Benefits
These are for reference only, please refer to your Travel Plan Policy at the time
of purchase.
Eligibility
At the time of application and during the whole Period of coverage, all Covered
persons must be covered under the Government health plan of their province/territory
of residence.
Conditions particular to this benefit
The following conditions are in addition to those applicable to all benefits:
- Benefits shall be payable only upon presentation of a certificate by the attending
Physician attesting that services for which a claim is made have been provided or
the covered loss has effectively occurred.
- When reimbursement of Hospital, medical and assistance expenses is not claimed by
the Covered person but settled between the Insurer and the provider of services,
the Policyholder shall provide any original document required for such settlement.
Failure to do so shall render the Policyholder responsible for the amounts the Insurer
cannot recover.
- Top-up insurance provided by Pacific Blue Cross may differ from the insurance that
covers the initial part of the trip because of the terms, conditions and exclusions
contained in the Policy. Pacific Blue Cross top-up insurance will not cover any
claim that occurs during the initial part of the trip. It is your responsibility
to verify that the initial part of your trip is covered by another insurance and
that the purchase of Pacific Blue Cross top-up insurance does not jeopardize your
eligibility for the other insurance.
Effective date of coverage
Coverage begins on the last of the following dates:
- the effective date of the Policy, or
- the departure date.
Expiry date of coverage
Coverage ends on the first of the following dates:
- the Expiry date of the Policy, or
- the return date, whether planned or premature.
What is covered
Benefits will be paid for reasonable and customary expenses incurred following
an emergency resulting from an Accident or sudden Illness, which occurs on a trip
during the Period of coverage. Eligible treatments are limited to what
is declared necessary for the stabilization of the medical condition. The benefits
provided by this coverage are over and above and may not be a duplication or substitution
of benefits granted by the Government health plan.
Benefits
The following benefits are provided for each Covered person for reasonable and customary
charges listed below, subject to a maximum of $10,000,000 during the period of the
Policy, and provided that these charges are not incurred before obtaining the
approval of CanAssistance.
Notice
Failure to contact CanAssistance in the event of medical consultation or hospitalization
following an Accident or sudden Illness could result in refusal of the compensation
requested.
The Insurer and CanAssistance are not responsible for the availability or quality
of medical and Hospital care rendered, or the lack thereof.
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Hospitalization
The cost of Hospital services in a private or semi-private room, which is in excess
of the amount refunded or refundable under government programs.
Incidental expenses
The expenses inherent to hospitalization (telephone, television, parking etc.) upon
presentation of documentary proof up to a maximum of $100 per hospitalization.
Physicians’ fees
The difference between fees charged by a Physician and benefits allowed under government
programs.
Medical appliances
The purchase or rental cost of crutches, canes or splints and the rental cost of
wheelchairs, orthopedic corsets and other medical appliances when prescribed by
the attending Physician.
Nursing care
The fees of a registered nurse (other than a relative) for private care while hospitalized
and when medically necessary and prescribed by the attending Physician.
Professional services (when prescribed as part of emergency treatment)
Professional services by a physiotherapist, chiropractor, osteopath or podiatrist
when medically necessary and prescribed by the attending Physician, up to a maximum
of $300 per profession.
Diagnostic services
The charges for laboratory tests and x-rays when prescribed by the attending Physician.
Drugs (when required as part of emergency treatment)
The cost of drugs requiring a Physician’s prescription, except when they are required
for the continued stabilization of a chronic medical condition.
Emergency Dental care
The fees of dental surgeons for treatment necessitated by an external injury (not
as a result of deliberate introduction of food or an object into the mouth), only
when natural and healthy teeth, which have had no previous treatment are damaged
or to reduce a fracture or dislocation of the jaw. In all cases, treatment must
begin during the Period of coverage and end within 6 months of the Accident. The
Covered person must transmit to the Insurer an x-ray taken after the Accident and
before the treatment begins, showing the damages sustained. The maximum refundable
is $2,000 per Accident per Covered person, and up to $500 for any other emergency
dental treatment, excluding root canal therapy.
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The following services must be approved and planned by CanAssistance:
Ambulance or taxi service
The cost of local ambulance or air ambulance service to the nearest Hospital or
accredited medical facility, including inter-Hospital transfer when the attending
Physician and CanAssistance determine that existing facilities are inadequate to
treat or stabilize the patient’s condition.
Repatriation to the province of residence
The cost of repatriation of the Covered person to his Province of residence by means
of appropriate transportation in order to receive immediate medical attention
following the authorization of the attending Physician and CanAssistance.
The cost of simultaneous repatriation of a Travelling companion or any Member of
the immediate family of the Covered person who is also covered under this Policy,
if he is unable to return to the departure point, by means of the transportation
initially planned for such return.
The cost of an escort person is covered in the case of child repatriation, as the
case may be.
Transportation to visit the Covered person
When a family member or friend of the Covered person visits the Hospital where he
is being treated, or travels to identify a deceased Covered person, if necessary,
prior to transportation of the deceased, the Insurer covers the following expenses
when they are incurred by the family member or friend of the Covered person who
travels:
- Up to $1,200 for:
- the cost of accommodation, the cost of meals in a commercial establishment, and
the cost of child care services, total up to a daily maximum of $300:
- the cost of travel insurance.
