travel agreement - alberta blue cross · travel plan single-trip plan one trip up to $5,000,000 not...

Travel Agreement | 1

Travel AgreementEmergency Medical Coverage Trip Cancellation, Trip Interruption and Baggage Coverage

2 | Alberta Blue Cross

COVERAGE AT A GLANCE

Travel insurance does not cover everything. It is designed to cover losses from sudden and unforeseen circumstances.

Your coverage will depend on the plan type, plan name and insurance purchased for you as indicated on the confirmation of coverage.

It is important that you read and understand this agreement before you travel as your coverage may be subject to certain limitations or exclusions. Some examples include: medical conditions that are not stable; high risk activities; pregnancy; misuse or abuse of alcohol, drugs or medication.

This agreement may not provide coverage for medical conditions or symptoms that existed before your trip, including those that you have told us about.

You must meet the eligibility requirements of this agreement at the time of application and your departure date for each trip.

Your travel insurance must be purchased before you leave your province or territory of residence and for the full duration of your trip, including your departure date and return date.

Your trip must involve travel from or within Canada.

In the event of a claim, your prior medical history may be reviewed.

IMPORTANT NOTICERead carefully before you travel

10-day Full Refund ProvisionYour satisfaction is our priority. If you are not completely satisfied with this agreement, you may cancel this agreement for a full refund within 10 days of purchase provided you have not:

a) departed on your trip; and

b) experienced an event that would cause you to submit a claim under this agreement.

If you need to cancel, please contact us at 1-800-394-1965. No refunds are available if a claim has been paid, incurred or reported. For details on refunds applicable to your plan, please see the Refunds section of this agreement.

Helpful TipWhen reading this agreement, you will notice that some words are printed in italics. These words are defined in the Definitions section on page 46. As an example, you means each person who is named as a covered person on the confirmation of coverage. Pay particular attention to these definitions as we have given a specific meaning to these terms.


Table of ContentsCoverage at a Glance 4

Emergency Medical Coverage 7

Description of Coverage 7

Do You Qualify? 8

What is Covered – Benefits 8

What is Not Covered – Exclusions 12General Exclusions 12

Exclusions Relating to Medical Conditions for Emergency Medical Coverage 15

Managing a Medical Emergency 18

Trip Cancellation, Trip Interruption and Baggage Coverage 19

TRIP CANCELLATION AND TRIP INTERRUPTION COVERAGE


Do You Qualify? 20

What is Covered – Benefits 20Trip Cancellation 20Trip Interruption 21

Covered Reasons 22

What is Not Covered – Exclusions 26

BAGGAGE COVERAGE


Do You Qualify? 28

What is Covered – Benefits 29

What is Not Covered – Exclusions 30

What Conditions Apply 31

Single-Trip Plan and Multi-Trip Annual Plan 32

Eligibility Requirements 32

When Does Coverage Begin and End? 33

When Does Coverage Automatically Extend? 35

What if You are Staying Longer than Planned? 35

Refunds 36

Claim Inquiries 37

How to File A Claim 38

General Conditions 42

Definitions 46



Helpful TipIf you have any questions or information that may influence a change in your travel plans, it is important you call us prior to your effective date (as indicated on your confirmation of coverage) as failure to accurately and completely disclose information to us may void your coverage. A misrepresentation of your medical condition will void coverage.

This agreement describes the following types of travel insurance available:

TYPE OF COVERAGE BENEFIT MAXIMUM DESCRIPTION

Emergency Medical Up to $5 million (CAD) per person per trip

• covers eligible expenses incurred by you up to the benefit maximum if you require immediate medical treatment as a result of an accident or medical emergency that occurs outside your Canadian province or territory of residence.

Trip Cancellation Amount indicated on your confirmation of coverage

• covers an event occurring on or prior to your departure date, causing you to cancel your trip; and

• reimburses you for the non-refundable portion of unused pre-paid travel expenses and cancellation penalties that a common carrier or tour guide may charge.

Trip Interruption Unlimited* • covers an event occurring on or after your departure date causing you to interrupt or disrupt your trip as originally scheduled or to return earlier or later than your return date.

Baggage Loss, theft or damage up to $1500±

Delay up to $500

• covers the reimbursement for the cost to replace baggage and personal effects you own and that you use during your trip and which are lost or damaged during your trip; and

• covers the reimbursement of your reasonable and necessary toiletries and essential clothing if your checked baggage is delayed by the common carrier for 12 hours or more during your trip.

* Additional benefit maximums: i) meals and accommodation: $250 per day, up to $2,500 per person per trip; ii) vehicle return costs: up to $1,000; iii) return of deceased: up to $7,000 (excluding the cost of a coffin); iv) cremation or burial at place of death: up to $2,500; and v) default of travel supplier: up to $3,500 subject to a maximum amount payable for all losses resulting from the default of one travel supplier to the aggregate maximum of $150,000 for all persons who make a claim under all in force agreements issued by us relating to the same travel supplier’s default. If return of deceased, vehicle return, meals and accommodation expenses are also covered under the Emergency Medical coverage benefit of this agreement (if applicable), the expenses are only payable under the Emergency Medical coverage benefit.

± Subject to a $500 per item maximum and a $150 maximum for loss of travel documents.

Coverage at a Glance



You may purchase Emergency Medical coverage or Trip Cancellation, Trip Interruption and Baggage coverage separately or as part of a package. It is important you are on the correct travel plan that will provide you coverage in the case of a claim.

Your coverage will depend on the plan type, plan name and travel insurance purchased for you as indicated on the confirmation of coverage and as noted below and on the next page:

PLAN NAME PLAN TYPE ELIGIBLE TRIP LIMIT¥

EMERGENCY MEDICAL‡ COVERAGE

TRIP CANCELLATION COVERAGE

TRIP INTERRUPTION COVERAGE

BAGGAGE COVERAGE

MAXIMUM AGE & AGREEMENT MAXIMUM

Emergency Medical 59 & Under Travel Plan

Single-Trip Plan

One trip Up to $5,000,000

Not covered Not covered Not covered Age 59 & under Up to 365 days

Multi-Trip Annual Plan

30 consecutive days per trip

Up to $5,000,000

Not covered Not covered Not covered Age 59 & under Up to 365 days

Comprehensive 59 & Under Package

Single-Trip Plan


Up to benefit maximum*

Unlimited** Loss, theft or damage up to $1,500± and

Delay up to $500

Age 59 & under Up to 365 days


30 consecutive days per trip

Up to $5,000,000

Up to $2,500 per person per trip


Delay up to $500

Age 59 & under Up to 365 days

Emergency Medical Blue Travel Plan

Single-Trip Plan


Not covered Not covered Not covered Age 60-79 Up to 275 days

Comprehensive Blue Package

Single-Trip Plan




Delay up to $500

Age 60-79 Up to 275 days

* As indicated on your confirmation of coverage.

** Additional benefit maximums: i) meals and accommodation: $250 per day, up to $2,500 per person per trip; ii) vehicle return costs: up to $1,000; iii) return of deceased: up to $7,000 (excluding the cost of a coffin); iv) cremation or burial at place of death: up to $2,500; and v) default of travel supplier: up to $3,500 subject to a maximum amount payable for all losses resulting from the default of one travel supplier to the aggregate maximum of $150,000 for all persons who make a claim under all in force agreements issued by us relating to the same travel supplier’s default. If return of deceased, vehicle return, meals and accommodation expenses are also covered under the Emergency Medical coverage benefit of this agreement (if applicable), the expenses are only payable under the Emergency Medical coverage.


‡ Emergency medical travel plans’ eligibility, exclusions and conditions vary for individuals age 60 and over.

¥ Maximum trip days may not exceed your eligible trip limit or 365 days (including extensions) whichever is lesser, from the departure date or effective date, whichever is the earliest.



PLAN NAME PLAN TYPE

ELIGIBLE TRIP LIMIT¥

EMERGENCY MEDICAL‡ COVERAGE

TRIP CANCELLATION COVERAGE

TRIP INTERRUPTION COVERAGE

BAGGAGE COVERAGE

MAXIMUM AGE & AGREEMENT MAXIMUM

Emergency Medical Preferred Travel Plan

Single-Trip Plan



Age 80+ Up to 182 days

Comprehensive Preferred Package

Single-Trip Plan




Delay up to $500



Emergency Medical Standard Travel Plan

Single-Trip Plan




Comprehensive Standard Package

Single-Trip Plan




Delay up to $500



Trip Cancellation, Trip Interruption and Baggage Plan

Single-Trip Plan

One trip Not covered Up to benefit maximum*


Delay up to $500

All ages up to 365 days


30, 45 or 60 consecutive days per trip

Not covered Up to $2,500 per person per trip


Delay up to $500

All ages up to 365 days

* As indicated on your confirmation of coverage.

** Additional benefit maximums: i) meals and accommodation: $250 per day, up to $2,500 per person per trip; ii) vehicle return costs: up to $1,000; iii) return of deceased: up to $7,000 (excluding the cost of a coffin); iv) cremation or burial at place of death: up to $2,500; and v) default of travel supplier: up to $3,500 subject to a maximum amount payable for all losses resulting from the default of one travel supplier to the aggregate maximum of $150,000 for all persons who make a claim under all in force agreements issued by us relating to the same travel supplier’s default. If return of deceased, vehicle return, meals and accommodation expenses are also covered under the Emergency Medical coverage benefit of this agreement (if applicable), the expenses are only payable under the Emergency Medical coverage.


‡ Emergency medical travel plans’ eligibility, exclusions and conditions vary for individuals age 60 and over.

¥ Maximum trip days may not exceed your eligible trip limit or 365 days (including extensions) whichever is lesser, from the departure date or effective date, whichever is the earliest.


EMERGENCY MEDICAL COVERAGE

This coverage only applies if we issue a confirmation of coverage that specifies you have Emergency Medical coverage.

Emergency Medical coverage may be purchased as part of a Single-Trip Plan or a Multi-Trip Annual Plan. Refer to the Single-Trip Plan and Multi-Trip Annual Plan section of this agreement for details on eligibility and when coverage begins and ends as they apply to the plan purchased for you.

Helpful TipThe Single-Trip Plan and Multi-Trip Annual Plan section of this agreement can be found on page 32.

Emergency Medical Coverage



Do You Qualify?

You are eligible for Emergency Medical coverage under this agreement if:

1. you meet all of the eligibility requirements outlined in the Eligibility Requirements section of this agreement;

2. an application for your coverage is accepted by us and we issue a confirmation of coverage in your name that specifies you have emergency medical coverage. We reserve the right to accept or decline coverage for any person; and

3. you are enrolled under your Canadian provincial government health plan prior to and for the entire duration of the trip. It is your responsibility to check that you have this coverage.

In addition to the above, if you are age 60 or older on or after the effective date:

a) you are eligible for coverage under a Single-Trip Plan only;

b) in addition to the “General Exclusions”, the additional exclusions set out in “Exclusions Relating to Medical Conditions for Emergency Medical Coverage” also apply; and

c) if requested by us, you must complete the travel insurance health questionnaire form. Your responses to this form must be answered correctly and completely and will be relied upon by us to determine the terms of coverage, type of coverage and/or the premiums that apply to you. If any of your responses are inaccurate or incomplete, your agreement will be void.

What is Covered – Benefits

COVERAGE PLAN TYPE BENEFIT MAXIMUM

Emergency Medical coverage (after departure)

Single-Trip PlanMulti-Trip Annual Plan

$5,000,000 per person per trip

Subject to the terms and conditions of this agreement, we will reimburse eligible expenses incurred by you for the following benefits up to the benefit maximum if:

1. you require immediate medical treatment as a result of an accident or medical emergency that occurs outside your Canadian province or territory of residence;

2. you incur eligible expenses as a result of a medical emergency;

3. the medical emergency occurs during the period of coverage;

4. you are covered by a Canadian government health plan when the medical emergency occurs;

5. we determine that the expense is necessary to stabilize your medical condition; and

6. the eligible expense does not fall within any of the exclusions set out in this agreement.

Helpful Tips• The Eligibility

Requirements section of this agreement can be found on page 32.

