Print | Close This Window


LP500605C

(LX50 STANDARD CERT) J3839 - 0505

CSA Luxe Plan

Certificate

Certificate of Insurance for CSA Travel Protection

for emergency assistance 24 hours a day during your trip, call:

IN THE U.S.
(866) 816-2068

COLLECT WORLDWIDE
(603) 328-1737

This plan is administered by CSA Insurance Services.

Eligibility and Effective Dates of Insurance

Who is Eligible for Coverage
A person who has arranged to take a Covered Trip, and pays the required plan payment, and is a resident of the United States of America or Canada.

When Coverage Begins

All coverages (except Pre-Departure Trip Cancellation and Post-Departure Trip Interruption) will take effect on the later of:
  1. The date the plan payment has been received by us;
  2. the date and time you start your Covered Trip; or
  3. 12:01 A.M. Standard Time on the Scheduled Departure Date of your Covered Trip.
Pre-Departure Trip Cancellation coverage will take effect at 12:01 A.M. Standard Time on the day after the date your plan payment is received by us. Post-Departure Trip Interruption coverage will take effect on the Scheduled Departure Date of your Covered Trip if the required plan payment is received.

When Coverage Ends

Your coverage automatically ends on the earlier of:
  1. the date the Covered Trip is completed;
  2. the Scheduled Return Date;
  3. your arrival at the return destination on a round trip, or the destination on a one-way trip;
  4. cancellation of the Covered Trip covered by the plan.
All coverages under the plan will be extended if your entire Covered Trip is covered by the plan and your return is delayed by unavoidable circumstances beyond your control.

If coverage is extended for the above reasons, coverage will end on the earlier of the date you reach your originally scheduled return destination or seven (7) days after the Scheduled Return Date.

SUMMARY OF COVERAGES

Accidental Death & Dismemberment

We will pay this benefit, up to the amount on the Schedule, if you are injured in an Accident, which occurs while you are on a Covered Trip, and covered under the plan, and you suffer one of the losses listed below within 180 days of the Accident. The principal sum is the benefit amount shown on the Schedule.

Loss: Percentage of Principal Sum Payable:
Life 100%
Both Hands; Both Feet 100%
Sight of Both Eyes; One Hand and One Foot 100%
One Hand and Sight of One Eye 100%
One Foot and Sight of One Eye 100%
One Hand; One Foot or Sight of One Eye 50%


If you suffer more than one loss from one Accident, we will pay only for the loss with the larger benefit. Loss of a hand or foot means complete severance at or above the wrist or ankle joint. Loss of sight of an eye means complete and irrecoverable loss of sight.

Air Flight Accident

We will pay this benefit, up to the amount on the Schedule, if you are injured in an Accident, which occurs while you are on a Covered Trip, and covered under the plan, and you suffer one of the losses listed below within 180 days of the Accident. The principal sum is the benefit amount shown on the Schedule.

Air Flight Benefits

The benefits provided by the plan for Air Flight applies only if you sustain a covered loss in an Accident which occurs while a passenger in or on, boarding or alighting from an aircraft of a regularly scheduled airline or an air charter company that is licensed to carry passengers for hire.

Loss: Percentage of Principal Sum Payable:
Life 100%
Both Hands; Both Feet 100%
Sight of Both Eyes; One Hand and One Foot 100%
One Hand and Sight of One Eye 100%
One Foot and Sight of One Eye 100%
One Hand; One Foot or Sight of One Eye 50%


If you suffer more than one loss from one Accident, we will pay only for the loss with the larger benefit. Loss of a hand or foot means complete severance at or above the wrist or ankle joint. Loss of sight of an eye means complete and irrecoverable loss of sight.

Exposure and Disappearance

If by reason of an Accident covered by the plan, you are unavoidably exposed to the elements and as a result of such exposure suffer a loss for which benefits are otherwise payable, such loss shall be covered hereunder.

If you are involved in an Accident which results in the sinking or wrecking of a conveyance in which you were riding and your body is not located within one year of such Accident, it will be presumed that you suffered loss of life resulting from Injury caused by the Accident.

Medical or Dental Expense Benefits

We will pay this benefit, up to the amount on the Schedule, for the following Covered Expenses incurred by you, subject to the following:
  1. Covered Expenses will only be payable at the Usual and Customary level of payment;
  2. benefits will be payable only for Covered Expenses resulting from a Sickness that first manifests itself or an Injury that occurs while on a Covered Trip;
  3. benefits payable as a result of incurred Covered Expenses will only be paid after benefits have been paid under any Other Valid and Collectible Group Insurance in effect for you.
We will pay that portion of Covered Expenses which exceeds the amount of benefits payable for such expenses under your Other Valid and Collectible Group Insurance.

Please refer to the Definitions, for an explanation of Pre-Existing Conditions, which are excluded under the Medical or Dental Expense Benefits.

Covered Expenses:
  1. expenses for the following Physician-ordered medical services: services of legally qualified Physicians and graduate nurses, charges for Hospital confinement and services, local ambulance services, prescription drugs and medicines, and therapeutic services, incurred by you within one year from the date of your Sickness or Injury;
  2. expenses for emergency dental treatment incurred by you during a Covered Trip.
Your duties in the event of a Medical or Dental Expense:
  1. You must provide us with all bills and reports for medical and/or dental expenses claimed.
  2. You must provide any requested information, including but not limited to, an explanation of benefits from any other applicable insurance.
  3. You must sign a patient authorization to release any information required by us, to investigate your claim.
Emergency Assistance Benefits

We will pay this benefit, up to the amount on the Schedule, for the following Covered Expenses incurred by you, subject to the following:
  1. Covered Expenses will only be payable at the Usual and Customary level of payment;
  2. benefits will be payable only for Covered Expenses resulting from a Sickness that first manifests itself or an Injury that occurs while on a Covered Trip;
  3. benefits payable as a result of incurred Covered Expenses will only be paid after benefits have been paid under any Other Valid and Collectible Group Insurance in effect for you.
We will pay that portion of Covered Expenses which exceeds the amount of benefits payable for such expenses under your Other Valid and Collectible Group Insurance.

Please refer to the Definitions, for an explanation of Pre-Existing Conditions, which are excluded under the Emergency Assistance Benefits.

