Ct 444110 p1-p4 0412; 444120 p1 0412; 444150 p1-p8 0412; 444155 p1 - p4 0412_0

PRIVACY PRINCIPLES
Table of Contents
We abide by these Privacy Principles and want You, Our policyholders, insureds and claimants (referred to as “Customers” or “You”), to be aware of how and why Wehandle personal information. We work hard to respect and maintain Your privacy. However, the very nature ofOur business is such that the collection, use and disclosure of personal information are fundamental to II. SPECIFIC DETAILS OF YOUR INSURANCE .9 the products and services We provide.
These Privacy Principles apply only to the product or service Our Customers have obtained or the insurance IV. FEATURES AND SERVICES TO SERVE YOU BETTER .21 Policy under which the Customer is seeking or receiving benefits. As a worldwide leader in the delivery ofinsurance products and services, the member companies of Chartis Inc. offer numerous products and services to many types of consumers and clients in many different countries around the world. Therefore, differing Chartis Inc. companies may adopt differing privacy practices tofit their own jurisdiction and business requirements. The Global Privacy Notice, located at www.travelguard.ca,may also be applicable to Our Customers as We conductOur business.
I. DEFINITIONS
We attach very specific meanings to the following words when
For the purposes of these Privacy Principles personal they appear in this Policy. We have capitalized these words when information means information that identifies an individual. For example: an individual’s name, birth date, Accident/Accidental: A sudden, unexpected, unintended,
address, age, health and financial information is personal unforeseeable, external event, occurring during an Insured Trip information which We may collect, use and in certain that independently of any other cause, results in Injury (or circumstances, where necessary, disclose, in the course damage, if the context relates to property loss or damage). of providing insurance services and carrying on business.
Accidental Death and Dismemberment (AD&D): Accidental
Personal information does not include the name, death meaning bodily Injury caused by an accident which results business title, address, phone or fax number of an in death if the Injury, accident and death occur while You are on Medical Policy
a Trip. Accidental dismemberment meaning one (1) of (i) theactual severance of a limb above Your ankle or wrist joint; or (ii) These Privacy Principles may be modified from time to the complete loss of eyesight in both eyes and/or hearing in both time. An individual may obtain Our most up to date version located at www.travelguard.ca or by contacting Change in Prescribed Medication means the medication dosage
or frequency has been reduced, increased, stopped and/or newmedications have been prescribed.
• an adjustment to the insulin or Coumadin (Warfarin) dosage you are currently taking provided it is not newly prescribed or stopped and there has been no change to your Medical • a change from a brand name medication to a generic brand medication (insofar as the dosage is not modified).
Common/Scheduled Carrier: Means an air, land, or sea
conveyance operated under a license for the transportation of
passengers for hire.
Your world, insured
Confirmation of Coverage: Your most recent computer printout,
Follow-up Treatment: Treatment that continues beyond the
Mental or Emotional Disorders: Emotional or anxiety states,
printed form, electronic copy, invoice, or Policy document that situational crisis, anxiety or panic attacks, or other mental health sets out the product You have purchased and any optional add on Follow-up Visit: The re-examination of You to monitor the
disorders treated with tranquilizers or anxiolytic drugs.
effects of earlier medical Treatment related to the initial (Example: a mental or nervous health disorder like: anxiety, Contamination: The act or process of rendering something
Emergency, except while Hospitalized. Follow-up visit does not depression, neurosis, psychosis and others or any related harmful or unsuitable to people by nuclear and/or chemical include further diagnostic or investigative testing related to the and/or biological substances causing illness, Injury and/or death. Minor Ailment: Any Sickness or Injury which does not require:
Departure Date: The date on which You are scheduled to leave
Government Health Insurance Plan (GHIP): Health insurance
the use of medication for a period of greater than 15 days; more coverage that Canadian provincial or territorial governments than one (1)Follow-up Visit to a Physician, Hospitalization, Departure Point: The city that You depart from Your Home
surgical intervention, or referral to a specialist; and which ends at Home Province: Your Canadian province or territory of
least 30 consecutive days prior to the Departure Date of each Dependent Child and/or Dependent Children: Unmarried
Trip. However, a chronic condition or any complication of a persons who are Your natural, adopted, step or foster children, Hospital: A medical facility which is legally accredited to provide
chronic condition is not considered a minor ailment.
dependent on You for support and care and less than 21 years of medical, diagnostic and surgical Treatment to in-patients during Mountain Climbing: The ascent or descent of a mountain
age, or full-time students less than 26 years of age, or mentally or the acute phase of their Sickness or Injury, which is primarily requiring the use of specialized equipment, including but not physically incapable of self support. You must be the legal engaged in the aforesaid activities and which operates under the limited to pick-axes, anchors, bolts, crampons, carabineers, and guardian of any foster children and they must reside at Your supervision of a staff of physicians and has a registered nurse continuously on duty. A Hospital does not mean an institution Physician: A medical doctor, other than Yourself, Your
Emergency: An unforeseen occurrence of, symptoms of
licensed as a home for the aged, rest home, nursing home, Immediate Family Member, Your Travel Companion or their Sickness, or of Injury, that occurs during a Trip (or for Trip convalescent hospital, health spa, or a rehabilitation centre or Immediate Family Member, who is licensed to administer cancellation, that occurs immediately prior to Your Trip), which Treatment facility for drug or alcohol abuse and/or addiction. medical Treatment and prescribe drugs in the place where he or requires immediate Treatment from a Physician or that requires Hospitalization or Hospitalized: The state of being admitted to
she provides medical services. The following are not considered Hospitalization, failing which there could be a serious a Hospital and receiving Emergency Medical Treatment on an to be Physicians: naturopath, herbalist, and homeopath. Policy or Policies: This document, any riders or endorsements to
Emergency Dental Treatment: Immediate and medically
Immediate Family Member: Any one (1) or more of Your Spouse,
this document, the application, any medical questionnaire if necessary dental services or supplies provided by a licensed natural, step, or adopted children, persons for whom You are the applicable, and the Confirmation of Coverage all of which form registered dentist, Hospital, or other licensed Provider, that is legal guardian, parents, parents-in-law, son-in-law, daughter-in- the result of an acute and unexpected condition that arose law, step-parents, sisters, brothers, sisters/brothers-in-law, step- Policy Purchase Date: The date You pay for specific insurance
sisters/brothers, grandparents, grandchildren, aunts, uncles, coverage which is listed on Your Confirmation of Coverage as Emergency Medical Treatment: Medically necessary services or
supplies provided during a Trip by a licensed Physician, Hospital Injury: A bodily injury sustained during a Trip, which is caused,
Premium: The cost of Your insurance Policy plus any additional
or other licensed Provider, that are required to treat any Injury or directly and independently of all other causes, by an Accident.
