What coverage will you
have?
Emergency Medical Insurance (Single -Trip and Multi-Trip)
Eligibility.
1. Coverage is NOT
AVAILABLE to any individual who, as of
their departure date:
a) has been
diagnosed with a terminal illness;
b) received
treatment for
pancreatic cancer, liver cancer or any type of cancer that has
metastasized;
c) had an organ transplant (heart, lung,
liver, kidney) or a bone marrow transplant;
d) has been diagnosed
with or received treatment for congestive heart failure or
cardiomyopathy in the last 24 months;
e) has had a has had a
lung condition
for which the use of home oxygen has been
prescribed in the last 24 months;
f) has been diagnosed with or received
treatment for stage 4 or Stage 5 chronic kidney disease or any
kidney condition requiring dialysis
2. You must NOT
have had, prior to your application date, your most recent heart
surgery (if any) more than 12 years ago.
Heart surgery includes
coronary bypass, coronary angioplasty, valve surgery (repair or
replacement), valvuloplasty, implanted pacemaker or implanted
defibrillator (excluding battery change).
3. In the 12 months prior to your application date, you must NOT have:
a) been hospitalized for 24 hours or more for any of the
following medical conditions:
• Artery or Vein disorder
• Diabetes (excluding diet controlled)
• Bowel
/
stomach disorder
• Heart condition
• Stroke (CVA), Transient Ischemic attack
(TIA)
• Cancer (excluding basal or squamous cell skin)
• Lung condition
• Liver or Pancreas disorder cancer and breast cancer treated
only with hormone therapy)
b) been diagnosed or treated for 3 or more of the medical
conditions listed in Question 3 a) above;
4. You must not have had, on the application date, a diagnosed aneurysm of 4 centimeters or more in
either length or diameter, that has not been surgically
repaired.
All
applicants have to complete the
Medical
questionnaire
to determine their rate category.
Important Notice: Your continued eligibility for coverage
is dependent on your health status not changing between Date of Application and your Policy Effective date. Accordingly, if your medical condition changes or if you undergo a change in medication
prior to your policy Effective date, you must immediately notify the insurer.
Single-Trip Plan
Provides coverage for a single trip from your province of residence.
During the period of coverage you may return once to your province or territory of residence
for up to 15 consecutive days without terminating this policy.
Multi-Trip Plan
You’ll be covered for 12 months and can take an unlimited number of trips up to the trip duration you have chosen.
Coverage for each separate trip commences and becomes effective immediately upon your departure
from your province or territory of residence and expires when you return to your province or territory of residence.
All trips must be separated by a 24 hour return to Canada.
If you incur a claim, you will need to provide proof of departure from and return
- to your province or territory of residence, for trips within Canada; and
- to Canada, for trips outside Canada.
Deductible
Deductible options $250 (standard),
$1,000; $2,000; $2,500; 5,000; $10,000 US are available for premium discount (10%, 20%, 30%, 45% respectively).
Discounts and Surcharges.
● Single trip
travelling companion discount : 5% savings available for anyone with a travelling companion.
● Smoker Surcharge :
15% if smoked or used tobacco products within 24 months prior to your departure date.
Waiting Period
If you purchased your policy after you have exited your province or territory of residence
or after the expiry date of your existing policy,
any sickness that manifests itself during the first 48-hours after the effective date is not covered even
if related expenses are incurred after the 48-hour waiting period.
Extending Your Trip
If you decide to apply for additional coverage after you have left
your province or territory of residence, you may apply for a new term of coverage if you:
a) make your application for extension prior to the expiry date of your policy; and
b) are in good health; and
c) have no reason to seek medical consultation during the new term of coverage.
If you have incurred a claim during your period of coverage, the insurer will
review your file before deciding on granting an extension.
Each policy or term of coverage is considered a separate contract.
Refunds.
Refunds for Emergency Hospital & Medical Single-trip Plans are payable when:
a) the entire trip is cancelled prior to the effective date; or
b) you return to your province or territory of residence prior to the expiry date.
There will be no refund of premium if a claim has been made.