Covered Expenses:
  1. expenses incurred by you for Physician-ordered emergency medical evacuation, including medically appropriate transportation and necessary medical care en route, to the nearest suitable Hospital, when you are critically ill or injured and no suitable local care is available, subject to the Program Medical Advisor's prior approval;
  2. expenses incurred for non-emergency medical evacuation, including medically appropriate transportation and medical care en route, to a Hospital or to your place of residence in the United States of America or Canada, when deemed medically necessary by the attending physician, subject to the Program Medical Advisor's prior approval;
  3. expenses for transportation, not to exceed the cost of one round-trip economy-class air fare, to the place of hospitalization for one person chosen by you, provided that you are traveling alone and are hospitalized for more than 7 days;
  4. expenses for transportation, not to exceed the cost of one-way economy-class air fare, to your place of residence in the United States of America or Canada, including escort expenses, if you are 18 years of age or younger and left unattended due to the death or hospitalization of an accompanying adult(s), subject to the Program Medical Advisor's prior approval;
  5. expenses for one-way economy-class air fare (or first class, if your original tickets were first class) to your place of residence in the United States of America or Canada, from a medical facility to which you were previously evacuated, less any refunds paid or payable from your unused transportation tickets, if these expenses are not covered elsewhere in the plan;
  6. repatriation expenses for preparation and air transportation of your remains to your place of residence in the United States of America or Canada, or up to an equivalent amount for a local burial in the country where death occurred, if you die while outside the United States of America or Canada.
Trip Cancellation and Trip Interruption Benefits

Pre-Departure Trip Cancellation

We will pay a Pre-Departure Trip Cancellation Benefit, up to the amount in the Schedule, if you are prevented from taking your Covered Trip due to your, a Family Member's or Traveling Companion's Sickness, Injury, or death, that occurs before departure on your Covered Trip. The Sickness or Injury must:
  1. commence while your coverage is in effect under the plan;
  2. require the examination and treatment by a Physician, in person, at the time the Covered Trip is canceled; and
  3. in the written opinion of the treating Physician, be so disabling as to prevent you from taking your Covered Trip.
We will pay a benefit if you are prevented from taking your Covered Trip due to Other Covered Events, as defined, that occur before departure on your Covered Trip.

Pre-Departure Trip Cancellation Benefits

We will reimburse you, up to the amount in the Schedule, for the amount of forfeited, prepaid, non-refundable, non-refunded, and unused published Payments or Deposits that you paid for your Covered Trip. We will pay your additional cost as a result of a change in the per-person occupancy rate for prepaid travel arrangements if a Traveling Companion's Covered Trip is canceled and your Covered Trip is not canceled.

Post-Departure Trip Interruption

We will pay a Post-Departure Trip Interruption Benefit, up to the amount in the Schedule, if:
  1. your arrival on your Covered Trip is delayed beyond the Scheduled Departure Date; or
  2. you are unable to continue on your Covered Trip after you have departed on your Covered Trip due to your, Family Member's or Traveling Companion's Sickness, Injury, or death.
For item 1 above, the Sickness or Injury must:
  1. commence while your coverage is in effect under the plan;
  2. for item 2 above, commence while you are on your Covered Trip and your coverage is in effect under the plan; and
  3. for both items 1 and 2 above, require the examination and treatment by a Physician, in person, at the time the Covered Trip is interrupted or delayed; and
  4. in the written opinion of the treating Physician, be so disabling as to delay your arrival on your Covered Trip or to prevent you from continuing your Covered Trip.
We will pay a benefit if:
  1. your arrival on your Covered Trip is delayed beyond the Scheduled Departure Date; or
  2. you are unable to continue on your Covered Trip after you have departed on your Covered Trip due to Other Covered Events, as defined.
Post-Departure Trip Interruption Benefits

We will reimburse you, less any refund paid or payable, for unused land or water travel arrangements, plus one of the following:
  1. the additional transportation expenses by the most direct route from the point you interrupted your Covered Trip:
    1. to the next scheduled destination where you can catch up to your Covered Trip; or
    2. to the final destination of your Covered Trip; or
  2. the additional transportation expenses incurred by you by the most direct route to reach your original Covered Trip destination if you are delayed and leave after the Scheduled Departure Date.

    However, the benefit payable under 1 and 2 above will not exceed the cost of a one-way economy air fare (or first class, if the original tickets were first class) by the most direct route less any refunds paid or payable for your unused original tickets.

  3. your additional cost as a result of a change in the per-person occupancy rate for prepaid travel arrangements if a Traveling Companion's Covered Trip is interrupted and your Covered Trip is continued.
Travel Delay

If your Covered Trip is delayed for 6 hours or more, we will reimburse you, up to the amount shown in the Schedule for reasonable additional expenses incurred by you for hotel accommodations, meals, telephone calls and local transportation while you are delayed. We will not pay benefits for expenses incurred after travel becomes possible.

Travel Delay must be caused by or result from:
  1. Common Carrier delay; or
  2. loss or theft of your passport(s), travel documents or money; or
  3. quarantine; or
  4. hijacking; or
  5. natural disaster or adverse weather; or
  6. a documented traffic accident while you are en route to departure; or
  7. unannounced strike; or
  8. a civil disorder; or
  9. your, a Family Member traveling with you, a Domestic Partner Traveling with you or a Traveling Companion's Injury or Sickness; or
  10. a Family Member traveling with you or a Traveling Companion's death.
Baggage and Personal Effects Benefit

We will reimburse you, up to the amount shown in the Schedule, for direct loss, theft, damage or destruction of your Baggage, passports or visas during your Covered Trip. We will also pay for loss due to unauthorized use of your credit cards, if you have complied with all of the credit card conditions imposed by the credit card companies.

Valuation and Payment of Loss

Payment of loss under the Baggage and Personal Effects Benefit will be calculated based upon an Actual Cash Value basis. For items without receipts, payment of loss will be calculated based upon 75% of the Actual Cash Value at the time of loss. At our option, we may elect to repair or replace your Baggage. We will notify you within 30 days after we receive your Proof of Loss.

We may take all or part of damaged Baggage as a condition for payment of loss. In the event of a loss to a pair or set of items, we will: 1) repair or replace any part to restore the pair or set to its value before the loss; or 2) pay the difference between the value of the property before and after the loss.

