will reimburse the Insured up to the Maximum Limit Insured. All Transportation arrangements made for evacuating
The Insured Must: Contact Travel Guard as soon as he/she shown on the Schedule for the purchase of Necessary Personal the Insured must be by the most direct and economical route
knows his/her Trip is going to be delayed more than 5 hours. Effects. Incurred expenses must be accompanied by receipts. possible. Expenses for Transportation must be:
This benefit does not apply if Baggage is delayed after the (a) ordered by the attending Physician who must certify that the
MISSED CONNECTION Insured has reached his/her Return Destination. severity of the Insured’s Injury or Sickness warrants his or
If while on a Trip the Insured misses a Trip departure resulting her Emergency Evacuation and adequate medical treatment
from cancellation or delay of 3 or more hours of all regularly MEDICAL EXPENSE BENEFIT is not locally available;
scheduled airline flights due to Inclement Weather or Common If, while on a Trip, an Insured suffers an Injury or Sickness that (b) required by the standard regulations of the conveyance
Carrier caused delay, the Insurer will reimburse the Insured up requires him or her to be treated by a Physician, the Company transporting the Insured; and
to the Maximum Limit shown in the Schedule for: Insurer will pay the Reasonable and Customary Charges, up to (c) authorized in advance by Travel Guard. In the event the
1. additional transportation expenses incurred by the Insured the Maximum Limit(s) shown on the Schedule of Benefits or Insured’s Injury or Sickness prevents prior authorization of
to join the departed Trip; Declarations Page. The Insurer will reimburse the Insured for the Emergency Evacuation, Travel Guard (1.877.653.2516
2. pre-paid, non-refundable trip payments for the unused Medically Necessary Covered Expenses incurred to treat such or collect 1.715.345.0505) must be notified as soon as
portion of the Trip. Injury or Sickness during the course of the Trip provided the reasonably possible.
initial treatment was received during the Trip. The Injury must Special Limitation: In the event Travel Guard could not be
The Common Carrier must certify the delay of the regularly occur or the Sickness must begin while on a Trip, while covered contacted to arrange for emergency Transportation, benefits are
scheduled airline flight. under the policy. limited to the amount the Insurer would have paid had the
Insurer or their authorized representative been contacted.
Coverage is secondary if reimbursable by any other source.

13 14
The Insurer will also pay a benefit for Reasonable and ACCIDENTAL DEATH AND DISMEMBERMENT Benefits will be payable for Eligible Expenses up to the Maximum
Customary Charges incurred for an escort’s transportation and If, while on a Trip, Injury to an Insured results within 365 days of Limit shown in the Schedule.
accommodations if an attending Physician recommends in the date of the accident which caused Injury, in one of the
writing that an escort accompany the Insured. Losses shown in the Table of Losses below, other than while Eligible Expenses are for Transportation and Related Costs to the
Emergency Evacuation means: riding as a passenger in or boarding or alighting from or struck Nearest Place of Safety necessary to ensure the Insured’s safety
(a) the Insured's medical condition warrants immediate or run down by a certified passenger aircraft provided by a and well-being as determined by the Designated Security
Transportation from the place where the Insured is injured or regularly scheduled airline or charter and operated by a properly Consultant.
sick to the adequate licensed medical facility of the Insured’s certified pilot, the Insurer will pay the percentage shown below of Security Evacuation benefits are payable only once per covered
choice where appropriate medical treatment can be the Maximum Limit shown in the Schedule. The accident must Trip.
obtained; occur while the Insured is on the Trip and is covered under the
(b) after being treated at a local licensed medical facility, the Policy. Benefits will also be payable for Transportation and Related
Insured's medical condition warrants transportation to the If more than one Loss is sustained by an Insured as a result of Costs within 14 days of the Security Evacuation to either of these
Insured’s home, or adequate licensed medical facility the same accident, only one amount, the largest applicable to locations as chosen by the Insured:
nearest the Insured’s home to obtain further medical the Losses incurred, will be paid. The Insurer will not pay more (1) back to the Host Country if return is safe and permitted; or
treatment or to recover; or than 100% of the Maximum Limit for all Losses due to the same (2) to the Insured Person’s Home Country;
(c) both (a) and (b) above. accident. (3) to the Insured’s point of origin for the Trip;
This benefit is subject to the overall Maximum Limit shown in the
LIMITATIONS: Table of Losses Schedule.
1) Benefits are only available under Emergency Evacuation if Loss of % of Maximum
they are not provided under another coverage in the plan. Limit Benefits will be payable for consulting services by Designated
2) The Maximum Limit payable for both Emergency Evacuation Life ....................................................................................100% Security Consultant for seeking information on Missing Person or
and Repatriation of Remains is shown in the Schedule. Both Hands or Both Feet ..................................................100% kidnapping cases if the Insured is deemed kidnapped or a
ADDITIONAL BENEFITS Sight of Both Eyes ............................................................100% Missing Person by local or international authorities. This benefit
In addition to the above covered expenses, if the Insurer has One Hand and One Foot ..................................................100% is subject to the overall Maximum Limit shown in the Schedule.
previously evacuated an Insured to a medical facility, the Insurer Either Hand or Foot and Sight of One Eye.......................100% The Worldwide Assistance Center must make all arrangements
will pay his/her airfare costs from that facility to the Insured’s Either Hand or Foot ............................................................50% and must authorize all expenses in advance of any benefits being
Return Destination, within one year from the Insured’s original Sight of One Eye.................................................................50% payable. The Worldwide Assistance Center is not responsible for
Return Date, less refunds from the Insured’s unused "Loss" with regard to: the availability of Transport services. Where a Security
transportation tickets. Airfare costs will be economy, or same (a) hand or foot means actual severance through or above the Evacuation becomes impractical because of hostile or dangerous
class as the Insured’s original tickets. wrist or ankle joints; conditions, a Designated Security Consultant will endeavor to
(b) eye means entire and irrecoverable Loss of sight in that eye. maintain contact with the Insured until a Security Evacuation
REPATRIATION OF REMAINS becomes viable.
