The benefits provided in this program are subject to certain restrictions and exclusions. Please read this brochure in its entirety for a complete description of all coverage terms and conditions. Note: Words beginning with capital letters are defined in this text.
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SUMMARY OF COVERAGES
Trip Cancellation and Trip Interruption Benefits
Pre-Departure Trip Cancellation
We will pay a Pre-Departure Trip Cancellation Benefit, up to the amount in the Schedule if you are prevented from taking your Covered Trip due to your, an Immediate Family Member’s, Traveling Companion’s, or Business Partner’s Sickness, Injury or death or Other Covered Events as defined, that occur(s) before departure on your Covered Trip. The Sickness or Injury must: a) commence while your coverage is in effect under the plan; b) require the examination and treatment by a Physician at the time the Covered Trip is cancelled; and c) in the written opinion of the treating Physician, be so disabling as to prevent you from taking your Covered Trip.
Pre-Departure Trip Cancellation Benefits
We will reimburse you, up to the amount in the Schedule for the amount of prepaid, non-refundable and unused Payments or Deposits that you paid for your Covered Trip.
Note: As respects air cancellation penalties, you will be covered only for air arrangements booked through Expedia, Inc. and flights connecting to such air arrangements booked through Expedia, Inc. We will not pay benefits for cancellation charges imposed on any other air arrangements you may book on your own.
Post-Departure Trip Interruption
We will pay a Post-Departure Trip Interruption Benefit, up to the amount in the Schedule, if: 1) your arrival on your Covered Trip is delayed; or 2) you are unable to continue on your Covered Trip after you have departed on your Covered Trip due to your, an Immediate Family Member’s, Traveling Companion’s or Business Partner’s, Sickness, Injury or death or Other Covered Events as defined. For item 1) above, the Sickness or Injury must: a) commence while your coverage is in effect under the plan; b) for item 2) above, commence while you are on your Covered Trip and your coverage is in effect under the plan; and c) for both items 1) and 2) above, require the examination and treatment by a Physician at the time the Covered Trip is interrupted or delayed; and d) in the written opinion of the treating Physician, be so disabling as to delay your arrival on your Covered Trip or to prevent you from continuing your Covered Trip.
Post-Departure Trip Interruption BenefitsWe will reimburse you, less any refund paid or payable, for the following:
- the additional transportation expenses by the most direct route from the point you interrupted your Covered Trip: a) to the next scheduled destination where you can catch up to your Covered Trip; or (b) to the final destination of your Covered Trip;
- the additional transportation expenses incurred by you by the most direct route to reach your original Covered Trip destination if you are delayed and leave after the Scheduled Departure Date. However, the benefit payable under (1) and (2) above will not exceed the cost of a one-way economy air fare by the most direct route less any refunds paid or payable for your unused original tickets.
Important: You, your Traveling Companion and/or your Immediate Family Member booked to travel with you must be medically capable of travel on the day you purchase this coverage. The covered reason for cancellation or interruption of your Covered Trip must occur after your effective date of Trip Cancellation coverage.Other Covered Events means only the following unforeseeable events or their consequences which occur while coverage is in effect under this Policy: a change in plans by you, an Immediate Family Member traveling with you, or Traveling Companion resulting from one of the following events which occurs while coverage is in effect under this Policy:
- being directly involved in a documented traffic accident while en route to departure;
- being hijacked, Quarantined, required to serve on a jury, or required by a court order to appear as a witness in a legal action, provided you, an Immediate Family Member traveling with you or a Traveling Companion is not: 1) a party to the legal action, or 2) appearing as a law enforcement officer;
- having your Home made uninhabitable by fire, flood, volcano, earthquake, hurricane or other natural disaster;
- Your involuntary termination of employment or layoff which occurs after your effective date of coverage and was not under your control. You must have been continuously employed with the same employer for 1 year prior to the termination or layoff. This provision is not applicable to temporary employment, independent contractors or self-employed persons.
In the certificate, “you”, “your” and “yours” refer to the Insured. “We”, “us” and “our” refer to the company providing the coverage. In addition certain words and phrases are defined as follows:
Accident means a sudden, unexpected, unintended and external event, which causes Injury.
Business Partner means an individual who is involved, as a partner, with you in a legal general partnership and shares in the management of the business.