• All Canadian government health plans have different maximum coverage limits on the number of days allowed outside the province or territory of residence before coverage will cease. Check with your Canadian provincial government health plan for a specific length of time permitted in your jurisdiction.


Helpful TipOur travel assistance service provider can be contacted (toll free) at 1-888-772-2583 (Canada and the United States). All other countries, or if you have any difficulties, (call collect) 1-403-225-4289.


To be eligible, the hospital or medical benefits covered under this agreement must have been provided at the nearest eligible facility capable of providing adequate service at the time of the medical emergency.

When marked with a , the benefit is payable only when pre-approved by the travel assistance service provider.

Hospital Services

1. The following hospital services or expenses:Accommodation

a) Hospital room accommodation (limited to a semi-private accommodation (not a suite)), in excess of the amount paid by your Canadian government health plan.

Outpatient b) Outpatient services provided by a hospital, in excess of the amount paid by your Canadian government health plan.

Incidental Expensesc) Incidental expenses which are incurred during the hospital stay, up to $50 per day to a maximum of $500

per hospital stay. Paid receipts must be submitted.

Health Care Professionals

2. The following services:Physicians

a) The services of a physician in excess of the amount paid by your Canadian government health plan.

Paramedical Servicesb) The services of a licensed physiotherapist, chiropractor, chiropodist, podiatrist or osteopath when required

for emergency medical treatment, limited to a maximum of $300 (including x-rays) for any one medical emergency for each practitioner.

Nursing Carec) The services of a qualified, private registered nurse who is not a related person and who performs duties

that require the skills and expertise of a registered nurse, during and immediately following hospitalization, when ordered by the attending physician.

Prescriptions and Services

3. The following prescriptions and services:Prescriptions

a) Drugs, serums and injectables prescribed by the attending physician and supplied by a licensed pharmacist, when required for medical treatment and not for maintenance of an existing condition, excluding vitamins, patent, proprietary or over-the-counter products.

b) Up to a combined maximum of $500 for one physician visit to obtain a new prescription and the cost of the new prescription drugs (excluding over the counter medication, vitamins, minerals and dietary supplements) in the event your prescription drugs are lost or stolen.

Diagnostic Services c) Laboratory tests and X-rays prescribed by the attending physician.

Medical Appliances

4. The cost of splints, casts, crutches, canes, slings, trusses, walkers and/or the temporary rental of a wheelchair, when prescribed by the attending physician and required due to an accident or illness.



Emergency Dental Services

5. Dental expenses you incur while on your trip for a direct accidental external blow to the mouth requiring the repair, extraction, replacement and treatment of sound natural teeth or permanently attached artificial teeth, to a maximum of $2,000 per accident. You must see a physician or dentist immediately following the accident.

You are also covered for continuing treatment after your return to your Canadian province or territory of residence provided:

a) the treatment is related to the accidental blow to the mouth;b) the initial treatment began prior to your return to your Canadian province or territory of residence;c) all treatment is completed no later than 182 days after the date of the accident; andd) an accident report from the treating physician or dentist is provided.

Dental expenses you incur while on your trip for any dental medical emergency, excluding root canals, for the relief of dental pain, to a maximum of $300. Treatment must be rendered at a location at least 200 kilometres outside your Canadian province or territory of residence.

Meals and Accommodation

6. We will reimburse you up to $250 per day for unavoidable additional expenses for meals and accommodation to a maximum of $2,500 per trip if your scheduled return to your Canadian province or territory of residence is delayed when remaining with a sick or injured travelling companion.

The delay must be verified by the attending physician and the expenses must be supported with receipts from commercial organizations.

Ambulance Services

7. Regular ambulance services from the place of illness or accident to the nearest qualified medical facility capable of providing appropriate medical treatment.

Emergency 8. When regular ambulance services cannot be used, the cost of your emergency evacuation from a mountain, body of water or other remote location to the nearest qualified medical facility capable of providing appropriate medical treatment, to a maximum of $5,000.

Medical Evacuation Air Ambulance Services

9. The cost of air evacuation between hospitals, or for hospital admission in to your Canadian province or territory of residence, or when ordered by the attending physician or the travel assistance service provider and approved by your government health plan provider or us.

If the air ambulance benefit is used, the unused portion of your air ticket must be surrendered to us.

Medical Evacuation Repatriation

10. When your medical emergency is such that the attending physician or the travel assistance service provider specifies in writing that you should immediately return to your Canadian province or territory of residence for immediate medical treatment, we will reimburse the extra cost incurred for the purchase of one way economy airfare on a commercial flight to:

a) return you, by the most direct route, to your Canadian province or territory of residence; b) accommodate a stretcher for you, if required; andc) return one member of your immediate family member to your Canadian province or territory of residence,

provided that immediate family member is covered by an Alberta Blue Cross Travel Agreement and is travelling with you at the time of illness or accident.

11. When your medical emergency is such that the attending physician or the travel assistance service provider or commercial airline specifies in writing that you must be accompanied by a qualified medical attendant registered or licensed in the jurisdiction in which medical treatment is provided (who is not a related person) or a non-medical escort, we will reimburse the following eligible expenses for that person:

a) round trip economy airfare on a commercial flight by the most direct route; andb) overnight hotel and meal expenses, if required.





Return Flight Due to Medical Delay

12. We will reimburse the additional cost of your one-way transportation by the most cost-effective itinerary (being the lesser of a one way fare or change fee on existing tickets) to return you back to your Canadian province or territory of residence when you are delayed beyond your scheduled return date due to your illness, accident or hospitalization.

Friend/Family Hospital Visit

13. We will reimburse one round trip economy airfare, by the most direct route from the province of residence, and up to $250 per day to a maximum of $2,500 per trip for meals and accommodation for an immediate family member or friend to visit you when you are confined in a hospital. This benefit requires you to have been an inpatient for at least 3 days while outside of your Canadian province or territory of residence, plus the written verification of the attending physician that the situation was serious enough to have required the visit.

The immediate family member or friend is responsible for their own emergency medical travel insurance.

Identification of Deceased

14. In the event of your death during a trip, we will reimburse eligible expenses for one immediate family member or friend to go to your place of death to identify your body, when it is necessary to be identified prior to the release of your body for:

a) one round trip economy airfare, by the most direct route from the province of residence;b) meals and accommodation, to a maximum of $250 per day to a maximum of 3 days.

The immediate family member or friend is responsible for their own emergency medical travel insurance.

Return of Deceased

15. In the event of your death during a trip, we will reimburse eligible expenses for:a) the cost of preparation and homeward transportation of your body to your Canadian province or territory

of residence, to a maximum of $7,000 (excluding the cost of a coffin); orb) the cost of your cremation or burial at the place of death, to a maximum of $2,500.

Return of Dependants

16. We will reimburse a one-way economy airfare for the return of dependants travelling with you back to their original departure point, provided you have been admitted to hospital for more than 48 hours or require medical repatriation. This includes the cost for an escort to accompany the dependants when necessary and at our discretion. Receipts must be submitted.

Return of Personal Items

17. We will reimburse the cost to return your luggage or personal items if you are returned to your departure point by air ambulance as a result of a medical emergency, to a maximum of $500. This benefit also applies to reimbursement towards the cost of returning your personal items to your Canadian province or territory of residence in the event of your death. Receipts must be submitted.

Return of Pets 18. We will reimburse the cost of one-way transportation for the return of a pet if you are returned to your departure point by air ambulance as a result of a medical emergency, to a maximum of $500. Receipts must be submitted.

Return of Vehicle

19. If the attending physician determines that as a result of a medical emergency, you are incapable of continuing your trip by means of the vehicle used for that trip and your travelling companion is unable to return the vehicle for you, we will reimburse the reasonable and necessary charges incurred to return a vehicle that you own or rented to either your Canadian province or territory of residence or the nearest appropriate vehicle rental agency, to a maximum of $1,000. Medical certification is required, as well as receipts for costs incurred (i.e. fuel, accommodation, meals, airfares, etc.).

If your vehicle is rendered inoperable due to an accident, we will reimburse the costs for one-way economy airfare, to return you by the most direct route to your Canadian province or territory of residence. An official police report of the accident is required.


What is Not Covered – Exclusions

GENERAL EXCLUSIONS

In addition to the exclusions outlined below under “Exclusions Relating to Medical Conditions for Emergency Medical Coverage”, we will NOT provide coverage, nor pay or accept any liability for claims or expenses incurred directly or indirectly as a result of any of the following:

PRIOR TO YOUR TRIP

Surgery 1. Surgery which required hospitalization as an inpatient during the 3 month period immediately prior to your departure date.

Waiting List 2. The need for any surgery, medication or medical treatment of a condition where you are currently on a medical waiting list in Canada for that condition.

Scheduled Testing 3. Any medical condition where, prior to your departure date, there was a recommended or scheduled medical investigation, testing, or surgery, whether the medical treatment has occurred or not.

Travel Advisory 4. A medical emergency that is related in any way with a published formal travel advisory:a) issued by the Canadian Government before your departure date from your Canadian province or territory

of residence; andb) advising Canadians to avoid all travel or avoid all non-essential travel to the country, region or city of your trip.

DURING YOUR TRIP

Self prescribed/ Related Persons

5. Services or products that are prescribed or rendered by you or a related person.

Refusal to transfer to another facility or return to your Canadian province or territory of residence

6. Your refusal to transfer to another facility for medical treatment or return to your Canadian province or territory of residence if we, or our travel assistance service provider, determine that you should transfer to another facility for medical treatment or return to your Canadian province or territory of residence. This exclusion applies:

a) only to expenses or claims occurred after the date of your refusal;b) even if the medical treatment available in your Canadian province or territory of residence could be of

lesser quality than that available outside your Canadian province or territory of residence; andc) even if you must go on a waiting list in your Canadian province or territory of residence for the medical treatment.

Non-Acute Accommodation Facilities

7. Medical treatment, services or supplies provided in a chronic care facility or unit of a hospital, convalescent or nursing home, health spa or rehabilitation centre.

Non-Essential Treatment or Services

8. Expenses that are:a) not incurred as a result of a medical emergency;b) not medically necessary;c) general health examinations for “check-up” purposes; for elective services or medical treatment

(e.g. cosmetic surgery, chronic care, rehabilitation including any expenses for directly or indirectly related complications that are performed for cosmetic purposes);

d) medical treatment that was anticipated prior to your trip;e) services provided by naturopaths, homeopaths, optometrists, acupuncturists or nurse’s assistants;f) related to any treatment which is experimental or recognized by Alberta Health as experimental;g) ongoing maintenance or care of an existing medical condition; orh) related to rehabilitation or ongoing care in connection with drugs, alcohol or any other substance abuse.




DURING YOUR TRIP (CONTINUED)

Unlawful Acts 9. Any of the following:a) driving a motorized vehicle while impaired by drugs, toxic substances, or by alcohol with an alcohol level

of more than 80 milligrams per 100 milliliters of blood (0.08);b) committing or attempting to commit a criminal act or illegal act under the legislation at the location

where the accident occurred;c) participating in any act of terrorism; ord) participating in any act of war.

Sports 10. A medical emergency that occurs while training, competing, practicing or participating:a) as a professional in a sport or activity; b) in activities that involve any motor sport; or

c) any activities that involve an extreme sport.

Flight Accident 11. A flight or flying activity unless you are riding as a fare paying passenger on a commercial airline or charter aircraft with a seating capacity of 6 people or more. A flight or flying activity includes, but is not limited to:

a) light, ultralight or homebuilt aircraft;b) ballooning;

c) hang gliding, gliding;d) para-gliding or para-sailing;

e) parachuting; or f) sky diving.

Travel Assistance Service Provider

12. You, or someone on your behalf, fail to contact the travel assistance service provider prior to hospitalization.

Pregnancy 13. Any of the following:a) routine pre-natal care or post-natal care;b) voluntary termination of pregnancy or resulting complications from such termination;c) any of the following which occurs after the 32nd week of gestation:

i. childbirth;ii. miscarriage;

iii. complications relating to pregnancy; iv. complications relating to childbirth;

v. medical treatment for the newborn.

d) if, at any time during your pregnancy, your medical history indicated a pregnancy that is at high risk for medical complications or there is the risk of a premature birth.