The Insurer will pay Repatriation Covered Expenses up to the EXPOSURE
Maximum Limit shown on the Schedule to return the Insured's The Insurer will pay a benefit for covered Losses as specified Right of Recovery
body to city of burial if he/she dies during the Trip. above which result from an Insured being unavoidably exposed If, after a Security Evacuation is completed, it becomes clear that
to the elements due to an accidental Injury during the Trip. The the Insured was an active participant in the events that led to an
Repatriation Covered Expenses include, but are limited to, the Loss must occur within 365 days after the event which caused Occurrence, the Company has the right to recover all
reasonable and customary expenses for transportation, the exposure. Transportation and Related Costs from the Insured Person.
according to airline tariffs, of the remains by the most direct and DISAPPEARANCE
economical conveyance and route possible. The Insurer will pay a benefit for Loss of life as specified above Excess Provision
Travel Guard must make all arrangements and authorize all if the Insured’s body cannot be located one year after Benefits payable for the eligible expenses under this Benefit will
expenses in advance for this benefit to be payable. disappearance due to an accidental Injury during the Trip. be limited to that part of the eligible expense, if any, which is in
excess of the total benefits payable for the same Security
Special Limitation: In the event the Insurer or the Insurer’s SECURITY EVACUATION Evacuation under any other valid and collectible insurance or
authorized representative could not be contacted to arrange for If, as a result of an Occurrence that takes place during an other indemnity. If the other valid and collectible insurance or
Repatriation Covered Expenses, benefits are limited to the Insured’s Trip and while traveling outside his or her Home indemnity provides benefits on an excess coverage basis,
amount the Insurer would have paid had the Insurer or their Country, an Insured requires a Security Evacuation, the Insurer benefits will be paid first by the insurer or services plan whose
authorized representation been contacted. will pay a benefit to Transport the Insured to the Nearest Place of coverage has been in effect for the longer period of time at the
Safety. The determination that an Insured requires a Security date of the Security Evacuation.
Evacuation must be made by a Designated Security Consultant For purposes of this Benefit, an Insured’s entitlement to other
and all arrangements must be made by contacting the Worldwide valid and collectible insurance or indemnity will be determined as
Assistance Center (1.877.653.2516 or collect 1.715.345.0505). if this Benefit did not exist and will not depend on whether timely
application for benefits from other valid and collectible insurance
or indemnity is made by or on behalf of the Insured.
16 17 18
Benefits under this Benefit will be reduced to the extent that 4. the Insured had been deemed kidnapped or a Missing Person 13. due to military or political issues if the Insured’s Security
benefits for expenses are covered by any other valid and by local or international authorities and, when found, his or her Evacuation request is made more than 30 days after the
collectible insurance or indemnity whether or not a claim is made safety and/or well-being are in question within 7 days of his or her Appropriate Authority(ies) Advisory was issued; or
for such benefits. being found. 14. due to a storm (wind, rain, snow, sleet, hail, lightning, dust or
Related Costs means food, lodging and, if necessary, physical sand), earthquake, flood, volcanic eruption, wildfire or other
Definitions protection for the Insured during the Transport to the Nearest similar event that: a. is due to natural causes; and b. results
The following definitions apply only with respect to this benefit. Place of Safety. in such severe and widespread damage that the area
Advisory means a formal recommendation by the Appropriate Security Evacuation means the extrication of an Insured from of damage is officially declared a disaster area by the
Authorities that the Insured or citizens of his or her Home Country the Host Country due to an Occurrence which results in the government of the Host Country and the area is deemed to
or citizens of the Host Country leave the Host Country. Insured being placed in Imminent Physical Danger. be uninhabitable or dangerous.
Appropriate Authority(ies) means the government authority(ies) Transport/Transportation means the most efficient and
in the Insured’s Home Country or the government authority(ies) of available method of conveyance. In all cases, where practical, PAYMENT OF CLAIMS
the Host Country. economy fare will be utilized. If possible, the Insured’s common Claim Procedures: Notice of Claim: The Insured must call
Designated Security Consultant means an employee of a carrier tickets will be used. Travel Guard as soon as reasonably possible, and be prepared
security firm under contract to Travel Assist or a Travel Assist Verified Physical Attack means deliberate physical harm of the to describe the Loss, the name of the company that arranged the
designated service provider who is experienced in security and Insured confirmed by documentation or physical evidence. Trip (i.e., tour operator, cruise line, or charter operator), the Trip
measures necessary to ensure the safety of the Insured(s) in his Verified Threat of Physical Attack means a threat against the dates, and the amount that the Insured paid. Travel Guard will fill
or her care. Insured’s health and safety as confirmed by documentation and/or in the claim form and forward it to the Insured for his or her
Excluded Countries means the following countries from which physical evidence. review and signature. The completed form should be returned to
Security Evacuations are not available under this Rider: any Travel Guard, PO Box 47, Stevens Point, Wisconsin 54481
country subject to the administration and enforcement of U. S. Exclusions (telephone 1.877.653.2516). All claims of California residents
economic embargoes and trade sanctions by the OFFICE OF No benefits are payable under this Benefit for charges, fees or will be administered by Mercury Claims Administrator Services,
FOREIGN ASSETS CONTROL (OFAC). expenses: LLC. All accident, health, and life claims will be administered by
Home Country means the country of citizenship of the Insured. 1. payable under any other provision of this plan; Mercury Claims & Assistance of WI, LLC, in those states where
If the Insured has dual citizenship, for the purposes of this Benefit, 2. that are recoverable through the Insured’s employer; it is licensed.
his or her Home Country is the country of the passport he or she 3. arising from or attributable to an actual fraudulent, dishonest Claim Procedures: Proof of Loss: The claim forms must be
used to enter the Host Country. or criminal act committed or attempted by an Insured acting sent back to Insurer no more than 90 days after a covered Loss
Host Country means any country, other than an Excluded alone or in collusion with others; occurs or ends, or as soon after that as is reasonably possible.