amounts required for any optional coverage You have purchased. Sickness or other sudden, acute and unexpected condition that Insured: The person named as the ‘primary traveller’ and/or one
Prescription Medication: A drug, medicine or medication only
arose during the Trip, and that cannot be reasonably delayed (1) or more other person(s), if any, named as ’other travellers’ on obtainable by the prescription of a licensed Physician for until You return to Your Home Province without endangering the Confirmation of Coverage, each as the context requires.
Emergency Medical Treatment or dentist for Emergency Dental Insurer: Chartis Insurance Company of Canada, 145 Wellington
Treatment, and dispensed by a licensed pharmacist. End Date: For annual plans the day which is one (1) day before
Street West, Toronto, ON, M5J 1H8. This Policy is administered on Provider: The Hospitals, clinics, Physicians, and other medical
Our behalf by Travel Guard Group Canada Inc. (Travel Guard service providers, the use of which must be approved by Us at the Expected Medical Treatment: Medical consultation or
Hospitalization that Your prior medical history indicates as being Medical Condition: An Injury or Sickness, including but not
Recurrence: The appearance of symptoms caused by or related
limited to disease, acute psychoses, and complications of to a Medical Condition that was previously diagnosed by a Expiry Date: For each Trip, the first to occur of:
pregnancy occurring within the first 31 weeks.
Physician or for which Treatment was previously received. • the date You return to Your Home Province; Medical Consultation: Any investigative medical service,
Rental Car: An automobile rented by You from a commercial
• the date You leave Your Home Province on a Trip plus the including history-taking, examination, testing, advice, or rental agency for Your personal use under a written rental number of days that is Your selected Trip duration, including Treatment by a Physician for a symptom, Sickness, illness, or disease that may or may not have been definitively diagnosed. Return Date: Either the date of Your scheduled return to Your
unless there has been an Automatic Extension of Coverage or Medical Emergency: An unforeseen occurrence of, symptoms of
Departure Point as indicated on Your most recent Confirmation Top-up, in which case the Expiry Date is the first to occur of: Sickness, or of Injury, that occurs during a Trip (or for trip of Coverage or (ii) the date of Your actual return to Your Home • the date You return to Your Home Province; or cancellation, that occurs immediately prior to Your Trip), which • the end of any extension of coverage determined in requires immediate Treatment from a Physician or that requires Selected Trip Duration: The Trip coverage period You have
accordance with the Automatic Extension of Coverage Hospitalization, failing which there could be a serious selected for Your annual coverage. Your selected Trip duration Section or the Top-up Section of this Policy. appears on Your Confirmation of Coverage Sickness: An acute illness or unforeseen disease requiring
WARNING:
incorrect, or if You have questions regarding Your coverage, it is Emergency Medical Treatment, Emergency Dental Treatment or THIS POLICY INCLUDES RESTRICTED BENEFITS
Your responsibility to contact Us at 1-866-878-0191. You should Hospitalization due to the sudden onset of symptoms. 1. This Policy covers losses resulting from unforeseeable and bring all of these documents with You when You travel. Spouse: The person legally married to You, or if there is no such
person, the person who has been living with You in a conjugal II. SPECIFIC DETAILS OF YOUR INSURANCE
2. A pre-existing condition exclusion applies to Medical relationship for at least one (1) year, regardless of gender.
AM I ELIGIBLE?
Conditions and/or symptoms that existed prior to travel.
Stable and Controlled: Any Medical Condition (other than a
There may be no coverage if You have a pre-existing Gold Emergency Medical Plan
Minor Ailment) for which there has been no new Treatment or newly Prescribed Medication; no change in Treatment or Change 3. You must contact Us before seeking medical attention and a To be eligible for this coverage You must: in Prescribed Medication; no new, more frequent or more severe failure to call will result in Your being responsible for 30% of 1. have purchased Your Policy prior to or on the same day as symptoms; no test results showing deterioration; no any eligible expenses incurred unless Your Medical Condition investigations initiated for symptoms whether or not Your prevents You from calling, in which case You must call as 2. have purchased Your Policy not more than 365 days prior to diagnosis has been determined; no Hospitalization and no soon as medically possible or have someone call on Your 3. have purchased coverage from Us for the full duration of Start Date: The date shown on Your most recent Confirmation of
4. Our medical department must approve and arrange all surgery and heart procedures, (including, but not limited to, 4. be covered under Your GHIP or UHIP for the full duration of Subsistence Allowance: Expenses incurred as a result of Your
heart catheterization), in advance and a failure to call will emergency, including accommodation, meals, and essential result in Your being responsible not only for the amount of 5. be a Canadian resident at the time your Policy is purchased Your deductible, if applicable, but also for 30% of any eligible and remain a Canadian resident for the full duration of Your Top-up: Coverage purchased from Us to extend Your insurance
expenses incurred unless Your Medical Condition prevents beyond Your selected Trip duration of nine (9), 16, 30, or 60 days.