Continuation of Coverage

If the covered Baggage, passports or visas are in the custody of a Common Carrier, and delivery is delayed, this coverage will continue until the property is delivered to you. This continuation of coverage does not include loss caused by or resulting from the delay.

Items Not Covered

We will not pay for damage to or loss of:
  1. animals;
  2. property used in trade, business or for the production of income, household furniture, musical instruments, brittle or fragile articles, or sporting equipment if the loss results from the use thereof;
  3. boats, motors, motorcycles, motor vehicles, aircraft, and other conveyances or equipment, or parts for such conveyances;
  4. artificial limbs or other prosthetic devices, artificial teeth, dental bridges, dentures, dental braces, retainers or other orthodontic devices, hearing aids, any type of eyeglasses, sunglasses or contact lenses;
  5. documents or tickets, except for administrative fees required to reissue tickets;
  6. money, stamps, stocks and bonds, postal or money orders, securities, accounts, bills, deeds, food stamps or credit cards, except as noted above;
  7. property shipped as freight or shipped prior to the Scheduled Departure Date;
  8. contraband.
Losses Not Covered

We will not pay for loss arising from:
  1. defective materials or craftsmanship; or
  2. normal wear and tear, gradual deterioration, inherent vice; or
  3. rodents, animals, insects or vermin; or
  4. mysterious disappearance; or
  5. electrical current, including electric arcing that damages or destroys electrical devices or appliances.
Your Duties in the Event of a Loss

In case of loss, theft or damage to Baggage and Personal Effects, you should:
  1. immediately report the incident to the hotel manager, tour guide or representative, transportation official, local police or other local authorities and obtain their written report of your loss; and
  2. take reasonable steps to protect your Baggage from further damage, and make necessary, reasonable and temporary repairs. We will reimburse you for these expenses. We will not pay for further damage if you fail to protect your Baggage.
Baggage Delay Benefit

We will reimburse you, up to the amount shown in the Schedule for the cost of reasonable additional clothing and personal articles purchased by you, if your Baggage is delayed for 24 hours or more during your Covered Trip. This coverage terminates upon arrival at the return destination of your Covered Trip.

Rental Car Damage Benefit
(Not available to residents of OR and TX)

If you rent a car while on your Covered Trip and the car is damaged due to collision, theft, vandalism, windstorm, fire, hail, flood or any cause not in your control while in your possession, or the car is stolen while in your possession and not recovered, we will pay you the lesser of:
  1. the cost of repairs and rental charges imposed by the rental company while the car is being repaired; or
  2. the Actual Cash Value of the car, up to the amount shown on the Schedule.
Coverage is provided to you, your Traveling Companion, and a Family Member traveling with you, provided you and your Traveling Companion or Family Member traveling with you are licensed drivers, and are listed on the rental agreement. This coverage is primary to other forms of insurance and indemnity.

Coverage is not provided for loss due to:
  1. Any obligation of you or a Traveling Companion or a Family Member traveling with you assume under any agreement (except insurance collision Deductible).
  2. Rentals of trucks, campers, trailers, off-road, or motor bikes, motorcycles, recreational vehicles or Exotic Vehicles.
  3. Any loss which occurs if you or a Traveling Companion or a Family Member traveling with you are in violation of the rental agreement.
  4. Failure to report the loss to the proper local authorities and the rental car company.
  5. Damage to any other vehicle, structure or person as a result of a covered loss.
Your Duties in the Event of a Loss:

You must:
  1. Take all reasonable, necessary steps to protect the vehicle and prevent further damage to it;
  2. Report the loss to the appropriate local authorities and the rental company as soon as possible;
  3. Obtain all information on any other party involved in an Accident, such as name, address, insurance information and driver's license number;
  4. Provide us all documentation such as rental agreement, police report and damage estimate.

DEFINITIONS

In the certificate, "you", "your" and "yours" refer to the Insured. "We", "us" and "our" refer to the company providing this coverage. In addition, certain words and phrases are defined as follows:

ACCIDENT means a sudden, unexpected, unintended and external event, which causes Injury.

ACCOMODATION means any establishment usd for the purpose of temporary, overnight lodging for which a fee is paid and reservations are required.

ACTUAL CASH VALUE means purchase price less depreciation.

BAGGAGE means luggage, personal possessions and travel documents taken by you on the Covered Trip.

COMMON CARRIER means any land, water or air conveyance operated under a license for the transportation of passengers for hire, not including taxicabs or rented, leased or privately owned motor vehicles.

COVERED TRIP means:
  1. A period of round-trip travel away from Home to a destination outside your city of residence; the purpose of the Trip is business or pleasure and is not to obtain health care or treatment of any kind; the Trip has defined departure and return dates specified when the Insured enrolls; the Trip does not exceed 365 days or,
  2. A period of one-way travel that starts in the U.S. or Canada (except U.S. citizens may begin their Trip outside the U.S., if returning to the U.S.); the purpose of the Trip is business or pleasure and is not to obtain health care or treatment of any kind; the Trip has defined departure and arrival dates and defined departure and arrival places specified when the Insured applies; and the Trip does not exceed 31 days in length.
DEDUCTIBLE means the amount which must be incurred by you before benefits are paid under the plan.

DOMESTIC PARTNER means a person who is at least eighteen years of age and you can show:
  1. evidence of financial interdependence, such as joint bank accounts or credit cards, jointly owned property, and mutual life insurance or pension beneficiary designations;
  2. evidence of cohabitation for at least the previous 6 months; and
  3. an affidavit of domestic partnership if recognized by the jurisdiction within which they reside.
ELECTIVE TREATMENT AND PROCEDURES means any medical treatment or surgical procedure that is not medically necessary including any service, treatment, or supplies that are deemed by the federal, or a state or local government authority, or by us to be research or experimental or that is not recognized as a generally accepted medical practice.

EXOTIC VEHICLE includes
  • Alfa Romeo,
  • Aston Martin,
  • Auburn,
  • Avanti,
  • Bentley,
  • Bertone,
  • BMC/Leyland,
  • BMW M Series,
  • Bradley,
  • Bricklin,
  • Cosworth,
  • Clenet,
  • De Lorean,
  • Excalibre,
  • Ferrari,
  • Iso,
  • Jaguar,
  • Jensen Healy,
  • Lamborghini,
  • Lancia,
  • Lotus,
  • Maserati,
  • Morgan,
  • Pantera,
  • Panther,
  • Pininfarina,
  • Rolls Royce,
  • Rover,
  • Stutz,
  • Sterling,
  • Triumph,
  • TVR,
  • Corvette,
  • Mercedes Benz,
  • Porsche, and
  • MG.
You must contact CSA Travel Protection at (800) 348-9505 before renting to obtain confirmation that the vehicle is covered.