Aircraft, Armed Forces or Commercial Vehicles

14. When a medical emergency or death occurs:a) while performing as a pilot or crew member of any aircraft;b) while participating in any maneuvers or training exercises of the armed forces;c) when you are a driver, the operator, a crew member or passenger on a commercial vehicle used for the

purpose of delivering goods or carrying a load. This exclusion is not applicable when the commercial vehicle is used during your trip solely for pleasure purposes and not for delivering goods or carrying a load.

Prior Approval Required 15. Failing to obtain our prior approval for any of the following:a) medical evacuation air ambulance services;b) medical evacuation repatriation;c) friend/family hospital visits;d) identification of the deceased;

e) return of the deceased;f) return of dependant children;g) return of personal items;h) return of pet(s);

i) diagnostic services;j) return of vehicle.

Helpful TipPlease see the Managing a Medical Emergency section on page 18 for further details on our travel assistance service provider.


PRIOR TO OR DURING OR AFTER YOUR TRIP

Misrepresentation, Inaccurate or Non-Disclosure of Information

16. You, or anyone acting on your behalf at any time, directly or indirectly, intentionally or unintentionally and/or knowingly or unknowingly:

a) provide incomplete or inaccurate information;b) make any material misrepresentation;c) fail to disclose any fact or circumstance including but not limited to:

i. your current medical condition or medical history;ii. answers to the travel insurance health questionnaire, if required;iii. your age; oriv. your coverage under the your provincial government health plan; or

d) make a fraudulent, false or exaggerated claim.

Failure to Follow Medical Advice

17. Any medical condition that you (whether prior to, during or after your trip):a) ignored symptoms;b) failed to accept or follow medical advice; orc) failed to undergo medical treatment, tests, or procedures as prescribed to you, including prescribed medication.

Misuse or Abuse of Alcohol, Drugs or Intoxicants

18. Any medical condition (whether prior to or during your trip), including symptoms of withdrawal, arising from, or in any way related to any of the following:

a) abuse of medication;b) toxic substances;c) abuse of alcohol;

d) the use of non-prescription drugs;e) the use of other intoxicants; orf) use of experimental drugs or products.

Helpful TipThis agreement is issued on the basis of information provided by you at the time of your application (including answers to the travel insurance health questionnaire, if required). When completing the application and answering the questions, your answers must be complete and accurate. In the event of a claim, we will review your medical history.




EXCLUSIONS RELATING TO MEDICAL CONDITIONS FOR EMERGENCY MEDICAL COVERAGE

In addition to the exclusions outlined under “General Exclusions” on page 12, the following exclusions apply to you if you are enrolled in one of the following plans:

IF YOU ARE COVERED UNDER: THE FOLLOWING EXCLUSION APPLIES TO YOUR COVERAGE:

PLAN NAME PLAN TYPE EXCLUSION

Emergency Medical 59 & Under Travel Plan


EXCLUSION 1: Applicable only if you are age 59 & underWe will NOT provide coverage, nor pay or accept any liability for any claim or expenses incurred directly or indirectly as a result of:

a) any medical condition that is NOT stable at any time within the 90 days prior to your departure date of each trip.

Comprehensive 59 & Under Package


Emergency Medical Blue Travel Plan

Single-Trip Plan

EXCLUSION 2:Applicable if you are age 60 & over We will NOT provide coverage, nor pay or accept any liability for claims or expenses:

a) incurred directly or indirectly as a result of ANY medical condition, that is NOT stable at any time within the 90 days prior to your departure date; OR

b) regardless of the nature of the medical emergency if:i. you have had any category A medical condition or related medical conditions

within 5 years of your departure date; ORii. you have had any category B medical condition or related medical conditions

within 2 years of your departure date.

Comprehensive Blue Package Single-Trip Plan

Emergency Medical Preferred Travel Plan

Single-Trip Plan

EXCLUSION 3:Applicable only if you are age 60 & overWe will NOT provide coverage, nor pay or accept any liability for claims or expenses:

a) incurred directly or indirectly as a result of any medical condition that is NOT stable at any time within the 90 days prior to your departure date; OR


within 5 years of your departure date; ORii. you have had any category B medical condition or related medical conditions

within 2 years of your departure date UNLESS you are stable for the entire 6 month period prior to your departure date.

Comprehensive Preferred Package Single-Trip Plan

Emergency Medical Standard Travel Plan

Single-Trip Plan

EXCLUSION 4:Applicable only if you are age 60 & overWe will NOT provide coverage, nor pay or accept any liability for claims or expenses:

a) incurred directly or indirectly as a result of any medical condition that is NOT stable at any time within the 90 days prior to your departure date; OR


within 5 years of your departure date UNLESS you are stable for the entire 12 month period prior to your departure date; OR

ii. you have had any category B medical condition or related medical conditions within 2 years of your departure date UNLESS you are stable for the entire 12 month period prior to your departure date.

Comprehensive Standard Package Single-Trip Plan


Please note, you must be stable based on the definition of stable in this agreement regardless of the opinion of your physician or any other person who may provide an opinion on your medical condition.

Table 1

CATEGORY A MEDICAL CONDITIONS

We will NOT provide coverage, nor accept any liability for claims or expenses regardless of the nature of the medical emergency if you currently have or have had any category A medical condition or related medical conditions within 5 years of your departure date AND if any of the following exclusions apply to you:

a) Exclusion 2;b) Exclusion 3; ORc) Exclusion 4 UNLESS you are stable for the entire 12 month period prior to your departure date.

Category A medical conditions include any or all of the following or any related medical conditions:

Cardiovascular/ Heart Conditions

• Aneurysm• Angina• Arrhythmia• Blood Clots• Chronic or recurrent Pericarditis• Congestive Heart Failure• Congenital Heart Disease• Coronary Artery Disease• Deep Vein Thrombosis

• Heart Attack• Heart Disease• Heart Palpitations• Hemophilia• Peripheral Vascular Disease• Pulmonary Embolism• Pacemakers• Valve Problems• Low Blood Pressure for persons

70 years of age and older

• Any prescription for Nitroglycerin medication (patch, pill, spray or any other form)

• Procedures involving any or all of angiogram, angioplasty, bypass, and carotid endarterectomy

• Any stent or bypass procedures• Any other circulatory problems • Any other cardiovascular or

heart conditions

Stroke and/or Transient Ischemic Attack (TIA) or Mini-Stroke

• Stroke• Transient Ischemic Attack (TIA) or Mini-Stroke

Inflammatory Bowel Disease

• Crohn’s Disease• Ulcerative Colitis

Liver Disease • Cirrhosis• Hepatitis

• Chronic or recurrent Pancreatitis• Any other liver diseases

Kidney Disease or Failure • Glomerulonephritis• Nephritis• Nephrotic Syndrome

• Renal Failure• Any serious kidney problems or disorders• Any other kidney diseases or kidney failures

Organ Transplant • Heart transplant• Kidney transplant• Liver transplant

• Lung transplant• Any other organ transplant




Please note, you must be stable based on the definition of stable in this agreement regardless of the opinion of your physician or any other person who may provide an opinion on your medical condition.

Table 2

CATEGORY B MEDICAL CONDITIONS

We will NOT provide coverage, nor accept any liability for claims or expenses regardless of the nature of the medical emergency if you currently have or have had any category B medical condition or related medical conditions within 2 years of your departure date AND if any of the following exclusions apply to you:

a) Exclusion 2;b) Exclusion 3 UNLESS you are stable for the entire 6 month period prior to your departure date; ORc) Exclusion 4 UNLESS you are stable for the entire 12 month period prior to your departure date.

Category B medical conditions include any or all of the following or any related medical conditions:

Cancer and/or Tumor • Aplastic Amenia• Benign Brain Tumor• Brain Cancer• Breast Cancer • Cervical Cancer • Colon Cancer• Hodgkin’s Disease

• Leukemia• Liver Cancer• Lung Cancer• Malignant Melanoma• Myelodysplastic Syndrome/

Myelofibrosis• Ovarian Cancer

• Pancreatic Cancer• Prostate Cancer• Stomach Cancer• Any other cancer or tumor

Gastrointestinal Conditions

• Bleeding Ulcers• Bowel Obstructions• Diverticulitis• Dysphagia

• Gallstones• Gastric Bypass• Gastrointestinal Bleed

• Procedures involving Ileostomy or Colostomy; and

• Any other bowel disorder

Lung Conditions • Active Tuberculosis • Asthma• Bronchiectasis• Chronic Bronchitis• Chronic Obstructive

Pulmonary Disease (COPD)

• Cystic Fibrosis• Emphysema• Pleural Effusion• Pneumothorax• Pulmonary Fibrosis

• Any use of Prednisone or any other oral steroids taken in pill or liquid form in the last two (2) years to treat a lung condition; and

• Any other lung conditions

If you have a medical condition or have been treated for a medical condition and are uncertain whether it pertains to the conditions listed, please call us.

Helpful TipPlease see definitions of medical condition and stable in the Definitions section of this agreement on page 46.


Managing a Medical Emergency

In a medical emergency, contact must be made with our travel assistance service provider before hospitalization, so that we may:

a) make the necessary arrangements to direct you to an appropriate clinic or hospital; and

b) provide pre-approval of medical treatment.

If it is impossible for you to make contact prior to obtaining medical treatment, we ask you to make contact as soon as possible or have someone make contact on your behalf.

If you, or someone on your behalf, do not contact the travel assistance service provider prior to hospitalization, your claim may be denied.

The travel assistance service provider has the authorization to act on our behalf. Subject to the terms and conditions of this agreement, the travel assistance service provider will:

1. Assist you in locating an appropriate physician, clinic or hospital.

2. Provide information and coordinate payment to the hospital and/or physician.

3. Monitor your medical treatment and keep your family informed.

4. Arrange for your transportation home, if medically permissible.

5. Arrange the transportation of an immediate family member to your bedside or to identify remains.

6. Arrange repatriation of remains when death occurs away from home.

7. Provide emergency response in most major languages, 24 hours/day, 7 days/week.

8. Assist in contacting family, business partner or family physician.

9. Coordinate local care of dependants or grandchildren with an escort if necessary, if you are hospitalized.

10. Coordinate the return home of dependants or grandchildren with an escort if necessary, if you are hospitalized.

11. Arrange the transmission of urgent messages to family members or business partners.

12. Coordinate with government embassies, airlines, tour operators, travel agents and others who will assist in the event of a medical emergency.

13. Assist in the event of loss of passports or airline tickets.

14. Assist in locating legal counsel in the event of a serious accident.

15. Coordinate claims processing and health care provider discounts.

Helpful TipOur travel assistance service provider can be contacted at:

Canada and the United States (call toll free): 1-888-772-2583

All other countries OR if you have any difficulties (call collect): 1-403-225-4289



TRIP CANCELLATION, TRIP INTERRUPTION, BAGGAGE COVERAGE

Trip Cancellation, Trip Interruption and Baggage Coverage

TRIP CANCELLATION AND TRIP INTERRUPTION COVERAGEThis coverage only applies if we issue a confirmation of coverage that specifies you have Trip Cancellation coverage and Trip Interruption coverage.

Trip Cancellation and Trip Interruption coverage may be purchased as part of a Single-Trip Plan or a Multi-Trip Annual Plan. Refer to the Single-Trip Plan and Multi-Trip Annual Plan section of this agreement for details on eligibility and when coverage begins and ends as they apply to the plan purchased for you.

Subject to the terms and conditions of this agreement, if your trip is cancelled, interrupted or delayed due to a covered reason, we will reimburse eligible expenses up to the benefit maximum as outlined in this benefits section.

Helpful TipThe Single-Trip and Multi-Trip Annual Plan section of this agreement can be found on page 32.


Do You Qualify?

You are eligible for Trip Cancellation and Trip Interruption coverage under this agreement if:


2. an application for your coverage is accepted by us and we issue a confirmation of coverage in your name that specifies you have Trip Cancellation coverage and Trip Interruption coverage. We reserve the right to accept or decline coverage for any person; and



The following benefits are applicable to both the Single-Trip Plan and the Multi-Trip Annual Plan. Refer to the Single-Trip Plan and Multi-Trip Annual section of this agreement for details on eligibility, when coverage begins and ends, changes, and refunds as they apply to the plan purchased for you.

