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HMC Travel Medical Insurance
Outside of Canada
Underwritten by The Empire
Life Insurance Company
Administered by TruStone
Health, a division of TruStone Financial Inc.
Emergency Assistance & Claims
by Trident Global Assistance
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Health Medical Care (HMC) Travel
insurance offers four Emergency Medical Care plans. You can
choose from the following options.
No coverage for pre-existing medical conditions
• HMC Premier Travel no pre-ex:
$5,000,000 coverage.
• HMC Value Travel no
pre-ex:
$2,000,000 coverage.
For both
plans: No medical questionnaire required. Savings
for travel outside USA & Mexico available for singe and annual
multi-trip plans.
Coverage for
stable pre-existing medical conditions included
• HMC Premier Travel with
pre-ex:
$5,000,000 coverage.
• HMC Value Travel
with pre-ex:
$2,000,000 coverage.
For both
plans:
Medical questionnaire is required. Savings for travel
outside USA & Mexico available for singe and annual multi-trip
plans.
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What
coverage you will get
Eligibility
To be eligible for coverage under this policy,
you must meet the Eligibility Requirements set out below on the
Effective Date of the policy.
You are NOT
eligible for coverage if:
1. You are experiencing
new or undiagnosed signs or symptoms of a
Sickness for which they reasonably expect may
require Treatment while the contract is in
force, or otherwise have a reasonably
foreseeable need for Treatment while the
contract is in force;
2. In
the 12 months prior to the
effective date you have:
i. Received a diagnosis
of Stage 3 or Stage
4 cancer, had cancer
that has
metastasized or
received Treatment
for pancreatic
cancer or liver
cancer;
ii. Received a Terminal
Prognosis or Amyotrophic Lateral
Sclerosis (ALS, Lou Gehrig's
disease);
iii. Been prescribed
home oxygen (including an oxygen
concentrator) or prednisone for
a Lung Condition or Heart
Condition;
iv. Had Pulmonary
Fibrosis, Cystic Fibrosis, or
Interstitial lung disease;
v. Been diagnosed with
or received Treatment for Stage
IV or Stage V Kidney disease,
kidney disease requiring
dialysis, or Cirrhosis of the
liver;
vi. Used nitroglycerine
in any form (spray, patch, or
pill) for a Heart Condition for
the relief of angina or chest
pain or had Cardiomyopathy with
a Grade IV ventricle or a
ventricular ejection fraction of
40% or less;
vii. Had a dilation
of the aorta or an aneurysm that
has not been surgically
repaired;
viii. Been a resident
in a long-term care facility or
an assisted living facility
where You were helped with any
activities of daily living
(bathing, eating, using a
toilet, taking Medication(s) or
getting into or out of a chair
or bed);
ix. Been advised by any
Physician that traveling on Your
trip would be medically unsafe
or that You should not travel on
Your trip;
3. In the 3 years prior
to the Effective Date, You have
received Treatment for aplastic
anemia, hemolytic anemia, sickle
cell anemia, or anemia requiring
blood transfusions or bone
marrow transplants, or have
received Treatment in a Hospital
for anemia through iron
supplements;
4. You have received
Treatment for or taken Medication for Congestive Heart Failure (CHF)
in the past 5 years;
5. You have undergone a
bone marrow transplant, stem cell transplant or an organ transplant
(except for a cornea transplant).
Single-Trip Plan provides
coverage between your departure date from your province of residence
and the date when you return to your home province (including
departure and return dates). This policy can top up coverage for
other travel insurance contracts.
Multi-Trip Annual Plans
If you take two or more trips
each year, you can purchase a Multi-trip annual plan for an
unlimited number of trips taken during one year. Coverage for
each separate trip commences and becomes effective immediately
upon your departure from your province of residence and the
duration of each trip does not exceed the Coverage Period that
is the number of days per trip chosen at the time of purchase
this insurance).
The Coverage Period for a
subsequent trip cannot begin
unless the Person Insured has
returned home for a period
of 24 hours or longer and the
contract is in force.
The Annual Multi-trip policy cannot be used
to top-up coverage from another travel insurance contract.
You can consider 8, 16, 32, 62
days per trip. Proof showing the duration of the trip will be
required when processing a claim.
Age
must be at least 15 days old and
less than 95 years old on the departure date.
Deductibles
The following deductible options are available for
Single-Trip and Multi-Trip Emergency Medical Care plans:
$50, $250, $500, $1,000, $2,500, $5,000, $10,000 USD.
Extension
Coverage
under this contract may be
extended:
• If the covered
persons remains eligible for insurance;
• If the insured's
health condition remains unchanged since the departure date;
• No claim is submitted or payable under the contract;
• The contract holder
must request extension at least 10 days prior to the original termination
date.