Multi-trip Plans are not refundable after the effective date.
Please refer to the
Policy wording (pg. 5) for full details.
SUMMARY OF
BENFITS
The
insurer will pay up to $5 million
CAD for reasonable and customary
costs incurred unexpectedly by an insured Canadian resident
during the period of coverage.
Benefit
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Details
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EMERGENCY MEDICAL EXPENSES
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Emergency Medical Services
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Care received from a physician in or out of a hospital
as well as the cost of a hospital room (to a maximum of
semi-private rates).
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Medical Appliances
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When approved in advance
by the insurer. The rental or purchase (whichever is less) of a wheelchair,
brace, crutch or other medical
appliance. |
Diagnostic Services
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Laboratory tests and
x-rays prescribed by the
attending physician due to an emergency. Note: This
policy does not cover magnetic
resonance imaging (MRI), cardiac catheterization, computerized axial tomography
(CAT) scans, sonograms, ultrasounds and biopsies unless such services
are approved in advance by the insurer.
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Prescription Drugs
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Limited to a 30-day supply per
prescription, unless you are hospitalized.
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Paramedical Services
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The services of a licensed
chiropractor, osteopath, physiotherapist or podiatrist
up to $500 per profession. |
Ambulance
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Local ground ambulance service to a medical service provider in an emergency. |
Emergency Dental
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Up to $3,000 emergency treatment in the case of accidental blow to
face and up to $500 for
the immediate relief of dental pain. |
Emergency Transportation
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Transportation to the nearest appropriate medical
facility or to a Canadian hospital due to a covered
emergency sickness or injury. |
Private Duty Nurse
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When approved in advance by
the insurer, the services of a registered nurse, other
than a relative, up to a maximum benefit of $5,000.
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EMERGENCY ASSISTANCE
SERVICES
All Emergency Assistance Services
Must be pre-approved by the Assistance Centre
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Expenses to return children under your care
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Up
to the cost of a one-way economy airfare to transport
your children or grandchildren to their original point
of departure if you are admitted to the hospital for
more than 24 hours or must be medically repatriated due
to an emergency
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Expenses to return your vehicle
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Up to $5,0000
for the return of the vehicle to your home in your
province/territory of residence or the nearest
appropriate rental agency.
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Emergency Evacuation and
Repatriation
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-
Air ambulance to the nearest appropriate medical
facility or to a Canadian hospital for medical
treatment;
-
Transport on a licensed airline with an attendant (when
required) for emergency return to your
province/territory of residence for immediate medical
attention;
- The fare for
additional airline seats to accommodate a stretcher on a
commercial flight;
- When required, the
return economy class/charter fare of a qualified medical
attendant and the attendant’s reasonable fees and
expenses;
- Up to the cost of a one-way economy airfare to return
your travel companion to your province/territory of
residence;
- Up to $5,000 for search and rescue should you be
stranded in a mountainous area, the sea or other similar
location.
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Return
to Original Trip Destination
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Up to a maximum of $2,500 for a one-way economy
flight to return you and one insured travel companion to
your original trip destination, if
you are returned to your province/territory of residence
under the Emergency Evacuation and Repatriation
benefit, and the attending physician
determines that the treatment received in Canada
resolved the emergency. The return must occur during the
original period of coverage.
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Subsistence Allowance
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If an emergency prevents you or your
travel companion from returning to your
province/territory of residence as
originally planned or if your emergency
medical treatment or that of your travel
companion requires your transfer to a
location that is different from your
original destination, we will reimburse
expenses for meals, hotel, phone calls
and taxis, up to $150 per day to a
maximum of $1,500.
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Expenses Related to your Death
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Reimbursement of
your estate for the transportation costs to
return your body home to your province/territory of
residence (using customary airline procedures), plus:
- up to $10,000
for the preparation of your body and the cost of the
transportation container; or
- up to $ 4,000
to cremate your body at the place of death;
- up to $10,000
for the preparation of your body and for your burial at
the place of death; and
- up to
$1,000 for the cost of a one-way economy airfare to
return your travel companion to your province/territory
of residence.