COVERAGE PLAN TYPE BENEFIT MAXIMUM

Trip Cancellation coverage (prior to departure)

Single-Trip Plan Amount you choose based on trip value and as shown on your confirmation of coverage.

Multi-Trip Annual Plan up to $2,500 per person per trip

Trip Interruption coverage (after departure)


Unlimited*

* Additional benefit maximums apply as described below.

TRIP CANCELLATION (PRIOR TO DEPARTURE)

If you are required to cancel your trip as a result of a covered reason, you must notify your travel supplier on the day you became aware of the cause to cancel or within 72 hours of the occurrence of the covered reason forcing cancellation prior to the departure date. Only the amount that is non-refundable (up to the benefit maximum) on the day the covered reason occurs, or within the 72 hour period following the event forcing cancellation, will be considered for the purposes of the claim.

If your trip is cancelled due to a covered reason before your departure date, we will reimburse the eligible expenses you actually incur for the following benefits, provided such expenses are not otherwise covered by the common carrier:

Transportation Costs 1. The non-refundable and non-transferable portion of:a) pre-paid transportation; b) other travel arrangements; andc) any cancellation penalties (including published cancellation penalties imposed by hotels for

unused accommodations).

Helpful TipThe Eligibility Requirements section of this agreement can be found on page 32.



Change Fees 2. If you choose to reschedule rather than cancel your trip, the change fee charged for rebooking the travel arrangements as originally booked for your trip (when such an option is made available).

New Occupancy Charges 3. The difference between double occupancy (or applicable rate) and single occupancy rate charged as a result of your travelling companion being unable to travel due to a covered reason, if you decide to go on your trip as originally planned.

TRIP INTERRUPTION (AFTER DEPARTURE)

If your trip is interrupted due to a covered reason that occurs after your departure date, we will reimburse the eligible expenses you actually incur for the following benefits, provided such expenses are not otherwise covered by the common carrier:

Transportation Costs 1. The additional cost of your one-way transportation by the most cost effective itinerary (being the lesser of a one way fare or change fee charged by the common carrier on existing tickets) to return to your Canadian province or territory of residence.

Additional Transportation Costs

2. The additional cost of transportation to rejoin a tour, group or trip if you have not been returned to your Canadian province or territory of residence as a result of a covered reason.

Non-Refundable Prepaid Expenses

3. The fully prepaid unused portion of travel arrangements for your trip that are non-refundable and non-transferrable to another travel date, less the prepaid unused transportation to your Canadian province or territory of residence.

Boarding Fees 4. We will reimburse boarding fees at a licensed facility for your domestic pets if you are prevented from returning to your original departure point due to a delay of a common carrier, to a maximum of $100.

Return of Deceased 5. In the case of death during a trip the cost of:a) preparation and transportation of your remains to your Canadian province or territory of residence,

to a maximum of $7,000 (excluding the cost of a coffin); or b) your cremation or burial at the place of death, to a maximum of $2,500.

New Occupancy Charges 6. The additional cost of new occupancy charges incurred if you choose to continue the trip when your travelling companion must cancel.

Vehicle Return Expenses 7. The published cancellation penalties imposed for early return of a rental vehicle prior to the contracted date of return, to a maximum of $1,000.

Meals and Accommodation

8. We will reimburse up to $250 per day per person to a maximum of $2,500 per person per trip, when certain essential expenses are incurred if:

a) your return to your Canadian province or territory of residence is delayed beyond your contracted date of return; or

b) your trip is delayed as a result of a covered reason.

The expenses covered are:a) accommodation;b) meals in a commercial establishment;c) your essential phone calls; and d) transportation by taxi.



Covered Reasons

Benefits are payable under Trip Cancellation and Trip Interruption coverage if your trip is cancelled, interrupted, or delayed due to any of the following covered reasons. The covered reason must occur after the later of the booking date or the effective date.

Health 1. Benefits are payable if, the person listed in Table 3 below suffers the covered reason noted in the column opposite that person.

If a medical emergency delays your return to your Canadian province or territory of residence, you must return on the earliest of:

a) the date you are deemed medically fit to travel by the attending physician or our travel assistance service provider; or

b) 72 hours following the end of your or your travelling companion’s medical emergency or discharge from hospital.

If you need to make a claim for health reasons, your claim must be supported by documentation from the attending physician at the place where the medical emergency occurs.

Table 3

Person Covered Reason

• you; or • your travelling companion

• medical emergency;• dies; or• unexpected birth of immediate family member

• your immediate family member;• your key employee; • caregiver; or• your travelling companion’s spouse

• admitted to hospital with a medical emergency; or • dies

• the person whose guest you are during your trip

• admitted to hospital at your destination with a medical emergency; or

• dies

• you; or • your travelling companion

• are not able, due to medical reasons, to receive an injection or medication that is suddenly required for entry into a country, region or city originally indicated in your itinerary, provided that this requirement was not mandatory prior to the booking date or prior to the date this coverage is purchased, whichever occurs later

Sports and Events 2. Benefits are payable if:a) you or your travelling companion are prevented from participating in a sporting event due to a medical

emergency if the purpose of your or your travelling companion’s trip was to participate in that sporting event; orb) your primary reason for the trip is to attend a wedding, funeral, school graduation ceremony, concert or

commercial entertainment event for which you have purchased tickets, and:i. your scheduled time of arrival is delayed for a reason beyond your control; orii. the event was scheduled before your booking date and cancelled for reasons beyond your or your

travelling companion’s control.

Supporting documentation, including tickets are required to substantiate the claim.



Pregnancy 3. Benefits are payable if the person listed in Table 4 below suffers a covered reason noted in Table 4:

Table 4

Person Covered Reason

• you;• your spouse;• your travelling companion;• your travelling companion’s spouse; • your immediate family member;• your travelling companion’s

immediate family member

• suffer complications of pregnancy*, including early delivery, in the first 32 weeks of a pregnancy; or

• are diagnosed as pregnant after the booking date for that trip or the effective date, whichever is later, if the departure date is in the 9 weeks before or after the expected delivery date.

* For the purposes of this covered reason only, the following are not considered complications of pregnancy:a) confirmation of a multiple pregnancy; or b) confirmation of a pregnancy as a result of fertility treatment.

Adoption 4. Benefits are payable if:a) you or your travelling companion are notified that the actual date of a legal adoption of a child by you or your

travelling companion is scheduled to take place during your trip.

Employment 5. Benefits are payable if:a) a business meeting, trade show, convention, conference or training course is cancelled for a reason beyond

your or your travelling companion’s control, or the control of your or your travelling companion’s employer if:i. it was scheduled before the purchase of this coverage;ii. it is the sole purpose for the trip;iii. it pertains to your current full-time occupation or profession; iv. it is held between or by companies with unrelated ownership; and v. in the case of a conference or convention, you or your travelling companion are a registered delegate;

b) you or your travelling companion are unexpectedly transferred by the employer for whom you or your travelling companion work on the booking date and must move from your or your travelling companion’s respective principal residence. The person who has been requested by their employer to relocate must be a full-time active employee for this benefit to apply;

c) you or your travelling companion experience involuntary loss of permanent employment (excluding self-employment or contract work) due to layoff or dismissal without just cause, provided:

i. you or your travelling companion were actively employed with the same employer for at least one year prior to the effective date; and

ii. the loss of permanent employment was not reasonably foreseeable on the booking date;d) you, your spouse, your travelling companion or your travelling companion’s spouse are called to or issued

a summons to essential emergency service during your trip as a reservist, firefighter, emergency medical personnel, police force or military service (active or reserve).

Educational Obligations

6. Benefits are payable if:a) you or your travelling companion’s accredited university or college examination or class was rescheduled

due to circumstances beyond you or your travelling companion’s control; andb) the examination or class is rescheduled to a date during you or your travelling companion’s trip.

A copy of the original official examination or class schedule and the notice of rescheduling must accompany any claim submission.



Travel Documents and Visas

7. Benefits are payable if:a) you or your travelling companion are not issued a travel visa (other than an immigration, student or

employment visa) necessary to enter the country or destination of the trip, for reasons beyond your or your travelling companion’s reasonable expectation or control;

b) your or your travelling companion’s passport or other necessary travel documents are lost or stolen while on your or their trip; or

c) your or your travelling companion’s passport is not issued within the time confirmed to you or them in writing by Passport Canada.

Legal 8. Benefits are payable if you or your travelling companion are:a) required to appear for jury duty; b) required to appear as a defendant in a civil suit; orc) subpoenaed as a witness,

and the court proceeding is scheduled to be heard during the trip. This covered reason does not apply if you are a law enforcement officer.

Government Advisories

9. Benefits are payable if:a) a travel advisory is issued for your trip destination where the Canadian government has recommended that

Canadians should avoid all travel, or avoid non-essential travel, to your trip destination for the period that includes your travel dates; and

b) such travel advisory is still in effect on your scheduled departure date.

Accommodations 10. Benefits are payable if:a) fire, flood, burglary, vandalism or natural disaster which is completely independent of any intentional or

negligent act on your or your travelling companion’s part:i. renders your or your travelling companion’s principal residence uninhabitable; orii. if you are self-employed, does not permit the operation of your or your travelling companion’s

primary business;b) fire, vandalism, burglary or other disaster renders your pre-booked destination accommodations

uninhabitable; or c) your principal residence or place of business is burglarized or vandalized within 7 days before the scheduled

departure date, or during your trip, as a result of which you must make the location secure or meet with the insurance company or police authorities.

Delays, Schedule Changes and Missed Connections

11. Benefits are payable if:a) an unannounced strike is issued for your common carrier for which you hold a valid ticket on;b) you or your travelling companion are delayed on route to a scheduled departure point when you are a passenger

in, or the driver of, a private passenger vehicle or a passenger in a common carrier that experiences a covered situation, provided:

i. the private passenger vehicle or common carrier was scheduled to arrive in enough time to meet the travel supplier’s check-in procedure; and

ii. such delay causes you to miss a departure or a connection at any point during your trip or results in the interruption of your trip.

A covered situation means mechanical failure, severe weather conditions, volcanic eruption, natural disaster, strike or lock- out lasting more than 24 hours, traffic accident or emergency police-directed road closure.

This covered reason 11(b) applies to Trip Interruption coverage only.

(continued on the next page)



Helpful TipMisconnection and travel delay coverage is intended to help you with the extra expense you incur to catch up to your trip if you experience a misconnection or travel delay. You must make reasonable efforts to continue on your trip.

Delays, Schedule Changes and Missed Connections (Continued)

11. c) you or your travelling companion experience an unexpected delay of a scheduled trip on a common carrier, due to weather conditions, for a period of at least 30% of the total duration of your trip, when you choose not to continue with your trip;

d) you miss a connection or your trip is cancelled due to a schedule change or cancellation by the common carrier that is providing transportation for a portion of your trip; or

e) you or your travelling companion are detained by immigration or customs officials due to mistaken identity which caused you to miss a departure or a connection at any point during your trip or results in the interruption of your trip.

Default of Travel Supplier

12. Benefits are payable if: a) your or your travelling companion’s travel services are undelivered due to the default of a travel supplier with

whom you or someone on your behalf booked your transportation and/or travel arrangements. Payment is limited to $3,500 subject to a maximum amount payable for all losses resulting from the default of one travel supplier to the aggregate maximum of $150,000 for all persons who make a claim under all in force agreements issued by us relating to the same travel supplier’s default. If it is estimated that claims will exceed the $150,000 aggregate limit in a calendar year, benefits will be payable on a prorated basis.

Cruise or Tours 13. Benefits are payable if:a) your cruise, tour, or travel package is cancelled or has a schedule change by the cruise company or tour

operator, for any reason other than default; orb) you or your travelling companion are taken off the cruise ship for medical reasons to the nearest medical facility

equipped to provide the required treatment. Benefits under this covered reason are only applicable during hospitalization. This covered reason applies to Trip Interruption coverage only.