- The total cost of round-trip, economy class transportation.
In the event that the family member or friend of the Covered person travels to the
Hospital where the Covered person is being treated, the expenses described above
will be reimbursed only if the Covered person remains hospitalized for at least
7 days and the attending Physician acknowledges in writing that the visit is necessary.
Return of the vehicle
The cost of returning a Covered person’s vehicle, either private or rental, by a
commercial agency, or by any person authorized by CanAssistance, to the Covered
person’s residence or nearest appropriate vehicle rental agency when the Covered
person is unable to return the vehicle due to Illness or Accident, subject to a
maximum refund of $5,000. A medical certificate from the attending Physician in
the locality where the incapacity occurred is required, attesting that the Covered
person is incapable of using his vehicle.
Baggage return
When the Covered person is repatriated for medical reasons to the Province of residence
at the Insurer’s expenses, the cost to bring back the Covered person’s baggage to
the Province of residence is covered, up to a maximum of $300.
Return of a pet
When the Covered person is repatriated for medical reasons to the Province of residence
at the Insurer’s expense, the cost to bring back the Covered person’s pet to the
Province of residence is covered, up to a maximum of $500.
Return of the deceased
The cost of preparation and transportation of the deceased person (excluding the
cost of a coffin) to the departure point in the Province of residence or the cost
of cremation or burial at the place of death, subject to a total reimbursement of
$10,000.
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Up to $3,000 (maximum $300 per day) for the cost of accommodation and meals in a
commercial establishment, when a Covered person’s return must be delayed due to
Illness or bodily injury to himself or to an accompanying immediate family member
or Travelling companion.
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What is not covered
Exclusions and reductions of coverage
No benefits are payable under this benefit if the loss sustained or the expenses
incurred result directly or indirectly from one of the following causes:
Exclusions relating to pre-existing conditions
- For persons:
- under the age of 61 and covered by Individual, Package, Annual; or
- aged 61 to 75 and covered by Package Insurance for a period of 30 days or less and
including the Trip Cancellation and Interruption benefit with an insured amount
before departure:
During the 3 months prior to the Effective date of coverage:
- any illness, injury or condition (with exception of a minor ailment) related to
a medical condition for which the Covered person:
- consulted a Physician (other than for a regular checkup); or
- was hospitalized; or
- was prescribed or received a new treatment; or
- received a change in an existing treatment; or
- was prescribed or had taken a new medication; or
- received a change in existing medication (including usage or dosage).
The insurer does not consider a change in existing medication the following elements:
- the routine adjustment of insulin or Coumadin;
- a change from a brand name medication to a generic brand medication, provided the
dosage is the same;
- Aspirin taken for non-prescribed medical purposes;
- decrease of the dosage of cholesterol medication;
- hormone replacement therapy;
- vitamins and minerals and non-prescription medication;
- creams or ointments prescribed for cutaneous irritations.
- any heart condition for which the Covered person has taken nitroglycerin more than
once in a 7-day period for the relief of a chest pain.
- any pulmonary condition for which the Covered person was treated with home oxygen
or had recourse to a corticoid therapy.
- For persons:
- aged 61 to 75 and covered by Individual, Annual; or
- aged 61 to 75 and covered by Package Insurance for a period of 30 days or less and
not including the Trip Cancellation and Interruption benefit with an insured amount
before departure; or
- aged 61 to 75 and covered by Package Insurance for a period of 31 days or more;
or
- aged 76 or over:
- During the 6 months prior to the Effective date of coverage, any Illness or condition
related to one of the medical conditions listed below for which the Covered person:
- consulted a Physician (other than for a regular checkup); or
- was hospitalized; or
- was prescribed or received a treatment; or
- was prescribed or had taken a medication for:
Cardiovascular conditions: myocardial infarction, angina, arrhythmia,
pacemaker, defibrillator, congestive heart failure, bypass, angioplasty, valvulopathy
or valve replacement, aortic aneurysm, heart transplantation, peripheral vascular
disease;
Chronic obstructive lung conditions: asthma, emphysema, chronic
bronchitis, lung transplantation;
Neurological conditions: cerebral-vascular accident, transient
ischemic attack;
Insulin-dependent diabetes: diabetes treated with insulin injections;
Kidney failure, kidney transplantation;
Gastrointestinal conditions: cirrhosis, hepatitis, ulcers, internal
bleeding, liver transplantation, intestinal obstruction;
Cancer or malignant tumor.
- During the 6 months prior to the Effective date of coverage, any other Illness,
injury or conditions (with the exception of a minor ailment) related to a medical
condition for which the Covered person:
- consulted a Physician (other than for • a regular checkup); or
- was hospitalized; or
- was prescribed or received a new treatment; or
- received a change in an existing treatment; or
- was prescribed or had taken a new medication; or
- received a change in existing medication (including usage or dosage).
