 |
Allianz Global Assistance
Visitors to Canada Insurance
|
Underwritten by CUMIS General
Insurance Company, a member of
the Co-operators group of
companies, and administered by
Allianz Global Assistance (AGA).
Who can apply?
Allianz Visitors to Canada insurance policy is designed for :
● Visitors to Canada,
● Landed immigrants
or returning Canadians waiting for Government Health
Insurance Plan coverage,
● Super Visa applicants, parent or grandparents visiting Canada on Super Visa.
For
assistance and to buy a policy
over-the-phone, please
call at
1-877-443-0101 416-493-0101
|
|
 What
coverage will you have?
Eligibility.
Coverage is NOT AVAILABLE to any individual who:
a) has been
diagnosed with a terminal illness; or
b) has been
diagnosed with stage 3 or 4 cancer; or
c) has
received treatment for any cancer (other than basal or
squamous cell skin cancer or breast cancer treated only with
hormone therapy) in the past 3 months; or
d) requires assistance with activities of daily living as the
result of a medical condition or state of health.
To be eligible for this policy you must,
as of the effective date:
● be at least
15 days old and not more than 89 years old; and
● not be
insured or eligible for benefits under a Canadian government
health insurance plan; and
● be in good health at the time you
purchase your policy and on the date you exit your country
of origin, and know of no reason to seek medical
consultation during the period of coverage.
Amount of coverage
The maximum amount payable is based on the plan you have purchased.
The amounts of coverage available : $25,000, $50,000, $100,000, $150,000, $300,000, $500,000CAD.
Deductibles
This insurance can be purchased with $0 deductible or $500 deductible.
Effective date
of the policy means the later of
:
- the date indicated as the effective date
on your confirmation of coverage; OR
- the
first time you exit your country of origin.
Expiry date
means the earlier of:
- the date
indicated as the expiry date on your confirmation of coverage;
OR
- the date you
become eligible for coverage under a Canadian government health
insurance plan.
Waiting period
Coverage for losses resulting from any
sickness will begin 48 hours after the effective date, if
you purchase your policy after you exit your country of origin,
or after the expiry date of an existing
Allianz Global Assistance policy.
Any sickness that manifests itself during the 48-hour waiting
period is not covered even if related expenses are incurred
after the 48-hour waiting period.
Family plan
is available. Family
includes the applicant, age
59
and under, the applicant's
spouse, age
59
and under, and dependent
children.
Dependent children means
your unmarried children who
are financially dependent on
you; and at least 15 days of
age and no more than 21
years of age.
The premium for family
coverage is calculated at
two times the premium for
the eldest adult age
59 and under.
Travel worldwide
Costs incurred
outside of Canada are covered provided majority
of the period of coverage is spent in Canada.
Costs incurred in your country of origin are not
covered.
Refunds
- The entire trip is cancelled prior to the
effective date.
- You return to
your country of origin prior to the expiry date, without intending to return to
Canada. Refunds are not payable for time spent in your country of origin between visits to
Canada.
- You become insured under a Canadian provincial or
territorial health/medical plan.
There will be no refund of premium if a
claim has been made.
Extending your trip
If you decide to extend you
trip, you may apply for a new period of coverage provided you
meet eligibility requirements. Each policy or period of coverage
is considered a separate contract and all limitations and
exclusions will apply.
MEDICAL AND HOSPITAL BENEFITS
|
Benefits
|
Details
|
|
EMERGENCY HOSPITAL
|
Up to the maximum aggregate limit
selected at the time of application,
including semi-private hospital accommodation and for reasonable and customary
services and supplies necessary for your emergency care
during confinement as a resident in-patient. |
|
EMERGENCY MEDICAL
Emergency means a sudden, unforeseen sickness or injury occurring
during the period of coverage, which requires immediate intervention
by a physician or legally licensed dentist and cannot reasonably be
delayed.
|
a) The emergency services of a
legally licensed physician, surgeon, or anaesthetist.
b) Follow-up visits as prescribed by
the attending physician at the time of the emergency.
c) Diagnostics, lab tests and/or
X-ray examinations as ordered by a physician for the
purpose of diagnosis.
d) The services of the following
legally licensed practitioners for treatment of a
covered sickness or injury: chiropractor,
steopath, podiatrist/chiropodist,
physiotherapist, when ordered by the attending physician; acupuncturist.
Not to exceed $500 per
profession.
e) Private duty services of a
Registered Nurse when approved in advance by AGA.
Not to exceed $10,000.
f) The use of a licensed local air,
land, or sea ambulance (including mountain or sea
evacuation) to the nearest hospital, when reasonable and
necessary.
g) Rental of crutches or
hospital-type bed, not exceeding the purchase price; and
the cost of splints, trusses, braces or other approved
prosthetic appliances approved in advance by AGA.
h) Emergency out-patient services
provided by a hospital.
i) When not hospitalized as an
in-patient, drugs or medications that require a
physician’s written
prescription, not exceeding a 30-day
supply, to a maximum of $1,000.
|
|
EMERGENCY TRANSPORTATION
|
When necessary transportation to
your country of origin when immediate medical
consultation is required due to a covered emergency
sickness or injury. Any emergency transportation such as
air ambulance, one-way economy airfare, stretcher and/or
a medical attendant must be pre-approved and arranged by
AGA.
|
|
TRANSPORTATION OF FAMILY OR FRIEND
|
Up to $3,000 for
round-trip economy class transportation by the most
direct route, and up to $1,000 for reasonable costs
incurred after arrival by your family member or close
friend if you are hospitalized. |
|
EMERGENCY RETURN HOME FOR YOU AND ONE
FAMILY MEMBER
|
Up to $3,000 for additional cost of
one-way economy transportation by the most direct route
for you and one insured family member to your country of
origin when approved and arranged by Allianz Global Assistance (AGA).