Other 14. Benefits are payable if: a) you or your travelling companion are hijacked or quarantined; orb) an act of terrorism directly or indirectly causes you a loss which benefits would otherwise be payable under

this agreement, provided a travel advisory was not issued for your trip destination prior to your departure date where the Canadian government has recommended that Canadians should avoid all travel, or avoid non-essential travel, to your trip destination for the period that includes your travel dates. Any benefit is subject to an overall aggregate maximum of $150,000 per calendar year for all persons who make a claim under all in force agreements issued by us, including this agreement, relating to that act of terrorism. If it is estimated that claims will exceed the $150,000 aggregate limit in a calendar year, benefits will be payable on a prorated basis. Coverage is available for up to 2 acts of terrorism within a calendar year.




We will NOT provide coverage, nor pay or accept any liability for claims or expenses incurred directly or indirectly as a result of any of the following:

Anticipated Events 1. Under a Single-Trip Plan, if on or before the effective date, you, your immediate family member or travelling companion knew, or were aware of, any reason, circumstance or event which might reasonably have been expected to necessitate cancellation, interruption or delay of your trip.

Under a Multi-Trip Annual Plan, if, on or before the later of the booking date of your trip or the effective date, you, your immediate family member or travelling companion knew, or were aware of, any reason, circumstance or event which might reasonably have been expected to necessitate cancellation, interruption or delay of your trip.

Financial Problems or Conflicts

2. If loss or expenses are incurred due to, or resulting from, or in any way related to any or all of the following:a) financial problems;b) conflicts between travelling companions;c) inability to obtain desired accommodations; or d) your aversion to the trip, transportation or accommodations.

Medical Conditions 3. If loss or expenses are incurred due to, or resulting from, or in any way related to any medical condition: a) that was NOT stable at any time under a:

i. Single-Trip Plan, within 90 days prior to the effective date; orii. Multi-Trip Annual Plan, within 90 days prior to the later of the booking date of your trip or the effective date.

b) if you undertake your trip with the prior knowledge that you will seek treatment, surgery, investigations, palliative care or alternative therapy of any kind, regardless of whether the treatment, surgery investigations, palliative care or alternative therapy is related in any way to the medical condition;

c) for which it was reasonable to expect before you left your Canadian province or territory of residence that you would need treatment during your trip; and/or

d) which caused symptoms that would have caused an ordinarily prudent person to seek treatment in the three months before leaving your Canadian province or territory of residence.

This applies to you, your immediate family member or travelling companion. You must be stable based on the definition of stable in this agreement regardless of the opinion of your physician or any other person who may provide an opinion on your medical condition.

Visiting Ailing Persons

4. If your trip was undertaken for the purpose of visiting or attending an ailing person, whose medical condition or ensuing death is the cause of the cancellation or interruption of the trip or delays your return home.

Default of Travel Supplier

5. If, on or before the later of the booking date of your trip or the effective date, you knew or ought to have known that the travel supplier was in receivership, insolvent or bankrupt, we will not pay any costs incurred due to losses arising as a result of the default of that travel supplier.

Helpful TipPlease see definitions of medical condition and stable in the Definitions section of this agreement.



Refused Entry 6. If you are refused entry at a customs, border crossing or security checkpoint due to:a) your failure or neglect to obtain required vaccinations; b) your inability to present required travel documents except as provided for under the covered reasons; or c) your criminal convictions.

Travel Accommodation from Owners

7. If accommodations are rented privately from a related person, we will not cover other private rental arrangements unless:a) you provide a written rental contract dated on or before non-refundable penalties went into effect;b) you provide copies of all payments, including the original deposit; andc) the property provider is available to verify cancellation penalty policies and verify partial or full refunds issued

or pending.

Scheduled Testing 8. If costs or expenses are incurred due to the change of the date of a medical test or surgery that was scheduled before your trip.

Government Advisories

9. If loss or expenses are incurred due to, contributed to by, or resulting from any accident or illness which:a) occurs in an area for which the Canadian government issued a travel advisory before the later of the

booking date or the effective date to avoid all travel, or to avoid non-essential travel, to that area; and b) is due to, contributed to by, or results from the reason for issuance of the Canadian government travel advisory.

Non-Common Carrier Air Travel

10. If loss or expenses are incurred due to, or resulting from, air travel, unless riding as a passenger on a common carrier.

Misuse or Abuse of Alcohol, Drugs or Medication

11. If loss or expenses are incurred due to, or resulting from, any medical condition (whether prior to or during your trip), including symptoms of withdrawal, arising from, or in any way related to any or all of the following:

a) misuse of medication (whether prescribed or not);b) toxic substances;c) abuse of alcohol;

d) the use of non-prescription drugs;e) the use of other intoxicants; orf) the use of experimental drugs or products.

Unlawful Acts 12. If loss or expenses are incurred due to, or resulting from, or in any way related to any or all of the following:a) driving a motorized vehicle while impaired by drugs, toxic substances, or by alcohol with an alcohol level of

more than 80 milligrams per 100 milliliters of blood (0.08);b) committing or attempting to commit, a criminal act or illegal act under the legislation at the location where

the accident occurred;c) participating in any act of terrorism; ord) participating in any act of war.

Risky Activities 13. If loss or expenses are incurred due to, or resulting from, or in any way related to training, competing, practicing or participating in any of the following:

a) as a professional in a sport or activity; b) in activities that involve any motor sport; or c) any activities that involve an extreme sport.

Work 14. If loss or expenses are incurred due to, or resulting from, or in any way related to a work related accident.

Pregnancy 15. If loss or expenses are incurred due to, or resulting from, or in any way related to pregnancy or childbirth except as specified under the Pregnancy covered reason.

Other Sources 16. If loss or expenses are reimbursed by any other source, including trustees or any government or industry compensation fund.



BAGGAGE COVERAGEThis coverage only applies if we issue a confirmation of coverage that specifies you have Baggage coverage.

Baggage coverage is included with Trip Cancelation and Trip Interruption coverage and may be purchased as part of a Single-Trip Plan or a Multi-Trip Annual Plan. Refer to the Single-Trip Plan and Multi-Trip Annual Plan section of this agreement for details on eligibility and when coverage begins and ends as they apply to the plan purchased for you.

Subject to the terms and conditions of this agreement, we will reimburse reasonable and customary expenses incurred due to the loss, theft, damage or delay of your baggage, not otherwise covered by the common carrier, up to the amount of coverage purchased for you as outlined in this benefits section.

Do You Qualify?

You are eligible for Baggage coverage under this agreement if:


2. an application for your coverage is accepted by us and we issue a confirmation of coverage in your name that specifies you have baggage coverage. We reserve the right to accept or decline coverage for any person; and


Helpful Tips• The Single-Trip Plan

and Multi-Trip Annual Plan section of this agreement can be found on page 32.

• The Eligibility Requirements section of this agreement can be found on page 32.


Helpful TipKeep receipts for all your purchases for items you usually take on trips.



COVERAGE BENEFIT MAXIMUM

Baggage Coverage (after departure)

Loss/Theft: $500 per item to a maximum of $1,500 per person per tripDelay: $500 per person per trip

Subject to the terms and conditions of this agreement, we agree to reimburse you for the eligible expenses per person, per trip, for the following benefits provided such expenses are not otherwise covered by the common carrier:

Reimbursement for Lost, Damaged or Stolen Baggage and Personal Effects

1. If, during your trip, any one item or set of items are lost, damaged or stolen, by reason of theft, burglary, fire or transportation hazards, we will reimburse you the lesser of:

a) the repair cost; or b) actual cash value of the item after depreciation based on age and condition.

The maximum we will reimburse you will not exceed the lesser of:a) the cost to replace with an item of similar quality and value; b) the reasonable proportion of the total value of a set when the item was part of a set; and c) $500 per item or set of items, up to a benefit maximum of $1,500. Items which are purchased for use

together and commonly used together are considered as a single item. Jewellery or photography equipment (including camera, video cameras and video or audio equipment) are, respectively, considered as a single item.

Replacement of Lost or Stolen Travel Documents

2. If any one or more of the following documents are lost or stolen, we will reimburse the expenses incurred by you to replace the lost or stolen documents, up to a benefit maximum of $150:

a) passport; b) driver’s license;

c) birth certificate; ord) travel visa.

Delay of Baggage and Personal Effects

3. If your checked baggage is delayed by the common carrier for 12 hours or more while en route and before returning to your departure point, we will reimburse you for the purchase of reasonable and necessary toiletries and essential clothing while on your trip, up to a benefit maximum of $500, subject to the following:

a) purchases must be made within 36 hours of arrival at your destination and before you receive your baggage; and

b) proof of delay of checked baggage from the common carrier along with receipts of purchases must accompany the claim.

This benefit does not apply to baggage delayed after you have returned to your Canadian province or territory of residence.

You must submit a claim to the common carrier first, if applicable.

Helpful Tips• Baggage Coverage covers the typical things you would travel with or would need at your destination.

The purpose of this coverage is to keep you travelling and well enough equipped to enjoy your trip in case your baggage does not arrive on time, or is lost. This Benefit does not cover items that you simply misplaced during your trip.

• When buying any new luggage, suitcases, or travel duffle bags, scan or photocopy the receipt. If you have a baggage claim in the future, it will be required. Keep receipts for all your purchases for items you usually take on trips.




We will NOT provide coverage, nor pay or accept any liability for claims or expenses incurred directly or indirectly as a result of any of the following:

Excluded Items 1. Benefits are not payable if any of the following are lost, stolen or damaged:• animals; • bicycles that are not checked as baggage

with the common carrier;• any camera, camera equipment or jewellery

placed in custody of the common carrier;• household items and furnishings; • consumables;• perishable goods;• artificial teeth or limbs; • hearing aids or other medical supplies or

appliances;• sunglasses; • contact lenses; • eye glasses;

• forms of money and currency; • paintings;• event tickets (except for administrative fees required

to reissue such tickets); • securities, document;• items related to your occupation; • antiques or collector items;• fragile items (unless loss or damage caused by fire

or theft);• computer software, including any expenses incurred

for the restoration of any lost or corrupted data;• items that are obtained illegally; or• articles that are insured on a valued basis by

another insurer.

Items Left Unattended 2. Benefits are not payable for personal property left in an unattended vehicle (including the vehicle’s trunk) unless it was securely locked and there was visible evidence of forced entry.

Unaccompanied Baggage 3. Benefits are not payable for unaccompanied baggage.

Normal Wear and Tear 4. Benefits are not payable for loss or damage due to, contributed to by, or resulting from normal wear and tear, deterioration, moths or vermin or while the item is actually being worked upon or processed.

Customs 5. Benefits are not payable for damage caused by the confiscation, detention, requisition or destruction of your baggage and personal effects by customs or other authorities.

Insufficient Supporting Documentation

6. Benefits are not payable for articles purchased during your trip without original receipts attached to the claim.

Other Insurance 7. Benefits are not payable for loss or damage to property insured under any insurance policy.

Reimbursement By Others

8. Benefits are not payable for any loss reimbursed by the common carrier, hotel or travel supplier including any services rendered by such common carrier, hotel or travel supplier.

Terrorism/War 9. Benefits are not payable for any loss or damage due to an act of terrorism or act of war.



What Conditions Apply

In addition to the General Conditions, Baggage Coverage is subject to the following conditions. Failure to comply with these conditions will invalidate any claim under this agreement.

1. In the event of theft, burglary, robbery or malicious mischief, immediately upon discovery, you must promptly:

a) notify and obtain supporting documentary evidence from the police, or if the police are unavailable, the hotel manager, tour guide or transportation authority. Failure to report the loss shall invalidate any claim under this agreement for such loss;

b) take all reasonable precautions to protect, save and/or recover the property; and

c) notify us upon your return to your departure point.

2. We have the option to repair or replace any damaged or lost property with other of similar kind, quality and value and to require submission of the property for appraisal of damage.

3. If property covered under this agreement is under check of a common carrier and delivery is delayed, coverage will continue until such property is delivered by the common carrier.


Helpful TipGeneral Conditions section of this agreement can be found on page 42.


