Microsoft Word - CCGG English DR.docServices provided by CORIS, represented by COREMAX ASISTENCIA INTERNACIONAL, SRL with offices at Av. John F. Kennedy # 604, 6th Floor, Suite 6-I-1. Ensanche Paraiso, Santo Domingo. Dominican Republic. Effective as of March 1, 2011. PROCEDURES TO REQUEST ASSISTANCE To request assistance services, the CARD HOLDER must first contact the PROVIDER’s Alarm Center by phone to the numbers appearing on his CARD FOR CALLS, stating his name, the number, term and validity of his CARD or VOUCHER, the place where he is and the reasons for assistance request. As from the first assistance or services provided, the CARD HOLDER must always contact the PROVIDER’s Alarm Center in order to obtain authorization for new assistance or supplementary services, even when they derive from the same cause that gave rise to the first assistance and it has been authorized to obtain reimbursable services. GENERAL PROVISIONS and DEFINITIONS CLAUSE I. SOLE AGREEMENT: This Travel Assistance Agreement is supplemented by the General Conditions of the ASSISTANCE PLAN as well as the CARD or VOUCHER and the CARD FOR CALLS, all of which constitute one single and SOLE AGREEMENT. A) These General Conditions govern the provision of travel assistance services by the PROVIDER and which are outlined in the CARD or VOUCHER, during the trips made by the CARD HOLDER. The CARD HOLDER acknowledges that he has chosen the ASSISTANCE PLAN of his COMPANY of preference and that he has read all terms, conditions, scopes and limitations of the assistance services under these General Conditions. B) Assistance services rendered in unforeseen emergency situations that take place abroad or nationally, except for the usual city of residence of the CARD HOLDER and depending on the type of product purchased, will not be considered services under a medical insurance policy or an extension of prepaid medicine programs and are in no way aimed at providing preventive care or definite treatment. C) In order to be fully aware of the assistance system and the many services we provide to our customers, we recommend a thorough reading of the instructions for the proper use of the services, guarantees and limitations of the ASSISTANCE PLAN purchased by the CARD HOLDER, which are clearly outlined in the CARD or VOUCHER. D) As this is a services agreement exclusively directed towards providing assistance in emergency situations that prevent the normal continuation of a trip, once the medical situation affecting the CARD HOLDER has been resolved in such a manner as it allows the repatriation of the CARD HOLDER for medical treatment, if necessary, the CARD HOLDER will be offered to be repatriated or
transferred to the airport of entrance to his country of usual residence. If the CARD HOLDER refuses to do so, he will lose the rights or benefits under these general conditions. All subsequent expenses incurred in connection with his treatment in the country of origin shall be borne by the CARD HOLDER, or charged to his health insurance taken from third parties, personal funds or any health service purchased. E) Events and Expenses Not Included: When an illness is excluded under the GENERAL EXCLUSIONS clause, the PROVIDER will only take charge of the expenses up to the amount specified in the CARD or VOUCHER and the ASSISTANCE PLAN under “Medical Assistance for Pre-existing Conditions”. The PROVIDER will not will not pay for any tests seeking to evaluate the medical condition of a pre-existing condition and/or to rule out its relation with the current condition giving rise to the need of assistance. Upon verifying that the reason for travelling abroad was to treat a basic pre-existing condition, and that the current treatment has some direct or indirect connection with the preexisting disease, the PROVIDER will be exempt from rendering services to the CARD HOLDER. To such end, the PROVIDER reserves the right to investigate the connection of the current fact with the pre-existing disease. CLAUSE II: DEFINITIONS: For all purposes of this Travel Assistance Agreement, the following terms, either in plural or singular, regardless of gender and of tense, in the case of verbs, will have the meaning ascribed below. If in capital letters, the following terms as used herein will have the following meanings. A) ACCIDENT: The event resulting in bodily injury suffered by the CARD HOLDER caused by foreign agents, out of control, external, violent and visible, as well as any injuries or pain directly caused by such agents and independent of any other cause. B) CATASTROPHE: Any accidental or unforeseen event affecting many VOUCHER or CARD HOLDERS. C) ALARM CENTER: Group of health care professionals who, providing supervision, control and/or coordination services for the PROVIDER, intervene and decide in all those matters and/or services rendered or to be rendered according to these General Conditions and directly or indirectly related to medical issues. D) CARD or VOUCHER: The document to be issued at the country of Origin of the CARD HOLDER prior to his trip (except for RECEPTIVE ASSISTANCE PLANS) and submitted to the CARD HOLDER. It includes –among other details- personal information of the CARD HOLDER, the number and type of ASSISTANCE PLAN purchased, which is an integral part of the Travel Assistance Agreement, also known as the General Conditions of the assistance services purchased by the CARD HOLDER and agreed to be supplied by the PROVIDER. E) COMPANY: CORAM ADVANTAGE SRL, a company duly authorized under the Argentine laws to issue CARDS or VOUCHERS of Travel ASSISTANCE PLANS of the PROVIDER and holder of ADVANTAGE Travel Assistance and CORIS trademarks.
F) CONGENITAL: Pathology present or existing before the moment of birth. G) AILMENT and/or ILLNESS: The terms “ailment” and/or “illness” will be understood to all purposes as synonyms of “sickness” within these General Conditions. H) ACUTE ILLNESS: The short and relatively severe process of alteration of the status of the body or of any of its organs, that might interrupt or disturb the balance of vital functions, producing pain, weakness or other manifestation alien to its normal behavior. I) CHRONIC ILLNESS: Any pathological process, continuous and persisting in time. J) PRE-EXISTING CONDITION: All physio-pathogical process that recognizes an origin or etiology previous to the date of the start of validity of the CARD or VOUCHER of the ASSISTANCE PLAN purchased by the CARD HOLDER and that can be determined through complementary diagnostic methods of customary use, daily accessible and frequent in all countries of the world (including but not limited to Doppler, MRI, Angioplasty procedures, etc.) K) SUDDEN OR UNEXPECTED ILLNESS: Rapid, fortuitous, unforeseen illness appearing after the starting date of validity. L) MAXIMUM GLOBAL AMOUNT: The total sum of expenses that the PROVIDER will pay and/or reimburse in every respect and for all the services provided under these General Conditions M) DEDUCTIBLE FIXED AMOUNT: The fixed and specific amount that will be borne by the CARD HOLDER and that will be paid by him at the time the first medical assistance is provided, as obligatory initial payment for expenses arising from such assistance. N) MAXIMUM GLOBAL AMOUNT IN CASE OF MULTIPLE EVENTS: The total sum of expenses that the PROVIDER will pay and/or reimburse to all the affected CARD HOLDERS in case one single event has caused injuries or death to more than one CARD HOLDER, in every respect and for all the services provided under these General Conditions. O) ASSISTANCE PLAN: The detailed group of Travel Assistance Services offered by the PROVIDER, containing an exhaustive list of all services to be provided and the monetary, quantitative, geographical and age limitations applicable to the CARD HOLDER. The Assistance Plan is detailed in the CARD or VOUCHER and is an integral part thereof. Only those services for each product expressly enumerated in the Assistance Plan detailed in the CARD or VOUCHER will be provided, subject to the scope and limitations therein stated. For all purposes of this Agreement, only the guarantees or benefits effective as of the date of issuance of the ASSISTANCE PLAN specified in the CARD or VOUCHER purchased by the CARD HOLDER will be valid. P) PROVIDER: CORIS, the entity responsible for coordinating the provision of the travel assistances services detailed in the CARD or VOUCHER during the CARD HOLDER trip abroad or in his country, as the case may be, through its Alarm Center. Q) TRAVEL ASSISTANCE SERVICES: The services offered by the COMPANY through its PROVIDER and specified in the CARD or VOUCHER
issued by the COMPANY at the request of the CARD HOLDER and its GENERAL CONDITIONS, ASSISTANCE PLAN and CARD FOR CALLS. For all purposes of this AGREEMENT, only the guarantees or benefits effective as of the date of issuance of the ASSISTANCE PLAN and specified in the CARD or VOUCHER purchased by the CARD HOLDER will be valid. R) CARD FOR CALLS: The credential that is submitted to the CARD HOLDER prior to his trip and that contains his full name, CARD or VOUCHER number, validity and type of ASSISTANCE PLAN purchased, and telephone numbers, email addresses and any other means to contact the PROVIDER’s Alarm Center from whichever country the CARD HOLDER is. S) CARD HOLDER: The individual designated within the CARD or VOUCHER of an ASSISTANCE PLAN offered by the COMPANY as the recipient and beneficiary of the services described in this Travel Assistance Agreement. CLAUSE III.- A) HOLDER OF THE SERVICES. The assistance services will be rendered by the PROVIDER only to the CARD HOLDER and are non-transferable to third parties. The CARD HOLDER must reside in the country of origin where the CARD or VOUCHER is issued (except for RECEPTIVE ASSISTANCE PLANS). The CARD HOLDER is the individual duly designated in the CARD or VOUCHER of the ASSISTANCE PLAN purchased, including his full name and ID number. B) AGE LIMIT: The CARD HOLDER designated in the VOUCHER will be the beneficiary of the services described in the ASSISTANCE PLAN purchased. However, no indemnification will be given to persons over 75 years of age at the time the ASSISTANCE PLAN becomes effective. Under some special products available to elder people, persons over 75 and younger than 85 will be entitled to 50% coverage of all services described in the products purchased. (Detailed information specified in the Specific Guarantees of each assistance plan.) For illustration purposes, a person is 75 years until the day before his 76th birthday. C) VALIDITY: The assistance services to be provided under the ASSISTANCE PLAN and described in the CARD or VOUCHER will only and exclusively be valid during the validity period indicated. The validity of the CARD or VOUCHER will be conditioned to the existence of a valid CARD or VOUCHER number assigned by the PROVIDER, which may be verified by the CARD HOLDER by contacting the PROVIDER Alarm Center by phone before the validity starting date. The CARD or VOUCHER will be valid provided it has been irrevocably purchased by the CARD HOLDER in his country of usual residence and before the beginning of the trip; that is, it may not be purchased by the CARD HOLDER in any country but his country of residence and after the beginning of the trip. (Except for RECEPTIVE ASSISTANCE PLANS) The PROVIDER prohibits issuance of a CARD or VOUCHER whenever the CARD HOLDER is still travelling even if it is issued as an extension, national or international. The PROVIDER may request to the CARD HOLDER to furnish all supporting documentation to demonstrate this fact. The PROVIDER will be released from its obligation to provide services upon failure by the CARD HOLDER to submit this documentation.
