These are for reference only, please refer to your Travel Plan Policy at the time
of purchase.
Benefits
The following benefits are provided for each Covered person for the reasonable and
customary charges listed below, subject to a maximum shown on the insurance certificate
during the period of the contract, 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.
Hospitalization
Hospitalization expenses for ward accommodation. Semiprivate or private accommodation
are not covered.
Physician fees
The reasonable and usual medical and surgical charges for the services of a Physician,
surgeon or anesthetist, up to the amount payable under the government fee schedule
in the area where services are rendered.
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.
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.
Accidental 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 six 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 $1,000 per Accident per Covered person.
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The following services must be approved and planned by CanAssistance.
Ambulance service
The cost of local ambulance or air ambulance service to the nearest 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 residence
The cost of repatriation of the Covered person to his 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 Traveling companion or any Member of
the immediate family of the Covered person who is also covered under this contract,
if he is unable to return to the departure point (as specified on the insurance
certificate) by means of the transportation initially planned for such return.
A round-trip ticket for a medical attendant is also covered.
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 $1,000. 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.
Return of the deceased
Up to $5,000 for the cost of preparation and transportation of the deceased person
(excluding the cost of a coffin) to the place of residence, or up to $3,000 for
the cost of cremation or burial at the place of death.
Subsistence allowance
Up to $1,000 ($100 per day for a maximum of 10 days) 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 Member
of the immediate family of the Covered person or Traveling companion.
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This benefit is offered free of charge with the purchase of any travel insurance
product included in this policy.
Medical assistance
If, following an Accident or sudden Illness, the Covered person must consult a Physician
or requires 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 country 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 immediate
family of the Covered person to the patient’s bedside if the Covered person is hospitalized
for at least seven 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, seven 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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No benefits are payable 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 61 years of age:
During the three months prior to the Effective date of coverage, any Illness, injury
or condition 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).
For persons 61 years of age or over:
a) During the six months prior to the Effective date of coverage, any Illness, injury
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.
b) During the six months prior to the Effective date of coverage, any other
Illness, injury or conditions 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).
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
- Pregnancy and complications arising there from
- Accident sustained by the Covered person while participating in a sport for remuneration,
any kind of motor vehicle competition or any kind of speed contest, gliding or hang-gliding,
mountain climbing (grade four or five routes, according to the scale of the Yosemite
Decimal System—YDS), parachuting or skydiving, bungee jumping, canyoning and any
extraordinary and uncommon sport with a high level of stress and risk involved
- Abuse of medication or alcohol, or use of drugs 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 of more than 80 milligrams
to 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 in Canada or the United States when such care or treatments
could have been obtained in the Covered person’s country of residence without endangering
the life or health of the Covered person (with the exception of expenses for immediately
necessary treatment following an emergency resulting from an Accident or sudden
Illness). Under this exclusion, the fact that the treatment available in the country
of residence of the Covered person could be of lesser quality than treatment available
in Canada or the United States (except Hawaii) does not in itself 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 residents of other countries traveling primarily or incidentally
to seek medical advice or treatment, even if such a trip is on the recommendation
of a Physician.
- Care or treatments that are not covered under government programs where such Hospital
and medical costs are incurred
- Care or treatments such as those rendered by a chiropractor, a podiatrist, an acupuncturist,
a homeopath, a physiotherapist or a 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 (GP products), antacids, digestives, laxatives, antidiarrheal drugs,
decongestants, antitussive drugs, 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
- Repatriation authorized by the Insurer for medical reasons terminates the contract
coverage from that moment on
- Treatment required for immigration purposes
- Eyeglasses and hearing aids
- Services or treatments received in the State of Hawaii in the United States or outside
Canada and the United States
- Services or treatments received within the United States by a resident of the United
States during the Period of coverage
- Acts of Terrorism Where an Act of terrorism directly or indirectly
causes a loss that would otherwise be payable under one of the covered risks in
accordance with the terms and conditions of the policy, this insurance will provide
coverage as follows:
- The benefit payable is reduced to 50%.
- The benefits payable shall be paid out of a fund and, where total claims exceed
fund limits, eligible claims shall be reduced on a pro rata basis so that the maximum
payment out of the fund for all policyholders shall be $5,000,000 (Canadian) per
Act of terrorism or series of Acts of terrorism occurring within a 72 hour period.
The total maximum payment out of the fund for all policyholders shall be $10,000,000
(Canadian) per calendar year regardless of the number of Acts of terrorism.
If, in our judgment, the total of all payable claims for all policyholders under
one or more Acts of terrorism may exceed the applicable fund maximum limits, your
prorated claim will be paid after the end of the calendar year.
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