Country, in which an Insured is traveling while covered under this 4. arising from or attributable to an alleged: All claims under the policy must be submitted to Travel Guard no
plan. a. violation of the laws of the Host Country by an Insured; or later than one year after the date of Loss or insured occurrence
Imminent Physical Danger means the Insured is subject to b. violation of the laws of the Insured’s Home Country; or as soon as reasonably possible. If Insurer has not provided
possible physical injury or sickness that could result in grave unless the Designated Security Consultant determines that claim forms within 15 days after the notice of claim, other proofs
physical harm or death. such allegations were intentionally false, fraudulent and of Loss should be sent to Travel Guard by the date claim forms
Missing Person means an Insured who disappeared for an malicious and made solely to achieve a political, propaganda would be due. The proof of Loss should include written proof of
unknown reason and whose disappearance was reported to the and/or coercive effect upon or at the expense of the Insured; the occurrence, type and amount of Loss, the Insured’s name,
Appropriate Authority(ies). 5. due to the Insured’s failure to maintain and possess duly the participating organization name, and the policy number.
Nearest Place of Safety means a location determined by the authorized and issued required travel documents and visas; Payment of Claims: When Paid: Claims will be paid as soon as
Designated Security Consultant where: 6. arising from an Occurrence which took place in an Travel Guard receives complete proof of Loss and verification of
1. the Insured can be presumed safe from the Occurrence that Excluded Country; age.
precipitated the Insured’s Security Evacuation; and 7. for repatriation of remains expenses; Payment of Claims: To Whom Paid: Benefits are payable to the
2. the Insured has access to transportation to his or her Home 8. for common or endemic or epidemic diseases or global Insured who applied for coverage and paid any required plan
Country; and pandemic disease as defined by the World Health cost. Any benefits payable due to that Insured’s death, will be
3. the Insured has the availability of temporary lodging, if needed. Organization; paid to the survivors of the first surviving class of those that
Occurrence means any of the following situations in which an 9. for medical services; or follow:
Insured finds himself or herself while covered by this plan: 10. for monies payable in the form of a ransom if a Missing (1) the Beneficiary named by that Insured and on file with Travel
1. expulsion from a Host Country or being declared persona non- Person case evolves into a kidnapping; or Guard
grata on the written authority of the recognized government of a 11. arising from or attributable, in whole or in part, to a debt, (2) to his/her spouse, if living. If no living spouse, then
Host Country; insolvency, commercial failure, the repossession of any (3) in equal shares to his/her living children. If there are none, then
2. political or military events involving a Host Country, if the property by any title holder or lien holder or any other (4) in equal shares to his/her living parents. If there are none,
Appropriate Authorities issue an Advisory stating that citizens of financial cause; or then
the Insured’s Home Country or citizens of the Host Country 12. arising from or attributable, in whole or in part to non- (5) in equal shares to his/her living brothers and sisters. If there
should leave the Host Country; compliance by the Insured with regard to any obligation are none, then
3. Verified Physical Attack or a Verified Threat of Physical Attack specified in a contract or license; or (6) to the Insured’s estate.
from a third party;
19 20
If a benefit is payable to a minor or other person who is incapable (c) give immediate notice to the carrier or bailee who is or may Coverage – as used in this Subrogation section, means no fault
of giving a valid release, the Insurer may pay up to $3,000 to a be liable for the loss or damage; motorist coverage, uninsured motorist coverage, underinsured
relative by blood or connection by marriage who has assumed (d) notify the police or other authority in the case of robbery or motorist coverage, or any other fund or insurance policy (except
care or custody of the minor or responsibility for the incompetent theft within 24 hours. coverage provided under the Policy to which this Description of
person’s affairs. Any payment Insurer makes in good faith fully Proof of Loss. The Insured must furnish the Insurer with proof Coverage is attached) and any fund or insurance policy providing
discharges Insurer to the extent of that payment. of Loss. Proof of Loss includes police or other local authority the Policyholder with coverage for any claims, causes of action
reports or documentation from the appropriate party responsible or rights the Insured may have against the Policyholder).
Benefits for Medical Expense/Emergency Evacuation services for the Loss. It must be filed within 90 days from the date of Loss. Third Party – as used in this Subrogation section, means any
may be payable directly to the provider of the services. However, Failure to comply with these conditions shall not invalidate any person, corporation or other entity (except the Insured, the
the provider: (a) must comply with the statutory provision for claims under the Policy. Policyholder and the Insurer).
direct payment, and (b) must not have been paid from any other Settlement of Loss. Claims for damage and/or destruction shall
sources. be paid immediately after proof of the damage and/or destruction GENERAL PROVISIONS
Trip Cancellation Payment of Loss: The Insured must provide is presented to the Insurer. Claims for lost property will be paid Physical Examination and Autopsy. The Insurer at its own
Travel Guard documentation of the cancellation or interruption after the lapse of a reasonable time if the property has not been expense has the right and opportunity to examine the person of
and proof of the expenses incurred. The Insured must provide recovered. The Insured must present acceptable proof of Loss any individual whose Loss is the basis of claim under the Policy
proof of payment for the Trip such as canceled check or credit and the value. when and as often as it may reasonably require during the
card statements, proof of refunds received, copies of applicable Valuation. The Insurer will not pay more than the Actual Cash pendency of the claim and to make an autopsy in case of death
tour operator or Common Carrier cancellation policies, and any Value of the property at the time of Loss. At no time will payment where it is not forbidden by law.