D) CANCELLATION AND/OR MODIFICATION OF VALIDITY: Neither any change in the validity date nor the cancellation of the CARD or VOUCHER by the CARD HOLDER will be accepted under any circumstances and for no reason whatsoever once its validity has started. Requests for cancellation and/or modification of validity dates by the CARD HOLDER or any third party may only be made no less than 3 (three) business days prior to the date indicated in the CARD or VOUCHER. If accepted, the request will result in the reimbursement of the amount paid by the CARD HOLDER, less 20% that is retained, or in the issuing of a new CARD or Voucher with a new validity period for the same duration as the one cancelled. Once the period above has ended or a new period has started, the right to seek cancellation or modification of the CARD or VOUCHER automatically expires, and the CARD HOLDER will have no right to any indemnification of any type. Only if due to unexpected trip prolongation abroad, the CARD HOLDER may request the extension of the duration of the CARD or VOUCHER for the necessary number of days, subject to the following conditions: a) The CARD HOLDER may request the extension of a CARD or VOUCHER only once. b) The PROVIDER reserves the right to accept or deny the extension request for no reason. c) The CARD HOLDER must request issuance of a new CARD or VOUCHER exclusively to the agent that issued the previous card, indicating the number of days to be purchased. d) The request of issuance of a new CARD or VOUCHER must be made prior to the expiration date of the previous CARD or VOUCHER. e) The CARD HOLDER must indicate the person that will make payment at the Issuing Agent’s office and receive, in return, the new CARD or VOUCHER, which will be issued and submitted at that moment or wherever the PROVIDER deems more convenient. The PROVIDER will not be responsible for sending the new CARD or VOUCHER to the CARD HOLDER. f) The validity period of the new CARD or VOUCHER must be immediately consecutive to the one of the original CARD or VOUCHER. g) The new CARD or VOUCHER issued under the conditions described in this Clause may not be used for any reason to initiate or continue treatment and/or assistance for any problems that had occurred during the validity of the original and/or prior CARD or VOUCHER or before the validity of the new CARD or VOUCHER, regardless if the proceedings or treatments in progress have been authorized by the PROVIDER. E) VALID GEOGRAPHIC AREA / TERRITORIAL VALIDITY: Depending on the type of CARD or VOUCHER purchased, it will be exclusively valid in the geographic areas indicated. 1. WORLDWIDE, except for the Country of Residence of the CARD HOLDER. 2. SCHENGEN AREAS: (European Union countries + the United Kingdom + Switzerland), except for the Country of Residence of the CARD HOLDER. 3. REGIONAL: Bordering countries of the Country of residence of the
CARD HOLDER + NATIONAL except beyond 100 km away from the usual place of residence of the CARD HOLDER. 4. NATIONAL: The Country of residence of the CARD HOLDER except beyond 100 km away from the CARD HOLDER’s usual place of residence. The services under the ASSISTANCE PLAN valid within the Country of issuance of the CARD or VOUCHER will be provided within its territorial limits, beyond 100 km (one hundred kilometers) away from the usual place of residence of the CARD HOLDER and only when he is temporarily travelling. In all cases, assistance services provided by the PROVIDER will always and without exception be complementary and ancillary to the financial responsibility that might correspond to the social security program and/or welfare program and/or insurance coverage and/or pre-paid medical attention program that the CARD HOLDER may be a beneficiary. CARDS or VOUCHERS within the country of issuance will not be valid and no services will be rendered in the CARD HOLDER’s country of residence even within the validity of the CARD or VOUCHER, except for REGIONAL or NATIONAL ASSISTANCE PLANS. The SCHENGEN Area (European Union countries + the United Kingdom + Switzerland) coverage whenever used outside the area will have a reduction in the medical expenses guarantee under the Specific Guarantees of the product purchased, unless expressly authorized thereby. F) OBLIGATIONS OF THE CARD HOLDER: In all cases, the CARD HOLDER undertakes to: 1) Contact first by phone the PROVIDER’s Alarm Center to obtain its authorization as many times as assistance is required, before taking any action or incurring in any expenses. 2) Should it be impossible for the CARD HOLDER or any third person to contact the PROVIDER’s Alarm Center to request the above-mentioned prior authorization, the CARD HOLDER may resort to the nearest emergency medical service. In all such cases, the CARD HOLDER must report the emergency to the PROVIDER’s Alarm Center within 24 hours following the incident, under the risk of loss of future reimbursement of any expenses incurred. This communication is essential even when the emergency has been solved, as no cost for assistance services will be borne by the PROVIDER without prior communication to and authorization by the PROVIDER’s Alarm Center. 3) The PROVIDER reserves the right to record and audit any telephone conversations as may be deemed necessary for the good rendering of its services. The CARD HOLDER expressly agrees on this established procedure and on the eventual usage of these records as a proof in the event of controversies arising in connection with the assistance services provided. 4) Accept the solutions indicated by the PROVIDER’s Alarm Center. Allow the repatriation to his country of origin whenever his state of health so allows and as indicated by the medical team. 5) Grant to the intervening professionals or medical institutions
authorizations to reveal the Medical History to the PROVIDER or any of its authorized representatives, as well as all information necessary to pay all expenses arising from hospitalization and/or treatment, and also to examine all related document. The PROVIDER will not be obliged to pay any services or reimburse any expenses if the Medical History requested has not been submitted. 6) Supply all documentation necessary to justify the case, in addition to all the original receipts for expenses reimbursable by the PROVIDER as well as all medical records (including those previous to the trip) that may be necessary for the PROVIDER’s Medical Department to authorize the services or the payment of any assistance services rendered. 7) Furnish a copy of the CARD HOLDER’s passport, including the page containing his personal data and that where the seal evidencing entrance to the country of destination and from where assistance is required. 8) In those cases when the PROVIDER assumes any fare difference from the original tickets, or when the PROVIDER arranges the repatriation of the CARD HOLDER in case of serious accident or death, he must deliver to the PROVIDER all duly endorsed tickets that he may possess. 9) The CARD HOLDER irrevocably and absolutely authorizes the PROVIDER to request in his behalf any medical information to professionals either from abroad or from his country of residence, with the purpose of evaluating and eventually deciding about the applicability of the restrictions in case of chronic or pre-existing conditions or illnesses that may have arisen the assistance request. The PROVIDER will not be obliged to pay any services or reimburse any expenses if the Medical History requested has not been submitted. G) OBLIGATIONS OF THE PROVIDER. The obligations of the PROVIDER established within this Travel Assistance Agreement will only apply and be rendered in the event of an accident and/or of a sudden or unforeseen and acute illness suffered by the CARD HOLDER after the beginning of the trip and/or during the validity period of the CARD or VOUCHER, whichever is later, and up to the maximum coverage amount offered by the product purchased. H) SPECIFIC CONDITIONS ($ USD or € Euros). The services and Specific Guarantees under the ASSISTANCE PLAN purchased by the CARD HOLDER are printed on the CARD or VOUCHER submitted to the CARD HOLDER at the time of purchase and prior to the beginning of the trip, specifying as well the characteristics of the ASSISTANCE PLAN valid as of the time of purchase, the CARD HOLDER’s personal data, telephone numbers to seek assistance, the General Conditions, any exclusions and limitations, which will be denominated in US dollars ($USD) or Euros (€). This is known as the CARD or VOUCHER and, jointly with the General Conditions, they constitute the entire travel assistance agreement. I) DESCRIPTION OF ASSISTANCE SERVICES The assistance services described in this clause are the services offered by the COMPANY through its PROVIDER. Only those guarantees or benefits effective as of the date of issuance of the ASSISTANCE PLAN and which are specified