FAMILY MEMBER includes your or your Traveling Companion's dependent,
  • spouse,
  • child,
  • spouse's child,
  • son/daughter-in-law, parent(s),
  • sibling(s),
  • brother/sister,
  • grandparent(s),
  • grandchild,
  • step-brother/sister,
  • step-parent(s),
  • parent(s)-in-law,
  • brother/sister-in-law,
  • aunt,
  • uncle,
  • niece,
  • nephew,
  • guardian,
  • Domestic Partner,
  • foster child, or
  • ward.
FINANCIAL INSOLVENCY means the total cessation or complete suspension of operations due to insolvency, with or without the filing of a bankruptcy petition, or the total cessation or complete suspension of operations following the filing of a bankruptcy petition, whether voluntary or involuntary, by a tour operator, cruise line, airline, rental car company, hotel, condominium, railroad, motor coach company, or other supplier of travel services which is duly licensed in the state(s) of operation other than the entity or the person, organization, agency or firm from whom you directly purchased or paid for your Covered Trip provided the Financial Insolvency occurs more than 14 days following your effective date for the Trip Cancellation Benefits. There is no coverage for the total cessation or complete suspension of operations for losses caused by fraud or negligent misrepresentation by the supplier of travel services.

HOME means your primary or secondary residence.

HOSPITAL means an institution which meets all of the following requirements:
  1. It must be operated according to law;
  2. It must give 24-hour medical care, diagnosis and treatment to the sick or injured on an inpatient basis;
  3. It must provide diagnostic and surgical facilities supervised by Physicians;
  4. Registered nurses must be on 24-hour call or duty; and
  5. The care must be given either on the hospital's premises or in facilities available to the hospital on a pre-arranged basis.
A Hospital is not: a rest, convalescent, extended care, rehabilitation or other nursing facility; a facility which primarily treats mental illness, alcoholism, or drug addiction (or any ward, wing or other section of the hospital used for such purposes); or a facility which provides hospice care (or wing, ward or other section of a hospital used for such purposes).

INJURY means bodily harm caused by an Accident which:
  1. occurs while your coverage is in effect under the plan; and
  2. requires examination and treatment by a Physician. The Injury must be the direct cause of loss and must be independent of all other causes and must not be caused by, or result from, Sickness.
INSURED means an eligible person who arranges a Covered Trip, and pays any required plan payment.

INSURER means Stonebridge Casualty Insurance Company.

OTHER COVERED EVENTS means only the following unforeseeable events or their consequences which occur while coverage is in effect under this Policy:
  1. Common Carrier delays resulting from inclement weather, or mechanical breakdown of the aircraft, ship or boat or motor coach on which you are scheduled to travel, or organized labor strikes that affect public transportation;
  2. Arrangements canceled by an airline, cruise line, motor coach company, or tour operator, resulting from inclement weather, mechanical breakdown of the aircraft, ship or boat or motor coach on which the Insured is scheduled to travel, or organized labor strikes that affect public transportation.

    Items 1 and 2 above are subject to the following conditions:
    1. the scheduled carrier connecting times must meet airline required legal minimum connect times; and
    2. the scheduled time between arrival at the Scheduled Trip Departure City and the scheduled trip departure must be 2 hours or longer.
  3. Arrangements canceled by a tour operator, cruise line, airline, rental car company, hotel, condominium, railroad, motor coach company, or other supplier of travel services, resulting from Financial Insolvency;

    Item 3 above is subject to your plan payment being received prior to/or within 24 hours of your final plan payment for your Covered Trip;

  4. a change in plans by you, a Family Member traveling with you, or Traveling Companion resulting from one of the following events which occurs while coverage is in effect under this Policy:
    1. being directly involved in a documented traffic accident while en route to departure;
    2. being hijacked, quarantined, required to serve on a jury, or required by a court order to appear as a witness in a legal action, provided you, a Family Member traveling with you or a Traveling Companion is not
      1. A party to the legal action, or
      2. Appearing as a law enforcement officer;
    3. your Home made uninhabitable by fire, flood, volcano, earthquake, hurricane or other natural disaster;
    4. your Accomodation at your destination made uninhabitale by fire, flood, volcano, earthquake, hurricane or other natural disaster.
    5. mandatory evacuation or public official evacuation advisements where there is no mandatory evacuation issued by local government authorities at your destination due to adverse weather or natural disaster. In order to cancel or interrupt your Covered Trip, you must have 4 days or 50% of your total Covered Trip length or less remaining on your Covered Trip at the time the mandatory evacuation ends.
    6. being called into active military service to provide aid or relief in the event of a natural disaster;
    7. a documented theft of passports or visas;
    8. a transfer of employment of 250 miles or more;
    9. a Terrorist Act which occurs in your departure city or in a city which is a scheduled destination for your Covered Trip, provided the Terrorist Act occurs within 30 days of the Scheduled Departure Date for your Covered Trip;
    10. a cancellation of your Covered Trip if your arrival on the Trip is delayed and causes you to lose 50% or more of the scheduled Covered Trip duration due to the reasons covered under the Covered Travel Delay Benefit;
    11. Your involuntary termination of employment or layoff which occurs more than 15 days after your effective date of coverage and your plan payment and was not under your control. You must have been continuously employed with the same employer for 5 years prior to the termination or layoff. This provision is not applicable to temporary employment, independent contractors or self-employed persons.
OTHER VALID AND COLLECTIBLE GROUP INSURANCE means any group policy or contract which provides for payment of medical expenses incurred because of Physician, nurse, dental or Hospital care or treatment; or the performance of surgery or administration of anesthesia. The policy or contract providing such benefits includes group or blanket insurance policies; service plan contracts; employee benefit plans; or any plan arranged through an employer, labor union, employee benefit association or trustee; or any group plan created or administered by the federal or a state or local government or its agencies. In the event any other group plan provides for benefits in the form of services in lieu of monetary payment, the usual and customary value of each service rendered will be considered a Covered Expense.

