|Benefits per Insured Person||Benefit Maximums (all are in Canadian dollars)|
|All benefits||Maximum as shown in confirmation of insurance|
|Prescription Drugs||Maximum 30 day supply|
|Licensed private duty nurse||$10,000|
|Hospital allowance||$150/day, to a maximum of $1,500|
|Chiropodist, chiropractor, osteopath, physiotherapist, podiatrist or acupuncturist services||$500 per provider|
|Emergency dental – blow to face||$3,000|
|Emergency dental – other than blow to face||$500|
|Accommodation and meals where Expiry Date||delayed $150/day, maximum of 10 days|
|Accommodation and meals of visiting Immediate Family Member||$150/ day, maximum of 10 days|
|Return of remains||$10,000|
|Incidental costs for identification of body||$300|
Subject to the conditions set out below, we will pay the following additional benefits, up to the maximum amount specified for each such benefit.
Return of Vehicle
If, as a result of an Emergency on a Trip, you are unable to return your vehicle or your rented vehicle, we will cover the reasonable costs to return the vehicle to your home or the rental agency, up to a maximum of $1,000.
Accommodation and Meals
We will pay up to $150 per day, for a maximum of ten (10) days, to cover your hotel expenses, meals and Commercial Ground Transportation fares if you or your Insured Travel Companion are delayed beyond your Expiry Date because you or your Insured Travel Companion are receiving Emergency Medical Care or have to relocate to receive appropriate Emergency Medical Care.
We will pay a hospital allowance of up to $150 per twenty-four (24) hour period to a maximum of $1,500 for your incidental expenses (telephone, internet and television rental) if you are Hospitalized for at least forty-eight (48) hours as a result of an Emergency. This benefit will be paid as a lump sum after your release from Hospital and upon approval of your claim.
If you are travelling alone on a Trip and are Hospitalized for more than three (3) days as a result of an Emergency, and if recommended by the attending Physician and approved by us, we will pay the return economy airfare for an Immediate Family Member or close friend to attend your bedside. We will also reimburse reasonable out-of-pocket expenses incurred for commercial accommodation and meals, Commercial Ground Transportation and telephone calls by the Immediate Family Member or close friend to a maximum of $150 per day, for a maximum of ten (10) days. We will provide this benefit immediately upon your Hospitalization if you are mentally or physically handicapped, or under twenty- six (26) years of age and dependent for support on the visiting Immediate Family Member.
Return of Dependent Children
If you are travelling with your Dependent Children on a Trip and you are Hospitalized for more than twenty-four (24) hours as a result of an Emergency or you must return to your Country of Residence because of your Emergency, and if approved by us, we will pay:
(a) the cost of a one-way economy airfare for the return of your Dependent Children to your Country of Residence; and
(b) the costs of a round trip economy airfare on a commercial flight for an escort, if the airline requires that the Dependent Children be escorted.
Return of Remains
In the event of your death during your Trip from an Emergency covered by this Policy, we will pay up to
(c) the cost for the transport of your remains from the place of death to your Country of Residence; or
(d) the burial or cremation of your remains where the death occurred, including the cost of a coffin or urn.
Identification of body
If someone is legally required to identify your remains because of your death during your Trip from an Emergency covered by this Policy, we will cover the cost of a round-trip economy airfare via the most cost effective route to transport someone to identify your body. We will also cover meals and accommodation for that person up to a maximum of $300.
To be eligible for getting coverage under the policy along with the eligibility conditions stated in the declarations, you must, as of the effective date:
● be at least fifteen (15) days old; and
● not be insured or eligible for benefits under a GHIP. If you become eligible for and insured under a GHIP after the Effective Date and prior to the Expiry Date, the coverage under this Policy will apply only to those benefits not provided by the GHIP. Coverage for losses resulting from any Sickness will only begin following the Waiting Period if you purchase your policy:
(a) After your arrival in Canada; or
(b) After the expiry date of an existing policy issued by the Administrator.
However, we will not pay for any expenses or benefits relating directly or indirectly to any Sickness that manifests or exists during the Waiting Period even if related expenses are incurred after the Waiting Period.
● The Waiting Period will be waived if this policy is purchased prior to arriving in Canada or prior to the expiry date of an existing Visitors to Canada Travel insurance policy already issued by the Administrator, to take effect on the day following such expiry date provided there is no increase in coverage amount or change in the plan you select. The existing policy must be in effect on the date of purchase and there must be no gap in coverage.
Limitations and Exclusions:
Your coverage is subject to the following conditions:
(a) All benefits are in Canadian dollars.
(b) Where not specified, airfares are one-way and economy class.
(c) The benefits payable under Section 3 and Section 4 are subject to the Deductible.
(d) All benefits under this coverage are in excess of similar insurance benefits payable by another insurer. If you are eligible under more than one (1) insurance plan for benefits which are similar to the benefits for which you are insured under this Policy, the total amount paid to you from all sources cannot exceed the actual expenses you incur.
(e) If we pay your health care provider or reimburse you for covered expenses, we will seek reimbursement from any other medical insurance or reimbursement plan under which you may have coverage.
(f) If you have any claim or right of action against any third party for expenses or covered losses for which we have paid any benefits under this Policy, you shall assign and transfer such claim or right of action to us if we so request. You shall cooperate with us fully in any such claim or right of action, including allowing us to bring an action in your name against the third party.