in the CARD or VOUCHER purchased by the CARD HOLDER will be valid and applicable for all effects under this AGREEMENT. No right will be exercised if the cause that gives rise to the event is included and specified in the GENERAL EXCLUSIONS. (1) AND (2) MEDICAL ASSISTANCE IN CASE OF AN ACCIDENT OR ILLNESS, INCLUDING a. Doctor consultations: medical assistance will be provided in case of an accident or acute and unforeseen illness suffered by the CARD HOLDER, always taking into account that the purpose of this agreement is not the final treatment of the CARD HOLDER but to allow the normal continuation of the trip or repatriation to the country of origin, where he may initiate treatment at his own cost and/or through his social security and/or welfare program and/or health insurance and/or pre-paid medical attention program. The PROVIDER reserves the right to decide on the most adequate treatment out of those proposed by the intervening medical team. b. Attention by specialists: medical assistance by specialists will be provided whenever prescribed and authorized by the PROVIDER’s Medical Department. c. Complementary medical examinations, follow-ups and controls: complementary medical examinations will be performed when prescribed and authorized by the PROVIDER’s Medical Department. d. Hospitalizations: When the nature of the illness or injuries so require and whenever the PROVIDER’s Medical Department so prescribes and authorizes, the CARD HOLDER will be hospitalized at the nearest Medical Center. e. Surgeries. Surgeries will be performed whenever authorized by the PROVIDER’s Medical Department in cases of emergency that urgently require such a procedure and which may not be delayed up to the return of the CARD HOLDER to his country of origin. If, at the discretion of the PROVIDER’s Medical Department and of the treating physicians, the CARD HOLDER can return to his country of origin to receive the necessary surgical treatment, the PROVIDER will arrange the return of the patient to the country of origin. The CARD HOLDER may not refuse to accept this solution or otherwise all guarantees or benefits granted under the CARD or VOUCHER will be denied. f. Intensive care and coronary unit: When the nature of the illness or injuries so require, intensive care and coronary unit treatments will be provided. These treatments must have been authorized by the PROVIDER’s Medical Department. g. Medical transfers: In case of an emergency and whenever deemed necessary by the PROVIDER, the PROVIDER will arrange the Medical Transfer of the CARD HOLDER to the nearest Medical Center in the means of transportation most adequate at the sole discretion of the PROVIDER and depending on the nature of the injuries or illness. Even in case of surgeries or treatments occurring in a situation that may be defined as an emergency, the Medical Transfer of the CARD HOLDER must be requested to and authorized by the PROVIDER’s Medical Department. Failure to comply with the above will release the PROVIDER from assuming all expenses incurred in connection with such transfer.
h. Medical repatriation: Medical repatriation means all the arrangements for the transportation of the ill or injured CARD HOLDER from where he is to the airport of entrance to his country of usual residence and where the CARD or VOUCHER was issued. Only the PROVIDER’s Medical Department may authorize the actions above. The CARD HOLDER or any relative may not carry out any of the above without the PROVIDER’s authorization. This repatriation must be authorized and justified in medical-scientific basis by the treating physician. Should the CARD HOLDER or any accompanying person decide to make a medical repatriation disregarding the opinion of the PROVIDER’s Medical Department, the PROVIDER will not be liable for such action, and the repatriation, its costs and its consequences will be at the sole risk and expense of the CARD HOLDER and/or any accompanying person. No claim for reimbursement by the PROVIDER will be valid. Whenever the PROVIDER’s Medical Department, in agreement with the treating physician, deems it necessary and recommends the Medical Repatriation of the CARD HOLDER, the repatriation of the CARD HOLDER to the airport of entrance to his country of usual residence will be performed by regular airline, in tourist class and subject to seat availability, accompanied by a doctor or nurse, if applicable, or by any such other means as the Medical Department deems more convenient. The PROVIDER will pay for any fare differences for the change of a ticket return date or the cost of a new ticket in tourist class and subject to seat availability. To such end, the CARD HOLDER must submit to the PROVIDER the return tickets duly endorse for no compensation. All expenses for this service will be charged to the Medical Assistance Expenses Limit account, indicated in the chart of services. Provided the CARD HOLDER remains hospitalized up to the date of the return trip, this assistance includes his transport by ambulance or any other means compatible with his state of health and approved by the PROVIDER’s Medical Department, from where he is hospitalized to the departure airport, as well as the support structure necessary, including stretcher, wheelchair, etc. The repatriation will always be from the location where the CARD HOLDER is ill or injured to the airport of entrance to his Country of usual residence as indicated as his domicile and where the CARD or VOUCHER must have been issued. The right to Medical Repatriation will not be recognized if the cause that gives rise to it is listed in the GENERAL EXCLUSIONS. The COVERAGE and VALIDITY PERIOD of the CARD or VOUCHER will cease to be valid as from the moment the CARD HOLDER returns to the airport of entrance to his Country of usual residence. The CARD HOLDER will be entitled to Medical Repatriation under this clause during the VALIDITY of the CARD or VOUCHER. The PROVIDER, always seeking the well-being of the CARD HOLDER, has priority in the Medical Repatriation decision. Even in case of surgeries or treatments occurring in a situation that may be
defined as an emergency, the Medical Transfer of the CARD HOLDER must be requested to and authorized by the PROVIDER’s Medical Department. Failure to comply with the above will release the PROVIDER from assuming all expenses incurred in connection with such transfer. i. Maximum Global Amount applicable for Medical Assistance due to an accident or illness in case of multiple events. Aggregate Limit per Catastrophe: The maximum global amount of the guarantees or benefits of medical assistance due to an accident or illness has an aggregate Limit per CATASTROPHE (regardless of the number of beneficiaries) per event of USD 500,000 (five thousand). This will be the total sum the PROVIDER will pay and/or reimburse all the affected CARD HOLDERS in case one single event has caused injuries or death to more than one CARD HOLDER, in every respect and for all the services as per these GENERAL CONDITIONS. (3) MEDICATIONS: The PROVIDER will pay for the cost of medications prescribed by the treating physician and approved by the PROVIDER’s Medical Department. The covered medications must be directly related to the reason for seeking medical assistance and the resulting diagnosis. All expenses incurred by the CARD HOLDER in the purchase of medicine previously authorized by the PROVIDER’s Medical Department will be reimbursed up to the limits of the guarantee or benefit and after the CARD HOLDER has returned to his country of origin, upon submission of the original receipts and medical prescription. Prescription renewals will be authorized always and when the medications are essential to the health of the CARD HOLDER. Medications purchased for treating pre-existing illness, psychological or emotional disturbances or problems will not receive reimbursement, even when the consultation has been authorized by the PROVIDER’s Medical Department. (4) EMERGENCY DENTAL TREATMENT As an exception to the other coverage for medical expenses, this benefit is not per event, but cumulative. The PROVIDER will only pay the expenses for emergency dental treatment, up to the maximum global amount specified in the Specific Guarantee of the product purchased. Dental assistance will be only limited to the treatment of pain and/or to tooth extraction. (5) TRANSFER OF A RELATIVE AND HOTEL EXPENSES In case a CARD HOLDER, travelling alone, is hospitalized abroad, and as long as the duration of the hospitalization is above five (5) calendar days, the PROVIDER will take upon the trip of one accompanying relative (parent, spouse, child or sibling –this is a limited, not-illustrative list), by paying for a tourist class airline ticket subject to seat availability, This BENEFIT will not be recognized if the reason for hospitalization is included in the EXCLUSIONS clause and if the VALIDITY period has elapsed by the time it is requested. This benefit will only be rendered if it has been handled through and authorized by the PROVIDER’s Alarm Center. Requests for reimbursement will not be accepted subsequently under any condition. In case of reimbursement of airline tickets, the amount to be reimbursed will
