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SIRIUS INTERNATIONAL INSURANCE COMPANYGROUP TRAVEL INSURANCE CERTIFICATEInternational Elite Single Trip Air, Cruise & Tour Program We promise and agree to provide You with the benefits described in the Policy, as outlined in this Certificate. We make this promise and agreement in consideration of Your application and payment of the premium in full. The benefits are subject to all provisions, terms, conditions, limitations and exclusions of the Policy. Any conflict between the terms of the Certificate and the Policy will be decided in favor of the Policy. POLICYHOLDER: National Small Business Travel & Health Association Our program manager of the Policy and this Certificate is iTravelInsured. All communications, correspondence, notices, claims and payments should be presented to Our program manager. TO FILE A CLAIM OR TO CANCEL: From North America, call: (1) 866-243-7524 From outside North America, call: (1) 317-655-9798 Mail to: iTravelInsured, P.O. Box 44914, Indianapolis, IN 46244 Right to CancelIf You are not satisfied for any reason, You may return this Certificate to Us within 10 days after receipt provided You have not already departed on your Covered Trip or filed a claim. Premium will then be refunded, and this Certificate will be void from the beginning.iTI200-14 SECTION 1. SCHEDULE OF BENEFITSAggregate LimitThe total aggregate limit of benefits payable in the event of any one Accident involving 2 or more Insureds is $1,500,000 under the Policy. In the event of multiple claims for a single Accident, benefits will be reduced so that each Insured's benefit amount will be a proportionate share of the total amount payable for all Insureds under this provision up to the total aggregate limit of liability. SECTION 2: GENERAL TERMS AND DEFINITIONS"Accidental or Accident" means an unexpected and unforeseen incident, including a Terrorist Incident."Baggage" means luggage and personal possessions, whether owned, borrowed or rented, that is taken or purchased by You on the Covered Trip. "Business Partner" means an individual who owns at least 10% of the same business as You and is actively involved in the day-to-day management of that business, and there are no more than three partners together who own the same business. "Certificate" means an outline of the terms of coverage and provisions of the Policy, which includes this document. "Common Carrier" means any land, water, or air conveyance operated under a license for the transportation of passengers for hire. "Covered Trip" means any travel and sojourn to a Destination more than 120 miles from the starting point of the Covered Trip and not exceeding 30 consecutive days. "Departure Date" means the scheduled date to begin the Covered Trip as referenced on Your coverage verification letter for this Certificate. "Destination" means one or more cities to which You are scheduled to travel on a Covered Trip. "Emergency" means a sudden, unexpected, unforeseen occurrence demanding immediate action. "Family Member" means Your
"Illness" means a sickness, impairment or physical condition that involves inpatient care in a Hospital, or requires treatment by a qualified Physician. "Injury" means trauma or damage to any part of the body caused solely by Accident and not contributed to by any other cause. "Insured" means the Member who arranged to take the Covered Trip, completed the application, paid the premium in full, and whose coverage under the Policy has become effective and has not terminated. "Locality" means an area large enough to represent a reasonable cross section of providers giving the type of service or supplies for which the charge was made. "Member" means any person who belongs to the Policyholder's association. "Necessary" means medical treatment that is vital and required for the treatment of a covered Injury or Illness. "Organized Labor Strike" means any stoppage of work:
"Policy" means the Group Travel Insurance Policy issued to the Policyholder by Us. As the underwriting insurance carrier, We are solely liable and responsible for the coverage and benefits provided under the Policy. "Policyholder" means the National Small Business Travel & Health Association. "Pre-Existing Condition" means an Injury or Illness which manifests itself during the 60 days immediately before and including the date Your coverage became effective, unless the condition is controlled through the taking of prescription drugs or medication and remains controlled throughout the 60 day period. An Illness or Injury has manifested itself when:
"Return Date" means the scheduled date on which You are to arrive at Your Return Destination as shown on the coverage verification letter for the Certificate. "Return Destination" means the place to which You are scheduled to return from a Covered Trip. "Scheduled Airline" (including scheduled charters) means an airline with a license for civil scheduled air transport issued by the country in which its aircraft are registered. Such airline must file and publish schedules and fares for regular passenger service between cities. "Terrorist Incident" means any violent act or an act that is dangerous to human life, property or infrastructure, that is committed within 120 miles of a Destination, by any person or persons who appear to be part of an effort to coerce a civilian population or affect the conduct of any government by coercion. "Travel Companion" means a person who accompanies You and shares sleeping quarters with You on a Covered Trip, and a physical cross-reference entry exists within a computerized reservation system, a global distribution system or Travel Supplier reservation system that references Travel Companions to each other. "Travel Companion's Family Member" means a Travel Companion's spouse, children, parents, grandparents or grandchildren. "Travel Supplier" means a travel agent, Scheduled Airline, cruise line, tour operator, bus line, or other licensed provider of travel. "Violent Attack" means a grave crime declared to be a felony at common law and which involves physical contact or bodily harm to you. "We, Us, Our" means Sirius International Insurance Corporation (publ), headquartered in Stockholm, Sweden. We are the underwriter of the Policy. "You or Your" means the Insured. SECTION 3: INSURANCE PROVISIONSEligibility and Effective DateSubject to Our acceptance of Your application and payment of the premium in full, coverage for all benefits except Trip Cancellation will begin on the Departure Date. The Trip Cancellation benefit will begin at 12:01 a.m. on the day after We receive Your application. Termination DateAll coverage for a Covered Trip ends on the earliest of:
Trip Cancellation / Interruption Subject to the limitations stated below, We will pay for non-refundable, unused payments and deposits, not to exceed the lesser of the total trip protection purchased, or the maximum benefit shown on the Schedule of Benefits, if Your Covered Trip is cancelled or interrupted as a result of any one of the following events which occurs after Your coverage is in effect and before such coverage terminates:
Travel DelaySubject to the limitations stated below, We will pay up to the maximum benefit shown on the Schedule of Benefits for additional reasonable traveling expenses that are incurred by You on a Covered Trip because of a travel delay of at least 24 hours, and are not otherwise paid by a Travel Supplier or Common Carrier. You must make every reasonable effort to avoid additional expenses. This benefit is payable for only one delay per Covered Trip.Travel Delay must be caused by:
We will also pay for additional reasonable transportation costs to help You join (catch up to) a covered cruise, up to the amount shown on the Schedule of Benefits, if You missed a cruise departure because the airline flight was canceled or delayed for at least 6 hours due to bad weather. Any benefit payable under this coverage will be reduced by any amount paid by a Common Carrier towards additional transportation costs. Baggage and Personal PossessionsSubject to the limitations stated below, We will pay up to the maximum benefit shown on the Schedule of Benefits for damage to or loss or theft of Your checked or stored Baggage on a Covered Trip when such Baggage is lost or damaged by a Common Carrier or stored with a hotel or motel in which You are registered as a guest.The following limitations will apply:
In the event of a loss to Baggage that is a pair or set, We may, at Our option, repair or replace any part to restore the pair or set to its value before the loss; or pay the difference between the value of the property before and after the loss. In the event of loss, theft or damage to Baggage, You must:
This coverage does not include loss caused by Baggage delay. Baggage DelayIn the event Your checked Baggage is delayed by a Common Carrier on a Covered Trip for 24 hours or more from the actual time of arrival at a Destination, subject to the limitations stated below, We will reimburse costs You incurred up to the maximum benefit shown on the Schedule of Benefits for reasonable additional clothing and essential personal articles You purchased. Verification of the delay by the Common Carrier and receipts for the necessary purchases must accompany any claim.The following limitations will apply:
Subject to the limitations stated below, We will pay up to the maximum benefit shown on the Schedule of Benefits for Covered Expenses You incurred for an Injury or Emergency Illness on a Covered Trip, provided initial treatment is received during a Covered Trip. The first expense must be incurred within 48 hours from the date of the onset of the Injury or Emergency Illness. This coverage is secondary to any other coverage available to You. Coverage continues until Your Covered Trip ends. "Covered Expenses" "Covered Expenses" means the Necessary and Reasonable Expenses for medical, surgical and Emergency dental services, treatments and supplies incurred during a Covered Trip. Covered Expenses also include expenses for professional nursing services, Hospital charges, X-rays, and ambulance services. We will not pay for:
Subject to the limitations stated below, We will pay up to the maximum benefit shown on the Schedule of Benefits for Covered Expenses, and We will arrange for Emergency assistance services You require as the result of Emergency Illness or Injury occurring during a Covered Trip. "Covered Expenses" means Reasonable Expenses for medical services required for evacuation to the nearest adequate medical facility from the place where the Injury or Emergency Illness occurred. Services and benefits will be arranged only if the treating Physician recommends such evacuation. Covered Expenses will be paid provided You are traveling on a Covered Trip and are more than 120 miles away from Your primary place of residence. In addition to the above Covered Expenses, when You are confined in a medical facility more than 120 miles from Your primary residence and Your treating Physician and We determine it is feasible and medically Necessary to transfer You to a medical facility nearer to Your primary residence to recuperate in familiar surroundings, medical repatriation will be provided. We will not pay for any services or Covered Expenses incurred without Our prior consent or approval. We will not pay for any services or Covered Expenses incurred as a result of a Pre-Existing Condition. Emergency Reunion and Return of Mortal RemainsSubject to the limitations stated below, We will either purchase or pay a total amount not to exceed the maximum benefit shown on the Schedule of Benefits for one or more of the following:
Common Carrier CoverageSubject to the limitations stated below, We will cover Injury to You on a Covered Trip limited to riding as a passenger, getting in or out of, or being struck by a Common Carrier.Description of BenefitsIf Your Injury results in a loss shown below within one year after an Accident causing the loss, which is not due to Terrorist Incident, We will pay a percentage of the principal sum shown on the Schedule of Benefits as follows:
Definitions"Loss of Hand or Foot" means the complete and permanent severance through or above the wrist or ankle joint."Loss of Sight" means the total and permanent loss of entire sight. Such loss correctable by surgery or lenses is not considered total and permanent. If You suffer more than one loss from any one Accident, We will pay only one amount which is determined to be the highest benefit payable not to exceed the Principal Sum. Exposure and DisappearanceWe will pay the appropriate percentage of the Principal Sum if You are exposed to the elements due to a covered Accident and You sustain a loss for which a benefit would otherwise be paid.We will presume death due to an Injury to You if Your body is not found within one year from the date of a Common Carrier Accident, in which You were a passenger. Violent AttackIf You incur a Violent Attack while on a Covered Trip, We will pay You $250. A Violent Attack may not be inflicted by You, a Family Member, a Travel Companion or a Travel Companion's Family Member. You must have filed a police report and provide Us with a copy.SECTION 5: EXCLUSIONSWe will not pay for any Illness, Injury or loss caused by or as a result of:
Where to Present a Claim To help facilitate prompt payment of claims, You should report all claims as soon as possible directly to Our program manager: iTravelInsured P.O. Box 44914 Indianapolis, IN 46244 From North America, call: (1) 866-243-7524 From outside North America, call: (1) 317-655-9798 Notice of ClaimWritten notice of claim must be given to Us within 30 days after a covered Injury, Illness or loss occurs or begins. We may deny coverage for any claim submitted thereafter. The notice must include the claimant's name, Your name and the Certificate number.Claim FormsUpon Your report of a claim, We will send the claimant forms for filing proof of loss within 15 days.Written Proof of LossWritten proof of loss includes fully completed claim forms, original invoices, receipts, medical records and all other supporting documentation that we require and request to reasonably support Your claim. In instances where medical information is required by Us for consideration of a claim but it is not available to Us, it is Your responsibility to obtain such information from Your Physician. Written proof of loss must be sent to Us within 90 days after the end of each period that benefits are payable. For any other loss, written proof must be given within 90 days after the date of loss. We may deny coverage for any claim in which written proof of loss is submitted thereafter.Payment of ClaimsAfter receiving written proof of loss, We will pay any benefits due within 30 days. All claims will be paid in U.S. dollars. If We have to make a conversion from a currency into U.S. dollars, We will choose a fair exchange rate on the date of loss. We are not responsible for any loss You may incur due to fluctuations in exchange rates, or for any bank charges You may incur when You cash a foreign currency draft, a check or when Your receive a bank transfer from Us.We will pay death benefits to the beneficiary designated by You and on file with the holder of beneficiary records. If a beneficiary has not been designated, death benefits will be paid to Your estate. All other benefits will be paid to You except for medical benefits (if applicable). These may be paid directly to the provider of medical services. Any payments We make in good faith will end Our liability to the extent of the payment. Physical Examination and AutopsyWe have the right to have You examined by a Physician of Our choice. This may be done as