The insurer does not consider a change in existing medication the following elements:
- the routine adjustment of insulin or Coumadin;
- a change from a brand name medication to a generic brand medication, provided the
dosage is the same;
- Aspirin taken for non-prescribed medical purposes;
- decrease of the dosage of cholesterol medication;
- hormone replacement therapy;
- vitamins and minerals and non-prescription medication;
- creams or ointments prescribed for cutaneous irritations.
Other exclusions and reductions of coverage
No benefits are payable under this benefit if the loss sustained or the expenses
incurred result directly or indirectly from one
of the following causes:
- Any state or condition for which symptoms were ignored or for which medical advice
was not followed or the recommended investigations, treatments, tests or procedures
were not carried out.
- Pregnancy and complications arising from the pregnancy within 8 weeks preceding
the expected date of delivery.
- Accident sustained by the Covered person while participating in a sport for remuneration
or to a sporting event where money prizes are awarded to the winners, any kind of
motor vehicle competition or any kind of speeding event, to a dangerous or violent
sport such as but not limited to: off-track snow sports, show jumping obstacles,
rock climbing or mountain climbing (grade 4 or 5 routes, according to the scale
of the Yosemite Decimal System — YDS), parachuting, gliding or hang-gliding, skydiving,
bungee jumping, canyoning and any sport or activity with a high level of stress
and risk involved. The restrictions as for the speeding event does not apply to
the amateur athletic activities which are non-contact and engaged in by the Covered
person solely for leisure or fitness purposes. Emergency Medical Care — Exclusions
21
- Abuse of medication or alcohol, or use of drugs, use of experimental drugs or products
or any other drug addiction, and any condition arising therefrom, or driving a motor
vehicle while ability to drive is impaired by drugs or by alcohol with an alcohol
level of more than 80 milligrams per 100 millilitres of blood.
- Trip undertaken for the purpose of receiving medical attention.
- Suicide, attempted suicide or self-inflicted injury of the Covered person, whether
sane or insane.
- War, invasion, enemy acts, hostility between nations (whether or not war is declared),
civil war, rebellion, revolution, insurrection, military power or usurped power,
confiscation or nationalization or requisition or destruction of or damages to belongings
due to any government or local or public authority.
- Perpetration of or attempt to perpetrate, directly or indirectly, a criminal act
under any law.
- Any condition resulting from a mental, nervous, psychological or psychiatric problem,
unless the Covered person is hospitalized for that specific reason.
- Any claim for patients in chronic care Hospitals or in chronic care units of public
Hospitals, or in nursing homes or health spas.
- Any care, treatment, products or services other than those declared by the appropriate
authorities to be required for the treatment of the injury or disease or stabilization
of the medical condition.
- Custodial care or services rendered for the convenience of the patient.
- Care or treatments for cosmetic purposes.
- Care or treatments received outside the Province of residence, when such care or
treatments could have been obtained in the Province of residence without endangering
the life or health of the Covered person, with the exception of care for immediately
necessary treatment following an emergency resulting from an Accident or sudden
Illness. Under this exclusion, the fact that the care available in the Province
of residence could be of lesser quality or take longer to obtain than the care available
outside his Province of residence does not constitute a danger to the Covered person’s
life or health. Without restricting the generality of this exclusion, no benefits
are available under this plan for any Covered person travelling outside his Province
of residence primarily or incidentally to seek medical advice or treatment, even
if such a trip is on the recommendation of a Physician.
- Care or treatments received outside the Province of residence, which are not covered
under the Government health plan.
- Care or treatments such as those rendered by a podiatrist, acupuncturist, homeopath,
or naturopath.
- Products listed below are not covered even when obtained by a prescription: processed
food for infants, dietary or food supplements or substitutes of any kind, including
protein, so-called “natural” products, multivitamins and drugs available over the
counter, antacids, digestives, laxatives, antidiarrheals, decongestants, antitussives,
expectorants and any other flu or cold medications, gargles, oils, shampoos, lotions,
soaps and all other dermatological products.
- Failure of the Covered person to communicate with CanAssistance
in the event of medical consultation or hospitalization following an Accident or
sudden Illness.
- Any medical condition not requiring any more emergency care which occurred during
the trip and is a potential claim, when the Covered person elects to continue the
trip as planned.
- Expenses incurred for a medical condition resulting from an infectious disease or
Illness for which there is a travel advisory or health warning by the Canadian Department
of Foreign Affairs and International Trade, or Health Canada and published or broadcast
in the media prior to the Covered person’s scheduled departure date from Canada.
For your information
For the latest health or travel advisory, you can contact the Department of Foreign
Affairs and International Trade by calling 1 800 267-8376 (in Canada and the US)
or 613 944-9136.
You can also access their website at: http://www.voyage.gc.ca/dest/ctry/new-en.asp.
To contact Health Canada, please call 604 666-2083 for the British Columbia/Yukon
regional office.
Their website is located at:
http://www.hc-sc.gc.ca/english/.