other information reasonably required to prove the Loss. Claims exceed what it would cost to repair or replace the property with Beneficiary Designation and Change. The Insured’s
involving Loss due to Sickness, Injury, or death require signed material of like kind and quality. beneficiary(ies) is (are) the person(s) designated by the Insured
patient (or next of kin) authorization to release medical Disagreement Over Size of Loss. If there is a disagreement and on file with Travel Guard.
information and an attending Physician’s statement. The Insured about the amount of the Loss either the Insured or the Insurer An Insured over the age of majority and legally competent may
must provide Travel Guard with all unused air, rail, cruise, or can make a written demand for an appraisal. After the demand, change his or her beneficiary designation at any time, unless an
other tickets if he/she is claiming the value of those unused the Insured and the Insurer each select their own competent irrevocable designation has been made, without the consent of
tickets. appraiser. After examining the facts, each of the two appraisers the designated beneficiary(ies), by providing Travel Guard with a
Baggage and Personal Effects Loss Payment of Loss: The will give an opinion on the amount of the Loss. If they do not written request for change. When the request is received,
Insured Must: (a) report theft Losses to police or other local agree, they will select an arbitrator. Any figure agreed to by 2 of whether the Insured is then living or not, the change of
authorities as soon as possible; (b) take reasonable steps to the 3 (the appraisers and the arbitrator) will be binding. The beneficiary will relate back to and take effect as of the date of
protect his/her Baggage from further damage and make appraiser selected by the Insured is paid by the Insured. The execution of the written request, but without prejudice to the
necessary and reasonable temporary repairs; (The Insurer will Insurer will pay the appraiser it chooses. The Insured will share Insurer on account of any payment made by it prior to receipt of
reimburse the Insured for those expenses. The Insurer will not with us the cost for the arbitrator and the appraisal process. the request.
pay for further damage if the Insured fails to protect his/her Benefit to Bailee. This insurance will in no way inure directly or Assignment. An Insured may not assign any of his or her rights,
Baggage); (c) allow the Insurer to examine the damaged indirectly to the benefit of any carrier or other bailee. privileges or benefits under the Policy.
Baggage and/or the Insurer may require the damaged item to be Misstatement of Age. If premiums for the Insured are based on
sent in the event of payment; or (d) send sworn proof of Loss as The following provision applies to Medical Expense, age and the Insured has misstated his or her age, there will be a
soon as possible from date of Loss, providing amount of Loss, Baggage/Personal Effects Loss, Emergency Evacuation and fair adjustment of premiums based on his or her true age. If the
date, time, and cause of Loss, and a complete list of Repatriation of Remains: benefits for which the Insured is insured are based on age and
damaged/lost items. Subrogation. To the extent the Insurer pays for a Loss suffered the Insured has misstated his or her age, there will be an
Baggage Delay Payment of Loss: The Insured must provide by an Insured, the Insurer will take over the rights and remedies adjustment of said benefit based on his or her true age. The
documentation of the delay or misdirection of Baggage by the the Insured had relating to the Loss. This is known as Insurer may require satisfactory proof of age before paying any
Common Carrier and receipts for the Necessary Personal Effects subrogation. The Insured must help the Insurer preserve its claim.
purchases. rights against those responsible for its Loss. This may involve Legal Actions. No action at law or in equity may be brought to
Medical Expense Payment of Loss: The Insured must provide signing any papers and taking any other steps the Insurer may recover on the Policy prior to the expiration of 60 days after
Travel Guard with: (a) all medical bills and reports for medical reasonably require. If the Insurer takes over an Insured's rights, written proof of Loss has been furnished in accordance with the
expenses claimed; and (b) a signed patient authorization to the Insured must sign an appropriate subrogation form supplied requirements of the Policy. No such action may be brought after
release medical information to Travel Guard. by the Insurer. the expiration of 3 years after the time written proof of Loss is
As a condition to receiving the applicable benefits listed above, required to be furnished.
The following provisions apply to Baggage Delay and as they pertain to this Subrogation provision, the Insured agrees, Concealment or Fraud: The Insurer does not provide coverage
Baggage/Personal Effects Loss: except as may be limited or prohibited by applicable law, to if the Insured has intentionally concealed or misrepresented any
Notice of Loss. If the Insured's property covered under the reimburse the Insurer for any such benefits paid to or on behalf material fact or circumstance relating to the policy or claim.
Policy is lost or damaged, the Insured must: of the Insured, if such benefits are recovered, in any form, from Payment of Premium: Coverage is not effective unless all
(a) notify Travel Guard as soon as possible; any Third Party or Coverage. premium due has been paid to Travel Guard prior to a date of
(b) take immediate steps to protect, save and/or recover the Loss or insured occurrence.
covered property;
22 23 24
Termination of the Policy: Termination of the policy will not The General Exclusion relating to Experimental or Investigative remains controlled without any change in the required
affect a claim for Loss which occurs while the policy is in force. treatment or procedures is amended to add the following: prescription drugs or medicines.
Transfer of Coverage: Coverage under the policy cannot be “unless such treatment or procedure has successfully completed The definition of Medically Necessary is amended to add: “The
transferred by the Insured to anyone else. a phase III clinical trial of the federal Food and Drug fact that a Physician may prescribe, order, recommend or
Administration;” approve a service or supply does not of itself make it Medically
STATE SPECIFIC NOTICES The General Exclusion relating to unlawful acts is amended to Necessary or covered by this plan.”
Notice to Colorado Residents: replace “unlawful acts” with “felonies”. The definition of Domestic Partner is amended as follows:
T30341NUFIC-CO The Medical Expense exclusion relating to alcohol or substance “Domestic Partner” means a person with whom an individual
The phrase “or insane” is deleted from the intentionally self- abuse is amended to read “ Intoxication or voluntary use of any maintains a committed familial relationship characterized by
inflicted Injury, suicide or attempted suicide exclusion when it controlled substance as defined in Title II of the Comprehensive mutual caring and the sharing of a mutual residence. Each
applies to Medical Expense Benefit and Emergency Evacuation. Drug Abuse Prevention and Control Act of 1970, as now or partner must be at least 18 years old and competent to contract,
hereafter amended, unless as prescribed by his physician for the be the sole Domestic Partner of the other person and not be
Notice to Connecticut Residents: Insured”. married.