You from calling, in which case You must call as soon as 6. be less than 60 years of age at the time your Policy is Travel Companion: The person with whom You are sharing travel
medically possible or have someone call on Your behalf.
arrangements and prepaid accommodation (to a maximum of 5. If You choose not to receive Treatment or services from a 7. be travelling for a maximum of 365 days. If travelling outside three (3) people) in respect of a Trip.
Provider, as directed by Us, You will not only be responsible Your Home Province for more than 183 days (212 for Ontario Treatment: A medical, therapeutic or diagnostic procedure
for the amount of Your deductible, if applicable, but also for and Newfoundland residents) You must get written evidence prescribed, performed or recommended by a licensed Physician, including but not limited to Prescription Medication, 6. Your Emergency Medical and Dental Coverage is subject to an aggregate limit of $10 million CAD if You are 60 years of Annual Option
Trip: Your travel for which coverage under this Policy has been
age or older. If You are less than 60 years of age on Your To be eligible for this coverage You must: purchased and is in effect. The purpose of the Trip is business or Policy purchase date, there is no such limit.
1. have purchased Your Policy prior to or on the same day as pleasure and is not to obtain health care or Treatment of any 7. There are limits, limitations and exclusions that apply to all kind; the Trip has defined Departure Dates and Return Dates 2. have the Departure Date not more than 120 days prior to 8. The coverage provided by this Policy shall be null and void for University Health Insurance Plan (UHIP): Provides insurance to
travel in, to, or through Cuba, because such travel is not 3. have purchased Top-up coverage from Us for the full pay the cost of the hospital and medical services that students or serviced and supported by the Insurer’s United States employees and their families at Ontario participating 4. be covered under Your GHIP or UHIP for the full duration of universities and affiliated colleges might need to maintain their 5. be a Canadian resident at the time your Policy is purchased Vehicle: A private passenger automobile, minivan, recreational
IMPORTANT INFORMATION
and remain a Canadian resident for the full duration of Your vehicle, or camper truck, which You use during Your Trip exclusively as conveyance of passengers other than for hire. It This Policy covers losses arising from sudden, unexpected and 6. be less than 60 years of age at the time Your Policy is can be either owned by You or rented by You from a rental unforeseeable circumstances only. Some words have very specific meanings that are set out in the Definitions Section.
7. be travelling for a maximum of 183 days (212 for Ontario and We, Us, Our: Chartis Insurance Company of Canada, 145
These words are capitalized in this Policy document when the Newfoundland residents) You must get written evidence of Wellington Street West, Toronto, ON, M5J 1H8. This Policy is extension from Your GHIP or UHIP. (including Top-up).
administered on Our behalf by Travel Guard Canada.
Coverage is provided for Trips of any length within Canada You, Yourself, Your: The person named as the ‘primary traveller’
Along with this Policy document, You should have received a and/or one (1) or more other person(s), if any, named as ’other Confirmation of Coverage. The Confirmation of Coverage sets travellers’ on the Confirmation of Coverage, each as the context out details specific to the product You purchased and it is part of Your contract of insurance as is this document and Our medicalquestionnaire (if applicable). If You did not receive all of thesedocuments, if any information contained in these documents is Gold Medically Qualified Emergency Medical Plan
complete Our medical questionnaire and Top-up Your annual WHEN DOES MY INSURANCE START AND END?
Policy with Us prior to Your Departure Date for coverage to be in To be eligible for this coverage You must: force during any portion of Your Trip. We will issue a This Policy comes into effect on Your Departure Date and ends 1. have purchased Your Policy prior to or on the same day as Confirmation of Coverage for that period of time.
1. the day indicated as Your Return Date on Your Confirmation 2. have purchased Your Policy not more than 150 days prior to If You are topping-up a different Insurer’s annual plan with Us then You must purchase Top-up prior to Your Departure Date and 2. the day You return to Your Home Province to end Your Trip; 3. have purchased Your Policy from Us for the full duration of You must choose a single trip plan. It is Your responsibility to 3. the day You have cause to file a trip cancellation claim.
ensure that Your annual plan from a different Insurer can be 4. be covered under Your GHIP for the full duration of Your Trip; topped-up with Our single trip plan.
For Annual Policy Coverage:
5. be a Canadian resident at the time your Policy is purchased This Policy comes into effect on Your Start Date and ends on Your and remain a Canadian resident for the full duration of Your Call Us before Your Expiry Date:
Canada and Continental USA: 1-866-878-0191; or
1. Coverage is limited to an Insured person who is travelling for International collect at 416-646-3723.
any number of trips that do not exceed the Selected Trip a. less than 75 years of age and travelling for less than 16 days and chosen not to complete Our medical HOW DO I BECOME INSURED?
2. Benefit limits are per Insured per each Trip, unless otherwise questionnaire and have paid the Premium from Rate Chart Coverage under this Policy will not come into effect until all of the following conditions have been satisfied: 3. If You do not Top-up Your coverage with Us then You will not b. less than 75 years of age and travelling for 16 days or 1. Your name appears on the Confirmation of Coverage; have coverage for any claim during any portion of Your Trip greater but less than 76 days and chosen not to complete 2. You have paid the required Premium on or before Your Start regardless of when the cause for claim arises. Our medical questionnaire and have paid the Premium 3. if applicable, You have truthfully and fully completed and UNDER WHAT CIRCUMSTANCES CAN MY POLICY EXTEND?
c. have satisfied Our requirements based on the answers submitted Our medical questionnaire and satisfied Our Automatic Extension of Coverage
You have provided on Our medical questionnaire and be requirements based on the answers You have provided. If You or Your Travel Companion are Hospitalized on Your travelling for a maximum of 183 days .
scheduled Return Date Your coverage will automatically be HOW DOES THE MEDICAL QUESTIONNAIRE AFFECT MY
extended at no additional Premium for the period of Annual Option
COVERAGE?