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Conditions particular to this benefit
The following conditions are in addition to the conditions applicable to all benefits:
- Notice of an event
When a covered event occurs prior to the departure date, the Covered person must
contact his travel agent or the carrier, as the case may be, to cancel his trip
within the 48 hours following the event and notify the Insurer within the same
period.
Claim settlement shall be limited to the amounts stipulated on the travel certificate
that are non-refundable at the time of the cause of cancellation.
- Insured amount
This benefit shall be valid solely when subscribed to within the 72 hours following
purchase or the first nonrefundable deposit for the trip or transportation ticket.
The Covered person must be insured for all prepaid travel expenses that are non-refundable.
- Documents required for a claim
To substantiate a claim for non-refundable or extra costs, the Covered person must
provide, where applicable:
- a medical certificate completed by the legally qualified Physician in active personal
attendance in the locality where the Illness or Accident occurred and providing
a complete diagnosis; this medical supervision must have begun before the departure
or return date, as the case may be;
- documentary evidence of the risk insured that was the cause of the claim;
- originals or electronic versions of unused transportation tickets, original invoice
from the travel provider, official receipts for return transportation, credit note,
or all four;
- receipts for land arrangements and other expenses.
Failure to provide the applicable substantiation shall invalidate any claim under
this benefit.
-
Any liability under this benefit is subject to the condition that a Covered person
is not aware, when applying for insurance and when making the subsequent payment(s)
for his holiday or package tour, of any event that could reasonably prevent him
from making the trip as booked.
Effective date of coverage
Coverage begins on the last of the following dates:
- the date of application for insurance, or
- the date of purchase or the date of the first non-refundable deposit on the trip
or transportation ticket. Expiry date of coverage
Expiry date of coverage
Coverage ends on the first of the following dates:
- the Expiry date of the Policy, or
- the return date, whether planned or premature.
What is covered
- Non-refundable prepaid expenses
The non-refundable portion of unused prepaid travel expenses when the Covered person
cancels, interrupts or misses part of the planned trip
- New occupancy charges
The additional cost of new occupancy charges incurred by the Covered person who
chooses to continue his trip when a travelling companion must cancel.
- Additional transportation costs
All extra costs associated with the most economical transportation (including charges
for schedule changes) to the destination or back to the departure point when the
Covered person must interrupt, extend or modify his trip.
- Vehicle return costs
The cost of returning a Covered person’s vehicle, either private or rental, to the
Covered person’s residence or nearest appropriate vehicle rental agency, subject
to a maximum refund of $5,000, when the Covered person is unable to return the vehicle
as planned. The person carrying out the return must be authorized by CanAssistance.
- Subsistence allowance
An allowance of $300 per day per Covered person for accommodation, meals in a commercial
establishment, essential phone calls and transportation by taxi:
- during transit to get to the destination when the Covered person must modify the
trip, or;
- during transit to get back to the departure point when the Covered person is unable
to return by the planned means, or;
- when the Covered person must extend his trip. The subsistence allowance is subject
to a maximum reimbursement of $3,000 per Covered person.
- Costs for returning the remains of a deceased person
In case of death, the cost of preparation and transportation of the deceased person
(excluding the cost of a coffin) to the point of departure in the province of residence,
or for the cost of cremation or burial at the place of death, up to a maximum of
$10,000.
If the Vehicle return costs, Subsistence allowance or Costs for returning the
remains of a deceased person are also covered under the Emergency Medical
Care benefit of this Policy, the expenses are only payable under the Emergency Medical
Care benefit.
What is not covered
Exclusions and reductions of coverage
No benefits are payable under this benefit if the loss sustained or the expenses
incurred result directly or indirectly from one of the following causes:
Reductions of coverage
- Insufficient coverage
Benefits for Non-refundable prepaid expenses and New occupancy charges are reduced
if the amount of insurance on the travel certificate is less than the non-refundable
prepaid travel expenses. In this case, the settlement will be reduced in proportion
to the insurance amount indicated in the Policy and the non-refundable prepaid travel
expenses.
Additional transportation costs, Vehicle return costs, Subsistence allowance and
Costs for returning the remains of a deceased person are not affected by the present
reduction of coverage.
- Travelling companion
When an event affects several people who plan, leave and return together on the
same trip, the settlement will be limited to the amount that corresponds to the
settlements of the members of the immediate family plus a maximum of six other travelling
companions.
- Default protection
The Insurer will reimburse the unused portion of prepaid, nonrefundable travel expenses
further to cease of operation of a Travel supplier due to bankruptcy, insolvency
or administrative supervision.
In the case of default of a travel supplier, the engagement of the Insurer is limited
to the amounts indicated on the travel certificate, subject to a maximum of $7,500
per Covered person.
An overall maximum of $2,000,000 will be paid for all claims incurred due to the
default of any one Travel supplier.
An overall maximum of $5,000,000 will be paid under this benefit in any one calendar
year.
- Acts of terrorism
The benefit payable is reduced to 50% when the loss is caused directly or indirectly
by an Act of terrorism.
The total payout for which the Insurer will be responsible in case of an Act of
terrorism, or a series of Acts of terrorism occurring within 72 hours shall not
exceed $5,000,000.