always be the cost of a tourist class ticket at the time of purchase, up to the maximum amount indicated in the Specific Guarantee of the COVERAGE purchased. If contemplated under the Specific Guarantees of the ASSISTANCE PLAN purchased, the CARD HOLDER will be entitled to the reimbursement of the hotel expenses incurred by the accompanying relative, up to USD 80 per day for a maximum period of seven days. Note: Both for this clause as well as any other that covers hotel expenses, it is understood that these are limited to simple accommodations, and that there is no coverage for meals, laundry, telephone calls other than to the Alarm Center, transportation, Internet access, etc. (this is a limited, not-illustrative list). (6) HOTEL EXPENSES The PROVIDER will reimburse the CARD HOLDER for hotel lodging expenses, as long as the PROVIDER’s Medical Department has previously authorized it, when the attending physician prescribes mandatory bed rest after hospitalization. In order to obtain this benefit, the CARD HOLDER must have been hospitalized for a minimum period of 5 (five) days and communicated with the PROVIDER’s Alarm Center to obtain its authorization. The PROVIDER will pay hotel lodging expenses up to the amount indicated in the Specific Guarantees of the ASSISTANCE PLAN and for a maximum period of ten (10) days. Requests for reimbursement will not be accepted subsequently without a justification. This benefit will only be provided within the validity period of the CARD or VOUCHER. Note: Both for this clause as well as any other that covers hotel expenses, it is understood that these are limited to simple accommodations, and that there is no coverage for meals, laundry, telephone calls other than to the Alarm Center, transportation, Internet access, etc. (this is a limited, not-illustrative list). (7) MINORS ESCORT Should the CARD HOLDER be travelling as the only companion of a child under the age of 15, who is also HOLDER of a CARD or VOUCHER, and is unable to take care of the child due to an illness or an accident as confirmed by the PROVIDER’s Medical Department, the PROVIDER will arrange, and pay for, the trip of the child back to his usual place of residence in the country of origin. The choice of the means of transportation to be used for the minor’s escort will be made exclusively by the PROVIDER. (8) REPATRIATION OF MORTAL REMAINS In case of death of the CARD HOLDER during the validity period of the assistance card and whenever caused by an event not excluded in the General Conditions, the relatives may opt for either of the two following alternatives: a) The PROVIDER will organize, and pay for, the repatriation of the mortal remains of the CARD HOLDER to the airport of entrance to his country of permanent residence, by the means that the PROVIDER deems more convenient, and will pay for the coffin required for transportation by air up to the maximum amount specified within the Specific Guarantees, including administrative procedures and the transportation of mortal remains. b) The PROVIDER will pay the expenses for the cremation and transportation
of ashes to the airport of entrance of the country of permanent residence of the deceased, by the means that the PROVIDER deems more convenient, up to the maximum amount specified within the Specific Guarantees of the ASSISTANCE PLAN purchased. Expenses for the definitive coffin, funerary procedures, transfers within the country of usual residence of the deceased CARD HOLDER, religious ceremonies, relatives and friends ceremonies, and for burial are expressly excluded and will not be paid by the PROVIDER. In either of the two alternatives above, all services must be handled through the PROVIDER’s Alarm Center, and the family of the CARD HOLDER or the travel agency may take no action without the PROVIDER’s Alarm Center prior written authorization. The PROVIDER will reimburse no expenses unless previously requested to or authorized by it. In no case expenses incurred by the relatives of the deceased CARD HOLDER to return home will be paid by the PROVIDER. Thus, the PROVIDER will take charge of no expenses incurred by third parties. Only when expressly authorized in writing by the PROVIDER’s Alarm Center will take charge of any penalties for the change of the return date of a flight ticket, in tourist class and subject to seat availability, for the transfer of an accompanying relative (parent, spouse, child or sibling - this is a limited, not-illustrative list), provided the accompanying relative is also HOLDER of a CARD or VOUCHER having the same validity and duration of that held by the deceased CARD HOLDER and when the ticket was issued at a reduced rate and with a fixed or limited return date. (9) EARLY RETURN DUE TO DEATH OR SERIOUS ILLNESS OF A FAMILY MEMBER In case the CARD HOLDER must return to his country of usual residence due to the death or serious illness of an immediate family member (parent, spouse, child or sibling - this is a limited, not-illustrative list) residing in that country, the PROVIDER will pay for the fare difference for a tourist class return ticket, when the CARD HOLDER’s original ticket was issued at a reduced rate and with a fixed or limited return date. Serious illness means the process of alteration of the health status implying hospitalization for more than 5 days. In all cases, the CARD HOLDER must communicate with the PROVIDER’s Alarm Center to obtain its authorization. Requests for reimbursement will not be accepted subsequently without a justification. This return trip benefit will only be provided within the validity period of the CARD or VOUCHER. Note: In the event of non-usage of the airline ticket initially acquired by the CARD HOLDER, both in the event foreseen in this clause, as well as in any other, the PROVIDER will always recover the ticket and will only pay for the difference between ticket price and the amount spent in rendering the service. 10) EARLY RETURN DUE TO DEATH OR SERIOUS ILLNESS OF THE CARD HOLDER. The PROVIDER will pay for the fare difference for a tourist or economy class return ticket of the CARD HOLDER when his original round trip ticket was issued at a reduced rate and with a fixed or limited return date, and such return
date cannot be met due to the CARD HOLDER’s illness or accident. This benefit will apply only if the CARD HOLDER has received medical assistance authorized by the PROVIDER’s Alarm Center. The events detailed in the Exclusions Clause 13 will not give rise to this benefit. (11) EARLY RETURN DUE TO SERIOUS DISASTER AT HOME In the event of fire, explosion, floods or robbery with loss of property and violence at the CARD HOLDER’s residence when he is travelling and provided there is no other person who can take charge of the situation and the CARD HOLDER’s original ticket does not permit a free change of the return date, the PROVIDER will pay for the applicable fare differences or the cost of a new ticket in tourist class from the CARD HOLDER’s location to the airport of entrance to his country of residence. Right to this coverage is obtained by providing the PROVIDER’s Alarm Center with the original supporting police report within 24 hours of the occurrence of the event. The CARD HOLDER must communicate with the PROVIDER’s Alarm Center to obtain its authorization. Requests for reimbursement will not be accepted subsequently without a justification. This benefit will only be provided within the validity period of the CARD or VOUCHER. (12) EXPENSES DUE TO DELAYED FLIGHT Should a CARD HOLDER’s flight (excluding charter flights) be delayed for more than 6 (six) consecutive hours beyond the scheduled departure time, and provided that no alternative transportation is available during those 6 (six) hours, the PROVIDER will reimburse the expenses for hotel lodging and communications by the CARD HOLDER during this period and up to the maximum limits of the guarantee or benefit purchased. The PROVIDER will only reimburse expenses upon submission of the original receipts to support the incurred expenses and a certificate from the airline certifying the delay or cancellation of the flight affecting the CARD HOLDER. To be entitled to this reimbursement, the CARD HOLDER must have contacted the PROVIDER’s Alarm Center before leaving the airport where the event took place. This benefit will only be rendered in a transit city at least 100 km away from the CARD HOLDER’s usual place of residence. This service will not be rendered if the CARD HOLDER is travelling with a ticket subject to seat availability or to a destination within the same country where the CARD or VOUCHER was issued, or in the final destination of the trip. This benefit will not apply if the delay is due to an event arising from any of the circumstances described in Clause L “Exception Circumstances and/or Force Majeure Events”. Note: Both for this clause as well as any other that covers hotel expenses, it is understood that these are limited to simple accommodations, and that there is no coverage for meals, laundry, telephone calls other than to the Alarm Center, transportation, Internet access, etc. (this is a limited, not-illustrative list). (13) EXPENSES DUE TO TRIP CANCELLATION (TRAVEL PACKAGES RESERVED) Special validity duration of clause 13. The services agreed under this clause will only be rendered from the date of issuance of the CARD or VOUCHER and up