Automatic Extensions to Coverage
The contract will automatically be extended for
the periods indicated below, without any
additional premium, if, on or immediately prior
to the coverage termination date:
• A Person Insured
becomes Hospitalized, for the duration of the Hospitalization
and up to 72 hours following the conclusion of the Emergency;
or;
• A Person Insured’s
scheduled commercial common carrier experiences delays due to
extreme weather conditions or mechanical failures, for a period
up to 72 hours following resolution of such delays
It is essential to notify
Trident Global Assistance immediately of such occurrences and
provide documented proof of such occurrences.
Refunds
Full refund: A full refund of the initial premium and fees paid
is available if you return the contract for cancellation within 10 days after
you receive it, pursuant to the “10 Day Free Look”.
Partial refund: If you have purchased a Single Trip Coverage,
you may cancel the contract and receive a refund of
prepaid premiums if the following conditions are met:
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The Person Insured either did not commence their trip or returned
before the policy termination date;
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No claims exceeding the Deductible(s) have been filed, paid, or are
pending; and
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The refund request is made before the contract termination date, and the
contract has not otherwise terminated.
A $25
administration fee applies for
cancellations (if not within 10
days after receiving your
contract).
Refunds and cancellations are not available for Annual Multi-Trip policies.
EMERGENCY
MEDICAL CARE
BENEFITS & SERVICES
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Key Benefits
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WHAT IS COVERED? |
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Coverage Limits
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Reasonable and customary charges, subject to a maximum
of $5,000,000 (Premier plan) or $2,000,000 (Value
plan). .If a Person Insured is not covered by a
Government Health Insurance Plan, the maximum coverage
limit they are eligible for is $200,000.
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EMERGENCY MEDICAL SERVICES both in and out of
Hospital, that are Medically Necessary for Emergency
Treatment |
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Emergency Medical Expenses
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▪
Care provided
by a Physician;
▪
Hospital room expenses, up to the
cost of semi-private rates;
▪
Diagnostic tests required for
obtaining a diagnosis from a
Physician;
▪
Medication(s)
prescribed by a Physician for the
Treatment of the Person Insured’s
Sickness or Injury;
▪
Removal of stitches or a cast (up to
a maximum of $300 per Emergency,
provided the removal is carried out
within 60 days of the date of claim
submission); and
▪ The rental
or purchase of medical equipment
such as Hospital beds, wheelchairs,
braces, crutches, or other necessary
medical appliances, with the lower
cost option being covered.
The
following procedures require the
insurer's prior approval:
(i) Surgical
procedures;
ii) Diagnostic tests such as
magnetic resonance imaging (MRI),
computerized axial tomography (CAT),
biopsy and other diagnostic tests;
and
(iii) Cardiac
or heart-related medical procedures,
such as cardiac catheterization,
coronary artery bypass surgery,
coronary angioplasty, or any
surgical interventions involving the
heart.
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Emergency Ambulance Services
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(i) The cost of local ground
ambulance services, and/or
(ii)
The cost of air ambulance services,
for transportation to a medical
service provider as a result of an
Emergency.
Approval
from the Medical Director is
required for transportation by air
ambulance.
Benefit
maximum is $4,000
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Emergency Dental Treatment Due
to Injury to the Mouth
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Dental
Treatment to repair or replace
intact natural teeth or permanently
attached artificial teeth due to an
Injury to the mouth, provided such
Treatment is completed within 30
days following the Injury. Benefit
maximum: $2,000.
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In Hospital Private Duty Nursing
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The cost of care received in a
Hospital from a private registered
nurse, provided the care:
((i) is a result of an Emergency;
(ii) has been approved by a
Physician; and
(iii) has been approved in advance
by the Medical Director
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Emergency Paramedical Services
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The cost of care received from
acupuncturists, chiropractors,
osteopaths, physiotherapists, or
podiatrists, when referred by a
Physician as a result of an
Emergency.
Benefit maximum: $250 per category
of practitioner. |
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EMERGENCY ASSISTANCE SERVICES
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Emergency Return Home
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If it is necessary for the Person
Insured’s Emergency Treatment to
continue in another Hospital or
return or transfer to their Canadian
province or territory of residence,
one or more of the following
expenses as arranged or authorized
by the insuer in advance, using the
most cost-effective itinerary:
(i) The cost of an economy class or
charter fare;
(ii) A stretcher fare on a
commercial flight;
(iii) The return economy class or
charter fare for a qualified medical
attendant, as well as the
attendant's reasonable fees and
expenses if deemed necessary by the
airline;
(iv) The cost of a jet or
propeller-powered air ambulance;
and/or
(v) The extra fare for a Travel
Companion to accompany You.
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Expenses Related to Death
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Expenses related to the preparation
or transportation of their body back
to their principal residence.
Benefit maximum is $5,000.
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Bedside Companion
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If a Person Insured is traveling
alone and Hospitalized for an
Emergency for a period of 3 days or
longer, the following expenses:
(i) Economy class or charter fare
for someone to be with the Person
Insured; and
(ii) Cost of meals and
accommodation for such person.
Benefit maximum is $300.