T30341NUFIC-CT The “Maximum Limit of Liability” provision is deleted in its General Exclusions (j) and (l) are amended to add "except as
The definition of Hospital with respect to the military or veterans entirety. state mandates".
hospital is amended to add “for which no charge is normally The Excess Insurance Limitation provision does not apply to the
made”. health benefits. Notice to Illinois Residents:
The definition of Medically Necessary is deleted in its entirety and The Pre-existing Medical Condition exclusion is deleted and T30341NUFIC-IL
replaced with the following: replaced with the following: The Insurer will not pay for any loss The definition of Complications of Pregnancy is amended to
“Medically Necessary” means health care services that a or expense incurred as the result of an Injury, Sickness or other delete “hyperemesis gravidarum and preeclampsia”.
physician, exercising prudent clinical judgment, would provide to condition of an Insured, Traveling Companion, Business Partner The definition of Injury is amended to read as follows:
a patient for the purpose of preventing, evaluating, diagnosing, or or Family Member for which medical advice, diagnosis, care or Injury/Injured means a bodily injury caused by an accident
treating an illness, Injury, disease, or its symptoms, and that are treatment was recommended or received within 90 days occurring while the Insured’s coverage under the Policy is in
(1) in accordance with generally accepted standards of medical immediately preceding the Insured’s coverage effective date. force and resulting directly from all other causes of Loss covered
practice; (2) clinically appropriate, in terms of type, frequency, The Medical Expense Payment of Loss provision is amended to by the Policy. The Injury must be verified by a Physician.
extent, site, and duration and considered effective for the add the following provision regarding appeals for medical claims The General Exclusions provision is amended as follows:
patient's illness, Injury, or disease; and (3) not primarily for the which have been denied. “Any unlawful acts committed” is deleted and replaced with
convenience of the patient, physician, or other health care If your medical claim is denied in whole or in part by the Insurer “commission of or attempt to commit a felony”.
provider and not more costly than an alternative service or based on medical necessity or refusal by the Insurer to pre- The Excess Insurance Limitation provision is deleted in its
sequence of services at least as likely to produce equivalent certify, you may appeal the denial to the Commissioner of entirety.
therapeutic or diagnostic results as to the diagnosis or treatment Insurance. Your appeal to the Commissioner must be made Notice to Kansas Residents:
of that patient's illness, Injury, or disease. “Generally accepted within sixty (60) days of your receipt of the Insurer’s final written T30341NUFIC-KS
standards of medical practice” means standards that are based notice of denial. Your written appeal must be submitted on forms The Disagreement Over Size of Loss provision in the Additional
on credible scientific evidence published in peer-reviewed provided by and prescribed by the Department of Insurance and Claims Procedures section is amended to read as follows: If
medical literature generally recognized by the relevant medical must include a general release, executed by You, of all pertinent there is a disagreement about the amount of the Loss either the
community or otherwise consistent with the standards set forth in medical records and a filing fee of twenty-five dollars ($25). The Insured or the Insurer can make a written request for an
policy issues involving clinical judgment. decision by the Department of Insurance is final and binding. appraisal. Appraisal or Arbitration will take place only if both
The following definitions are added: parties agree, voluntarily to have the Loss appraised or
“Intoxication” means a person with an elevated blood alcohol Notice to Washington DC Residents: arbitrated. After examining the facts, each of the two appraisers
content of a ratio of alcohol in the blood of such person that is T30341NUFIC-DC will give an opinion on the amount of the Loss. If they do not
eight-hundredths of one per cent or more of alcohol, by weight or The Pre-existing Medical Condition Exclusion is amended as agree, they will select an arbitrator. Any figure agreed to by 2 of
such person has sustained such Injury while under the influence follows: the 3 (the appraisers and the arbitrator) will be binding. The
of intoxicating liquor or any drug or both. (v) PRE-EXISTING MEDICAL CONDITION EXCLUSION: The appraiser selected by the Insured is paid by the Insured. The
“Riot” means a tumultuous disturbance of the public peace by Insurer will not pay for any Loss or expense incurred as the result Insurer will pay the appraiser it chooses. The Insured will share
three or more persons assembled together and acting with a of an Injury, Sickness or other condition of an Insured, Traveling with us the cost for the arbitrator and the appraisal process.
common intent. Companion, Business Partner or Family Member which, within The Subrogation Provision in the Additional Claims Procedures
The General Exclusions relating to suicide and Mental, Nervous the 90 day period immediately preceding and including the section is amended by adding: Medical coverage will not be
and Psychological Disorders do not apply to the medical benefits. Insured’s coverage effective date: (a) first manifested itself, subrogated.
The General Exclusion relating to use of drugs is deleted in its worsened or became acute or had symptoms which would have The expiration period in the Legal Actions provision in the
entirety and replaced with the following: “voluntary use of any prompted a person to seek diagnosis, care or treatment; (b) for General Provisions section is amended to read 5 years.
controlled substance as defined in Title II of the Comprehensive which care or treatment was given or recommended by a “The Concealment or Fraud provision has been amended to add:
Drug Abuse Prevention and Control Act of 1970, as now or Physician; (c) required taking prescription drugs or medicines, A “fraudulent insurance act” means an act committed by any
hereafter amended, unless as prescribed by his physician for the unless the condition for which the drugs or medicines are taken person who, knowingly and with intent to defraud, presents,
Insured;”
25 26
causes to be presented or prepares with knowledge or belief that transaction, plus 2 percent, upon all money from the time it Notice to South Carolina Residents:
it will be presented to or by an insurer, purported insurer, broker becomes due. T30341NUFIC-SC
or any agent thereof, any written statement as part of, or in The “Claim Procedures: Proof of Loss” provision is amended to The “Physical Examination and Autopsy” provision is amended
support of, an application for the issuance of, or the rating of an add the following: to add: “The autopsy of a South Carolina resident must be
insurance policy for personal or commercial insurance, or a claim if Travel Guard requires additional information or time to approve performed in the state of South Carolina.”