Single-Trip Plan and Multi-Trip Annual Plan(Applicable to all coverage described in this agreement)

Eligibility Requirements

You are NOT eligible for ANY coverage under this agreement, regardless of the nature of the claim, and we will not pay ANY benefit or claim or accept ANY liability if ANY of the following apply to you:

Medical 1. If you have intentions of seeking any medical consultation, medical treatment, surgery, investigation, diagnosis, palliative care, alternative therapy or second opinion. This applies even if the trip is on the recommendation of a physician or other medical professionals;

2. If you have booked travel or commenced travel contrary to medical advice or where your physician or other medical professionals have advised you not to travel;

3. If you have ever had two or more major strokes (major strokes are strokes that have resulted in symptoms that lasted for more than 24 hours);

4. If you have an implantable cardioverter-defibrillator (ICD);5. If you are currently using home oxygen;6. If you are currently receiving kidney dialysis;7. If you have received a terminal prognosis; 8. If you have been diagnosed with acquired immune deficiency syndrome (AIDS).

Trip Duration 9. If you did not purchase coverage from us for your entire trip;

Must Purchase Before You Leave

10. If you did not purchase coverage from us before you leave your Canadian province or territory of residence (not applicable to extensions).

SINGLE-TRIP PLAN AND MULTI-TRIP ANNUAL PLAN


When Does Coverage Begin and End?

Coverage begins and ends depending on the type of plan purchased for you (Single-Trip Plan or Multi-Trip Annual Plan) as indicated on the confirmation of coverage and depending on the type of coverage as described below:

SINGLE-TRIP PLAN

covers only one trip

must be purchased before you leave your Canadian province or territory of residence

is valid for the maximum number of consecutive days (the eligible trip limit) as indicated on the confirmation of coverage

is valid only if you purchase coverage from us for your entire trip

if you return to your Canadian province or territory of residence prior to the return date, any unused days of coverage under this agreement are void

if a trip begins on the departure date and ends on the return date as indicated on your confirmation of coverage

if you need to change your dates of travel before you depart, you must contact us prior to your departure date

if you need to extend your coverage after you depart, you must contact us prior to the expiry date indicated on your confirmation of coverage

TYPE OF COVERAGE WHEN DOES COVERAGE FOR THE TRIP BEGIN? WHEN DOES COVERAGE FOR THE TRIP END?


On the later of the:a) departure date; andb) effective date.

On the earlier of:a) the date you return to your Canadian province

or territory of residence; andb) at 11:59 p.m. on the return date.

Trip Cancellation Coverage

On the effective date as indicated on your confirmation of coverage.

On the earlier of:a) the date of the cancellation of your trip; and b) the date you depart your Canadian province or

territory of residence.

Trip Interruption Coverage

On the departure date. On the earlier of:a) the date you return to your Canadian province


Baggage Coverage On the departure date. On the earlier of:a) the date you return to your Canadian province




MULTI-TRIP ANNUAL PLAN

is in effect from the effective date and terminates on the expiry date as shown on your confirmation of coverage, which is a period of one year less a day

must be purchased before you leave your Canadian province or territory of residence

covers any number of trips, each to a maximum number of consecutive days per trip (the eligible trip limit) as indicated on the confirmation of coverage. All terms and conditions in this agreement are effective prior to the departure date for each trip

the duration of each trip begins on the departure date and terminates when you return to your Canadian province or territory of residence

you may travel as many times as you wish during the period of coverage provided that no one trip exceeds the eligible trip limit

you must return to your Canadian province or territory of residence to be eligible for an additional trip

if you plan to travel for longer than the eligible trip limit for any trip, then you must contact us to purchase an extension prior to the return date for that trip

TYPE OF COVERAGE WHEN DOES COVERAGE FOR THE TRIP BEGIN? WHEN DOES COVERAGE FOR THE TRIP END?


On the later of the:a) departure date; andb) effective date.

On the earliest of:a) the date you return to your Canadian province or

territory of residence;b) the date you turn 18 years of age, if you are a dependant; orc) at 11:59 p.m. on the date the eligible trip limit for that trip is

reached; andd) at 11:59 p.m. on the expiry date.

Trip Cancellation Coverage

On the later of the:a) booking date of your trip; andb) effective date.

On the earliest of:a) the date of cancellation of your trip;b) the date you depart your Canadian province or territory of residence;c) the date you turn 18 years of age, if you are a dependant; andd) at 11:59 p.m. on the expiry date.

Trip Interruption Coverage

On the departure date for that trip. On the earliest of:a) the date you return to your Canadian province or

territory of residence; b) the date you turn 18 years of age, if you are a dependant; orc) at 11:59 p.m. on the date the eligible trip limit for that trip is


Baggage Coverage On the departure date for that trip. On the earliest of:a) the date you return to your Canadian province or

territory of residence; b) the date you turn 18 years of age, if you are a dependant; orc) at 11:59 p.m. on the date the eligible trip limit for that trip is




When Does Coverage Automatically Extend?

If you cannot return to your Canadian province or territory of residence as originally scheduled, your coverage will automatically be extended without additional premiums only under any of the following circumstances. You will be required to provide proof of the reason for the delay in the event that you have to file a claim.

Delay of Transportation 1. Coverage will be automatically extended for up to 72 hours if you are prevented from returning to your Canadian province or territory of residence on or before the return date for that trip due to:

a) delay, due to circumstances beyond control, of the common carrier in which you are riding or are scheduled to ride as a passenger. The delay must occur before the return date for that trip and the common carrier must have been originally scheduled to arrive before the return date for that trip; or

b) mechanical breakdown or an accident of the personal vehicle in which you are travelling. The mechanical breakdown or accident must occur before the return date for that trip and your return journey must have commenced prior to the return date for that trip.

Medically Unfit to Travel 2. Coverage will automatically be extended for up to 72 hours if medical evidence supports that you or your travelling companion are medically unfit to travel due to a medical emergency on or before the return date for that trip.

Hospitalization 3. Coverage will automatically be extended during the period of hospitalization, plus up to an additional 72 hours after discharge from the hospital, if you or your travelling companion are hospitalized at the end of your trip as a result of a covered reason. The hospitalization must occur before the return date for that trip.

What if You are Staying Longer than Planned?

If you are staying longer than planned, to maintain coverage you must purchase an extension. An extension is required to extend:

a) the eligible trip limit in a Single-Trip Plan or Multi-Trip Annual Plan; or

b) the number of days of coverage available by your existing individual health plan or your existing group travel plan.

We will extend the number of trip days for your coverage provided that:

1. you apply for the extension prior to the expiry of your current coverage;

2. you maintain coverage from us for the entire duration of your trip;

3. there is no cause for a claim against this agreement;

4. there will be no coverage under the extension in relation to any claim or treatment that, directly or indirectly, has occurred or will be submitted prior to the effective date of the extension; and

5. the extension is approved by us and you have paid any additional required premium prior to the effective date of the extension.

If approved by us, an extension is in effect from the effective date and terminates on the return date.

All terms, conditions and exclusions of this agreement apply to you during an extension period. Please be aware that the exclusions and conditions of this agreement will be in effect during the extension period. These exclusions and conditions may differ from those within your individual health plan or your existing group travel plan.

Helpful TipThere must not be a break in coverage from us for the entire duration of your trip.



REFUNDS

RefundsEligibility Requirements

A refund may be available provided no claim has been paid, incurred or reported under this agreement. If a refund is provided, no claims will be paid by us under this agreement.

Please refer to the coverage outlined below for the refund that may be available for the coverage purchased. Refunds will be issued provided you provide us with satisfactory evidence that the conditions applicable to the respective coverage listed below are met. An administration fee may be deducted from any refund.

PLAN TYPE COVERAGE CONDITIONS

Single-Trip Plan Emergency Medical coverage a) a full refund will be issued if we receive a request to terminate this agreement prior to the effective date.

b) a partial refund will be issued if, i. prior to the expiry date, we receive a request to terminate

coverage and proof of your early return (e.g. customs or immigration stamp, gas receipts); and

ii. there is no claim pending or paid.

Trip Interruption, Trip Cancellation and Baggage coverage

A full refund will be issued if:a) you cancel your trip before any cancellation penalties

are in effect; b) the carrier/travel supplier cancels the entire trip and

all penalties are waived; orc) the carrier/travel supplier changes the travel dates and

you are unable to travel on those dates and all penalties are waived.


Emergency Medical coverage a) Non-refundable (for any reason) after the effective date.

Trip Interruption, Trip Cancellation and Baggage coverage

A full refund will be issued if:a) no travel has taken place by you; and b) the request for the refund is received by us prior to

the effective date.


Claim InquiriesEmergency Medical

If you must contact our travel assistance service provider in the event of a medical emergency or prior to hospitalization as shown under “What is Covered – Benefits” for Emergency Medical coverage, or if you require assistance with benefit eligibility for Emergency Medical coverage, please contact our travel assistance service provider:

Canada and the United States (call toll free) 1-888-772-2583

All other countries; OR If you have any difficulties, (call collect) 1-403-225-4289

Trip Interruption, Trip Cancellation and Baggage

If you must cancel your trip, if your trip is interrupted, or if you experience loss, theft or damage to your baggage, and require assistance with benefit eligibility, please contact us at 1-800-661-6995, so that we may:

a) provide information on the specific benefits;

b) relay eligibility criteria concerning the benefits and any benefit maximum; or

c) provide assistance on how to claim for the benefits.

CLAIM INQUIRIES


HOW TO FILE CLAIM

How to File ClaimEligibility Requirements

1. CLAIMS SUBMISSION

a) When must you notify us of a claim? You must report your claim to us within 30 days of the date the eligible expense was incurred under Trip Cancellation, Trip Interruption and Baggage coverage.

b) When must you submit your claim for approval?You must submit your information required to support to your claim within 90 days of the date the eligible expense was incurred. If it is not reasonably possible to provide such information within 90 days, you must do so within 12 months of the date the eligible expense was incurred. We will not be liable for any claim received by us more than 12 months after the date the eligible expense was incurred.

c) What must you provide when you submit a claim?You must substantiate your claim by providing the documents described in the applicable coverage below as well as all supporting documentation reasonably required by us, including but not limited to, proof of both departure from and return to your Canadian province or territory of residence. The type of proof depends on whether you travelled via airline, car, boat, or train (for example, copies of airline tickets, itinerary, boarding passes, gas receipts).

i. Emergency Medical CoverageWhen submitting a claim for Emergency Medical coverage, the following documentation is required:

(1) a completed Insurance Claim Consent and Authorization Form;

(2) a completed Travel Claim Form outlining the details of the loss and which must include original invoices; and

(3) medical information, records, or copies of medical records from any physician (including but not limited to your physician), dentist, health care practitioner, hospital, other insurers, or any party that has diagnosed, treated, attended or rendered service to you.

Forms are available at ab.bluecross.ca

ii. Trip Cancellation, Trip Interruption and Baggage CoverageWhen submitting a claim for Trip Cancellation, Trip Interruption and Baggage coverage, the following documentation is required:

(1) a completed Trip Cancellation, Trip Interruption and Baggage Coverage Claim Form (available by contacting us at 1-800-661-6995 or at ab.bluecross.ca) outlining the details of the loss and which must include original invoices from commercial organizations including the return of unused travel documents or original tickets for claimed expenses, a copy of the travel supplier’s refund policy and other supporting documentation as requested;



HOW TO FILE CLAIM

(2) proof of the cause of the claim, including:

a) if your claim is for medical reasons, a medical certificate completed by the attending physician stating why travel was not possible as booked and a copy of the entire medical file of any person whose health or medical condition is the reason for your claim. The medical certificate must include:

i. a complete diagnosis;

ii. the date the medical condition was known; and

iii. the medical necessity of cancelling, delaying or interrupting your trip.

b) a report from the police, common carrier, cruise, tour operator or other responsible authority documenting the reason for the delay if your claim is due to misconnection.