The total payout for which the Insurer will be responsible in case of Acts of terrorism
shall not exceed $10,000,000 per calendar year.
Exclusion
No benefits are payable under this benefit if the loss sustained or the expenses
incurred result directly or indirectly from one
of the following causes:
- Pre-existing conditions
During the 3 months prior to the Effective date of coverage:
- any illness, injury or condition (with exception of a minor ailment) related to
a medical condition for which the Covered person:
- consulted a Physician (other than for a regular checkup); or
- was hospitalized; or
- was prescribed or received a new treatment; or
- received a change in an existing treatment; or
- was prescribed or had taken a new medication; or
- received a change in existing medication (including usage or dosage).
The insurer does not consider a change in existing medication the following elements:
- the routine adjustment of insulin or Coumadin;
- a change from a brand name medication to a generic brand medication, provided the
dosage is the same;
- Aspirin taken for non-prescribed medical purposes;
- decrease of the dosage of cholesterol medication;
- hormone replacement therapy;
- vitamins and minerals and non-prescription medication;
- creams or ointments prescribed for cutaneous irritations.
- any heart condition for which the Covered person has taken nitroglycerin more than
once in a 7-day period for the relief of a chest pain.
- any pulmonary condition for which the Covered person was treated with home oxygen
or had recourse to a corticoid therapy.
- Other exclusions
- Any state or condition for which symptoms were ignored or for which medical advice
was not followed or the recommended investigations, treatments, tests or procedures
were not carried out prior to the date of purchase or the date of the first non-refundable
deposit on the trip or transportation ticket.
- Trip undertaken by the Covered person for the purpose of obtaining medical care
or visiting or attending an ailing person and the medical condition or ensuing death
of that person is the cause of cancellation, curtailment or delayed return.
- Illness or hospitalization of any person other than a travelling companion, family
member or person that takes care of the Covered person’s business (key-employee)
or residence during his trip.
- Illness that does not require hospitalization of the host at destination.
- Any condition resulting from a mental, nervous, psychological or psychiatric problem
except if the Covered person must be hospitalized due to this condition.
- Pregnancy of the Covered person and complications arising from the pregnancy within
8 weeks preceding the expected date of delivery.
- Premature birth of a child if the anticipated trip is scheduled to take place during
the last 8 weeks of pregnancy or during the first 8 weeks following the expected
delivery date.
- Diagnosis of pregnancy after the effective date of coverage, if the departure or
return date of the trip is scheduled to take place during the first 32 weeks of
pregnancy.
- Abuse of medication or alcohol, or use of drugs, use of experimental drugs or products
or any other drug addiction by the Covered person, and any condition arising therefrom,
or driving of a motor vehicle while ability to drive is impaired by drugs or by
alcohol with an alcohol level of more than 80 milligrams per 100 millilitres of
blood.
- Suicide, attempted suicide or self-inflicted injury of the Covered person, whether
sane or insane.
- Accident sustained by the Covered person while participating in a sport for remuneration
or to a sporting event where money prizes are awarded to the winners, any kind of
motor vehicle competition or any kind of speeding event, to a dangerous or violent
sport such as but not limited to: off-track snow sports, show jumping obstacles,
rock climbing or mountain climbing (grade 4 or 5 routes, according to the Yosemite
Decimal System — YDS), parachuting, gliding, hand-gliding, skydiving, bungee jumping,
canyoning and any sport or activity with a high level of stress and risk involved.
The restrictions as for the speeding event does not apply to the amateur athletic
activities which are non-contact and engaged in by the Covered person solely for
leisure or fitness purposes.
- Perpetration of or attempt to perpetrate, by the Covered person, directly or indirectly,
a criminal act under any law.
- War, invasion, enemy acts, hostility between nations (whether or not war is declared),
civil war, rebellion, revolution, insurrection, military power or usurped power,
confiscation, nationalization, requisition or destruction of or damages as a result
of any government or local or public authority.
- Except for stops between 2 transportation segments, all missed transportation when
the Covered person did not plan to arrive at the connecting point within the time
frame recommended by the carrier.
- Financial problems, conflicts of Covered persons, disagreement with a travelling
companion on the part of the Covered person, inability to obtain the accommodation
desired, or aversion of the Covered person to the trip or the transportation.
- Loss of employment of the person who had a temporary, contract or permanent position
for less than one year.
- Cancellation of a business meeting by the employer of the Covered person.
- Law enforcement officers being summoned for jury duty or subpoenaed as a witness
or defendant in a case that is scheduled to be heard during the trip.
- Late visa application or request for a visa subsequent to a previous refusal or
ineligibility of the Covered person to file a visa application.
- Refused entry at customs or security checkpoints, except in a case of mistaken identity.
- Failure of the Covered person to communicate with CanAssistance.
- Cancellation of the trip prior to departure if adverse weather conditions cause
a delay to the carrier of less than 30% of the total duration of the trip.
- Situation known at the time of effective coverage that
could reasonably lead to an event which may prevent the Covered person from making
the trip as planned.