Hospitalization and up to 120 hours after discharge. If You have a To be eligible for this coverage You must: If You are 60 years of age or older at the time You purchase Your Medical Condition rendering You medically unable to travel on 1. have purchased Your Policy prior to or on the same day as Policy You must complete Our medical questionnaire. Each Your scheduled Return Date but You are not Hospitalized, Your question on Our medical questionnaire assigns a point value for coverage will be automatically extended for up to 120 hours after 2. have the Departure Date not more than 120 days prior to each yes answer. Once Our medical questionnaire is completed the total point score will determine the medical exclusion that 3. have purchased Top-up coverage from Us for the full You qualify for and the Premium that You will pay. The Coverage will automatically be extended for up to 72 hours when completed medical questionnaire forms part of Your Policy and there is a delay of a Common Carrier on which You are pre- 4. be covered under Your GHIP for the full duration of Your Trip; will be reviewed should a claim arise. If on Your medical 5. be a Canadian resident at the time your Policy is purchased questionnaire there is an incorrect answer the Policy is voidable and remain a Canadian resident for the full duration of Your Optional Policy Extension
policy. Coverage is provided for trips of any length withinCanada outside of Your Home Province. For the Medically Qualified Medical Plan, Single Trip Option, if If You choose to extend Your Trip beyond Your scheduled Return 6. be 60 years of age or older and have satisfied Our You choose not to complete Our medical questionnaire and: Date and you have not made a claim nor is there a reason to requirements based on the answers You have provided on claim, and You are covered under a single Trip option or You have Our medical questionnaire and be travelling for a maximum a. are less than 75 years of age travelling for less than 16 days; purchased Top-up coverage, You may apply for a Policy extension of 183 days (annual Trip Duration plus Top-up).
You must have paid the Premium from Rate Chart 3 and Your pre-existing condition exclusion is ME#2; 1. the request for an extension must be made and approved by Top-up of Coverage
b. are less than 75 years of age travelling for 16 days or greater 2. You must pay the required additional Premium before Your If You selected the annual option and choose to extend Your Trip but less than 76 days; You must have paid the Premium from beyond Your Selected Trip Duration You must Top-up Your Rate Chart 4 and Your pre-existing condition exclusion is 3. You must have been eligible for the insurance that You seek annual Policy with Us for coverage to be in force. We will issue a to extend at the time of Your original booking and at the time new Confirmation of Coverage document for that period of time. If You selected the medically qualified annual option and chooseto extend Your Trip beyond Your Selected Trip Duration You must CAN MY PREMIUM BE REFUNDED?
h. of one (1) follow-up visit for Your Emergency that happened 6. Return of Dependent Children Under Your Care:
while on Your Trip which was covered under this Policy.
If You are Hospitalized for more than 24 hours while on a Trip or Refunds are available up to Your Departure Date as long as there is no 2. Ground Ambulance:
if while on a Trip You must return to Your Home Province risk to the Policy. Refunds will also be issued if a supplier cancels or because of a Medical Condition validated by a Physician, We alters service and all of Your non-refundable prepaid travel a. the cost of local ground ambulance service to a medical arrangements Insured by Us are refunded without penalty.
service Provider if medically required; or a. the extra cost via the most cost-effective itinerary for Your b. taxi fare instead of ambulance transportation, where an Dependent Children to be transported to their Departure No refund of Premium will be made in the event that a claim has been ambulance is medically required but not available. paid, incurred or reported under this Policy. b. the return airfare of a qualified escort when the airline 3. Emergency Evacuation and Repatriation:
Annual policies are non-refundable 10 days after the Start Date If Your attending Physician recommends Your return to Your The Dependent Children must have been travelling with You and as shown on Your Confirmation of Coverage. Departure Point or Home Province because of Your Medical under Your care during Your Trip and they must be covered under Condition or if Your attending Physician recommends Your All refunds must be requested through Your issuing agent.
return after Your Emergency Medical Treatment, and if approvedin advance by Us, We cover, via the most cost-effective itinerary, 7. Return to Your Trip Destination:
III. EMERGENCY MEDICAL COVERAGE
Should Our medical department request You to return to Your A. Benefits – Emergency Medical and Dental Coverage
a. the extra cost of an economy or charter class fare; Departure Point to receive immediate medical attention within If You incur expenses due to a covered risk, on or after Your b. a stretcher fare on a commercial flight or charter; Your period of coverage and provided Your attending Physician in Departure Date and prior to or on Your Expiry Date, while You are c. the return economy or charter class fare of a qualified Your Home Province then determines that You require no further on a Trip, We provide coverage for the following covered benefits medical attendant and the attendant’s reasonable fees and medical attention for Your Medical Condition We cover the cost up to the specific benefit limits set out below. Benefit limits are of a one–way economy air fare on a commercial flight or charter for each Insured under this Policy. We do not pay more than the d. the cost of air ambulance transportation, pre-approved and via the most cost effective itinerary to transport You to Your scheduled Trip destination. Once You return to Your Trip e. one (1) Travel Companion’s extra fare to accompany You, if destination, a Recurrence of the Medical Condition which medically necessary and directed by Your attending necessitated Your return to Your Home Province or any related Emergency Medical Coverage for Injury and Sickness
condition or complication will not be covered under this Policy.