(3) for coverage due to default, written notice of the claim must be submitted within 60 days of the day on which the travel supplier announces that it is in default, along with the following:

a) copies of receipts and proof of payment to travel suppliers;

b) copies of unused transportation or accommodation documents; and

c) where appropriate, evidence of claim to or reimbursement from any federal, provincial or other compensation fund or any other source (including credit card companies) that is legally responsible or under contract to reimburse you for the cost of the undelivered travel services.

trip cancellation

In addition to the documents above, when submitting a claim for Trip Cancellation coverage, the following documents are required:

a) For cancellation due to a disaster or event independent of any intentional act or negligence, an accident on the way to departure, jury duty, subpoena, transfer or involuntary loss of employment:

i. a legal certificate (police report, the summons and/or subpoena, record of employment) confirming the circumstances of the cancellation; and

ii. a letter from your employer (if applicable); and

b) For penalties, a copy of the travel supplier’s or the common carrier’s or accommodation provider’s publication confirming the cancellation penalties imposed.

trip interruption

In addition to the documents above, when submitting a claim for Trip Interruption coverage, the following documents are required:

a) For out of pocket expenses, an explanation of expenses in the event of a late return, along with original receipts; and

b) For death or repatriation, a death certificate accompanied by receipts from the funeral home, airline, etc.


baggage

When a baggage loss has occurred, you must take all reasonable precautions to save and protect your property. When submitting a claim for Baggage coverage, the following documents are required:

1. A completed claim form (available by contacting us at 1-800-661-6995 or at ab.bluecross.ca).

a) For baggage loss, you must submit:

i. a report by the police or the hotel manager, tour guide or transportation authorities in whose custody the property was at the time of loss;

ii. adequate proof of loss, (original purchase receipts, original replacement receipts or original replacement estimates on store stationery or letterhead) ownership and itemized value; and

iii. Property Irregularity Report (available by contacting your common carrier) when luggage is lost or damaged while in the custody of the common carrier.

b) For baggage delay, you must supply proof of delay of checked baggage from the common carrier and original receipts of purchase, along with the following:

i. original itemized receipts for expenses actually incurred;

ii. a copy of the baggage claim ticket;

iii. copy of your common carrier ticket;

iv. verification delay of checked baggage from the common carrier including the reason and the duration of the delay; and

v. a copy of the delivery receipt.

When making a claim, you may be required to provide certified documents. Costs to obtain documents to support your claim are not covered.

d) Where do you send your completed form and documentation?Please send your completed claim form and supporting documentation to:

Alberta Blue Cross10009 108 StreetEdmonton, Alberta T5J 3C5Attention: Travel Claims

2. PAYMENT OF CLAIMS

a) Payment – Benefits are only payable for the plans and coverage selected and paid for by you and accepted by us as shown on your confirmation of coverage. Unless otherwise indicated in this agreement, benefits under this agreement are payable directly to the applicant. Payments payable as a result of the applicant’s death are payable to the applicant’s estate.

b) Interest – We will pay claims when we receive proof of the cause of the claim. No sum payable under this agreement shall carry interest.

c) Currency – All amounts indicated in this agreement are in Canadian funds unless otherwise stated. We will use the exchange rate we determine to be in effect on the date the expense was incurred.

HOW TO FILE CLAIM


3. MEDICAL RECORDSAs a condition of this agreement, we have the right to request and obtain medical information, records, or copies of medical records from any:

a) authorized provider;

b) physician;

c) dentist;

d) healthcare practitioner;

e) hospital, clinic or related facility;

f ) other insurers, or

g) any other party that diagnosed, treated, attended or rendered service to you.

You are responsible for paying any additional costs with providing this information. Our right to medical records applies to those cases where we consider the information is required to assess the application and administer claims arising under this agreement. We may deny any claims if such substantiating documentation is not provided.

We will hold as confidential all materials, records and information obtained from a provider or any other party and will not reveal information to any person or company without your written authorization except:

a) when required by law;

b) to provide statistical information of a general nature;

c) when required for claim abuse investigation purposes; or

d) to obtain or release information required to enforce this agreement.

4. RIGHT TO AUDITWe have the right, at any time, to inspect or audit your claim records in relation to a claim for benefits. This right to inspect or audit applies to records held by us or in the files of providers and may be exercised by us or by a third party on its behalf. Where, as a result of review of the information and records, we determine that a claim submitted was not an eligible expense, or we are refused access to the information and records, we may, at our discretion, refuse to pay the claim and any of your future claims.

HOW TO FILE CLAIM


GENERAL CONDITIONS

General Conditions(Applicable to all coverage described in this agreement)

1. ELIGIBILITYIf you do not meet the eligibility conditions outlined in this agreement, coverage shall be void. We reserve the right to accept or decline your application for coverage or for an extension.

2. EXCLUSIONSThe exclusions set forth in this agreement apply regardless of whether we issue you a confirmation of coverage.

3. MISREPRESENTATION, INACCURATE OR NONDISCLOSURE OF INFORMATIONYou agree that it is your responsibility to ensure that, at all times, we receive complete and accurate information. Therefore, should you (or anyone authorized to act on your behalf, directly or indirectly, intentionally or unintentionally and/or knowingly or unknowingly, at any time:

a) make any material misrepresentation;

b) provide incomplete or inaccurate information; or

c) fail to disclose information

to us or to our travel assistance service provider, then:

a) we retain all available legal and equitable remedies including, without limitation, the right to rescind this agreement, the right to refuse payment of any claim, the right to recover damages and the right to seek reimbursement of money paid; and

b) we shall be able to pursue all such available remedies either individually or in any combination.

4. AGEThroughout this agreement, any reference to age refers to:

a) your age on the effective date indicated on the confirmation of coverage (applicable to a Multi-Trip Annual Plan only); and

b) your age on the departure date (applicable to a Single-Trip Plan only).

5. GOVERNING LAW This agreement shall be construed and enforced in accordance with the laws of your Canadian province or territory of residence.

6. MAXIMUM PAYABLEBenefits are payable only for the coverage purchased and in accordance with the benefits listed in this agreement. Benefits are limited to the benefit maximum.

7. ASSIGNMENTAny benefits payable or which may become payable under this agreement cannot be assigned by you and we are not responsible for and will not be bound by any assignment entered into by you.


GENERAL CONDITIONS

8. EXCESS COVERAGE/COORDINATION OF BENEFITS

a) Excess Coverage to Government Health Plan – Any amounts payable under this agreement are in excess of what would normally be paid by a government health plan even if you are not entitled to monies from a government health plan.

b) Excess Coverage to Other Insurance. Any amounts payable under this agreement are in excess of any amounts available or collectible under any existing coverage concurrently in force held by or available to you. If we make payment for benefits to you and a third party makes payment for those same benefits, you are responsible for reimbursing us the amount previously paid by us. Other coverage includes, but is not limited to:

i. homeowners insurance;

ii. tenants insurance;

iii. multi-risk insurance;

iv. any credit card, third party liability, group or individual or extended health insurance; or

v. any private or legislative plan of motor vehicle insurance providing hospital, medical or therapeutic coverage.

c) Coordination of Benefits – Should any of you be eligible to receive benefits under this agreement and have similar benefits covered under any other plan, if that other coverage is also “excess only”, the amount payable under this agreement shall be coordinated with such other coverage. The total payment available from all coverage shall not exceed 100% of the eligible expense.

9. SUBROGATIONWe have the right to take legal action in your name against third parties who may be responsible for giving rise to a claim under this agreement or who may be responsible for providing indemnity or similar benefits. We have full rights of subrogation. You will co-operate fully with us if we choose to exercise our rights of subrogation and not do anything to prejudice such rights. If you institute a demand or action for a covered loss, you will immediately notify us so that we may safeguard our rights.

10. RECOVERY OF OVERPAID AMOUNTSPayment of any amount by us on your behalf does not constitute a guarantee that we will cover your expense if we determine that you have no coverage under this agreement. You must repay, on demand, any amount paid or authorized by us on your behalf if and when we determine that the amount was not payable under the terms and conditions of this agreement. When submitting claims to us, it is your responsibility to ensure the services being claimed have been received by eligible persons under this agreement.

11. CONSENTBy applying for coverage, you:

a) consent to our verifying with government and other relevant authorities your health care card number and other information to process a claim;

b) authorize physicians, dentists, hospitals and other medical providers (where applicable) to provide us and our travel assistance service provider with any and all documentation they have regarding you while under observation or treatment including medical history, treatment, diagnosis, test results;

c) consent to our requesting an independent assessment of your medical condition, if we deem necessary; and

d) consent to the collection, use and if necessary, disclosure, of the information available under (a) and (b) above from and to other sources as may be required for the consideration and, if necessary, the processing of your claim for benefits or co-ordination of benefits obtainable from other sources;



GENERAL CONDITIONS

e) agree that you will be required to substantiate all claims made under this agreement. This may require providing us with personal information of a third party. You represent to us that you have the consent to share any personal information you provide to us and agree that if a third party refuses to provide consent to share their personal information needed to substantiate a claim, the claim may be denied.

12. RIGHT TO INVESTIGATEWe reserve the right to investigate or obtain a private opinion on any claim and to obtain any and all information relating to a claim.

13. ENTIRE AGREEMENTThis agreement contains the entire agreement of all parties with regard to the matters dealt with herein; no understandings or agreements, verbal or otherwise, exist between the parties except as expressed in this agreement and any amendments to this agreement.

14. WAIVERThe failure of any party at any time to require performance by the other party of any provision of this agreement will not constitute a waiver of any provision of this agreement.

15. NOTICESWe may send any notice required to be given to you under this agreement to the applicant. Each notice will be deemed to have been received by the applicant if:

i. mailed, on the fifth day following deposit by us at a post office with postage properly paid unless there is a postal strike; or

ii. sent electronically, to the email address provided to us. Each notice may be sent to the address last provided to us.

Any notice to us must be directed to [email protected].

16. ELECTRONIC COMMUNICATIONWe may provide this agreement and any other related documentation electronically and in accordance with applicable legislation.

17. CHANGE OF ADDRESSThe applicant agrees to immediately notify us of any change of address, telephone number or email address.

18. HEADINGSHeadings used throughout this agreement are for convenience purposes only and shall not serve to limit, expand or interpret the paragraph to which they apply.

19. UNDERWRITINGUnless otherwise stated in this agreement, all benefits are underwritten by Alberta Blue Cross.

20. LIMITATION PERIODS FOR LEGAL ACTIONSEvery action or proceeding against us for the recovery of money payable under this agreement is absolutely barred unless commenced within the time set out in the Insurance Act (BC, AB, MB, NS, PE – title of act may vary by jurisdiction), Limitations Act (SK, NF), Limitations Act, 2002 (ON) or other applicable legislation. For those actions or proceedings governed by the laws of Quebec, the prescriptive period is set out in the Quebec Civil Code.


21. PREMIUM PAYMENTThe total premium is due and payable at the time of application. We reserve the right to suspend claims reimbursement until such time we receive full payment of the premium. This agreement will be void, at our option, if the premium payment is not paid to us, whether as a result of non-payment, non-sufficient funds (NSF) cheque or credit card chargeback or reversal.

22. LIMITATION ON LIABILITYNeither we, nor the travel assistance service provider, will be responsible or liable for the availability, quality or results of any medical treatment or transportation or your failure to obtain medical treatment.