for payment or other benefit pursuant to an insurance policy for or deny a claim, it will notify the Insured within 20 days after The “Legal Actions” provision is amended to replace the
commercial or personal insurance which such person knows to receipt of the claim, and at least once every 30 days thereafter expiration period of 3 years with 6 years.
contain materially false information concerning any fact material until the claim is approved or denied. The notice will contain the Notice to South Dakota Residents:
thereto; or conceals, for the purpose of misleading, information reason why the additional information or time is required. Travel T30341NUFIC-SD
concerning any fact material thereto. Guard will approve or deny the claim within: 30 days after it Exclusion (l) of the General Exclusions provision is deleted in its
The Excess Insurance Limitation provision is deleted in its receives the additional information; or 31 days after the last entirety.
entirety. timely notice was provided. The “alcohol or substance abuse or treatment for the same”
exclusion in the Medical Expenses Benefit Exclusions is deleted
Notice to Louisiana Residents: Notice to North Carolina Residents: in its entirety.
T30341NUFIC-LA T30341NUFIC-NC Exclusion (j) is amended to read “the Insured being under the
The “use of drugs, narcotics or alcohol” exclusion is amended to The definition of Hospital is deleted in its entirety and replaced influence of drugs during the commission of a felony”.
read: “being under the influence of narcotics or intoxicants, with the following: The Legal Actions provision is amended to change the expiration
unless prescribed by a Physician;” “Hospital” means a facility that: period to six years.
The Subrogation provision is amended by adding the following: (1) is operated according to law, including North Carolina state Notice to Texas Residents:
The Insurer’s right of subrogation will not be enforced until the hospitals, for the care and treatment of sick or Injured people; T30341NUFIC-TX
Insured has been made whole, as determined by a court of law, (2) has organized facilities for diagnosis and surgery on its The Proof of Loss Provision is amended by adding the following:
as a result of the Loss. The Insurer agrees to pay our portion of premises or in facilities available to it on a prearranged basis; The Insurer will acknowledge receipt of the notice of claim in
the Insured’s attorneys’ fee or other costs associated with a claim (3) has 24 hour nursing service by registered nurses (R.N.’s); writing within 15 business days after the Insurer receives the
or lawsuit to the extent that we recover any portion of the benefits and claim. The Insurer will notify a claimant in writing of the
paid under the policy pursuant to our right of subrogation. (4) is supervised by one or more Physicians available at all acceptance or rejection of a claim not later than the 15th
The Family Member definition is amended to delete Domestic times. business day after the date the Insurer receives all required
Partner. A Hospital does not include: documentation to secure final proof of Loss. If the Insurer rejects
The Disagreement Over Size of Loss provision of the Additional (1) a nursing, convalescent or geriatric unit of a hospital when a the claim, the required notice will state the reasons for the
Claims procedures section are deleted in their entirety. patient is confined mainly to receive nursing care; rejection. If the Insurer is unable to accept or reject the claim
(2) a facility that is, other than incidentally, a clinic, a rest home, within that time period, the Insurer will notify the claimant of the
Notice to Nevada Residents: nursing home, convalescent home, home health care, or reasons that additional time is needed. The Insurer will accept or
T30341NUFIC-NV home for the aged; nor does it include any ward, room, wing, reject the claim not later than the 45th day after the claimant is
The Medical Expense Benefit is amended by removing the or other section of the hospital that is used for such notified. If the claim is accepted, the Insurer will pay the claim
following provision: “This coverage does not apply to medical purposes; or within 5 days of the notice of acceptance. If payment of the claim
expenses incurred by any Child born during the Trip.” and is (3) any military or veterans hospital or soldiers home or any is delayed, the Insurer will pay the claim plus 18% interest per
replaced with “Children born during the Trip are covered for hospital contracted for or operated by any national year, plus reasonable attorney fees. If a lawsuit is filed, such
medical expenses for the first 31 days from the moment of birth government or government agency for the treatment of attorney fees shall be taxed as part of the costs in the case.
at no additional expense. Continuation of coverage until the end members or ex-members or the armed forces for which no The Disagreement Over Size of Loss provision is amended as
of the Trip will be subject to notification of the birth and payment charge is made. follows:
of any applicable premium. Disagreement Over Size of Loss. If there is a disagreement
The General Exclusions section is amended to delete the The Subrogation provision will not apply to Medical Expense about the amount of the Loss either the Insured or the Insurer
following exclusion: “use of drugs, narcotics or alcohol, unless benefits. can make a written demand for an appraisal within 30 days of the
administered upon the advice of a Physician. The time period in the Proof of Loss provision is amended to 180 date of the disagreement notice. Within 30 days after the
The “Payment of Claims: When Paid” provision is deleted and days. demand, the Insured and the Insurer each select their own
replaced with the following: The following notice is added: This plan includes all of the competent appraiser and notify the other party. After examining
Payment of Claims: Claims will be approved or denied within 30 applicable benefits mandated by the North Carolina Insurance the facts, each of the two appraisers will give an opinion on the
days after Travel Guard receives the claim. If the claim is Code, but is issued under a group master policy located in amount of the Loss. If they do not agree, they will select an
approved Travel Guard will pay the claim within 30 days after its another state and may be governed by that state’s laws.” arbitrator or request selection by the courts within 30 days of the
approval. If the approved claim is not paid within that period, The pre-existing conditions exclusion is amended to delete appraisers’ opinions. Any figure agreed to by 2 of the 3 (the
Travel Guard will pay interest on the claim at the rate equal to the reference to “first manifested” and to replace “a reasonable appraisers and the arbitrator) or the court, will be binding. The
prime rate at the largest bank in Nevada, as ascertained by the person” with “a person”. appraiser selected by the Insured is paid by the Insured. The
commissioner of financial institutions, on January 1 or July 1 as Insurer will pay the appraiser it chooses. The Insured will share
the case may be, immediately preceding the date of the with us the cost for the arbitrator and the appraisal process.