Covered Risk 1: Expenses incurred as a consequence of an
Emergency and resulting from Injury, Sickness or death occurring
4. Return of Your Vehicle:
Please note: This benefit must be pre-authorized by Us in
on a Trip. This includes one (1) Follow-up visit (not including If You are unable to drive Your Vehicle to Your original Departure advance and can only be used once during a scheduled Trip.
ongoing Treatment), when the medical process in dealing with Point due to an Emergency, We cover the reasonable costs to When this benefit has been used Your Effective Date under this the Emergency requires such a Follow-up visit. The Follow-up return Your Vehicle to Your residence. If You used a Rental Car Policy then becomes the day You leave Your Departure Point to visit must take place within 14 days of the initial Emergency. In during Your Trip, We will cover the cost of its return to the rental the case of Hospital confinement any coverage related to the agency excluding the rental cost. No benefit is available for Hospital confinement terminates upon release from Hospital. commercial vehicles. Arrangements must be pre-authorized by 8. Return of Remains:
Us in advance and original receipts must be submitted for all If You die during Your Trip We cover reasonable expenses Benefit Limit for Covered Risk 1:
incurred for any one (1) of the following: $10,000,000.00 per Insured if You are 60 years of age or older; or a. reasonable transportation costs (using customary airline unlimited per Insured if You are less than 60 years of age on Your 5. Bedside Companion Travel and Subsistence:
procedures) to return Your remains to Your Departure Point If You are travelling alone and are admitted to a Hospital for plus up to $3,000 per Insured for the preparation of Your three (3) days or more, We cover, until You are medically fit to remains and a transportation container; or Benefits for Covered Risk 1:
b. reasonable transportation costs (using customary airline 1. Eligible Emergency Medical Expenses
a. the economy/charter class fare via the most cost-effective procedures) to return Your remains to Your Departure Point If prescribed by a Physician and pre-authorized by Us in advance, itinerary for the round-trip flight for someone to be with You; plus up to $2,000 per Insured for the cremation of Your b. a Subsistence Allowance for such person’s hotel and meals remains and the cost of a standard burial urn at the place of a. of care received from a Physician in or out of a Hospital; (original receipts must be submitted for all eligible expenses) c. up to $3,000 per Insured for the preparation of Your remains c. of rental or purchase (whichever is less) of a Hospital bed; c. coverage for such person under this Policy, subject to all of and the cost of a standard burial container plus up to $2,000 d. of wheelchair, brace, crutch or other medical appliance; its terms, conditions, limitations and exclusions. per Insured for the burial of Your remains at the location e. of tests that are needed to diagnose Your condition; For an Insured who is a Dependent Child or if You are mentally or physically disabled, a bedside companion is available Benefit Limit: $5,000 per Insured.
g. of the services of a licensed private duty nurse while You are immediately upon Hospital admission.
Further, if someone is legally required to identify Your body dog(s) or cat(s) to Your Departure Point up to a maximum of 4. Our medical department must approve and arrange all because You have died while on a Trip, We cover: surgery and heart procedures, including heart d. the cost of a round-trip economy airfare on a commercial 2. When approved in advance by Us, reimbursement up to a flight or charter via the most cost effective itinerary to maximum of $300 for Emergency veterinary services in the 5. if You choose not to receive Treatment or services from the transport someone to identify Your body; event Your pet(s) (domestic dog(s) and/or cat(s) only) suffers Provider, as directed by Us, You will be responsible not only e. a Subsistence Allowance up to $500 for commercial an Accidental bodily Injury while accompanying You during for the amount of Your deductible, if applicable, but also for accommodations and meals for that person (original receipts must be submitted for all eligible expenses); and 6. You must return to Your Home Province or Departure Point f. that person under the terms of this insurance during the Please note: Arrangements must be pre-authorized by Us in
prior to any Treatment or following Emergency Treatment or period in which he or she is required to identify Your body, up Hospitalization if, on medical evidence, You are able to return to Your Home Province or Departure Point without Emergency Dental Coverage for Injury and Sickness
endangering Your health and if, in these circumstances, You 9. Meals and Accommodation:
Covered Risk 2: Expenses incurred as a consequence of the
elect not to return to Your Home Province or Departure If a Medical Emergency prevents You or Your Travel Companion unforeseen occurrence of symptoms of Sickness or Injury Point, then any expenses incurred for continuing medical from returning to Your Departure Point of Your Insured Trip or if occurring on a Trip resulting in the necessity of immediate Treatment or surgery with respect to such Emergency will Your Emergency Medical Treatment or that of Your Travel Treatment by a licensed registered dentist, Physician or Hospital. not be covered AND all coverage and benefits under this Companion requires Your transfer to a location that is different from Your original destination or You or Your Travel Companion Benefits for Covered Risk 2:
7. You must be covered by GHIP or UHIP for the full duration of are delayed beyond Your scheduled Return Date in order to 1. Emergency Dental Treatment:
Your Trip. If travelling outside Your Home Province for more obtain Emergency Medical Treatment, We cover a Subsistence than 183 days (212 for Ontario and Newfoundland residents) Allowance for Your commercial accommodations and meals, a. expenses You incur during Your Trip for care ordered, You must get written evidence of extension from Your GHIP essential telephone calls and taxi fares, up to a daily maximum of prescribed or received from a licensed dentist if You need or UHIP. If You do not have GHIP or UHIP for the full $175, to a maximum of $1,750 (original receipts must be submitted Emergency Dental Treatment to repair or replace Your duration of Your Trip, Your aggregate limit for all Emergency natural or permanently attached artificial teeth because of an Accidental blow occurring on a Trip to Your face or mouth; 8. the Emergency medical attention You receive must be 10. Emergency Professional Services:
and expenses for continuing care after You return to Your outside of Your Home Province and be required as a We cover expenses resulting from an Emergency, for services Home Province and completed within 180 days of Your consequence of an Emergency and ordered by a Physician. from a licensed physiotherapist, chiropractor, chiropodist, podiatrist or osteopath if ordered by a Physician, up to $300 per C. Limitations – Emergency Medical and Dental Coverage
b. expenses You incur during Your Trip, up to the benefit limit, Our liability under this Policy for expenses under this Emergency for Emergency Dental Treatment required because of an Medical and Dental Coverage is limited as follows.
