Policy Coverage / Schedule of Benefits
Description |
Available Benefit Range (USD) |
|
Emergency Medical Evacuation |
$250,000 per Policy Period |
|
Air Ambulance |
100% UCR per Policy Period |
|
Accompaniment |
$300 per day up to $3,000 per Policy Period |
|
Continuation |
$5,000 per Policy Period |
|
Repatriation for Medical Treatment |
100% UCR per Policy Period |
|
Emergency and Accidental Medical Treatment (Non-Sports) |
$250,000 per Policy Period |
|
Acute/Emergency Sickness and Injury |
100% UCR per Policy Period |
|
Treatment by Authorized Physicians, Nurses and Specialists |
100% UCR per Policy Period |
|
Hospitalization (Semi-Private Rooms) |
100% UCR per Policy Period |
|
Surgery, Anesthesiologist |
100% UCR per Policy Period |
|
Prescribed Medicines, Dressings |
100% UCR per Policy Period |
|
Local Transport To and From the Place of Treatment |
100% UCR per Policy Period |
|
Treatment by Physiotherapists and Chiropractors |
$2,500 per Policy Period |
|
Medically Necessary Required Durable Medical Equipment |
100% UCR per Policy Period |
|
Limited Motorcycle and Sports Vehicle Coverage for Injuries Only |
$10,000 per Policy Period |
|
Emergency Dental Treatment for Immediate Relief of Pain |
$500 per Policy Period |
|
Sports Coverage (Requires Additional Premium) |
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Sports Coverage for Injuries resulting from participation in sanctioned high school, church, or recreational league sports
|
$250,000 per Policy Period |
|
Other Benefits |
||
Repatriation of Mortal Remains |
$20,000 per Policy Period |
|
ATMSafe |
$500 per Policy Period |
|
Baggage Delay |
$100 per day up to $700 per Policy Period |
|
Baggage Loss / Theft |
$300 per item up to $1,500 per Policy Period Subject to $100 Deductible per Event |
|
Personal Liability |
$10,000 per Policy Period |
|
Accidental Death & Disability / Permanent Total Disability |
$10,000 per Policy Period |
|
Additional Hospital Benefit |
$75 per day up to $600 per Policy Period |
|
Physical Assault |
$5,000 per Policy Period |
|
Money and Documents (Tickets, Cash, Banknotes) |
$500 per Policy Period |
|
Loss of Passport |
$250 per Policy Period |
|
Travel Delay (after the rst 24-hours) |
$100 per day up to $1,000 per Policy Period |
|
Missed Departure |
$1,000 per Policy Period |
|
Legal Expenses |
$10,000 per Policy Period |
|
Hijacking |
$1,000 per Policy Period |
|
Emergency Evacuations for Non-Medical Reasons, including War, Civil Unrest, or Natural Disasters |
$1,500 per Policy Period |
|
Cancellation and Curtailment |
$1,000 per Policy Period Subject to $100 Deductible per Event |
|
Compassionate Repatriation / Family Return |
$6,000 per Policy Period |
|
The information contained herein is for illustrative purposes only.