PHYSICIAN means a person licensed as a medical doctor by the jurisdiction in which he/she is resident to practice the healing arts. He/she must be practicing within the scope of his/her license for the service or treatment given and may not be you, a Traveling Companion, or a Family Member of yours.

PRE-EXISTING CONDITION means an illness, disease, or other condition during the 180-day period immediately prior to your effective date for which you or your Traveling Companion or Family Member is scheduled or booked to travel with you:
  1. received, or received a recommendation for a diagnostic test, examination, or medical treatment; or
  2. took or received a prescription for drugs or medicine.
Item 2 of this definition does not apply to a condition which is treated or controlled solely through the taking of prescription drugs or medicine and remains treated or controlled without any adjustment or change in the required prescription throughout the 180-day period before coverage is effective under this Policy.

SCHEDULED DEPARTURE DATE means the date on which you are originally scheduled to leave on your Covered Trip.

SCHEDULED RETURN DATE means the date on which you are originally scheduled to return to the point where the Covered Trip started or to a different final destination.

SCHEDULED TRIP DEPARTURE CITY means the city where the scheduled trip on which you are to participate originates.

SICKNESS means an illness or disease of the body which:
  1. requires examination and treatment by a Physician, and
  2. commences while the plan is in effect.
TERRORIST ACT means an act of violence, other than civil disorder or riot, (that is not an act of war, declared or undeclared) that results in loss of life or major damage to property, by any person acting on behalf of or in connection with any organization which is generally recognized as having the intent to overthrow or influence the control of any government.

TRAVELING COMPANION means a person whose name(s) appear(s) with you on the same Covered Trip arrangement and who, during the Covered Trip, will accompany you.

USUAL AND CUSTOMARY CHARGE means those charges for necessary treatment and services that are reasonable for the treatment of cases of comparable severity and nature. This will be derived from the mean charge based on the experience in a related area of the service delivered and the MDR (Medical Data Research) schedule of fees valued at the 100th percentile and the Anesthesia Relative Value Guide.

GENERAL PLAN EXCLUSIONS

The following exclusion applies to the Air Flight Accident coverage:
  1. We will not pay for loss caused by or resulting from Sickness of any kind.

    The following exclusion applies to the Medical or Dental Expense, Emergency Assistance, Trip Cancellation, Trip Interruption, and Travel Delay coverages:
  2. We will not pay for loss or expense caused by or incurred resulting from a Pre-Existing Condition, as defined in the plan, including death that results therefrom. This Exclusion does not apply to benefits under Covered Expenses items 1 and 2 (emergency medical evacuation) or item 6 (repatriation of remains) of the Emergency Assistance Benefits Coverage.

    The following exclusion applies to all coverages:
  3. We will not pay for any loss under the plan, caused by, or resulting from:
    1. Your, or your Traveling Companion's, or your Family Member's booked to travel with you, suicide, attempted suicide, or intentionally self-inflicted injury, while sane or insane (while sane in CO & MO);
    2. mental, nervous, or psychological disorders;
    3. being under the influence of drugs or intoxicants,unless prescribed by a Physician;
    4. normal pregnancy or resulting childbirth or elective abortion;
    5. participation as a professional in athletics;
    6. participation in organized amateur and interscholastic athletic or sports competition or events;
    7. riding or driving in any motor competition;
    8. declared or undeclared war, or any act of war;
    9. civil disorder (does not apply to Travel Delay);
    10. service in the armed forces of any country;
    11. nuclear reaction, radiation or radioactive contamination;
    12. operating or learning to operate any aircraft, as pilot or crew;
    13. mountain climbing, bungee cord jumping, skydiving, parachuting, hang gliding, parasailing or travel on any air-supported device, other than on a regularly scheduled airline or air charter company;
    14. any unlawful acts, committed by you or a Traveling Companion (whether insured or not);
    15. any amount paid or payable under any Worker's Compensation, Disability Benefit or similar law;
    16. a loss or damage caused by detention, confiscation or destruction by customs;
    17. Elective Treatment and Procedures;
    18. medical treatment during or arising from a Covered Trip undertaken for the purpose or intent of securing medical treatment;
    19. Financial Insolvency of the person, organization or firm from whom you directly purchased or paid for your Covered Trip, Financial Insolvency which occurred before your effective date for the Trip Cancellation Benefits, or Financial Insolvency which occurs within 14 days following your effective date for the Trip Cancellation Benefits;
    20. business, contractual or educational obligations of you, a Family Member, or a Traveling Companion;
    21. failure of any tour operator, Common Carrier, or other travel supplier, person or agency to provide the bargained-for travel arrangements other than Financial Insolvency;
    22. a loss that results from an illness, disease, or other condition, event or circumstance which occurs at a time when the plan is not in effect for you.
Waiver of the Pre-Existing Condition Exclusion

The Pre-Existing Condition Exclusion is waived provided you meet all of the following requirements:
  1. the payment for this plan is received prior to/or within 24 hours of your final payment for your Covered Trip; and
  2. you are not disabled from travel at the time you make your plan payment; and
  3. the booking for the Covered Trip must be the first and only booking for this travel period and destination.

GENERAL PROVISIONS

Arbitration If we and you disagree on the amount of loss, either may make written demand for arbitration. In this event, each party will select a competent and impartial arbitrator. The two arbitrators will select a third. If they cannot agree within 30 days, either may request that selection be made by a judge of a court having jurisdiction. Each party will
  1. pay the expense if incurred and
  2. bear the expenses of the third arbitrator equally. A decision agreed to by two arbitrators will be binding.
Concealment or Fraud We do not provide coverage if you have intentionally concealed or misrepresented any material fact or circumstance relating to the coverage plan.

Conformity to Law Any provision of the plan that is in conflict with the laws of the state in which it is issued is amended to conform with the laws of that state.

Duplication of Coverage You may only purchase one certificate from us for each Covered Trip. If you do purchase more than one certificate for a specific Covered Trip, the Maximum Limit of Coverage payable will be as specified in the certificate with the highest level of benefits. We will refund plan payments received from you under any other certificate.

Entire Contract; Changes The plan may be changed at any time by written agreement between us. Only our President, Vice President or Secretary may change or waive the provisions of the plan. No agent or other person may change the plan or waive any of its terms. The change will be endorsed on the plan.