11. Hospital Expenses:
Emergency due to a cause other than an Accidental blow to 1. If You have purchased the Medically Qualified Medical Plan: We cover Your incidental Hospital expenses (telephone calls, Your face or mouth; and
a. You are responsible for the deductible limit in USD that television rental) while You are Hospitalized for at least 48 hours.
c. expenses You incur for Prescription Medication as a result of We cover these expenses up to $75 per day to a maximum of $750 b. You have qualified for ME#3 (Rate 5), then You are Benefit Limit for Covered Risk 2: Continuing care for an
responsible for a $200 USD deductible.
Accidental blow to the face or mouth - $1,500 per Insured; 2. A failure to contact Us before seeking medical attention will 12. Return of Travel Companion:
Emergency Dental Treatment other cause (no continuing care) - result in Your being responsible not only for the amount of If You must return to Your Home Province because of a covered Your deductible, if applicable, but also for 30% of any eligible Medical Condition and if You are travelling with a Travel expenses incurred unless Your Medical Condition prevents Companion, We cover the Travel Companion for the extra cost of B. Conditions – Emergency Medical and Dental Coverage
You from calling, in which case You must call as soon as a one-way economy air fare on a commercial flight or charter via medically possible or have someone call on Your behalf.
the most cost effective itinerary to return Your Travel Companion All of the conditions set out in the General Conditions Section of 3. A failure to call and receive the approval of Our medical this Policy and all of the following conditions must be satisfiedbefore a benefit is payable for Emergency Medical Treatment or department before all surgery and heart procedures,(including, but not limited to heart catheterization) will 13. Pet Coverage
Emergency Dental Treatment as set out in Section III, A: result in Your being responsible not only for the amount of 1. If Your domestic dog(s) or cat(s) travel with You during Your 1. You must not know of any reason why You will need to seek Your deductible, if applicable, but also for 30% of any eligible Trip and You must return to Your Home Province or medical or dental attention before You leave on a Trip; expenses incurred unless Your Medical Condition prevents Departure Point because of a covered Medical Condition, We 2. the portion of the expenses claimed are not covered by Your You from calling, in which case You must call as soon as cover the cost of one-way transportation of Your domestic GHIP, UHIP or any other related insurance or reimbursementplan; medically possible or have someone call on Your behalf.
3. You must contact Us before seeking medical attention; D. Exclusions – Emergency Medical and Dental Coverage
Pre-Existing Condition Medical Exclusion Identifier ME#2
period if exclusion identifier ME#2 or ME#3 is applicable) before If Your exclusion identifier is ME#2 Your Emergency Medical and These exclusions apply to the Emergency Medical and Dental Dental Coverage is subject to all of the exclusions set out in the Coverage set out in Section III, A. The additional exclusions set General Exclusions Section of this Policy and the following out in the General Exclusions Section of this Policy also apply. IV. FEATURES AND SERVICES TO SERVE YOU BETTER
exclusion: ME#2. We do not cover any loss or expense related directly or 24/7 Worldwide Emergency Assistance
Based on Your age and, when applicable, the answers You and Livetravel™
provided on Our medical questionnaire there are four (4) a. Your Medical Condition or any related condition if in the 180- Canada and Continental USA: 1-866-878-0192 or International
possible exclusion identifiers which can apply to Your Policy day period immediately preceding Your Departure Date that Collect at 416-646-3723
depending on the product selected and whether You have condition has not been Stable and Controlled; purchased a single trip or annual option. This service is available to You for the duration of Your Trip.
b. Your heart condition if in the 180-day period immediately Whether You need Emergency medical care or Emergency These four (4) identifiers are GE, ME#1, ME#2, or ME#3. arrangements to return home, Our Emergency assistance i. You have had any heart condition that has not been coordinators, doctors and nurses can help You any time of day. ii. You have been required to use, take, or been prescribed 24/7 Concierge Service
to take nitroglycerin in any form, more than once per a Continental USA: 1-866-878-0191 or
International Collect at 416-646-3723
c. Your lung condition if in the 180-day period immediately This service is available to You for the duration of Your Trip. Our i. You have had any lung condition that has not been Stable concierge service team can help You find and coordinate the extra things that make Your Trip enjoyable. Services include: ii. You required the use of home oxygen or had to take oral • Highlights on sights and attractions; steroids; for example prednisone or prednisolone.
• Restaurant referrals and reservations: Worldwide dining referrals and reservations made on the Your behalf, based on Pre-Existing Condition Medical Exclusion Identifier ME#3
Pre-Existing Condition Exclusion for Identifier GE
If Your exclusion identifier is ME#3 Your Emergency Medical and If Your exclusion identifier is GE only the exclusions set out in the • Tee-time reservations: Assistance with scheduling tee-off Dental Coverage is subject to all of the exclusions set out in the General Exclusions Section of this Policy apply to Your General Exclusions Section of this Policy and the following • Assistance getting tickets to cultural and sporting events, ME#3. We do not cover any loss or expense related directly or Pre-Existing Condition Medical Exclusion Identifier ME#1
• Travel documents assistance, emergency cash transfer If Your exclusion identifier is ME#1 Your Emergency Medical and assistance, emergency message centre, and interpretation a. any Medical Condition for which You have taken medication, Dental Coverage is subject to all of the exclusions set out in the been prescribed medication, received Treatment, General Exclusions Section of this Policy and the following experienced a deterioration of the condition or had cause to seek Treatment at any time within the 180-day period ME#1. We do not cover any loss or expense related directly or immediately preceding and including Your Departure Date • Access to passport, visa, and vaccine requirements, travel and this exclusion applies whether or not the condition has a. Your Medical Condition or any related condition if in the safety and health advisories, embassy contacts, weather and 90-day period immediately preceding Your Departure Date b. Your heart condition if in the 180-day period immediately that condition has not been Stable and Controlled; preceding Your Departure Date You have taken medication, b. Your heart condition if in the 90-day period immediately been prescribed medication, received Treatment, experienced a deterioration of the condition or had cause to i. You have had any heart condition that has not been V. GENERAL CONDITIONS
seek Treatment for any heart condition; or c. Your lung condition if in the 180-day period immediately ii. You have been required to use, take, or been prescribed All of the following conditions apply to all coverage under this preceding Your Departure Date You have taken medication, to take nitroglycerin in any form, more than once per a been prescribed medication, received Treatment, Your coverage will be declared null and void if, for any reason: experienced a deterioration of the condition or had cause to c. Your lung condition if in the 90-day period immediately a. the required Premium is not received by Us; b. You are ineligible for coverage in accordance with any a. You have had any lung condition that has not been Please note: You may have more than one (1) Departure Date
c. You have incompletely or falsely provided information during any one (1) annual Policy. The pre-existing condition b. You required the use of home oxygen or had to take oral when purchasing your Policy or on Our medical medical exclusion applies, in each 90-day period (or 180-day steroids; for example prednisone or prednisolone.