- Any event that does not lead the government to issue a general recommendation not
to travel in a region that is the trip destination; the insurance must have been
purchased prior to the disclosure of the government recommendation.
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Effective date of coverage
Coverage begins on the last of the following dates:
- the date the Policy comes into force, or
- the departure date.
Expiry date of coverage
Coverage ends on the Expiry date of the Policy.
What is covered
The Emergency Return benefit covers transportation expenses for the return to the
Province of residence and then the return to the original trip destination if the
return is made necessary by:
- death, or hospitalization for at least 7 days of a Member of the family of the Covered
person, a Member of the family or his Spouse or of the person for whom the Covered
person acts as legal guardian or estate executor. It is not necessary to wait 7
days before departure, but expenses will be reimbursed only if the Covered person
remains hospitalized for at least 7 days;
- disaster that renders the Covered person’s principal residence uninhabitable or
causes significant damages to his commercial establishment.
The refundable expenses correspond to the cost of a round-trip economy fare ticket
by the most direct route.
What is not covered
Exclusions and reductions of coverage
- Only one emergency return per trip shall be reimbursed.
- When applying for insurance, the Covered person must not know the reason which would
keep him from continuing his trip as originally planned.
- Accommodation costs during transportation are not covered.
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Effective date of coverage
Coverage begins on the last of the following dates:
- the date the Policy comes into force, or
- the departure date.
Expiry date of coverage
Coverage ends on the first of the following dates:
- the Expiry date of the Policy, or
- the return date, whether planned or premature.
What is covered
Subject to the provisions, conditions, exclusions and reductions of coverage of
this Policy, the Insurer hereby insures the Covered person for the accidental loss
of life or loss of use of one or several limbs.
The loss must result directly from an Accident sustained during the Period of coverage
and occur within 12 months of the Accident.
The Insurer shall pay an amount corresponding to the percentage shown in the Benefits
Chart of the sum insured indicated on the travel certificate.
Benefits chart
|
Accidental loss of
|
Percentage Payable of Sum Insured
|
|
|
Under age 18
|
Age 18 to 64
|
Age 65 and over
|
|
Life in public transportation
|
40%
|
200%
|
40%
|
|
Life under any other circumstance
|
20%
|
100%
|
20%
|
|
Use of several limbs or sight of both eyes
|
20%
|
100%
|
20%
|
|
Use of one limb or sight of one eye
|
10%
|
50%
|
10%
|
Limit and payment of the sum insured
Under no circumstances may the total amount paid under this plan exceed $300,000
per Covered person. In case of the loss of life of a Covered person,
the benefit shall be paid directly to the Policyholder if he is living, and to the
designated beneficiary if the Policyholder is deceased. If no beneficiary is designated
or if the designated beneficiary is deceased, payment will be made to the Policyholder’s
estate. In the case of accidental loss of one or more limbs or sight of one eye
or both eyes, the benefit shall be paid to the Covered person who has been the victim
of the Accident, his representative, or to his legal guardian if he is a minor.
If the Covered person sustains more than one loss, the Insurer shall pay for one
loss only, namely that which allows the highest amount.
Limit applicable to the Accidental Death and Dismemberment benefit and the Air
Flight Accident benefit (as described hereafter)
The total benefits payable under the Accidental Death and Dismemberment benefit
and the Air Flight Accident benefit may in no way exceed $300,000 per Covered person.
What is not covered
Exclusions and reductions of coverage
- Accident sustained by the Covered person while participating in a sport for remuneration
or to a sporting event where money prizes are awarded to the winners, any kind of
motor vehicle competition or any kind of speeding event, to a dangerous or violent
sport such as but not limited to: off-track snow sports, show jumping obstacles,
rock climbing or mountain climbing (grade 4 or 5 routes, according to the Yosemite
Decimal System — YDS), parachuting, gliding, handgliding, skydiving, bungee jumping,
canyoning and any sport or activity with a high level of stress and risk involved.
The restrictions as for the speeding event does not apply to the amateur athletic
activities which are non-contact and engaged in by the Covered person solely for
leisure or fitness purposes.
- Abuse of medication or alcohol, or use of drugs, use of experimental drugs or products
or any other drug-addiction, and any condition arising therefrom, or driving of
a motor vehicle while ability to drive is impaired by drugs or by alcohol with an
alcohol level or more than 80 milligrams per 100 millilitres of blood.
- Suicide, attempted suicide or self-inflicted injury of the Covered person, whether
sane or insane.
- War, invasion, enemy acts, hostility between nations (whether or not war is declared),
civil war, rebellion, revolution, insurrection, military power or usurped power,
confiscation, nationalization, requisition or destruction of or damages as a result
of any government or local or public authority.
- Perpetration of or attempt to perpetrate, directly or indirectly, a criminal act
under any law.
- Act of terrorism.
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Effective date of coverage
Coverage begins on the last of the following dates:
- the date the Policy comes into force, or
- the departure date.
Expiry date of coverage
Coverage ends on the first of the following dates:
- the Expiry date of the Policy, or
- the return date, whether planned or premature.