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Return of Dependents
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In the event a Person Insured is
Hospitalized for an Emergency for a
duration exceeding 24 hours:
(i)
the transportation costs for a
Dependent to return to their
original departure point, and
(ii) if the airline mandates it, the
transportation costs for a qualified
escort to and from the Dependent’s
original departure point, using the
most cost-effective itinerary.
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Return of Vehicle
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In the event a Person Insured is
unable to drive their vehicle back
to their original departure point
due to an Emergency, the reasonable
costs for returning the vehicle back
to the original departure point,
provided the following conditions
are met:
(i)
a Person Insured reports this
Emergency to Trident Global
Assistance within 24 hours of
receiving Treatment;
(ii) the vehicle is returned within
30 days from the first day of the
Emergency;
(iii) the vehicle is returned to the
original departure point by a driver
employed by a professional vehicle
return company; and
iv) An invoice is obtained from the
professional vehicle return company
for the driver’s services.
Benefit maximum is $2,500. |
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Subsistence Allowance
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In the event of an Emergency that
prevents a Person Insured or Travel
Companion from returning to the
point of departure or requires a
transfer to another location, some
expenses, including meals, hotel
accommodations, phone calls, and
taxi fares, but excluding other
forms of public transportation and
internet or cellular services.
Benefit maximum: $150 per day, up to
a maximum of $1,500.
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Return Home Due to Major
Event
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In the event of the occurrence of
one of the following major events
during the Coverage Period,
reasonable transportation expenses
in relation to such major event as
specified below:
(i)
A
Person Insured or a Travel Companion
has been hospitalized for a minimum
of 7 consecutive days and, upon
discharge from the Hospital with
medical evidence that the Person
Insured is unable to drive back;
death of a Relative in Canada;
(ii)
Hospitalization
of a Relative for a minimum of 7
consecutive days in Canada;
(iii)
A
disaster has rendered the Person
Insured’s principal residence in
Canada uninhabitable; or
(iv)
A disaster has made the Person
Insured’s land-based residence at
their Trip destination uninhabitable
(including trailers and motorhomes).
Some conditions apply.
Benefit maximum is $3,000.
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EXCLUSIONS AND LIMITATIONS
Travel medical insurance does not cover everything. This
insurance has exclusions, conditions and limitations. Please
read them and understand the policy before you buy this
insurance.
Coverage for Pre-Existing Medical Conditions (Premier Plan)
Pre-Existing Condition(s) means a medical or physical condition,
symptom, illness, or disease, whether diagnosed or not, for which Treatment has been
received or taken, or for which a Person Insured exhibited signs or symptoms, at any time before the Effective Date.
To qualify for coverage for Pre-Existing Conditions,
a Person Insured must fully and truthfully answer the questions in the medical questionnaire
in the Application including disclosing all Pre-Existing Conditions, and
the Person Insured’s health must not change and must remain Stable between the Application Date and the Effective Date.
If a Person Insured’s health changes or does not remain Stable between the Application Date and the Effective Date,
or if, as of the Effective Date, the Person Insured’s responses to the questions
in the Application are no longer accurate or complete for any reason, you
should contact your broker.
The Company may void the contract, based on misrepresentations or omissions
of information material to the insurance in
your or the Person Insured’s responses to the questions in the Application.
Pre-existing Medical condition Exclusion
The contract will not provide any coverage, and no payments will be issued for any
expenses that result from any Pre-Existing Condition that was not
Stable at any time during
the 180 days immediately before the Effective Date.
STABLE means a pre-existing
medical condition that has remained unchanged
for several months prior to the effective date
of insurance or is not deteriorating. This includes:.
(i) no alteration in signs or symptoms or the appearance of new signs or symptoms;
(ii) no reduction, increase, or discontinuation of Medication dosage or frequency;
(iii) no new Medications prescribed;
(iv) no Hospitalization or need for medical consultation (except routine examinations); and/or
(v) no prescription, receipt, or recommendation of any medical, therapeutic,
or diagnostic procedure by a Physician, including investigative testing or surgery.
Please
review
Other Exclusions.
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NOTE: The product-related information is for illustration
purpose only. Please refer to the Policy wording for details on
the coverage provided, conditions, exclusions, limitations and
claim procedure.
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If
you have questions about this insurance coverage, or need help
to complete the online application, or you want to purchase a
policy, please, please call at
416-493-0101 or 1-877-443-0101 or
click here to ask
your question Online.
What To Do in a Medical Emergency
24/7
EMERGENCY ASSISTANCE
For Medical Emergencies,
Assistance and General Inquiries regarding your travel
insurance, please call Trident Global Assistance
at:
Canada, United States:
Toll-Free 1-833-370-8777
International Collect:
416-814-7615 (from any other country)
If it is not medically possible for you to call, please
have someone call on your behalf. Failure to contact
Trident Global Assistance within the first 24 hours of a
hospitalization or Emergency room or medical clinic
visit for an Emergency may result in a reduction in
benefits under the contract.
Settlement of Claims
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