to the date of commencement of VALIDITY of the CARD or VOUCHER, which must be the same as that of the beginning of the trip purchased. In case the CARD HOLDER must cancel a trip, he must inform so by phone and within 24 hours of the occurrence of a justified cause to the PROVIDER’s Alarm Center. The PROVIDER will take charge of all expenses for trip cancellation incurred by the CARD HOLDER provided the trip was cancelled due to any of the detailed justified causes. This benefit will not be rendered if trip cancellation is due to either of the following: 1. An event arising from any of the circumstances expressly indicated in the “GENERAL EXCLUSIONS” clause. 2. Trip cancellation due to incomplete or deficient trip documentation of the CARD HOLDER or an accompanying person at the time of departure. 3. Any of the circumstances described in Section L “Exception Circumstances and/or Force Majeure Events” of these General Conditions. Reimbursement will be limited to the maximum limit of the ASSISTANCE PLAN purchased. The CARD HOLDER must have obtained the CARD or VOUCHER at the day of payment of an amount as down payment or final payment of its trip (travel package) to the travel agency or broker, involving one or more suppliers (flight ticket/hotel), excluding cruises, except if specifically mentioned in the Cruise Protector Special ASSISTANCE PLAN. JUSTIFIED REASONS TO CLAIM REIMBURSEMENT OF EXPENSES FOR TRIP CANCELLATION ARE THE FOLLOWING: 1. Death, accident or acute illness of the CARD HOLDER or an immediate family member (parent, spouse, child or sibling –- this is a limited, not-illustrative list) provided it is not included in the GENERAL EXCLUSIONS clause and, at the exclusive discretion of the PROVIDER’s Medical Department, preventing the CARD HOLDER from initiating the trip at the date specified in the CARD or VOUCHER. Serious illness means the process of alteration of the health status implying hospitalization for more than 5 days. 2. Selection to be a party, a witness or a jury member in court preventing the CARD HOLDER from travelling on the date specified in the CARD or VOUCHER. 3. Loss caused by fire, robbery or nature at the CARD HOLDER’s home or professional facilities that make them unsuitable for living or working and justify the CARD HOLDER’s cancellation of the trip. 4. Medical quarantine resulting from an unplanned event. 5. Notice to act as a member of a poling station in the elections of National or Provincial Government. 6. Receipt of a child in adoption 7. Pregnancy problems suffered by the CARD HOLDER up to the 30th week and which, at the entire discretion of the PROVIDER’s Medical Department, makes it impossible the initiation of the trip at the date of start of validity indicated in the CARD or VOUCHER. 8. Cancellation of the CARD HOLDER’s marriage scheduled before the date of
issuance of the CARD or VOUCHER, provided it is caused by any of the events specified in paragraph 1 above 9. Dismissal from work, duly certified, and provided it has occurred after the issuance of the CARD or VOUCHER and the event does not derive from any of the causes specified in the GENERAL EXCLUSIONS clause. 10. If the accompanying person travelling with the CARD HOLDER must cancel the trip for any of the reasons above. An accompanying person will be any person sharing the same hotel room or cruise cabinet or an immediate family member (parent, spouse, child or sibling - this is a limited, not-illustrative list) travelling with the CARD HOLDER and who is also holder of a CARD or VOUCHER of the same characteristics of that purchased by the CARD HOLDER. The PROVIDER will deduct from the compensation any reimbursement received by the CARD HOLDER from any of the service providers due to the same event. Documentation necessary for reimbursement: • Original receipts evidencing form of payment (down payment or installments granted at the time of purchase) and detailing all services included, as well as a letter from the travel agent certifying that such amounts have been retained due to trip cancelation. • Service agreement signed by the service supplier (airline, hotel, maritime company, etc.), including cancellation policy, in the service supplier’s headed paper (the airline must present the fare base rule). • Original medical history in legible format and a copy of the medical examinations performed confirming the health problem that gave rise to the cancellation. The medical history must include the date of issuance, seal and signature of the treating physician (including license number), contact information of the physician or medical center (phone number, email address) and diagnosis. • Copy of the document sent by the travel agency to the operator requesting trip cancellation. • …Original letter from the service suppliers involved, confirming cancellation and the penalty charged. • Copy of ID documents of all passengers which are part of the group that has to cancel its trip accordingly How to proceed: The CARD HOLDER must: • Submit a note drafted and signed by the passenger (printed name included), briefly explaining what happened and providing its COVERAGE or VOUCHER number and bank data for the deposit of the reimbursement requested. Specific Exclusion of Clause 13: This coverage is not valid for cruises in unless specially mentioned in the Cruise Protector Special ASSISTANCE PLAN. (14) TRIP POSTPONEMENT If the CARD HOLDER must postpone his trip due to any of the reasons
specified as a Justified Cause to be eligible to reimbursement of expenses for trip cancellation and as long as it is not contemplated under the GENERAL EXCLUSIONS clause, the PROVIDER will take charge of any penalties for the change of the date of the flight ticket, in tourist class, when the ticket was issued at a reduced rate and with a fixed or limited return date. The CARD HOLDER must communicate with the PROVIDER’s Alarm Center to obtain its authorization. Requests for reimbursement will not be accepted subsequently without a justification. This benefit will only be provided within the validity period of the CARD or VOUCHER. Note: In the event of non-usage of the airline ticket initially acquired by the CARD HOLDER, both in the event foreseen in this clause, as well as in any other, the PROVIDER will always recover the ticket and will only pay for the difference between ticket price and the amount spent in rendering the service. (15) CRUISE / TRIP FOLLOW-UP The PROVIDER will pay to the CARD HOLDER, except if any of the exclusions specific to this service applies, a one-way tourist class ticket from the port of boarding to the first port of call where the cruise can be boarded if the CARD HOLDER could not board the cruise as scheduled due to a delay in the connection flight of more than 6 hours from the scheduled time of arrival. (16) TRANSFER OF EXECUTIVES DUE TO AN EMERGENCY In case the CARD HOLDER is abroad on a business trip and is hospitalized as a consequence of a serious medical emergency that makes it impossible for him to continue with the purpose of the trip, the PROVIDER will pay for a tourist class ticket, subject to seat availability, for the person that the company of the CARD HOLDER appoints as a replacement of the hospitalized CARD HOLDER and for hotel accommodation up to USD 80 per day during a maximum period of five days. The CARD HOLDER must communicate with the PROVIDER’s Alarm Center within 24 hours from the occurrence of the event in order to obtain its authorization. Requests for reimbursement will not be accepted subsequently without a justification. Note: Both for this clause as well as any other that covers hotel expenses, it is understood that these are limited to simple accommodations, and that there is no coverage for meals, laundry, telephone calls other than to the Alarm Center, transportation, Internet access, etc. (this is a limited, not-illustrative list). (17) TRANSMISSION OF URGENT MESSAGES The PROVIDER’s Alarm Center will take charge of transmitting urgent and justified messages related to any of the events included within the services described in the ASSISTANCE PLAN. (18) LOCALIZATION AND ASSISTANCE IN THE EVENT OF LOST OR STOLEN DOCUMENTS, TICKETS AND/OR LUGGAGE The PROVIDER will assist and inform the CARD HOLDER by all means at its reach to report the loss or theft of his luggage and personal belongings. To try to locate lost pieces of luggage that have been shipped in the luggage compartment of the same flight on which the CARD HOLDER was travelling, the PROVIDER, through Alarm Center, will cooperate with the CARD HOLDER
in the follow-up of the search of lost luggage by the airline that received the claim. The PROVIDER will not be liable for pieces of luggage lost or unfound by the airline. (19) TELEPHONE NUMBER FOR QUERIES Up to 24 hours before the date of departure, the CARD HOLDER may ask the PROVIDER’s Alarm Center for information regarding consular, sanitary and tourist requirements, among others, applicable at the country of destination. (20) SUPPLEMENTARY INDEMNIFICATION FOR TOTAL AND DEFINITE LOSS OF LUGGAGE BY AN AIRLINE The CARD HOLDER will be entitled to a supplementary indemnity for total and definite loss of luggage by the PROVIDER, up to the amount paid by the airline as compensation. In no case, the sum of the compensation paid by the airline and the supplementary indemnification of the PROVIDER will be higher than the maximum amount specified in the ASSISTANCE PLAN purchased. Supplementary indemnification refers exclusively to pieces of luggage shipped in the luggage compartment of a commercial flight, subject to IATA regulations. This supplementary compensation will be subject to the following terms and conditions. 1. The CARD HOLDER must have informed the PROVIDER’s Alarm Center of the missing piece of luggage before leaving the airport where it was confirmed to be missing and the P.I.R. (Property Irregularity Report) form has been issued or the claim form has been submitted to the airline. 2. The piece of luggage must have been lost during its transportation on an international flight on a regular airline or a domestic connection flight 3. The piece of luggage must have been duly checked in into the aircraft’s luggage compartment. 4. The piece of luggage must have been lost between the moment it was handed over to authorized personnel of the airline in order to be loaded on board the aircraft and the moment it should have been returned to the passenger when the flight ended. 5. The airline must have been assumed its liability for the loss of the luggage and paid the CARD HOLDER the corresponding compensation established by the airline. 6. If the airline offers to the CARD HOLDER, as compensation, the possibility to receive an amount of money or one or more tickets, the PROVIDER will pay the monetary compensation for loss of luggage, once such option has been exercised. SPECIFIC EXCLUSIONS: In no case will the PROVIDER be liable for loss of luggage if: (1) The CARD HOLDER is a crew member, employee or officer of the transportation that caused the event. (2) The luggage has been kept or retained by the customs or any other government authorities. (3) In no case will the PROVIDER be liable for any missing goods and/or partial or total damage to the content of the luggage, or the pieces of luggage or any