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The Legal Actions provision is amended to change the expiration Puede communicarse con el Departamento de Seguros de Texas Notice to Vermont Residents:
period from 60 days to 90 days. para obtener informacion acerca de companias, coberturas, U30000DDBG
The Pre-Existing Medical Condition Exclusion is amended to derechos o quejas al: Vermont law requires that health insurers offer coverage to
remove “first manifested itself” and to replace “reasonable 1.800.252.3439 parties to a Civil Union that is equivalent to coverage provided to
person” with “ordinarily prudent person”. Puede escribir al Departamento de Seguros de Texas: married persons. This endorsement is made a part of and
The following provisions are added: P. O. Box 149104 amends the Policy or Description of Coverage on the later of: (1)
TEXAS LAWS GOVERN POLICIES. Any contract of insurance Austin, TX 78714-9104 3/1/2009; or (2) the Policy Effective Date; or (3) the Description
payable to any citizen or inhabitant of this State by any insurance Fax # (512) 475 1771 of Coverage Effective Date, to which this Endorsement is
company or corporation doing business within this State shall be Web: http://www.tdi.state.tx.us attached. It is subject to all of the provisions, limitations, and
held to be a contract made and entered into under and by virtue E-mail: ConsumerProtection@tdi.state.tx.us exclusions of the Policy or Description of Coverage except as
of the laws of this State relating to insurance, and governed they are specifically modified by this Endorsement.
hereby, notwithstanding such policy or contract of insurance may DISPUTAS SOBRE PRIMAS O RECLAMOS: 1.The definition of Civil Union is added to and made a part of the
provide that the contract was executed and the premiums and Si tiene una disputa concerniente a su prima o a un reclamo, Definitions section.
policy (in case it becomes a demand) should be payable without debe comunicarse con la compania primero. Si no se resuelve Civil Union – means that two eligible persons have established
this State, or a at the home office of the company or corporation la disputa, puede entonces communicarse con el departamento a relationship pursuant to 15 V.S.A. chapter 23 of Vermont’s
issuing the same. (TDI). Statues and may receive the benefits and protections and be
ELECTED OFFICIALS. An insurer may not cancel or refuse to subject to the responsibilities of spouses.
renew an insurance policy based solely on the fact that the UNA ESTE AVISO A SU POLIZA: 2.The definition of Party(ies) to a Civil Union is added to and
policyholder is an elected official. Este aviso es solo para proposito de informacion y no se made a part of the Definitions section.
53593DBG convierte en parte o condicion del documento adjunto. Party(ies) to a Civil Union – means an Insured who has
IMPORTANT NOTICE established a Civil Union with another person pursuant to 15
To obtain information or make a complaint: Notice to Wisconsin Residents: V.S.A. chapter 23 and 18 V.S.A. chapter 106.
T30341NUFIC-WI 3.The definitions, terms, conditions or any other provisions of the
You may call National Union Fire Insurance Company of The Subrogation provision is amended to add the following Policy, Description of Coverage, and/or Riders and
Pittsburgh, Pa.'s toll free number for information or to make a language: Endorsements to which this mandatory Endorsement is attached
complaint at: The Insurer’s right of subrogation will not be invoked until are hereby amended and superseded as follows:
1.800.551.0824 benefits to which the Insured is entitled under the Policy are paid Terms that mean or refer to a marital relationship, or that may
to or on behalf of the Insured, and the Insured has been made be construed to mean or refer to a marital relationship, such
You may contact the Texas Department of Insurance to obtain whole and is fully compensated for damages. as “marriage”, “spouse”, “husband”, “wife”, “dependent”,
information on companies, coverages, rights or complaints at: The Concealment or Fraud provision is deleted and replaced with “next of kin”, “relative”, “beneficiary”, “survivor”, “immediate
1.800.252.3439 the following language: family” and any other such terms include the relationship
You may write the Texas Department of Insurance: Concealment or Fraud: The Insurer does not provide benefits created by a Civil Union.
P. O. Box 149104 for any Loss incurred if the Insured has intentionally concealed or Terms that mean or refer to the inception or dissolution of a
Austin, TX 78714-9104 misrepresented any material fact or circumstance which impacts marriage, such as “date of marriage”, “divorce decree”,
Fax # (512) 475 1771 payment of such Loss. “termination of marriage” and any other such terms include
Web: http://www.tdi.state.tx.us The Proof of Loss provision is deleted and replaced with the the inception or dissolution of a Civil Union.
E-mail: ConsumerProtection@tdi.state.tx.us following language: Terms that mean or refer to family relationships arising from
Proof of Loss. The Insured must furnish the Insurer with proof a marriage, such as “family”, “immediate family”,
PREMIUM OR CLAIM DISPUTES: of Loss. Proof of Loss includes police or other local authority “dependent”, “children”, “next of kin”, “relative”, “beneficiary”,
Should you have a dispute concerning your premium or about a reports or documentation from the appropriate party responsible “survivor” and any other such terms include family
claim you should contact the Insurer first. If the dispute is not for the Loss. It must be filed within 90 days from the date of Loss. relationships created by a Civil Union.
resolved, you may contact the Texas Department of Insurance. Failure by the Insured to give notice within such time does not 4. As provided in this Endorsement the term child or covered
invalidate or reduce the claim unless the Insurer is prejudiced by child shall mean a child (natural, stepchild, legally adopted child,
ATTACH THIS NOTICE TO YOUR POLICY: the failure to give notice within such time. a minor, or a disabled child) who is: (1) dependent on the Insured
This notice is for information only and does not become a part or The Payment of Claims: When Paid: is deleted and replaced for support and maintenance; and (2) born to or brought to: (a)
condition of the attached document. with the following language: a marriage; or (b) a Civil Union established according to Vermont
Payment of Claims: When Paid: Claims will be paid as soon as law.