What is covered
Subject to the provisions, conditions, exclusions and reductions of coverage of
this Policy, the Insurer hereby insures the Covered person for the accidental loss
of life or loss of use of one or several limbs occurring while:
- travelling as a paying passenger in an Aircraft operated from the departure point
to the destination or return point;
- riding as a passenger in a land or water conveyance at the expense of the airline;
- riding as a passenger in a scheduled helicopter shuttle service to and from airports
to connect with a flight insured under this insurance;
- exposed to the elements due to the forced landing or disappearance of an Aircraft
on which the Covered person is insured by this insurance;
- waiting at the airport for the departure of a flight insured under this insurance.
The loss must result directly from an Accident sustained during the Period of coverage
and occurring within 12 months of the Accident.
The Insurer shall pay an amount corresponding to the percentage shown in the Benefits
Chart of the sum insured indicated on the travel certificate.
Benefits chart
|
Accidental loss of
|
Percentage Payable of Sum Insured
|
|
Life
|
100%
|
|
Use of several limbs or sight of both eyes
|
100%
|
|
Use of one limb or sight of one eye
|
50%
|
Limit and payment of the sum insured
Under no circumstances may the total amount paid under this benefit exceed $300,000
per Covered person. In case of the loss of life of a Covered person,
the benefit shall be paid directly to the Policyholder if the Policyholder is living,
and to the designated beneficiary if the Policyholder is deceased. If no beneficiary
is designated or if the designated beneficiary is deceased, payment will be made
to the Policyholder’s estate. In the case of accidental loss of one or more limbs
or sight of one eye or both eyes, the benefit shall be paid to the Covered person
who has been the victim of the Accident, his representative or to his legal guardian
if he is a minor. If the Covered person sustains more than one loss, the Insurer
shall pay for one loss only, namely that which allows the highest amount.
Limit applicable to the Accidental Death and Dismemberment benefit and the Air Flight
Accident benefit
The total benefits payable under the Accidental Death and Dismemberment benefit
and the Air Flight Accident benefit may in no way exceed $300,000 per Covered person.
What is not covered
Exclusions and reductions of coverage
- Suicide, attempted suicide or self-inflicted injury of the Covered person, whether
sane or insane.
- War, invasion, enemy acts, hostility between nations (whether or not war is declared),
civil war, rebellion, revolution, insurrection, military power or usurped power,
confiscation or nationalization or requisition or destruction of or damages to belongings
due to any governmental or local or public authority.
- Perpetration of or attempt to perpetrate, directly or indirectly, a criminal act
under any law.
- Act of terrorism.
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Conditions particular to this benefit
The following conditions are in addition to conditions applicable to all benefits:
- Where loss is due to theft, burglary, vandalism or disappearance, the Covered person
shall notify the police upon discovery of the loss. Failure to report the said loss
to the authorities shall invalidate any claim under this benefit for such loss.
- In the event of loss, the Covered person shall notify the Insurer as promptly as
possible and take all reasonable precautions to protect, safeguard or recover his
property and shall also promptly notify the police and obtain from them written
confirmation regarding such loss. The Covered person shall obtain written confirmation
from the hotel manager, tour guide or transportation authorities. The Covered person
shall furnish proof of loss or damage and value with a sworn statement within 90
days of the date of loss. Failure by the Covered person to comply with these conditions
shall invalidate claims under this benefit.
- If the covered property is checked with a public carrier and delivery is delayed
until after expiry of the coverage, coverage shall be continued until such property
is delivered by the public carrier.
- The Insurer shall not be liable beyond the actual cash value of the property at
the time any loss or damage occurs and may elect to repair or replace any damaged
or lost property with other of like quality or value.
- Upon the occurrence of any loss for which a claim is made, the amount of the applicable
limit of liability is reduced by the amount equivalent to such loss.
- This benefit shall not profit, directly or indirectly, any carrier or guarantor.
Effective date of coverage
Coverage begins on the last of the following dates:
- the date the Policy comes into force, or
- the departure date.
Expiry date of coverage
Coverage ends on the first of the following dates:
- the Expiry date of the Policy, or
- the return date, whether planned or premature.
What is covered
This benefit shall cover loss of or damage to the baggage owned by a Covered person
during a trip in or outside the Province of residence within the Period of coverage.
In the event the checked baggage is delayed by the carrier for 12 hours or more
while en route and before returning to the point of departure, the Insurer will
reimburse 50% of the amount covered, up to a maximum reimbursement of $500, for
the purchase of necessary toiletries and clothing. Proof of delay of checked baggage
from the carrier along with receipts of purchases must accompany the claim upon
presentation to the Insurer when returning from the trip.
This benefit covers expenses to replace passport, driver’s license, birth certificate
or travel visa in case these documents are lost or stolen, up to a maximum of $50.
The maximum amount payable under the Baggage benefit per Covered person, for the
duration of the trip, is the amount chosen on the travel certificate subject to
the exclusions and reductions of coverage.
