General terms of coverage
This Policy provides coverage for anyone while traveling outside their Home Country, providing coverage for you, your spouse/domestic partner/traveling companion and dependent children/grandchildren. Please note this policy IS NOT valid for travel from, in, or to the United States of America.
We maintain Our right to investigate to verify that the eligibility requirements have been met. If and whenever We discover that the eligibility requirements have not been met, Our only obligation is refund of premium.
While the certificate is in effect, the Benefit Period does not apply. Upon termination of the certificate, in accordance with this provision, We will pay eligible medical expenses for up to 90 days beginning on the first day of diagnosis or treatment of a covered Sickness or Injury while a Covered Person is outside Their Home Country. The Benefit Period applies only to eligible medical expenses related to the eligible Sickness or Injury that began while the certificate was
in effect. In the event you begin a benefit period while the certificate is in effect, and the certificate terminates because you return to your home country, we will continue to pay eligible medical expenses which are incurred in your home country during the benefit period until the exhaustion of the Benefit period or the Policy Medical Maximum, whichever comes first.
An eligible person will be insured on the latest of the following dates: 1. the Covered Person’s departure from Their Home Country; or 2. the date and time the Covered Person completed enrollment form and Their correct premium is received; or 3. the effective date requested and shown on the certificate.
The coverage provided with respect to the Named Insured shall terminate at 12:01 AM North American Central Time on the earliest of the following dates: 1. The date shown on the insurance confirmation card, for which the premium is paid; or 2. The date the Covered Person returns to Their Home Country; or 3. Three hundred and sixty four (364) days after the Covered Person's original effective date, unless extended.
An extension notice will be sent to the Covered Person before the Policy Period ends and includes links to extend prior to the termination date. The Covered Person is subject to the following rules at extension: If it is initially purchased for a minimum of 5 days. If available, additional periods are charged at the premium rate in force at the time of extension. 5 days premium is the minimum acceptable extension premium and 364 days premium is the maximum. There are no grace periods for extension. Once the policy has lapsed, reapplication is required. Please note, upon application for a new policy, the Pre-Existing Condition exclusion, deductible and co-insurance start over.
CANCELLATION AND REFUND PROCEDURE PROVISIONS
Full cancellation and refund will only be considered if We receive written request prior to the Effective Date of the coverage. If We receive a written request for cancellation and refund after the Effective Date of coverage, a partial cancellation and refund may be allowed. The following conditions apply: a) If any claims have been filed with Us, the premium is fully earned and is non-refundable. b) If no claims have been filed with the Company, then (i) a cancellation fee of US $25 will be charged; and (ii) only unused days premiums will be considered as refundable; and c) If after a refund is made, it is determined that a claim was presented to Us on a Covered Person’s behalf, the Covered Person will be fully responsible for that claim in its entirety.
We will pay Covered Accident and Sickness Medical Expenses up to the Maximum Benefit as outlined in the Schedule of Benefits and after each Insured satisfies any Deductible, without regard to any other Health Care Plan benefits payable for the Insured. We will pay these benefits without regard to any Coordination of Benefits provision in any other Health Care Plan.