other element of transportation. In case of loss of luggage, follow these instructions: • …Proceed to the airline counter or individual in charge in the luggage claim area as soon as you confirm that your luggage is missing, request and complete a P.I.R. (Property Irregularity Report) form. • Before leaving the airport, call the PROVIDER’s Alarm Center, to report that your luggage has been lost, indicating the P.I.R. form number for monitoring purposes before the airline. Once you return to your country of origin and after payment of compensation by the airline, submit to the COMPANY’s offices the following documentation: • P.I.R. form + ID or Passport + Original CARD or VOUCHER • Original receipt of payment of compensation from the airline to the CARD HOLDER The CARD HOLDER must furnish the original documentation to require this benefit. Copies will not be accepted. The CARD HOLDER is entitled to collect coverage established in the guarantees of the ASSISTANCE PLAN purchased, regardless the number of events and losses that may take place over the validity period of the CARD or VOUCHER, even if it is a yearly card. This benefit is per person. When two or more individuals share the same lost piece of luggage, reimbursement will be divided between them, provided their names are specified in the P.I.R. form. Compensation will be paid in the country of origin where the CARD or VOUCHER was purchased, within 30 days following receipt of all documentation required. (21) REIMBURSEMENT OF EXPENSES FROM THE PURCHASE OF BASIC NECESSITY ITEMS DUE TO DELAY IN THE LOCATION OF LUGGAGE If the luggage is not found within six (6) hours from flight arrival and from the time of call to the PROVIDER’s Alarm Center by the CARD HOLDER before leaving the airport where the luggage was confirmed to be missing, and the P.I.R. (Property Irregularity Report) form was issued or the claim form was submitted to the airline, informing of the missing piece of luggage, the PROVIDER will reimburse the CARD HOLDER, up to the amount established within his ASSISTANCE PLAN, for expenses arising from the purchase of basic necessity items made within the moment of notification of missing luggage and until the luggage has been returned by the airline. Should the lost luggage not be found after thirty six (36) hours from the time of flight arrival and from the time the PROVIDER’s Alarm Center was informed of the loss, the CARD HOLDER may receive an additional amount up to the maximum amount established within his ASSISTANCE PLAN purchased, upon submission of the receipts evidencing the purchase of basic necessity items within time elapsed from the moment of notification of missing luggage and until the luggage has been returned by the airline. To obtain this benefit, the CARD HOLDER must have communicated with the PROVIDER’s Alarm Center within six (6) hours from flight arrival and also after
thirty six (36) hours from flight arrival and from the time the CARD HOLDER communicates with the PROVIDER’s Alarm Center to inform the loss and request authorization. To obtain reimbursement, the CARD HOLDER must submit evidence of the date and time the airline has furnished him the found luggage. Restrictions: Once the luggage has been declared lost and the applicable compensation has been paid by the airline, the amount paid will be deducted from the payment applicable for definite loss of luggage. This benefit will not apply in the event of loss of luggage in the return trip to the Country of usual residence of the CARD HOLDER or country of issuance of the CARD or VOUCHER. This benefit will be rendered only if the loss of luggage has taken place in a transit city at least 100 km away from the usual place of residence of the CARD HOLDER. The CARD HOLDER will not be entitled to this benefit when travelling with a ticket subject to seat availability and to a destination within the country where the CARD or VOUCHER was issued. No compensation will be paid in case of loss of luggage at the final destination of the trip. (22) TRANSFER OF FUNDS AND BAILMENT During the trip and in case of urgent and unforeseen need, the PROVIDER will arrange the transfer of money to the CARD HOLDER in the country where he is, up to the limit specified in the ASSISTANCE PLAN purchased, prior deposit in the COMPANY’s office. This benefit will be rendered only once during the validity of the CARD or VOUCHER. Should the CARD HOLDER be incarcerated as a consequence of a traffic accident, the PROVIDER will arrange the transfer of amounts of money specified in the ASSISTANCE PLAN to pay bailment, prior deposit of the amount requested in the COMPANY’s offices, at the CARD HOLDER’s expense. (23) LEGAL ASSISTANCE IN CASE OF TRAFFIC ACCIDENT Should a CARD HOLDER be charged with liability for a traffic accident, the PROVIDER will pay for all expenses arising from the defense of the CARD HOLDER in a civil or criminal action. The PROVIDER will take charge of lawyer’s fees up to the maximum amount specified within the ASSISTANCE PLAN purchased. (24) ACCIDENTAL DEATH AND/OR DISMEMBERMENT. (DOES NOT APPLY IN THE CARIBBEAN) The CARD HOLDER is automatically insured against accidental death and/or dismemberment and at no additional cost when the ASSISTANCE PLAN purchased includes this coverage. This insurance has been taken from the insurance company indicated in this COVERAGE. The insurance policy for Personal Accidents is subject to its own particular and general conditions and it is available to any interested parties at the offices of the insurance company. The Accidental Death and/or dismemberment benefit has an aggregate limit per disaster (regardless of the number of beneficiaries) of USD 5,000,000.00 (five million). This amount will be distributed among the total number of CARD HOLDERS that died in the event. In no case will the amount payable to the
beneficiaries of each CARD HOLDER be able than the amount purchased by the CARD HOLDER. SPECIFIC EXCLUSIONS: (1): Accidents that have taken place in non-regular flights that are not operated by duly authorized and ruled commercial airlines. (25) CHRONIC OR PRE-EXISTING ILLNESSES Except for the monitoring and control of prior checkups and/or treatments, the PROVIDER will take charge of the expenses of the first medical assistance due to an acute episode during the trip, related to a chronic or pre-existing illness, and up to the maximum amount specified within the ASSISTANCE PLAN detailed in the CARD or VOUCHER. The PROVIDER will not pay for any medication or treatment related to such chronic or pre-existing illness. (26) Deductible (US$) / (Km.): 1. In the event that the payment of a deductible has been established for the product acquired, the CARD HOLDER must pay it when seeking assistance for any service rendered. In the case of using the PROVIDER’s assistance services for a second time for an event unrelated to the previous one, the CARD HOLDER must pay the deductible for the second time at the moment of assistance. 2. If the product acquired has a kilometer deductible, the CARD HOLDER cannot use the assistance services in the event that the distance between his place of usual residence and the place where he seeks assistance is less than the kilometer deductible (Specified under the CARD or VOUCHER in KM). (27) MULTITRIP ANNUAL AND LONG STAY PLANS (FOR A VALIDITY PERIOD OVER TWO MONTHS) Multitrip Annual ASSISTANCE PLANS will be valid for 365 days. However, the CARD HOLDER may not remain abroad for more than 90, 60, 45 or 30 days, as indicated under the ASSISTANCE PLAN purchased, per trip during the validity duration of the plan, except for Long Stay Special ASSISTANCE PLANS. Once this period has elapsed, the CARD HOLDER will not be entitled to any assistance services under the ASSISTANCE PLAN purchased. The CARD HOLDER will be required by the PROVIDER’s Alarm Center to submit a copy of his passport by fax, evidencing the date of departure from his country of usual residence or the date of entrance to the country where medical assistance is required. Except for Long Stay Special ASSISTANCE PLANS for students abroad and for CARD HOLDERS sent abroad on business by their company, the purpose of the trip must be exclusively for tourism, with no coverage for a person involved in a professional activity abroad. Students that have purchased this type of ASSISTANCE PLAN must, at the moment of seeking assistance, send their credentials from the University or School where they are studying, via fax, to the PROVIDER’s Alarm Center. As for businessmen, they should ask the company in the country of origin to send a letter with company letterhead that states the validity of the business trip, or should request that such proof be sent via e-mail by the company. SPECIFIC EXCLUSION: The CARD HOLDER will receive no assistance if he is in an illegal migration or labor condition (including any job not declared in the