often as reasonably necessary while a claim is pending or while We are paying benefits. We may require an autopsy where lawful. We will pay the cost of both the exam and autopsy.SECTION 7: GENERAL PROVISIONSAssignmentYou may assign Your interest under the Policy. In the case of an irrevocable beneficiary, that person must give written consent. No assignment will be binding on Us unless it is in writing and a copy is sent to Us. We accept no responsibility for the validity of an assignment. Duplication of CoverageYou are eligible for coverage under only one Certificate from Us for each Covered Trip. If You have more than one Certificate, the maximum benefit payable will be as specified in the Certificate with the highest level of benefits. We will refund certificate premiums received under any other Certificate.Entire ContractThe Policy, the Insureds' applications, and the Policy application are the entire contract of insurance. All statements made by the Policyholder or by You, in the absence of fraud, are deemed representations and not warranties. No statement made by You will be used in any contest unless a copy of the instrument with the statement is or has been furnished to You, or in the event of Your death or incapacity, to Your beneficiary or personal representative.Facility of PaymentIf no beneficiary is living or if the benefit is payable to Your estate, We may pay up to $1,000 to the person We deem is equitably entitled to a benefit by reason of having incurred funeral or other expenses related to Your last illness or death. Any payment We make in good faith fully discharges Us to the extent of Our payment.Legal ActionsNo legal action may be brought on the Policy within 60 days from the date written proof of loss has been given or after 5 years from the date written proof of loss is required to be given.Misstatement of AgeIf Your age has been misstated in the application, We will change the benefit to the applicable amount available for the correct age. We will refund any excess premium paid over the amount due for the correct benefit amount.We will require payment for any overdue premium for the correct benefit amount. If the misstatement is discovered after a benefit is due and payable, We will reduce or increase the benefit amount payable by the amount of excess or due premium because of the misstatement. If You are not eligible for coverage because of age, We will refund all premiums paid on and after the date You were no longer eligible. Right of RecoveryWe have the right to recover any overpayment made because of an error in processing a claim. Also, if We make a payment under the Policy, and the person to or for whom the payment is made has a right to recover damages from another, We shall be subrogated to that right. However, Our right is subordinate to the Insured's right to be fully compensated. We are entitled to all rights of recovery that You have against another. You must sign any papers necessary to transfer these rights to Us, help exercise these rights in any reasonable way requested, and do nothing to prejudice these rights.Right of RescissionSubject to the Incontestability provision, We may rescind Your Certificate upon discovery of a material misrepresentation or omission of fact in Your application. We will then refund all premiums paid for Your coverage, less any benefits paid prior to such discovery.Workers' CompensationThe Policy is not a substitute for any Workers' Compensation law requirement.Your Duty of CareYou agree at all times to: act in a prudent manner and exercise reasonable care and take reasonable precautions to prevent Injury or Illness; minimize any costs incurred; comply with recommended vaccination schedules; and take appropriate malaria and other medicinal prophylaxis.Government Law, Regulations and TaxationWe reserve the right to amend the Policy and Your Certificate at any time in order to reflect any change in regulatory requirements, insurance law, insurance premium tax or other government levies as may be imposed upon Us.You warrant that You are not infringing on any local insurance law, regulation or taxation issue by purchasing this Certificate, and You understand and agree that this Certificate and the Policy are not designed to comply with any particular local insurance law or regulation. We accept no liability in the unlikely event that You infringe on any local insurance law, regulation or taxation issue by purchasing this Certificate. Choice of LawThe contract of insurance between You and Us as represented by the Policy and evidenced by the Certificate shall be deemed issued, finalized and made in Indianapolis, Indiana. Sole and exclusive jurisdiction and venue for any court action or administrative proceeding relating to this insurance shall be in Marion County, Indiana, for which You expressly consent. The subjects, risks and benefits of insurance covered by the Policy and evidenced by this Certificate are not intended or considered by You or Us to be resident, located or to be performed in any particular State of the United States of America or in any particular country.Applicable CurrencyAll benefits, premiums and any other amounts stated in the Policy, the Application and this Certificate are in U.S. dollars. |