2. Canadian Currency: The benefit, benefit limits and all other provision in this Policy which is in conflict with any such 2. reimbursement for expenses once the Emergency ends and amounts expressed in this Policy are expressed in Canadian statute is hereby amended to conform to such statute. in the opinion of the attending Physician or dentist, You are currency, except any deductible which is expressed in US 8. Confirmation of Coverage: In the event that You are found to able to travel to Your Home Province for any further dollars. Where covered losses are billed in foreign currency, be ineligible for coverage or that a claim is found to be invalid Treatment relating to the Sickness or Accident that led to the the rate of exchange is based on the rate effective on the or benefits are reduced in accordance with any Policy Emergency other than for a follow-up visit as listed under the date when We pay the claim. No sum payable shall bear provision, We have the right to collect from You any amount benefits for Emergency Medical Treatment; interest. To facilitate direct payment to providers, We may which We have paid on Your behalf to medical providers or 3. optional Policy extensions or Top-ups: Sickness or Injury elect to pay the claim in the currency of the country where which first appeared, was diagnosed or received medical the charges were incurred based on the rate of exchange 9. Your Policy will be declared null and void in the case of fraud Treatment after your Departure Date and prior to the established by any chartered bank in Canada: or attempted fraud by You, or if You conceal or misrepresent Effective Date of the optional insurance extension or Top-up; any material fact or circumstance concerning this insurance. 4. any Treatment that is not Emergency Treatment. For example b. on the date the claim was incurred if a cheque is issued 10. During the claims process, We may require You to have a directly to Physicians, Hospitals or other medical medical examination by one (1) or more physicians chosen by a. expenses incurred for medication commonly available without prescription; vaccinations, injections or 3. If You are covered under more than one (1) of Our policies, or 11. We are not responsible for the availability, quality or results medication received on a preventative basis or for the have similar coverage with another insurance company, the of any medical Treatment. We are not responsible for any maintenance of a Medical Condition; contraceptives; total amount paid to or for You will not exceed Your actual transportation arranged by Us. We are not responsible for fertility medication; vitamin preparations; general physical expenses and the maximum to which You are entitled is the Your failure to obtain medical Treatment. largest amount specified for that benefit under any one (1) of 12. You must, at all times while You are covered under this Policy, b. transplants including but not limited to organ Our Policies with the exception of the Flight Accident benefit act in a prudent manner so as to minimize costs to Us.
transplants or bone marrow transplants, artificial joints, or which has a maximum payable of $100,000 if You are covered 13. If Your health status changes (including a Change in prosthetic devises/implants including any associated under more than one (1) of Our Policies providing that Prescribed Medication or Treatment) prior to departure for any Trip, You must notify Us immediately. At Our sole c. expenses incurred for acupuncture or naturopathic or 4. The coverage outlined in this Policy is last payor only. If, at discretion, We may opt to waive the exclusion that precludes the time of loss, You have insurance from another source, or Your unstable Medical Condition from coverage. This would 5. ionizing radiation or radioactive Contamination from any if any other party is also responsible, to pay for benefits also allow You to continue with Your Trip and retain coverage for nuclear fuel or waste which results from the burning of provided under this Policy, We will pay eligible expenses only nuclear fuels, or, the radioactive, toxic, explosive or other in excess of those covered by that other insurance company 14. Any reference to age in this document is specific to Your age dangerous properties of nuclear machinery or any part of it; or insurance companies or other responsible party or parties, on the date You apply for insurance.