(g) In the event that we have paid any amounts on your behalf under this Policy and you are found to be ineligible for coverage, or a claim is found to be invalid, or the amount of your benefits are reduced in accordance with the terms of this Policy, we have the right to collect from you any amount we have paid on your behalf to any other parties.
(h) We must approve in advance any surgery or invasive procedure prior to you undergoing such procedure.
(i) During an Emergency (whether prior to admission or during a covered Hospitalization), we reserve the right to:
(i) transfer you to one
(1) of our preferred health care providers; and/or
(ii) return you to your Country of Residence for the Medical Treatment of your Sickness or Injury. If you decline the transfer or return when our Medical Director declares you are medically able to travel, we will be released from any liability for expenses incurred for such Sickness or Injury after the proposed date of transfer or return.
(j) We are not responsible for the availability, quality or results of any Medical Treatment or transportation, or your failure to obtain Medical Treatment.
(k) Subject to section 3.6, once you are deemed medically able to return to your Country of Residence either in the opinion of our Medical Director or because you have been discharged from Hospital, your medical Emergency is considered to have ended, whereupon you will no longer be eligible for coverage under this Policy for any further Medical Treatment related to your Emergency.
Limitations and Exclusions:
We will not pay for any expenses incurred directly or indirectly as a result of:
(a) A Sickness that manifests or exists during the Waiting Period even if related expenses are incurred after the Waiting Period.
(b) Sickness, death or Injury as a result of the abuse of medication, drugs, alcohol or any other toxic substance during your Trip. Alcohol abuse includes having a blood alcohol level in excess of eighty (80) milligrams of alcohol per one hundred (100) millilitres of blood. Drug abuse includes, but is not limited to, having a THC level in excess of two (2) nanograms of THC per one
(1) milliliter of blood.
(c) A Sickness, Injury or related condition during a Trip undertaken:
(i) with the knowledge that you will require or seek Medical Treatment for that Sickness, Injury or related condition; or
(ii) for the purpose of obtaining Medical Treatment.
(d) A Sickness, Injury or related condition for which:
(i) future investigation or Medical Treatment (except routine monitoring) is planned before your Trip; or
(ii) it was reasonable to expect Medical Treatment or Hospitalization during your Trip.
(e) Any condition for which you had symptoms before your Departure Date that would have caused a prudent person to seek diagnosis or Medical Treatment, or recurrence or complication of any Medical Condition following Medical Treatment during your Trip where we recommended that you return to your Country of Residence and you declined to do so.
(f) Your routine prenatal care or childbirth at any time during your Trip, or complications, conditions or symptoms of pregnancy during the nine (9) weeks prior to or after the expected delivery date.
(g) Death or Injury sustained:
(i) while performing as a pilot or crew member of any aircraft;
(ii) while participating in any maneuvers or training exercises of the armed forces; or
(iii) during your professional participation in any sport or your participation in any motorized or mechanically assisted speed contests.
(h) Medical Treatment or Emergency medical benefits in your Country of Residence.
(i) Medical Treatment, medication, services or supplies that are not Medically Necessary or that you elect to have provided outside your Country of Residence when medical evidence indicates that you could return to your Country of Residence to receive such treatment.
(j) Medical Treatment that is non-emergent or could reasonably be delayed until your return to your Country of Residence.
(k) Medical Treatment received in unlicensed facilities or given by unlicensed health care providers, or given by your Immediate Family Member or Travel Companion.
(l) The replacement cost of an existing Prescription Drug, whether by reason of loss, renewal or inadequate supply, or the purchase of drugs and medications (including vitamins) which are commonly available without a prescription or which are not legally registered and approved in Canada.
(m) Cardiac catheterization, angioplasty and/or cardiovascular surgery including any associated diagnostic test(s) or charges unless approved in advance by us prior to being performed, except in in extreme circumstances where such surgery is performed as a medical Emergency immediately upon admission to Hospital.
(n) Magnetic resonance imaging (MRIs), computerized axial tomography (CAT) scans, sonograms, ultrasounds or biopsies unless approved in advance by us.
(o) Services in connection with alternative Medical Treatments or general health examinations, regular care of a chronic condition, the continuing care and/or Medical Treatment of an acute Sickness or Injury after the initial medical Emergency has ended (as determined by our Medical Director) or a medical consultation where the Physician observes no change in a previously noted condition, symptom or problem.
(p) Medical care or surgery that is cosmetic in nature.
(q) Cataract surgery or services provided by a naturopath or an optometrist or in a convalescent home, nursing home, rehabilitation centre or health spa.
(r) Your participation in High Risk Activities;
(s) Air ambulance services unless approved in advance and arranged by us.
(t) Injury resulting from air travel, unless you are a passenger in a commercial aircraft with a seating capacity of six (6) people or more that is licensed to carry passengers for hire.
(u) Upgrade charges or cancellation penalties for airline tickets, unless approved in advance by us.
(v) Damage to or loss of sunglasses (non-prescription), contact lenses, or prosthetic teeth or limbs, and resulting prescriptions therefor.
(w) Noncompliance with prescribed Medical Treatment or therapy.
(x) Suicide (including any attempt thereat) or self-inflicted Injury.
(y) Commission or attempted commission of a criminal, criminal-like, illegal or negligent act by you.
(z) Expenses for which no charge would normally be made in the absence of insurance. (aa) Any Act of War.
If termination of this Policy is requested a pro-rata refund will be provided for the period from the requested date of termination to the Expiry Date, subject to an administration fee
You will not be eligible for any refund in premiums in the event that we have paid any claims under this Policy or you have incurred or reported any claims that have not yet been paid.