Your coverage under this policy ceases once you have
been returned to your country of origin under this
benefit. |
|
DENTAL
|
Accidental Dental: Up to $4,000
for repair or replacement of whole or sound natural
teeth caused by an accidental blow to the face.
Dental Emergencies: Up to
$500 for the immediate relief of acute dental pain,
other than provided under Accidental Dental.
Treatment relating to any dental
claim must begin within 48 hours after the onset of the
emergency and must be completed within the period of
coverage and prior to your return to your country of
origin.
|
|
RETURN OF DECEASED
(REPATRIATION)
|
In the event of death, up
to $10,000 is provided to return your body home, or up
to $4,000 for cremation or burial at the place of death.
|
|
OUT-OF-POCKET EXPENSES
|
Reimbursement of up to
$150 per day to a maximum of $1,500 or up to a maximum
10 days in the event you (or your insured travelling
companion) are confined to hospital on the date on which
you are scheduled to return home. |
|
ACCIDENTAL DEATH & DISMEMBERMENT
|
Up to the aggregate limit
selected at the time of application for accidental loss
of life, limb, or sight. |
|
ACT OF TERRORISM
|
If you sustain a loss from
an act of terrorism that is otherwise covered under this
plan, AGA will pay up to an
aggregate limit of $2.5 million for one or a series of
such acts and up to $5 million for all such acts in a
calendar year involving all AGA-issued policies
including this policy. Terrorism from nuclear,
biological or chemical means is excluded. |
Exclusions.
Visitors to Canada
medical insurance does not cover everything.
This insurance has exclusions, conditions and
limitations.
Pre-Existing Medical
Condition Exclusion
Stability period
a) If you
are 59 years of age or under
on the effective date:
Benefits are not payable for costs incurred due to
or resulting from your medical condition or related
condition that was not stable at any time during the
90 days immediately before the effective date.
b) If you are 60 to 89 years of age on the effective date:
Benefits are not payable for costs incurred due to or
resulting from your pre-existing medical condition or
related condition that was not stable at any time during
the 180 days immediately before the effective date.
STABLE describes any medical condition or related condition,
including any heart condition or lung condition, for which:
a) there has been no new treatment; and
b) there has been no change in treatment or change in
treatment frequency or type; and
c) there have been no signs or symptoms or new
diagnosis; and
d) there have been no test results showing deterioration;
and
e) there has been no hospitalization; and
f) there has been no referral to a specialist (made or
recommended) and you are not awaiting surgery or
the results of further investigations performed by any
medical professional.
The following are considered STABLE:
a) Routine (not prescribed by a physician) adjustment
of insulin to control diabetes provided the insulin was
not first prescribed during the stability period.
b) Change from a brand name medication to a generic
medication provided the medication was not first
prescribed during the stability period and there is no
increase or decrease in dosage.
c) A minor ailment, which describes a sickness or injury
during the stability period which ended more than
30 days prior to the effective date and which did not
require:
i. treatment for a period longer than 15 consecutive
days; or
ii. more than one follow-up visit to a physician; or
iii. hospitalization, surgery, or referral to a specialist.
The following conditions are not considered stable:
a) any lung condition for which you were prescribed or
are taking prednisone;
b) any heart condition for which you were prescribed or
are taking nitroglycerin.
Terminal applies to a medical condition
Some Other
Exclusions
Benefits are not payable for costs incurred due
to
- any treatment,
investigation or hospitalization which is a
continuation of, or subsequent to, emergency treatment of a sickness or injury,
unless approved in advance by AGA.
- pregnancy,
abortion, miscarriage, childbirth or complications thereof.
- loss, death or injury,
if at the time of the loss, death or injury,
evidence supports that the medical condition causing the
loss was in any way contributed to by:
a) your intoxication or abuse of alcohol; or
b) your use of prohibited drugs, or any other intoxicant; or
c) your non-compliance with prescribed treatment
or medical therapy; or
d) your misuse of medication.
- injury resulting from training for or participating in:
a) motorized speed contests; or
b) stunt activities; or
c) professional sport activities; or
d) high-risk activities.
- sickness or injury
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.
- your travelling against the advice of a physician or any loss
resulting from your sickness or medical condition that was
diagnosed by a physician as terminal prior to the effective
date of this policy.
- any
treatment which can be reasonably delayed until you return
to your country of origin (whether or not you intend to
return) by the next available means of transportation, unless
approved in advance by AGA.
- any
medical consultation that is non-emergency, on-going,
elective
or the consequence of a prior elective procedure.
- hospitalization or
services rendered in connection
with general health examinations for check-up purposes,
treatment of an on-going condition, regular care of a
chronic condition, home health care, investigative testing,
rehabilitation, or on-going care or treatment in connection
with drugs, alcohol or any other substance abuse.
Please refer to the
policy wording for a full list of exclusions
and limitations.
Note: The product-related
information is for illustration purpose only. For
the full details of coverage, eligibility, exclusions, limitations
and claims procedures, please refer to the
Policy Wording.
 |
If
you have questions about this insurance coverage, or need help
to complete the application, or want to buy insurance over the
phone, please call at 416-493-0101
or
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 call Allianz Global Assistance at the telephone numbers
shown on your policy confirmation and the Policy Wording (pg. 2). 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 Allianz Global
Assistance. Consult the claim guideline on the
Policy Wording (pg.23).
Important Notice regarding claim procedure !
You, or someone on your behalf, must notify
Allianz Global Assistance prior to any surgery being
performed or within 24 hours of admission to a hospital. Failure
to do so, without reasonable cause, will result in the reduction
of eligible benefit amounts payable by 20%.
|
|
|