23. PRIVACYWe are committed to respecting and safeguarding personal information entrusted to us. We and our travel services assistance provider will comply with all applicable privacy legislation. We have a privacy policy which governs our collection, use and disclosure of personal information (including personal health information). A copy of our current privacy policy is available from us on request or on our website at ab.bluecross.ca. By becoming our customer or filing a claim for benefits, you agree to allow your personal information to be collected, used and disclosed in accordance with our privacy policy. If you have any questions about our privacy policy, please contact our privacy officer at:

Alberta Blue Cross10009 108 Street NWEdmonton, AB T5J 3C5Attention: privacy officer

[email protected]

GENERAL CONDITIONS


DEFINITIONS

Definitions(Applicable to all coverage described in this agreement)

Words printed in italics in this agreement are defined in this section. These definitions apply to all coverage purchased.

accident or accidental means a happening due to external, sudden, fortuitous causes beyond your control.

accommodations means lodging in a hotel, motel, hostel or a private home offering lodging for commercial purposes (i.e. bed and breakfast or vacation rental by owner). It does not include non-commercial lodgings which include but are not limited to homes of friends or family, or tents or campers.

act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, including hijacking or kidnapping, of an individual or group in order to intimidate or terrorize any government, group, association or the general public, for religious, political or ideological reasons or ends, and does not include any act of war (whether declared or not), act of foreign enemies or rebellion.

act of war means war, civil war, riot, rebellion, insurrection, revolution, invasion, hostilities, or warlike operations (whether or not war has been declared or undeclared), civil commotion, overthrow of the legally constituted government, military or usurped power or explosions of war weapons.

agreement means the application, the confirmation of coverage, this contract and any subsequent amendments and when applicable, the travel insurance health questionnaire.

applicant means the person who has applied for and been accepted by us for benefits under this agreement. Applicant does not include a spouse or dependant.

application means the process for applying for coverage (whether in writing, verbally, electronically or otherwise) under this agreement.

benefit maximum provided the premium is paid, means the maximum sum payable for a particular benefit, which you selected at the time of purchase, or which applies automatically to a given coverage, and as indicated on your confirmation of coverage.

booking date means the first day on which you contracted your trip and issued payment in full or in part for the trip.

caregiver means a person you have entrusted with the care of your dependant on a permanent, full-time basis and whose services cannot be easily replaced.

category A medical condition means a medical condition identified in Table 1 of this agreement as category A medical condition or that meets the criteria identified in Table 1 of this agreement for a category A medical condition.

category B medical condition means a medical condition identified in Table 2 of this agreement as category B medical condition or that meets the criteria identified in Table 2 of this agreement for a category B medical condition.


DEFINITIONS

change in medication means any increase or decrease in dose, strength or frequency of a prescribed medication, as well as the addition or discontinuation of any medication. Any written prescription not filled is considered a change. The following are NOT considered to be new treatments or medication changes:

a) routine (not prescribed by a physician) adjustment of insulin to control diabetes provided the insulin was not first prescribed during the 90 days prior to your trip;

b) a change from a brand name medication to the generic form of the same medication, provided the dosage and frequency is the same;

c) routine adjustment of coumadin or warfarin or other anticoagulant medications except where newly prescribed or stopped;

d) change in aspirin taken for non-prescribed medical purposes;

e) decrease in the dosage of cholesterol medication;

f ) dosage change of thyroid or hormone replacement therapy medication;

g) creams or ointments prescribed for cutaneous irritations; or

h) vitamins and minerals and non-prescription medications.

common carrier means a conveyance (bus, taxi, train, boat, airplane or other vehicle), that is licensed, intended and used to transport paying passengers.

confirmation of coverage means the most recent document issued by us which confirms the travel insurance purchased for you under this agreement.

contracted means an agreement entered into where there is reference to a destination, a date and/or the time and place of arrival and/or departures for the trip.

covered reason means unforeseen events for cancelling or interrupting your trip that we will provide coverage, as set out in this agreement.

covered situation means mechanical failure, severe weather conditions, volcanic eruption, natural disaster, strike or lock-out lasting more than 24 hours, traffic accident or emergency police-directed road closure.

default means a complete cessation of operations as a result of bankruptcy or insolvency of a contracted travel supplier.

dentist means a doctor of dental surgery licensed to practice the profession of dentistry or dental surgery in the jurisdiction in which the professional services are rendered to you.

departure date means the day you leave your Canadian province or territory of residence.

dependant means any unmarried child of yours or your spouse (including step-child, adopted child or a child for whom you have been granted custody pursuant to an Order of the Court) who is chiefly dependent upon you or your spouse for support and maintenance, who is listed on your confirmation of coverage and who is:

a) under 18 years of age (applicable to Multi-Trip Annual Plan only);

b) under 21 years of age (applicable to Single-Trip plan only); and’

c) listed under the applicant’s government health plan.

effective date means the date indicated as the effective date on your confirmation of coverage.


eligible expenses means reasonable and customary charges for expenses incurred by you and payable by us based on the provisions of this agreement.

eligible trip limit means the maximum number of consecutive days, as shown on your confirmation of coverage, you are eligible for coverage for each trip under this agreement, which:

a) for a Multi-Trip Annual Plan, begins for each trip on the departure date; and

b) for a Single-Trip Plan, begins on the departure date as shown on your confirmation of coverage.

expiry date means the expiry date as indicated on the confirmation of coverage.

extension means the coverage you purchase from us to extend your trip beyond the eligible trip limit covered under your (i) existing Single-Trip Plan; (ii) existing Multi-Trip Annual Plan; or (iii) the number of days of coverage available by your existing individual health plan or your existing group travel plan.

extreme sport means any sporting or recreational activity that lies outside the normal rules or limits of traditional sports or an activity that is made extreme or dangerous by modifying the equipment or locales, or where there can be a high probability of physical danger, risk of injury or death as a result of participation. Extreme sports include, but are not limited to, any of the following:

• ballooning, parachuting;

• bungee jumping;

• climbing or mountaineering, rock climbing;

• hang gliding;

• heli-skiing;

• downhill skiing or snowboarding outside marked trails;

• rodeo activity;

• sky diving;

• white water rafting;

• ziplining;

• paragliding, parasailing;

• amateur scuba diving, unless you hold at least a basic scuba diving license from a certified school.

government health plan means any health insurance provided by or under the administrative control of any Canadian government or governmental agency in accordance with any law (other than The Employment Insurance Act of Canada).

group travel plan means an extended health benefit plan issued by us to a plan sponsor which includes travel insurance.

hospital means an institution legally licensed as an accredited hospital in the jurisdiction in which the services are performed and that is staffed and operated for the care and medical treatment of inpatients and outpatients. Medical treatment must be supervised by physicians and there must be registered nurses on duty 24 hours a day. Diagnostic and surgical capabilities must also exist on the premises or in facilities controlled by the establishment. A hospital is not: an establishment used mainly as a clinic, extended or palliative care facility, rehabilitation facility, addiction medical treatment centre, convalescent, rest or nursing home, home for the aged or health spa.

hospitalization means treatment in a hospital when admitted as an inpatient.

illness means a disease or disorder of the body which results in loss while this coverage is in effect. The illness must be sufficiently serious to prompt a reasonably prudent person to consult a physician for the purposes of medical treatment and for the physician to certify in writing the necessity of cancelling, interrupting or delaying a trip.

immediate family member means your spouse, natural, adopted, foster or step-child(ren), brother, sister, step-brother, step-sister, parent, step-parent, grandparent, grandchild(ren), aunt, uncle, nephew, niece, son-in-law, daughter-in-law, parent-in-law, brother-in-law, sister-in-law, legal guardian, legal ward or key-person of the applicant.

DEFINITIONS


incidental expenses means miscellaneous expenses incurred by the covered inpatient as a result of hospitalization due to a covered accident or illness (i.e. telephone, television).

individual health plan means an extended health benefit plan issued by us which includes travel insurance.

inpatient means admission and confinement to a hospital for more than 24 consecutive hours on the recommendation of the attending physician.

key employee means an employee or business partner whose continued presence is critical to the ongoing affairs of your business during your absence.

medical condition means any irregularities in your health, an illness or injury for which you have:

a) presented or exhibited signs or symptoms which would have caused an ordinary person to seek medical treatment or medical consultation;

b) received a diagnosis;

c) required or received medical consultation;

d) taken or prescribed medication;

e) required medical treatment;

f ) had test results showing deterioration;

g) had a medical investigation whether or not a diagnosis has been given;

h) been hospitalized;

i) been referred to a specialist, whether or not the medical condition, illness or injury had been diagnosed by a physician; or

j) received medical treatment or medical consultation as its related to undiagnosed symptoms.

medical consultation means the act of meeting with a physician for the purpose of discussing and evaluating signs or symptoms in an effort to diagnose a medical condition, illness or injury; or for the purpose of evaluating your progress and medical treatment of a medical condition, illness or injury.

medical emergency means a sudden and unforeseen disease, illness or injury that requires immediate medical treatment.

medical treatment means a procedure prescribed, performed or recommended by a physician for a medical condition. This includes but is not limited to prescribed medication, investigative testing and surgery.

motor sport means any competition, speed event or other high-risk activity involving the use of a motor vehicle on land, water or air, including training activities, whether on approved tracks or elsewhere.

physician means a person who is a medical doctor licensed to prescribe and administer medical treatment within scope and jurisdiction where the medical treatment is provided and who is not you, a related person or your travelling companion.

professional means an individual who participates in a sport or activity with an expectation of remuneration or sponsorship or endorsement or to receive financial return which could form a substantial part of their livelihood.

province or territory of residence means the province or territory that you have declared as your permanent residence and you reside in for the required number of days outlined by your provincial health care legislation and/or government health plan in order to maintain your provincial health coverage.

DEFINITIONS


reasonable and customary means the normal charges, as determined by us made to you:

a) for the treatment, services or supplies provided; and

b) which do not exceed the general level of fees and prices in the geographical area where the expense was incurred.

related person means an individual who is ordinarily a resident of your home or who is related to you by blood or marriage.

return date means

a) for the Multi-Trip Annual Plan, the earliest of:

i. the date in which you are contracted to return from any individual covered trip to your Canadian province or territory of residence;

ii. the date you actually return to your Canadian province or territory of residence; and

iii. one year less a day from your effective date (the expiry date).

b) for the Single-Trip Plan, the earlier of:

i. the date you actually return to your Canadian province or territory of residence; and

ii. the date in which you are scheduled to return to your Canadian province or territory of residence as shown on your confirmation of coverage;

spouse means the person who is legally married to the applicant or under any formal union recognized by law.

stable means you have NOT had any of the following:

a) a new prescription drug or a change in medication;

b) a new medical treatment;

c) a new diagnosis, medical treatment or evaluation of symptoms;

d) a change in diagnosis or medical treatment;

e) a medical consultation to investigate symptoms that remain undiagnosed;

f ) hospitalization related to any medical condition;

g) a referral to a medical specialist or a specialty clinic (made or recommended) where there are no further investigations or results pending;

h) in-hospital care or a referral to a specialist, including initial follow-up visits, tests or investigations related to the medical condition and pending results;

i) experienced a deterioration in your medical condition;

j) experienced new, more frequent or more severe symptoms;

k) new test results or test results show a deterioration pending test results (other than routine tests as part of regular follow-ups); or

l) investigations or future investigations initiated or recommended.

DEFINITIONS


terminal prognosis means an advanced stage of a medical condition for which a physician gave a prognosis of eventual and inevitable death or palliative care was received.

transportation means economy class transport on a common carrier whether by land, air or sea.

transportation hazard means accidental loss or damage caused by collision, upset, overturn, derailment, stranding or sinking of any common carrier.

travel arrangements means any pre-arranged provisions made as part of a trip including but not limited to airfare, accommodations, food, car rentals, excursions or events.

travel assistance service means the assistance service provider that has been appointed by us and which provides assistance, primarily in medical emergencies, during travel and who are authorized to act on our behalf.

travel insurance health questionnaire means the form that contains questions that must be answered correctly at the time of application, and that, once completed and signed forms part of this agreement.

travel supplier means a licensed, registered or otherwise legally authorized tour operator, travel wholesaler, ground transporter, airline, cruise line or provider of accommodations that has been contracted by you or on your behalf to provide travel services to you.

travelling companion means a person (i) with whom you have accommodation or transportation for the same trip arranged in advance of the departure date; and (ii) who will accompany you throughout the entire trip. A maximum of 4 people, including the applicant, will be considered travelling companions.

trip means the entire period of travel contracted by you, and for which a premium was paid.

vehicle means any form of transportation which is drawn, propelled, or driven by any means and includes, but is not restricted to, an automobile, truck, motorcycle, moped, bicycle, snowmobile, boat or all terrain vehicle.

you, yourself or your means each person named as a covered person on the confirmation of coverage.

we, us or our means ABC Benefits Corporation, operating as Alberta Blue Cross.

DEFINITIONS



Purchasing travel insurance is affordable, easy and convenient. Call or visit us online!

1-800-394-1965 | ab.bluecross.ca

®*The Blue Cross symbol and name are registered marks of the Canadian Association of Blue Cross Plans, an association of independent Blue Cross plans. Licensed to ABC Benefits Corporation for use in operating the Alberta Blue Cross Plan. ®†Blue Shield is a registered trade-mark of the Blue Cross Blue Shield Association. IP18-001 2020/09