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Other Benefits
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Bedside Companion Travel and
Subsistence, Pet Return, Identity Fraud
Recovery, Hospital Allowance
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Automatic Extension of
Coverage
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Coverage will be automatically
extended during the period of hospitalization, plus 72
hours after release to travel home, if you are
hospitalized at the end of your trip as a result of a
covered injury or sickness.
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This is a
summary of the benefits. Please read the
Policy
wording
before purchasing the policy for more details on the coverage
provided, conditions, exclusions and claim procedure.
Exclusions
and limitations.
Travel medical insurance does not cover everything. This
insurance has exclusions, conditions and limitations.
Please learn them and understand the policy before you buy this
insurance.
Pre-Existing Medical Condition
Coverage
Please click on
Pre-Existing Medical Condition for details on this exclusion. Depending on your answers
on the medical questionnaire,
you may qualify for one of four plans, which have
different automatic stability periods for
pre-existing medical conditions. Depending on the
plan, benefits are not payable for costs incurred
due to or resulting from your medical condition or
related condition, other than a minor ailment that was not stable
at any time during the 90, 180, or 365 days immediately
before the effective date.
Reduced
Stability Period Option
If you selected the
Reduced Stability Period Option,
coverage is limited to $150,000 for eligible expenses incurred
due to or resulting from your medical condition or related
condition, other than a minor condition, that was stable for more than 30,
or 90, or 180 days (depending on the plan you qualify for)
but less than an automatic stability period
for this this plan. You can complete the
Destination medical questionnaire, calculate your points and
see what stability periods are available for you.
Some other exclusions:
Benefits are not payable
for cost incurred:
● Due to traveling against the advice of a physician
or notice of a terminal illness has been given<;
● For ongoing or follow-up treatment,
rehabilitative care, or the recurrence of a medical condition or
related condition once the emergency is declared over by the
attending physician;
● Due to any medical
treatment that is non-emergency,
elective or the consequence of a prior elective procedure;
● Resulting from a motor vehicle accident where you are
entitled to receive benefits pursuant to any policy or
legislative plan of motor vehicle insurance except when such
benefits are exhausted;
● Due to your engagement in manual labour for
wages or profit including the operation of transport vehicles;
performing employment duties on any aircraft or ship; performing
duties in any regular armed forces service;
● For any loss incurred in a city,
region, or country when, prior to the effective date, the
Department of Foreign Affairs and International Trade of the
Canadian Government issued a written warning to avoid all
travel, or to avoid non-essential travel, to that city, region,
or country.
Please refer to the
Policy wording (pg.3) for a full list of exclusions.
NOTE: The product-related information is for illustration purposes
only. For complete benefits, terms, conditions, limitations and
exclusions, please refer to the policy wording.
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If
you have questions about this coverage, or want to make changes
to your existing policy or to purchase the policy, please, call
Natalia at 416-493-0101, 1-877-443-0101 or click here to
ask your question online.
What to do if you get sick or injured.
Have your policy confirmation with you at
all times. In the event of sickness or injury which may result
in claim, please contact the Assistance Centre
at the telephone numbers shown on your Letter
of confirmation and the
Policy wording (pg.1). When contacting the
Assistance Centre, please provide your name, your policy number,
your location and the nature of your emergency.
To apply for benefits under this policy, you will need to send a
completed claim form (with all original bills attached) to
the insurer. Consult the claim
guideline on the
Policy wording (pg. 7).
Important Notice regarding claim procedure !
You must notify
the Assistance Centre at +1(519) 945-1068 (collect) or
1-833-886-1068 within 24 hours of any emergency medical
treatment. Failure to do so will
result in your being responsible for 20% of any eligible
expenses incurred unless your emergency prevents
you from calling. You must call as soon as medically
possible or have someone call on your behalf. If you or someone
on your behalf does not call
the Assistance Centre prior to the
arrangement of an Emergency Assistance Service (as stated in
Part 3 - Benefits), no benefit is
payable.
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