Examination Under Oath As often as we may reasonably require, you or any person making a claim under the plan must submit to examination under oath.

Maximum Limit of Coverage The maximum benefit amount for each claim is listed in the Schedule, subject to the individual benefit amount and the company's Maximum Limit of Liability. The total limit of our liability for any one covered event, in which two or more persons submit a claim, is subject to the individual benefit amount and the company's Maximum Limit of Liability. In the event of multiple claims by you for one event, the available funds will be distributed in order of notice of claim by each Insured subject to the above limitations.

Our Right to Recover From Others We have the right to recover any payments we have made from anyone who may be responsible for the loss. You and anyone else we insure must sign any papers and do whatever is necessary to transfer this right to us. You and anyone else we insure will do nothing after the loss to affect our rights.

CLAIMS PROVISIONS

Notice of Claim We must be given written notice of claim within 90 days after a covered loss occurs. If notice cannot be given within that time, it must be given as soon as reasonably possible. Notice may be given to us or to our authorized agent. Notice should include the claimant's name and enough information to identify him or her.

Proof of Loss Written Proof of Loss must be sent to us within 90 days after the date the loss occurs. We will not reduce or deny a claim if it was not reasonably possible to give us written Proof of Loss within the time allowed. In any event, you must give us written Proof of Loss within twelve (12) months after the date the loss occurs unless you are legally incapacitated.

Physical Examination and Autopsy At our expense, we have the right to have you examined as often as necessary while a claim is pending. At our expense, we may require an autopsy unless the law or your religion forbids it.

Legal Actions No legal action may be brought to recover on the plan within 60 days after written Proof of Loss has been given. No such action will be brought after three years from the time written Proof of Loss is required to be given. If a time limit of the plan is less than allowed by the laws of the state where you live, the limit is extended to meet the minimum time allowed by such law.

Payment of Claims Benefits for loss of life will be paid to your estate, or if no estate, to your beneficiary. All other benefits are paid directly to you, unless otherwise directed. Any accrued benefits unpaid at your death will be paid to your estate, or if no estate, to your beneficiary. If you have assigned your benefits, we will honor the assignment if a signed copy has been filed with us. We are not responsible for the validity of any assignment.

TRAVEL INSURANCE IS UNDERWRITTEN BY:

Travel Insurance is underwritten by Stonebridge Casualty Insurance Company, Columbus, Ohio; NAIC # 10952 (all states except as otherwise noted) under Policy/Certificate Form series TAHC5000. In CA, CT, HI, NE, NH, PA, TN and TX Policy/Certificate Form series TAHC5100 and TAHC5200. In IL, IN, KS, LA, OR, OH, VT, WA and WY Policy Form #'s TAHC5100IPS and TAHC5200IPS.

10-DAY RIGHT TO EXAMINE CERTIFICATE:

If you are not satisfied for any reason, you may return you certificate within 10 days after receipt. Your plan payment will be refunded, provided there has been no incurred covered expense. When so returned, the certificate is void from the beginning. Return the certificate to us at our Home Office or to our authorized agent.

After this 10-day period, the payment for this plan is non-refundable.

WHERE TO PRESENT A CLAIM

All claims should be presented to the Program Administrator:

CSA Travel Protection
P.O. Box 939057
San Diego, CA 92193-9057
(800) 541-3522 (Toll-Free)



(50 SERIES ID THEFT) J3890 -0605 Description of I.D. Theft Protection Services

CSA Travel Protection

This plan is brought to you by Intersections, Inc. and administered by CSA Insurance Services

AVAILABLE SERVICES AND COVERAGE

Identity theft protection services and insurance coverage are provided along with the CSA Travel Protection plans. A description of the service, insurance coverage and terms of use is contained in this document.

The services and coverage are only available to persons whose primary residence is in the United States. This plan is administered by CSA Insurance Services.

AVAILABILITY OF SERVICES AND COVERAGE

The Identity Theft Protect Services and Identity Theft Insurance become available at the start of your trip. Services end 180 days (six months) from the date of your scheduled trip departure.

IDENTITY THEFT PROTECTION SERVICES

If you suspect someone has compromised your identity, call us toll-free at (800) 348-9505 and ask to be connected with the Identity Theft Recovery Unit.

The Identity Theft Recovery Unit (ITRU) offers fast and responsive support to victims of identity theft. This unit's trained fraud specialists will help guide you through the necessary steps of restoring your credit profile. Specialists are proactive in contacting the credit reporting agencies, creditors and in providing helpful information to assist you with recovering and restoring your credit. The service provides the following benefits:
  • Pull a three-bureau credit report with your authorization.
  • Assistance reviewing your report to review and identify instances of suspected fraud.
  • Assistance in placing Fraud alerts at all three credit reporting agencies at your request.
  • Dispute letters written on your behalf for you to review and sign, and for you to forward to Bureaus and Creditors.
  • Assistance with contacting law enforcement agencies.
  • A "Recovering from Identity Theft" information kit, including a copy of the three-bureau report which was reviewed.
  • Convenient toll-free access to the Identity Theft Recovery Unit so you can contact ITRU with follow-up questions or concerns.
  • Six months of daily monitoring and alert service at all three bureaus.

IDENTITY THEFT INSURANCE

In addition to receiving assistance from the Identity Theft Recovery Unit, you are eligible for up to $20,000 in financial reimbursement, with no deductible, for certain expenses associated with identity theft.

Your $20,000 coverage includes:
  • Lost wages (up to $500 per week for a maximum of four weeks) as a result of time taken off work to deal with the fraud, including wrongful incarceration. Lost wages must occur during the policy period.
  • Notary and certified mailing costs for completing and delivering fraud affidavits or similar documents.
  • Loan application fees incurred when reapplying for loans when the original application is rejected solely because the lender received incorrect information.
  • Long-distance phone charges associated with reporting or discussing an actual identity fraud
  • Attorney fees incurred (with prior Intersections consent) for defending suits
    1. brought incorrectly by merchants and their collection agencies,
    2. for removing criminal or civil judgments wrongly entered against an Insured Person, and
    3. for challenging the accuracy or completeness of any information in a consumer credit file.
The full details of your coverage are set forth in the following Certificate of Insurance. Coverage depends on the facts and circumstances involved in the claim or loss, all applicable policy provisions, and any applicable law.