AVISO IMPORTANTE Travel Guard receives complete proof of Loss and verification of 5.The defined terms Eligible Spouse or Insured Spouse, or the
Para obtener informacion o para someter una queja: age, but not later than 30 days. term spouse, wherever they appear in the Policy, Description of
Usted puede llamar al numero de telefono gratis de National Coverage, Rider, Endorsement, and/or Application are deemed
Union Fire Insurance Company of Pittsburgh, Pa. para to include a Party to a Civil Union.
informacion o para someter una queja al:
1.800.551.0824

31 32
THIS ENDORSEMENT IS NOT MEANT TO PROVIDE Worldwide Travel Assistance Identity Theft Assistance
DEPENDENT COVERAGE IF DEPENDENT COVERAGE IS • Lost baggage search; stolen luggage replacement • Assist identity theft victim with ordering and reviewing credit
NOT PROVIDED UNDER THE POLICY. assistance bureau records
CAUTION: FEDERAL LAW RIGHTS MAY OR MAY NOT BE • Lost passport/travel documents assistance • Assist identity theft victim with investigating financial
AVAILABLE • ATM locator accounts where identity theft is suspected
Vermont law grants parties to a Civil Union the same benefits, • Emergency cash transfer assistance • Assist victim in communications with creditors to help make
protections and responsibilities that flow from marriage under • Travel information including visa/passport requirements the creditors aware of the victim’s identity theft issues
state law. However, some or all of the benefits, protections and • Emergency telephone interpretation assistance • Assist identity theft victim in identifying proper law
responsibilities related to health insurance that are available to • Urgent message relay to family, friends or business enforcement to pursue prosecution of criminals
married persons under federal law may not be available to associates • Assist identity theft victim in reviewing account activity to
Parties to a Civil Union. For example, federal law, the Employee • Up-to-the-minute travel delay reports identify any suspicious activities
Income Retirement Security Act of 1974 known as "ERISA", • Long-distance calling cards for worldwide telephoning • Obtain additional resources for reviewing and resolution of
controls the employer/employee relationship with regard to • Inoculation information victim’s issues
determining eligibility for enrollment in private employer health • Embassy or Consulate Referral
benefit plans. Because of ERISA, Act 91 does not state • Currency Conversion or purchase *Non-insurance services are provided by Travel Guard.
requirements pertaining to a private employer's enrollment of a • Up-to-the-minute information on local medical advisories,
Party to a Civil Union in an ERISA employee welfare benefit plan. epidemics, required immunizations and available preventive Any payments under the policy will only be made in full
However, governmental employers (not federal government) are measures compliance with all United States of America economic or trade
required to provide health benefits to the dependents of a Party • Up-to-the-minute travel supplier strike information sanction laws or regulations, including, but not limited to,
to a Civil Union if the public employer provides health benefits to • Legal referrals/bail bond assistance sanctions, laws and regulations administered and enforced by
the dependents of married persons. Federal law also controls • Worldwide public holiday information the U.S. Treasury Department's Office of Foreign Assets Control
group health insurance continuation rights under "COBRA" for (“OFAC”). Therefore, any expenses incurred or claims made
employers with 20 or more employees as well as the Internal Business Assistant involving travel that is in violation of such sanctions, laws and
Revenue Code treatment of health insurance premiums. As a • Emergency dictation and business correspondence regulations will not be covered under the policy. For more
result, Parties to a Civil Union and their families may or may not assistance. information, you may consult the OFAC internet website at:
have access to certain benefits under the Policy, Description of • Business Service location assistance (quick printers, internet www.treas.gov/offices/enforcement/ofac/ or a Travel Guard
Coverage, Rider, or Endorsement that derive from federal law. cafes, overnight delivery, etc). representative.
You are advised to seek expert advice to determine your rights • “411” Global Directory Service.
under the Policy. • Wireless Accessory Replacement Assistance.
• Business Conference Call Coordination.
ASSISTANCE SERVICES* • Urgent Messaging to clients, colleagues & family members.
All Assistance Services listed below are not insurance benefits • Up-to-the-minute travel delay and departure reports.
and are not provided by the Insurer. • Driving and walking directions worldwide.
• Emergency return travel arrangements.
Travel Medical Assistance
• Emergency medical transportation assistance Concierge Services
• Physician/hospital/dental/vision referrals • Restaurant Referrals and Reservations
• Assistance with repatriation of mortal remains • Ground Transportation
• Return travel arrangements • Event Ticketing
• Assistance with emergency prescription replacement • Tee Times and Course Recommendations
• Dispatch of doctor or specialist • Floral Services Satisfaction Guaranteed — Travel Guard is committed to
• Medical evacuation quote providing products and services that will exceed
• In-patient and out-patient medical case management Personal Security Assistance expectations. If you are not completely satisfied, you can
• Qualified liaison for relaying medical information to family • Security evacuation assistance receive a refund of the cost, minus the service fee. Requests
members • Immediate 24-hour support services must be submitted to Travel Guard in writing within 15 days
• Arrangements of visitor to bedside of hospitalized Insured • Security and safety advisories, global risk analysis, and of the effective date of the coverage, provided it is not past
• Eyeglasses and corrective lens replacement assistance consultation specialist the original departure date.
• Medical payment arrangements • Urgent message alert and relay
• Medical cost containment/expense recovery and overseas
investigation
• Medical bill audits 008366-CT 2/10 TRAVEL GUARD 5/19/10
• Shipment of medical records T30337NUFIC-TG-DOC
• Assistance with medical equipment rental/replacement
34 35 36

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