What is not covered
Exclusions and reductions of coverage
The benefits are reduced or not payable in the event of or with regard to:
- Loss of or damage to automobiles or automobile equipment, motorcycles, bicycles
(unless registered with the carrier), boats, motors or other conveyances or their
accessories, household furnishings or accessories, false teeth, artificial limbs,
glasses, contact lenses, cash notes, securities, tickets and documents, professional
equipment or property, goods brought with the intent of trading them, antiques and
collectors items, perishable articles, cosmetics, personal effects, animals or any
item that is not part of the usual baggage.
- Breakage of fragile or brittle articles unless caused by fire or theft.
- Loss or damage due to confiscation or damage by order of any government or public
authority, or to illegal transportation or trade, war, demonstration or insurrection
or hostilities between nations (whether or not war is declared).
- Loss or damage caused by wear and tear, gradual deterioration, moths or vermin or
while the article is actually being worked upon or processed.
- Theft from an unattended automobile, trailer or other vehicle, unless such vehicle
was securely locked or was equipped with a closed compartment, which was securely
locked and the theft occurred as a result of forcible entry (of which there must
be visible marks).
-
The maximum amount payable for loss or damage for each item comprising the Covered
person’s baggage is $300.
For the purpose of calculating the maximum, the following items are grouped in categories,
and each category is considered, pursuant to the Policy, as a single article:
- jewelry: jewelry, watches, silver, gold or platinum items;
- furs: fur or fur-trimmed articles;
- photography equipment: cameras and photography equipment, video
cameras and video or audio equipment.
In addition, the maximum amount payable for loss or damage of the total of the 3
categories mentioned above is the lesser of $500 or 50% of the maximum amount chosen.
- Loss or damage caused by any imprudent action or omission by the Covered person.
When an article or personal property in question cannot be located and the circumstances
of its disappearance cannot be explained or do not lend themselves to a reasonable
conclusion that a theft occurred.
- Loss or damage to articles specifically insured under any other insurance policy
at the time this benefit is in effect.
- In the event of the loss of an article, which is part of a set, the measure of loss
shall be in reasonable and fair proportion to the total value of the set, giving
consideration to the importance of such article and with the understanding that
such loss shall not be construed to mean total loss of the set.
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This benefit applies only if the Covered person subscribed to the Emergency Medical
Care benefit.
When a Covered person is repatriated to his place of residence in Canada at the
Insurer’s expense further to a Hospital stay out of Canada, the Insurer will reimburse
the following costs if they are engaged within 15 days of the repatriation.
- The cost of a semi-private room in a Hospital or a rehabilitation centre or a convalescent
home up to a maximum of $1,000.
- The fees for home nursing care when medically required and provided by a registered
nurse or a registered nursing assistant, up to a maximum of $50 per day, for a maximum
of 10 days.
- The costs for the rental of the following devices, up to a maximum of $150: crutches,
standard walker, canes, trusses, orthopedic corset and oxygen.
- The cost for transportation (ambulance and/or taxi) in order to receive medical
care up to a maximum of $250.
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This benefit is offered free of charge with the purchase of any travel insurance
product included in this Policy.
- Medi-Assist Travel Assistance is provided by CanAssistance
Medical assistance
If, following an Accident or sudden Illness, the Covered person must consult a Physician
or require hospitalization, he must contact CanAssistance immediately. CanAssistance
will make the necessary arrangements in order to provide the Covered person with
the following services:
- for the State of Florida, direct the Covered person to an appropriate clinic or
hospital member of the Preferred Patient Care network;
- for the State of South Carolina, direct the Covered person to an appropriate clinic
or hospital member of the Preferred Personal Care network;
- for all other destinations, direct the Covered person to an appropriate clinic or
Hospital and advance funds to the Hospital if necessary;
- confirm the medical insurance coverage in order to avoid paying a substantial deposit;
- provide the follow-up of the medical file and communicate with the family Physician;
- repatriate the Covered person to his Province of residence, when necessary;
- coordinate the safe return home of Dependent children if the parent is hospitalized;
- make the necessary arrangements for the transportation of a Member of the family
of the Covered person to the patient’s bedside if the Covered person is hospitalized
for at least 7 days and if the attending Physician advises such attendance;
- coordinate the return of the Covered person’s vehicle if he is unable to bring it
back due to Illness or Accident.
Notice
Failure to contact CanAssistance in the event of medical consultation or hospitalization
following an Accident or sudden Illness could result in refusal of the compensation
requested.
The Insurer and CanAssistance are not responsible for the availability or quality
of medical and Hospital care rendered, or the lack thereof.
General assistance
In the event of any other emergencies, the Covered person can contact CanAssistance
in order to receive the following services:
- toll-free assistance lines available 24 hours a day, 7 days a week;
- transmission of urgent messages;
- coordination of claims;
- services of an interpreter for emergency calls;
- referral to legal counsel in the event of a serious Accident;
- settlement of formalities in the event of death;
- assistance in the event of loss or theft of identification papers;
- information regarding embassies and consulates.
Through CanAssistance, the Insurer may also provide pre-travel information with
regard to visas and vaccines.
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