CERTIFICATE OF INSURANCE FOR THE IDENTITY FRAUD EXPENSE COVERAGE MASTER POLICY

This Certificate of Insurance is a coverage description intended to provide important information about the protection available to an Insured Person under the Identity Fraud Expense Coverage Master Policy (the "Master Policy"). Keep this coverage description for your records. This coverage description is not an insurance policy and does not amend, extend or alter the coverage afforded by the Master Policy described herein. Terms shown in bold in this coverage description are defined in the Master Policy. The insurance afforded by the Master Policy as described herein is subject to all the terms, exclusions and conditions of such Master Policy. The policy period is specified in the Master Policy.

Policy Number: 104391562

Underwritten by:
Travelers Casualty and Surety Company of America Hartford, CT 06183 ("Travelers") to provide insurance to an Insured Person as described in this Certificate

Limit of Insurance for any one loss:
Limit of Insurance = $20,000
Deductible = $0

The Master Policy has been issued to:
Intersections Inc.
Chantilly, VA 20151
(the "Master Policy Holder")

General Information:

Should you have any questions regarding the Membership Program provided by the Master Policy Holder, or wish to view a complete copy of the Master Policy, please call the customer service number located in your membership materials.

Filing a Claim:

To file a claim under the Master Policy, please contact CSA Travel Protection. Telephone: (800) 348-9505

INSURING AGREEMENT

(1) IDENTITY FRAUD EXPENSE COVERAGE

To reimburse an Insured Person for Expenses incurred by the Insured Person as the direct result of any one Identity Fraud discovered during the policy period.

Only an Insured Person will be entitled to coverage under this Insuring Agreement (1).

CONDITIONS
  1. Definitions:
    1. "Expenses" means
      1. Costs for notarizing fraud affidavits or similar documents for financial institutions or similar credit grantors or credit agencies that have required that such affidavits be notarized.
      2. Costs for certified mail to law enforcement agencies, credit agencies, financial institutions or similar credit grantors.
      3. Lost wages as a result of time taken off from work to meet with, or talk to, law enforcement agencies, credit agencies and/or legal counsel, to complete fraud affidavits, or due to wrongful incarceration arising solely from someone having committed a crime in the Insured Person's name up to a maximum payment of $500 per week for a maximum period of four weeks. Lost wages shall not apply in the case of wrongful incarceration absent all charges being dropped or an acquittal.
      4. Loan application fees for re-applying for a loan or loans when the original application is rejected solely because the lender received incorrect credit information.
      5. Charges incurred for long distance telephone calls to merchants, law enforcement agencies, financial institutions or similar credit grantors, or credit agencies to report or discuss an actual Identity Fraud.
      6. Reasonable attorney fees incurred, with the Company's prior consent, for:
        1. defense of lawsuits brought against the Insured Person by merchants or their collection agencies,
        2. the removal of any criminal or civil judgments wrongly entered against an Insured Person, and
        3. challenging the accuracy or completeness of any information in a consumer credit report.
    2. "Identity Fraud" means the act of knowingly transferring or using, without lawful authority, a means of identification of an Insured Person with the intent to commit, or to aid or abet, any unlawful activity that constitutes a violation of Federal law or a felony under any applicable state or local law.
    3. "Insured Person" means any natural person who is currently subscribed to a Membership Program or affinity group that has been specifically expanded by the Master Policy Holder to include the protection afforded by the Master Policy.
    4. "Master Policy Holder" means Intersections Inc.
    5. "Membership Program" means a membership program sponsored by the Master Policy Holder and that is specifically named within an endorsement attached to the Master Policy.
    6. "Policy Period" means the dates shown in the Master Policy.
  2. Exclusions
    The Master Policy does not apply:
    1. to loss due to any fraudulent, dishonest or criminal act by an Insured Person or any person acting in concert with an Insured Person, or by any authorized representative of an Insured Person, whether acting alone or in collusion with others;
    2. to loss other than Expenses;
    3. to an Identity Fraud that was discovered, or Expenses incurred, when an individual was not an Insured Person;
    4. to loss due to nuclear reaction, nuclear radiation or radioactive contamination, or due to any act or condition incident to any of the foregoing;
    5. to loss due to war, whether or not declared, civil war, insurrection, rebellion, revolution, or to any act or condition incident to any of the foregoing.
  3. Policy Period
    Discovery - The Master Policy applies only to Identity Fraud, occurring anywhere in the world, which is discovered during the Policy Period and is reported to the Company during the Policy Period or within 30 days following the termination of either:
    1. this Policy; or
    2. membership of the Insured Person in a Membership Program.
  4. Limits of Insurance
    Under Insuring Agreement (1), the limit of the Company's liability per Insured Person for loss covered under the Master Policy shall not exceed the applicable Limit of Insurance shown in the Declarations. Under the Master Policy, all losses incidental to an act or series of related acts or arising from the same method of operation, whether committed by one or more persons, shall be deemed to arise out of one occurrence and shall be treated as one loss. However, solely with respect to Insuring Agreement (1), should one such act cause a covered loss to more than one Insured Person, the available Limit of Insurance under the Master Policy and the deductible amount shall apply to each Insured Person separately.

    Regardless of the number of Membership Programs that an Insured Person is a member of, the Company's liability to such Insured Person for loss covered under the Master Policy shall not exceed the applicable Limit of Insurance shown in the Declarations.
  5. Deductible
    The Company shall be liable only for the amount by which any loss exceeds the applicable Deductible Amount as shown in the Declarations. This Deductible Amount applies to each and every loss and shall have no aggregate limitation.
  6. Recoveries
    Any recoveries, less the cost of obtaining them, made after settlement of loss covered by the Master Policy will be distributed as follows:
    1. first, to the Insured Person, until the Insured Person is reimbursed for any loss that was sustained by the Insured Person that exceeds the Limit of Insurance and the Deductible Amount, if any;
    2. then to the Company, until the Company is reimbursed for the settlement made; and
    3. then to the Insured Person until the Insured Person is reimbursed for that part of the loss equal to the Deductible Amount, if any.
    Recoveries do not include any recovery from insurance, suretyship, reinsurance, security or indemnity taken for the Company's benefit.
  7. Ownership Interests Covered
    This Policy shall be for the sole use and benefit of the Insured Persons and the Master Policy Holder. It provides no rights or benefits to any other person, entity, or organization.
  8. Insured Duties When Loss Occurs
    Upon knowledge or discovery of loss or of an occurrence which may give rise to a claim under the terms of the Master Policy, the Insured Person shall give notice thereof as soon as practicable to the Company, and file detailed proof of loss, duly sworn to, with the Company within four months after the discovery of loss. If the loss involves a violation of law, the Insured Person shall also notify the police.

