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)

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.