Description of Coverage

Medical Benefits

When a covered Injury or Illness results, The Company will pay:

In Hospital Medical Services 100%* of covered expenses
In Hospital Surgical Services 100%* of covered expenses
Out of Hospital Medical Expenses 100%* of covered expenses
*The policy will pay 100% up to a maximum amount in Plan A ($25,000) or Plan B ($100,000) per incident. (There are no medical benefits in Plan C.)

DEDUCTIBLE: The above medical expenses are excess of a $50 deductible paid per Injury or Illness. The deductible amount consists of covered expenses which would otherwise be payable under this policy. These expenses must be borne by the Insured Person.

Treatment of an Injury or Illness must occur within 180 days of the accident or illness. Illness must be contracted and manifest itself during the period of coverage. All benefits provided in the Confirmation will cease when an eligible Insured Person returns to their home country.

Covered Expenses: For the purpose of this section, only such expenses incurred as the result of and within 180 days from a disablement and which are specifically enumerated in the following list of charges, and which are not excluded in the Exclusions Section, shall be considered covered expenses:

  1. Charges made by a Hospital for room and board, floor nursing and other services, including charges for professional services and with the exception of personal services of a non-medical nature; provided, however, that expenses do not exceed the hospital’s average charge for semi-private room and board accommodation.
  2. Charges made for diagnosis, treatment and surgery by a Physician.
  3. Charges made for the cost and administration of anesthetics.
  4. Charges for medication, x-ray services, laboratory tests and services, the use of radium and radioactive isotopes, oxygen, blood transfusions, iron lungs, and medical treatment.
  5. Charges for physiotherapy, if recommended by a Physician for the treatment of a specific disablement and administered by a licensed physiotherapist.
  6. Dressings, drugs, and medicines that can only be obtained upon a written prescription of a Physician.
  7. Hotel room charge, when the insured, otherwise necessarily confined in a hospital, shall be under the care of a duly qualified Physician in a hotel room owing to the unavailability of a hospital room by reason of capacity or distance or to any other circumstances beyond the control of the insured.

The charges enumerated above shall in no event include any amount of such charges which are in excess of reasonable and customary charges. A charge incurred by an Insured Person shall be deemed a reasonable and customary charge for the services and supplies for which the charge is made if it is not in excess of the average charge for such services and supplies in the locality where received, considering the nature and severity of the sickness or bodily injury for which such services and supplies are received. If the charge incurred is in excess of such average charge, such excess amount shall not be recognized as covered expenses. All charges shall be deemed to be incurred on the date such services or supplies which give rise to the expense or charge are rendered or obtained. All benefits provided in this policy will cease when an eligible Insured Person returns to their home country. This policy will not pay for expenses incurred in the Insured Person’s home country and in the U.S.

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Emergency Medical Evacuation

The Company will pay benefits for covered expenses incurred up to the maximum stated in the Schedule of the Confirmation if any Injury or Illness commencing during the course of a trip results in the necessary emergency medical evacuation of the Insured Person.

Emergency Medical Evacuation means: (a) the Insured Person’s medical condition warrants immediate transportation from the place where the ­Insured Person is injured or ill to the nearest hospital where appropriate medical treatment can be obtained; or (b) after being treated at a local hospital, the Insured Person’s medical condition warrants transportation to their home country to obtain further medical treatment or to recover.

Covered Expenses are expenses, up to the maximum, for transportation, medical services and medical supplies necessarily incurred in connection with emergency medical evacuation of the Insured Person. All transportation arrangements made for evacuating the Insured Person must be: (a) by the most direct and economical route; (b) subject to prior approval of The Company; and (c) arranged by AIGAssist. (See section on Emergency Medical Assistance.)

Expenses for special transportation must be (a) recommended by the attending Physician or (b) required by the standard regulations of the conveyance transporting the Insured Person. Expenses for medical supplies and services must be recommended by the attending Physician. Transportation means any land, water or air conveyance required to transport the Insured Person during an emergency medical evacuation. Special transportation includes, but is not limited to air ambulance, land ambulance, and private motor vehicles.

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Repatriation of Remains

The Company will pay the reasonable covered expenses incurred to return the Insured Person’s body home (to his/her home country) if he or she dies, not to exceed the maximum stated in the Schedule of the Confirmation. Covered expenses include, but are not limited to, expenses for embalming, cremation, coffins, and transportation. All arrangements must be made by AIGAssist.

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Accidental Death & Dismemberment (AD&D)

The Company shall pay an indemnity determined from the Table of Losses if an Insured Person sustains a loss stated therein resulting from injury, provided that: (1) such loss occurs within 365 days after the date of accident causing such loss; (2) the indemnity payable for any such loss shall be the amount stated opposite such loss in said Table, and the Principal Sum stated therein shall be the amount stated as Principal Sum in the Schedule of the Confirmation, as applicable to such person and this Coverage; and (3) if more than one loss stated in said Table is sustained as the result of one accident, only one of the amounts so stated in said Table, the largest, shall be payable.

Table of Losses

Description of Loss Indemnity
For Loss of:
Life		 Principal Sum
Both Hands or Both Feet or Sight of Both Eyes Principal Sum
One Hand and One Foot Principal Sum
Either Hand or Foot and Sight of One Eye Principal Sum
Either Hand or Foot One-Half the Principal Sum
Sight of One Eye One-Half the Principal Sum

The term “Loss” as used herein shall mean with regard to hands and feet, actual severance through or above wrist or ankle joints, and with regard to eyes, entire irrecoverable loss of sight.