    Upon the Company's request, the Insured Person shall submit to examination by the Company, subscribe the same, under oath if required, and produce for the Company's examination all pertinent records, all at such reasonable times and places as the Company shall designate, and shall cooperate with the Company in all matters pertaining to loss or claims with respect thereto. Compliance with all terms and conditions of the Master Policy are conditions precedent to recovery under the Master Policy.

    The Insured Person shall keep books, receipts, bills and other records in such manner that the Company can accurately determine therefrom the amount of any loss. At any time subsequent to the reporting thereof to the Company, the Company may examine and audit the Insured Person's books and records as they relate to a loss under the Master Policy.

  9. Other Insurance
    If there is any other valid and collectible insurance which would apply in the absence of the Master Policy, the insurance under the Master Policy shall apply only as excess insurance over such other insurance.
  10. Action Against Company
    No action shall lie against the Company unless, as a condition precedent thereto, there shall have been full compliance with all terms of the Master Policy, nor until 90 days after the required proof of loss has been filed with the Company, nor at all unless commenced within two years from the date when the Insured Person first discovers the loss. If any limitation of time for notice of loss or any legal proceeding herein contained is shorter than that permitted to be fixed by agreement under any statute controlling the construction of the Master Policy, the shortest permissible statutory limitation of time shall govern and shall supersede the time limitation herein stated.
  11. Subrogation
    In the event of any payment under the Master Policy, the Company shall be subrogated to all the Insured Person's rights of recovery therefore against any person or organization, and the Insured Person shall execute and deliver instruments and papers and shall take whatever other actions are necessary to secure such rights for the Company. The Insured Person shall not take any action after the discovery of any loss that would prejudice such rights.
  12. Changes
    Notice to any agent or knowledge possessed by any agent or by any other person shall not effect a waiver or a change in any part of the Master Policy or stop the Company from asserting any right under the terms of the Master Policy; nor shall the terms of the Master Policy be waived or changed, except by endorsement issued by the Company and made to form a part of the Master Policy.
  13. Assignment
    Assignment of interest under the Master Policy shall not bind the Company until its consent is endorsed herein.
  14. Concealment or Misrepresentation
    The Master Policy is void as to any Insured Person if, at any time, said Insured Person intentionally conceals or misrepresents a material fact concerning either the insurance afforded by the Master Policy or a claim under the Master Policy.

TERMS OF USE

Legally Binding Terms. You have purchased the product or service you have ordered (the "Product") from CSA Insurance Services ("CSA"). The Product is delivered to you by its provider Intersections Inc., a company located in Chantilly, Virginia ("Intersections"). Your order of the Product constitutes your acceptance of these Terms of Use and the enclosed Certificate of Insurance. If you ordered this Product on behalf of someone else, you must deliver these Terms of Use, together with the enclosed Certificate of Insurance, to that person as a condition of your use of the Product. These Terms of Use, together with the enclosed Certificate of Insurance, are binding on you and each other person on behalf of whom you ordered the Product.

Use. You may use the Product only for non-commercial purposes. You may not use the Product for anyone else.

Service Period. You may use the Product for a period of six months commencing on your travel date, after which time your use of the Product expires.

No Representations or Warranties. THE PRODUCT IS PROVIDED ON AN "AS IS" BASIS ONLY. INTERSECTIONS AND CSA DO NOT MAKE, AND EXPRESSLY DISCLAIM, ANY REPRESENTATION OR WARRANTY OF ANY KIND, WHETHER EXPRESSED, IMPLIED, OR ARISING OUT OF COURSE OF DEALING OR USAGE, INCLUDING WITHOUT LIMITATION ANY WARRANTY OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NONINFRINGEMENT, NONINTERFERENCE WITH DATA, AVAILABILITY, OR THAT THE PRODUCT IS ERROR-FREE. YOU ARE SOLELY RESPONSIBLE FOR ANY USE YOU MAKE OF THE PRODUCT OR ACTION OR DECISION YOU MAKE BASED ON IT.

Limitation of Liabilities. IN NO EVENT MAY INTERSECTIONS OR CSA BE LIABLE FOR ANY CONSEQUENTIAL, INDIRECT, SPECIAL, EXEMPLARY, PUNITIVE OR SIMILAR DAMAGES ARISING FROM OR RELATED TO THE PRODUCT, EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGES IN ADVANCE. INTERSECTIONS' AND CSA'S TOTAL LIABILITY ARISING FROM OR RELATED TO THE PRODUCT MAY NEVER EXCEED THE AMOUNT PAID BY YOU FOR THE PRODUCT.

Third-Party Providers. The Product contains information provided by one or more credit reporting agencies, as identified in your materials: The Product may contain credit score analysis provided by one or more third-party providers, as identified in your materials. INTERSECTIONS DOES NOT CONTROL AND IS NOT RESPONSIBLE FOR THE INFORMATION PROVIDED BY ANY CREDIT REPORTING AGENCY OR SCORE ANALYSIS PROVIDER.

Changes. Intersections in its sole discretion may modify or cancel the Product at any time without notice to you, and may modify these Terms of Use by posting the changes on the Product Web site. The changes will be binding on you.

General. These Terms of Use are governed by the laws of the Commonwealth of Virginia, USA, exclusive of its choice of law principles. Any claim arising out of or relating to the Product shall be settled by binding arbitration in accordance with the commercial arbitration rules of the American Arbitration Association on an individual basis not consolidated with any other claim. Any party, however, may seek interim injunctive relief in a court of competent jurisdiction. Identity theft insurance is governed by additional terms and conditions stated in the certificate provided to you with these materials. These Terms of Use, together with the enclosed Certificate of Insurance state the exclusive terms, conditions, representations and warranties governing the Product.

TRADEMARK AND COPYRIGHT

Intersections, is a trademark or federally registered trademark of Intersections Inc.; and other trademarks are trademarks of their respective owners.

(c) Intersections 2002-2005. All rights reserved.