country where assistance is required). (28) REPATRIATION DUE TO THE BANKRUPTCY OF THE AIRLINE In the event of bankruptcy or ceasing of operations of the airline or Tour Operator after the beginning of the trip, and as long as no private or public agency has the obligation to take charge of the return of passengers to their country of origin, the PROVIDER will arrange and provide the CARD HOLDER with a return ticket in tourist class to his country of origin. (29) ADMINISTRATIVE REPATRIATION In the event the CARD HOLDER, for any reason, is deported from the country to which he traveled, during the validity period of the CARD or VOUCHER, the PROVIDER will supply, at the request of the authorities, an economy class return ticket. The CARD HOLDER will return the ticket he possesses to the PROVIDER, properly endorsed, without compensation. (30) MULTISPORTS (a) – Guarantee of trip interruption. In the event of accident or illness when the repatriation of the CARD HOLDER becomes necessary, or if the Medical Department of the PROVIDER’s Alarm Center believes that the CARD HOLDER should stay resting, the PROVIDER will reimburse prorrata temporis (after auditing the original proof documents), Ski Pass expenses, sports lessons, or the rental of sports material up to the maximum amount of US$300. (b) - Practice of covered sports: All sports in the amateur category, except: Bobsleigh, Ski and Snowboard outside authorized tracks, Olympic luge, hunting dangerous animals, mountain climbing over 6,000 meters, speleology and skeleton. (C) – Search and rescue costs: The PROVIDER will be responsible for a maximum amount of US$ 1,000 for the expenses of search and rescue operations including helicopter or airplane at the moment of organizing the rescue of the CARD HOLDER, resulting from the practice of an amateur sport. SPECIFIC EXCLUSION: Excluded is the practice of sports by professionals in competitions or training for professional competitions. (Professional sports persons are defined as the persons who live from the practice of their sport without exercising other professional activities). (31) MEDICAL ASSISTANCE IN CRUISES IN CASE OF ILLNESS OR ACCIDENT When seeking medical assistance on board a ship, the CARD HOLDER is authorized to hire such assistance services as may be necessary inside the ship. The CARD HOLDER must communicate with the PROVIDER’s Alarm Center to obtain its authorization. Requests for reimbursement will not be accepted subsequently without a justification. This benefit will only be provided within the validity period of the CARD or VOUCHER. The CARD HOLDER must contact the PROVIDER’s Alarm Center, as many times as assistance is required, at the phone numbers appearing in the CARD FOR CALLS in order obtain authorization before taking any action or incurring in any expenses. If the CARD HOLDER or a third party is unable to communicate with the PROVIDER’s Alarm Center, the PROVIDER’s Alarm Center must be informed
of the emergency and the services rendered within 24 hours following the occurrence of the event or at the first port, or reimbursement will be denied. Reimbursement of medical expenses must be requested by the CARD HOLDER at his return, upon submission of original receipts and medical prescription. The PROVIDER will cover medical expenses due to accident or illness up to the maximum amount established within the Specific Guarantees of the ASSISTANCE PLAN. J) Subrogation: Up to the total amount of the sum reimbursed in fulfillment of its obligations under this General Conditions, the PROVIDER is automatically subrogated in the rights and actions that may correspond to the CARD HOLDER or his heirs against third parties, either individuals or legal entities, in connection with the event that caused the assistance to be rendered. The CARD HOLDER commits himself to return, on the spot, to the PROVIDER any amount he may have received from the person who caused the accident and/or from the Insurance Company as advance payments due to the final settlement to which the CARD HOLDER is entitled up to the responsibility limits assumed by the PROVIDER. Expressly comprehended by this subrogation are the rights and actions that may be exercised with respect to the following persons: 1) Third parties liable for traffic accidents, 2) Transportation companies in that which is related to the total or partial restitution of the price of tickets not used when the PROVIDER took on financial responsibility for the transfer of the CARD HOLDER or of his mortal remains. As a consequence, the CARD HOLDER irrevocably assigns to the PROVIDER the rights and actions included in this clause, committing himself to carry out all the legal actions that may be necessary and also to cooperate whenever required for the purpose of the subrogation hereby agreed upon. Upon refusal by the CARD HOLDER to cooperate or to subrogate such rights to the PROVIDER, the latter will automatically be released from the obligation to cover the expenses of the assistance provided. 3) Other companies covering the same risk.- K) Unduly paid services: The PROVIDER reserves the right to demand reimbursement to the CARD HOLDER of any expenses unduly incurred by the PROVIDER for the provision of services after the expiration of the CARD or VOUCHER and/or not contemplated under this agreement. For collection purposes, a copy of receipts of payment made by the PROVIDER and the Specific Guarantees of the CARD or VOUCHER will be sufficient and conclusive evidence. L) Exceptional Circumstances and/or Force Majeure Events As specified within this travel assistance agreement, the PROVIDER is expressly released, exempt and excused from any of its obligations and liabilities in the event the CARD HOLDER suffers any damage or requires assistance as the consequence and/or arising from fortuitous or force majeure events, such as, catastrophes, earthquakes, floods, storm, declared or undeclared international or civil war, rebellion, internal uproar, actions of guerrillas or counter-guerrillas, hostilities, reprisals, conflicts, seizures, internal
riots, strikes, mass movements, lock-out, public riots or acts of sabotage or terrorism, etc. as well as problems and/or delays resulting from the termination, interruption or suspension of communication services. When elements of this kind are involved, and once such event is terminated, the PROVIDER will fulfill its commitments and obligations within the shortest possible time. M) Liability: The PROVIDER will not be liable nor compensate the CARD HOLDER for any damage, illness, infirmity or injuries caused by a professional upon the CARD HOLDER’s request or medical, legal or pharmacy assistance services rendered. The PROVIDER only coordinates and facilitates assistance services so that third party professionals render such services upon request. Thus, the PROVIDER will be released from liability for any of the circumstances above. In these cases, the persons appointed by the PROVIDER will be deemed as agents of the CARD HOLDER without any action against the PROVIDER for such appointment. The PROVIDER undertakes to provide a service but guarantees no result. N) Statute of limitation: Any claim seeking enforcement of any of the PROVIDER’s obligations under this General Conditions must be made in writing within 30 (thirty) consecutive calendar days from the expiration of CARD or VOUCHER. After expiration of this period, which may not be extended, no other claim may be brought. O) Jurisdiction: The parties hereby expressly agree that any controversy arising in connection with the contractual relationship between the CARD HOLDER and the PROVIDER and/or any other legal claim, which may not settled by the mutual agreement of the parties, will be submitted to the courts of the City of Buenos Aires, expressly waiving any other jurisdiction that may apply. P) Exemption from liability: The PROVIDER will not be responsible for any claims arising in connection with the relationship between the CARD HOLDER and the PROVIDER, after 365 calendar days following the occurrence of the event. Q) Exemption from responsibility of sales agents: The COMPANY’s sales agents and/or representatives (travel agencies, tour operators, transportation companies and any other issuing agent) are not parties to this Travel Assistance Agreement and, consequently, are free of any responsibility pertaining to the purpose of this agreement. R) Non-cumulative services and/or intervention of other companies: In no case will the PROVIDER render assistance services to the CARD HOLDER under the ASSISTANCE PLAN and/or reimburse any expenses incurred if the CARD HOLDER has required assistance for the same problem and/or illness to any other company during, before or after having required the assistance services to the PROVIDER. REIMBURSEMENTS General provisions: For any type of reimbursement to apply, the CARD HOLDER must have first contacted, and obtained authorization from, the PROVIDER’s Alarm Center, asking for advice on the documentation to be submitted.