BENEFICIARY: The beneficiary or beneficiaries of an Insured Person shall be that person or those persons designated by the Insured Person on the Enrollment Form. Any Insured Person who has not made an irrevocable designation of beneficiary may designate a new beneficiary at any time by writing to USI Travel Insurance Services.

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Escort For Minor

If the Insured Person is hospitalized for more than 7 days, The Company will pay to return the Insured Person’s accompanying dependent children under age 18 to their home, limited to the cost of a one-way economy airfare, less the value of applied credit from an unused return travel ticket, with an attendant if necessary. These expenses must be authorized in advance by AIGAssist.

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Bedside Visit

The Company will pay for strictly necessary traveling costs up to a maximum of $1,500 incurred by a friend or relative to visit the Insured Person when in the opinion of a medical practitioner acceptable to The Company, such a visit is necessary due to a bodily Injury or Illness which constitutes an immediate danger to life. These expenses must be authorized in advance by AIGAssist.

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Optional Benefit: Hazardous Activity Coverage

If the optional benefit is selected and the premium paid in advance of the Period of Coverage, Medical Expense Coverage will be provided for the following hazardous activities: motorcycling, mountain climbing, sky diving, amateur racing and piloting an aircraft.

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Exclusions

With respect to Medical Expenses, no benefits shall be payable with respect to expenses incurred:

  1. For pre-existing conditions, defined as any Injury or any Illness which was contracted or which manifested itself, or for which a licensed Physician was consulted, or for which treatment or medication was prescribed within three (3) years prior to the effective date of this insurance;
  2. For services, supplies or treatment, including any period of Hospital confinement, which were not recommended, approved and certified as necessary and reasonable by a Physician, or expenses which are non-medical in nature;
  3. For suicide or any attempt thereat while sane or self destruction or any attempt thereat while insane;
  4. For declared or undeclared war or any act thereof;
  5. For injury sustained while participating in professional athletics;
  6. For sickness resulting from pregnancy, childbirth, or miscarriage;
  7. For miscarriage resulting from accident;
  8. For routine physicals or other examinations where there are no objective indications or impairment in normal health, and laboratory diagnostics or x-ray examinations except in the course of a disability established by the prior call or attendance of a Physician;
  9. For cosmetic or plastic surgery, except as the result of an accident;
  10. For elective surgery which can be postponed until the Insured returns to their home country;
  11. For any mental or nervous disorders or rest cures;
  12. For dental care, except as the result of Injury to natural teeth caused by accident;
  13. For eye refractions or eye examinations for the purpose of prescribing corrective lenses for eyeglasses or contact lenses or for the fitting thereof, unless caused by accidental bodily Injury incurred while insured hereunder;
  14. In connection with alcoholism or drug addiction, or use of any drug or narcotic agent;
  15. For expenses as a result of or in connection with intentionally self-inflicted Injury;
  16. For expenses as a result of or in connection with the commission of a felony offense;
  17. For specific named hazards: motorcycling, mountain climbing, sky diving, professional or amateur racing, and piloting an aircraft;
  18. For treatment paid for or furnished under any other individual or group policy, or other medical prepayment plan arranged through the employer to the extent so furnished or paid, or under any mandatory government program or facility set up for treatment without cost to any individual;
  19. For medical expenses incurred in the United States and the Insured Person’s home country.

With respect to Accidental Death and Dismemberment, Emergency Medical Evacuation Expense, and Repatriation of Remains Expense, this plan does not cover any loss, fatal or non-fatal, caused by, or resulting from: (1) suicide or self-destruction or any attempt thereat while sane or insane; (2) disease of any kind; (3) bacterial infections except pyogenic infection which shall occur through an accidental cut or wound; (4) hernia of any kind; (5) injury sustained in consequence of riding as a passenger or otherwise in any vehicle or device for aerial navigation; (6) declared or undeclared war or any act thereof; (7) service in the military, naval or air service of any country. With regard to Emergency Medical Evacuation or Repatriation of Remains, exclusions 2, 3, and 4 above shall be deleted.

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Emergency Medical Assistance Service

TO OBTAIN ASSISTANCE IN THE EVENT OF A MEDICAL EMERGENCY OR TO FACILITATE MEDICAL CARE, contact the insurance company’s 24 hour assistance service, AIGAssist, located in Houston, Texas. AIGAssist can recommend a local doctor or hospital, verify coverage, organize all emergency medical transportations, and provide multilingual assistance. Call collect 0-713-267-2551. Identify yourself as an AEROMEDICAL insured and refer to Policy No. 9105877 and AIGAssist Identification No. 0906. ALL EMERGENCY MEDICAL EVACUATIONS, BEDSIDE VISITATIONS AND REPATRIATIONS ARE TO BE ARRANGED BY AIGASSIST.

How to File a Claim

You will need to save copies of all receipts. All itemized bills must be submitted to the Insurance Company with a Claim Form. To request a claim form, please contact: American International Companies, Accident & Health Claims, Travel Insurance Services Claims Unit, P.O. Box 15701, Wilmington, Delaware, 19850-5701 or call toll free in the U.S. and Canada 1-800-551-0824 or call from outside the U.S. and Canada 302-661-4176.

Written notice of a claim must be made to the Claims Unit within twenty (20) days after the occurrence or commencement of any loss covered by the Policy, or as soon thereafter as is reasonably possible.

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