6. expenses incurred for any portion of benefits that require including insurance plans provided through credit cards, 15. The coverage provided by this Policy shall be null and void for prior authorization and arrangements by Us if such benefits third party liability, group or individual basic or extended travel in, to, or through Cuba, because such travel is not health insurance plans or contracts including any private or serviced and supported by the Insurer’s United States 7. any Medical Condition if on Our medical questionnaire there provincial or territorial auto insurance plan, providing is an incorrect answer. In this case the Policy is voidable and Hospital, medical or therapeutic coverage, or any third party liability insurance in force concurrently with this Policy. VI. MAXIMUM LIMITS OF LIABILITY
8. more than one (1) Follow-up Treatment, Recurrence or 5. In the event of a payment of a claim under this Policy, We General Liability: Our liability under this Policy is limited solely complication of a Medical Condition or related condition, have the right to proceed, in Your name, but at Our expense, to the payment of eligible benefits, up to the benefit limits following Emergency Treatment of that condition during against third parties who may be responsible for giving rise specified herein, for any loss or expense. Your Trip if the medical department determines that You to a claim under this Policy. You will execute and deliver were medically able to return to Your Home Province and documents as necessary and co-operate fully with Us so as to VII. GENERAL EXCLUSIONS
allow Us to fully assert Our rights. You will do nothing to 9. more than one (1) Follow-up Treatment of any heart or lung The following exclusions apply to each benefit available under condition, following Emergency Treatment for a related or 6. We have full rights of subrogation; however, We do not this Policy. In addition to any exclusion that apply to specific unrelated heart or lung condition during Your Trip if the subrogate against any retiree plan benefit if the lifetime benefits outlined within each section, We also do not cover any medical department determines that You were medically maximum limits for all in-country and out-of-country claim, loss or any expense related in whole or in part, directly or able to return to Your Home Province and You chose not to 7. Notwithstanding any provision of this Policy, this Policy is 10. any Medical Condition, if Our medical department subject to the statutory conditions of the Insurance Act expenses resulting from any Sickness, Injury or state of recommends that You return to Your Home Province applicable to contracts of Accident and Sickness insurance health prior to Your Policy purchase date that would cause following Your Emergency Treatment, and You choose not to and the laws and regulations in Your Home Province. The Expected Medical Treatment or Hospitalization during Your laws and regulations of the province or territory in Canada in 11. expenses incurred for Treatment or services that are which You normally reside govern this Policy and any 12. expenses in excess of reasonable and customary rates where 28. any Medical Condition, if prior to Your Departure Date, such Important Travel Tips
Treatment has occurred before You or someone on Your Medical Condition renders You ineligible or causes You to qualify for a different rate. You must be and remain eligible To help you prepare for your long-awaited, much- 13. any medical expense incurred while travelling in Your Home and rate qualified under this Policy when You purchase and deserved, vacation, here are some helpful hints.
continuously until You take a Trip for coverage to come into 14. routine pre-natal care; a child born during Your Trip; and be in effect when You take a Trip.
a Take a carry-on with your important travel childbirth or complications of childbirth; pregnancy or documents, including your Travel Guard Policy.
complications thereof within the nine (9) weeks before or VIII. CLAIM PROCEDURES AND
anytime after the expected date of delivery; CUSTOMER SERVICE INQUIRIES
a Make sure your family or close friend knows your By paying the Premium for this insurance, You agree that: travel itinerary and insurance information.
16. Your committing or attempting to commit suicide or We may verify Your GHIP/UHIP and other information intentionally self-inflicted Injury (whether sane or insane); Remove the 24-hour Emergency Travel Assistance required to process Your claim, with government and other 17. any alcohol related Sickness, death, or Injury or the abuse of Card below and carry it with you at all times.
medication, drugs, alcohol or any other toxic substance 2. physicians, Hospitals and other medical providers are a Make a list of all identification, credit card numbers during the Trip; Alcohol abuse includes having a blood authorized by You to provide to Us any and all information and corresponding customer service telephone alcohol level in excess of 80 milligrams of alcohol per 100 they have regarding You, while under observation or Treatment, including Your medical history, diagnoses and 18. a Trip undertaken in contravention of a Physician’s a Make sure you have a passport – it’s the best piece recommendation or after the manifestation of medical 3. We may disclose the information available under 1) and 2) symptoms which would cause an ordinarily prudent person above and from other sources to such other persons, as may to seek medical advice or Treatment in the 90 days prior to Make sure your passport is valid for six months be required for the purposes of providing assistance about or Your Departure Date; or where a terminal condition prognosis has been diagnosed by any Physician; 4. failure to complete the required claim form and a Put bag tags on your luggage and inside each piece 19. a Medical Condition or related condition that arises during a authorization form in full will delay the processing of Your Trip You undertake with the prior knowledge that You will claim and could invalidate Your claim. We cannot process require or seek Treatment or surgery for that Medical a You may be required to fill out customs forms. Keep Your claim in full until all required documentation has been 20. a Medical Condition for which future investigation or a You may need extra cash to pay any airport Treatment is planned before Your Departure Date. This does improvements taxes, departure taxes, or service 21. the commission of or Your direct or indirect attempt to commit a criminal act or Injury occurring while You are 145 Wellington Street West, Toronto, ON M5J 1H8 committing or attempting to commit a criminal act; 22. Your participation in rock or Mountain Climbing; To Claim For Emergency Medical and Dental Benefits:
participation in a motorized race or motorized speed contest;Your participation as a professional athlete in a sporting You must notify Us at 1-866-878-0192 or collect at 416-646-3723 prior to any Emergency Medical Treatment and prior to any 23. operating or learning to operate any aircraft, as pilot or crew; surgery, invasive procedure or Hospitalization. Our assistance 24-HOUR EMERGENCY ASSISTANCE
performing employment duties on any aircraft or ship; or co-ordinators will provide guidance. We will make every effort, You must notify Us prior to any Emergency Medical performing duties in any regular armed forces service; although We cannot guarantee, to pay providers directly. You 24. expenses incurred if You travel to a country that The must provide Us with original receipts for incurred expenses Treatment and prior to any surgery, invasive procedure Department of Foreign Affairs and International Trade of the including those for Subsistence Allowance expenses. or Hospitalization. Failure to do so will result in Your Canadian Government or Health Canada has advised being responsible for 30% of any eligible expenses travellers not to travel to during the time of Your Trip. This exclusion applies if the advisory is issued prior to YourDeparture Date; Canada and Continental USA: 1-866-878-0192
25. war (declared or not), acts of foreign enemies or rebellion; International: 416-646-3723 (collect)
26. interest on a payment or reimbursement;27. expenses incurred relating to travel in, to, or through Cuba, because such travel is not serviced and supported by theInsurer’s United States affiliates;

Source: http://www.kanetix.ca/website/online_apps/travel_policy_TG_gold.pdf