In case of an accident, illness or injuries, the CARD HOLDER may use, with no cost, the services of the professionals and/or medical facilities that are indicated and/or provided by the PROVIDER’s Alarm Center, within the limits and conditions established in this agreement. If at the time of the assistance requested to the PROVIDER’s Alarm Center, a medical team that can provide care within a reasonable period is not immediately available in the location, the CARD HOLDER may use all the medical services that might be necessary. All such costs may be paid directly to the service provider and reimbursed to the CARD HOLDER, provided the following conditions are met. Conditions for reimbursement: For the purposes of reimbursement, the cause of the assistance must not be included in the EXCLUSIONS clause. The CARD HOLDER must report to the PROVIDER’s Alarm Center within the first 24 (twenty-four) hours after the occurrence of the event that gave rise to the service rendered, providing data related to the physician and/or medical center used, as well as the reasons that hindered him from seeking assistance directly from the PROVIDER’s Alarm Center. Failure to provide this information to the PROVIDER’s Alarm Center within this 24-hour period will result in the annulment of the reimbursement payment. The cost of the service contracted must be in accordance with the prices and fees in effect in the country in which it was provided. Appropriate documentation: The CARD HOLDER or the service provider, as the case may be, must submit original documentary evidence, invoices and receipts of payment of all expenses incurred for previously-authorized services. The PROVIDER reserves the right to verify and audit the content of such documentation or request further explanations. The documentation provided must be original and contain: clinical history, diagnosis and medical prescription, a letter from the CARD HOLDER describing the event, the original CARD or VOUCHER. The documentation must be submitted to the PROVIDER’s offices within 30 (thirty) business days from the expiration of the CARD or VOUCHER. Upon expiration of this period, the CARD HOLDER will not be entitled to reimbursement. Only expenses accompanied by original proof documents will be reimbursed. Reimbursement in foreign currency will follow applicable rules issued by the Central Bank and will be exchanged at the US dollar exchange rate applied when the CARD or VOUCHER was issued (or when the invoice for the services rendered was received). Effective payment will be made within 30 (thirty) days from receipt of the complete documentation by the PROVIDER. GENERAL EXCLUSIONS The following shall be expressly excluded from the free medical assistance detailed in the ASSISTANCE PLAN of the CARD or VOUCHER to be rendered by the PROVIDER: 1. All chronic, pre-existing, congenital or recurrent conditions, known or
unknown to the CARD HOLDER, existing before the beginning of the trip and/or of the validity of the CARD or VOUCHER, as well as its consequences and acute episodes (even when they appear for the first time during the trip), except as specified in clause (25), Chronic or pre-existing illnesses include without limitation the following: kidney lithiasis, vesicle lithiasis, diabetes, phlebitis, deep venous thrombosis and ulcers of any kind of etiology. this is a limited, not-illustrative list 2. Diseases affecting the immunological system, both as a consequence of the disease or drugs used for treatment, oncology drugs, cardiovascular disorders, chronic respiratory illnesses, chronic kidney infections, hepatitis, any type of endemic, epidemic and/or pandemic diseases, etc., known or not to the CARD HOLDER. 3. Illnesses, infirmities, injuries and their complications, resulting from the treatment or care given by persons or professionals not authorized by the PROVIDER’s Medical Department 4. Homeopathic treatments, acupuncture, kinesiotherapy, thermal treatments, podiatry, etc. 5. Infirmities, diseases, or injuries resulting from criminal actions or torts directly or indirectly performed by the CARD HOLDER. 6. Treatment of illnesses or pathological conditions caused by the intentional ingestion or administration of toxics (drugs) narcotics, or because of the use of medications without a doctor's prescription. 7. Expenses for prosthesis, orthesis, synthesis or mechanical-help devices of any type, either of internal or external use, including but not limited to: orthopedic articles, dental prosthesis, hearing aids, glasses, contact lenses, splints, crutches, nebulizers, respirators, etc. 8. (This exclusion clause is only applicable for Multisports Special Assistance Plan). Accidents resulting from training, practice, or active participation in (professional or amateur) sports competitions as well as any events arising from the practice of hazardous sports, including but not limited to motorcycling, motor car racing, boxing, polo, water skiing, diving, paragliding, hang-gliding, flights in any device that is not commercial, parachuting, bungee jumping, mountaineering, kite surf, skiing, snowboard and, in general, other winter sports. 9. Diagnosis, control, follow-up and treatment of pregnancy, childbirth, abortions and their consequences, except in consequence of an accident. 10. Mental illnesses of any sort, emotional and psychological disturbances or treatments of any kind. 11. Illnesses, injuries or complications resulting from the use of alcohol or drugs of any nature. 12. Blood pressure controls. Hypertension and hypotension or any consequence thereof. 13. Auto-Immune Deficiency Syndrome, AIDS and HIV in any/all of its forms, as well as its consequences. Venereal or sexually-transmitted diseases, and/or any service, study and/or treatment performed without prior authorization from the PROVIDER.
14. Events in consequence of the release of forces of nature, nuclear radiation y radioactivity, epidemic, as well as any other extraordinary phenomenon or event that due to its proportions or gravity, may be considered to be a national disaster or catastrophe 15. Suicide, suicide attempt or injuries intentionally provoked by the CARD HOLDER to himself and/or his family, as well as any act of manifest irresponsibility or imprudence on the part of the CARD HOLDER. 16. Events derived from acts of war, terrorism or other serious disturbances of the public order. 17. Intentional or bad faith actions of the CARD HOLDER or any of his attorneys-in-fact. If it is confirmed that the true purpose of the trip was the treatment abroad of an existing disease and that the current treatment is directly or indirectly related to the pre-existing infirmities, the PROVIDER will be released from its obligation to provide services. To such end, the PROVIDER reserves the right to investigate the connection between the actual facts with the prior infirmity. 18. Cancer and all its treatments. 19. Lesions to drivers or passengers caused by the unlicensed use of uninsured vehicles, including aircraft and motorcycles without a helmet. 20. Injuries resulting from participating in wagers or fights. 21. Plastic surgeries and esthetic or rejuvenation treatments 22. Tests and/or hospitalization for tests, stress tests, and every kind of preventive checkups. 23. Any type of hernia and its consequences 24. Kidnapping and/or kidnapping attempts. 25. Risks resulting from situations not included under the definition of personal accident, such as injuries resulting, depending, predisposed or facilitated by repeated efforts or cumulative micro traumas, or which have a cause and effect relationship, as well as injuries classified as: lesions due to repetitive strain, work-related musculoskeletal disorders, continuous or cumulative trauma disorders, or similar ones, as well as their consequences, treatments and posttreatments, including surgeries at any time. 26. Situations equivalent to or recognized by official social security agencies, or a similar entity, as disability due to an accident, in which the event that caused the injuries does not entirely fit the description of invalidity due to a personal accident. 27. Professional Risks: If the CARD HOLDER’s trip involves the execution of works or tasks which entail a professional risk. In every case, the services described in the PROVIDER’s General Conditions will be complementary to those that have to be provided by assistance and insurance entities according to the industrial and professional risk security regulations that apply in the country where the illness or accident takes place. 28. Illegal labor or migration condition of the CARD HOLDER: Professional Risks: If the CARD HOLDER’s trip involves the execution of works or tasks which entail a professional risk. (In every case, the services described in the