Covered Trip means a period of travel away from Home to a destination outside your city of residence; the purpose of the Trip is business or pleasure and is not to obtain health care or treatment of any kind; the Trip has defined departure and return dates specified when the Insured enrolls; and the Trip does not exceed 31 consecutive days in length.
Common Carrier means any land, water or air conveyance operated under a license for the transportation of passengers for hire.
Domestic Partner means a person who is at least eighteen years of age and you can show: 1) evidence of financial interdependence, such as joint bank accounts or credit cards, jointly owned property, and mutual life insurance or pension beneficiary designations; 2) evidence of cohabitation for at least the previous 6 months; and 3) an affidavit of domestic partnership if recognized by the jurisdiction within which they reside.
Flight means a scheduled trip for which
coverage has been elected and the plan payment paid and all travel arrangements are arranged by the Expedia, Inc. prior to the Scheduled Departure Date of the trip.
Home means your primary or secondary residence.
Hospital means an institution, which meets all of the following requirements:
it must be operated according to law;
it must give 24 hour medical care, diagnosis and treatment to the sick or injured on an inpatient basis;
it must provide diagnostic and surgical facilities supervised by Physicians;
registered nurses must be on 24 hour call or duty; and
the care must be given either on the hospital’s premises or in facilities available to the hospital on a pre-arranged basis.
A Hospital is not: a rest, convalescent, extended care, rehabilitation or other nursing facility; a facility which primarily treats mental illness, alcoholism, or drug addiction (or any ward, wing or other section of the hospital used for such purposes); or a facility which provides hospice care (or wing, ward or other section of a hospital used for such purposes).
Immediate Family Member includes your or the Traveling Companion’s, spouse, child, spouse’s child, son-daughter-in-law, parent(s), sibling(s), brother-sister, grandparent(s), grandchild, step brother-sister, step-parent(s), parent(s)-in-law, brother-sister-in-law, aunt, uncle, niece, nephew, guardian, Domestic Partner, foster-child, or ward.
Injury means bodily harm caused by an accident which: 1) occurs while your coverage is in effect under the plan; and 2) requires examination and treatment by a Physician. The Injury must be the direct cause of loss and must be independent of all other causes and must not be caused by, or result from, Sickness.
Insured means an eligible person who arranges a Covered Trip, and pays any required plan payment.
Insurer means Stonebridge Casualty Insurance Company.
Payments or Deposits means the cash, check or credit card amounts actually paid to Expedia, Inc. for your Flight. Physician means a person licensed as a medical doctor by the jurisdiction in which he/she is a resident to practice the healing arts. He/she must be practicing within the scope of his/her license for the service or treatment given and may not be you, a Traveling Companion, or an Immediate Family Member of yours.
Policy means the contract issued to the Policyholder providing the benefits specified herein.
Policyholder means the legal entity in whose name this Policy is issued, as shown on the benefit Schedule.
Program Medical Advisors means On Call International.
Quarantined means the enforced isolation of an Insured and/or the restriction of free movement of an Insured suffering or suspected to suffer from a contagious disease to prevent the spread of contagious disease.
Schedule means the benefit schedule shown on the Certificate for each Insured.
Scheduled Departure Date means the date on which you are originally scheduled to leave on your Covered Trip.
Scheduled Return Date means the date on which you are originally scheduled to return to the point where the Covered Trip started or to a different final destination.
Scheduled Trip Departure City means the city where the scheduled trip on which you are to participate originates.
Sickness means an illness or disease of the body which:1) requires examination and treatment by a Physician, and 2) commences while the plan is in effect.
Traveling Companion means a person whose name(s) appear(s) with you on the same Trip arrangement and who, during the Trip, will accompany you.WE WILL NOT PAY FOR ANY LOSS CAUSED BY OR INCURRED RESULTING FROM:
- mental, nervous, or psychological disorders, except if hospitalized;
- being under the influence of drugs or intoxicants, unless prescribed by a Physician;
- normal pregnancy, except if hospitalized; or elective abortion;
- declared or undeclared war, or any act of war;
- service in the armed forces of any country;
- operating or learning to operate any aircraft, as pilot or crew;
- any unlawful acts, committed by you or a Traveling Companion (whether insured or not);
- any amount paid or payable under any Worker’s Compensation, Disability Benefit or similar law;
- elective Treatment and Procedures;
- medical treatment during or arising from a Covered Trip undertaken for the purpose or intent of securing medical treatment;
- business, contractual or educational obligations of you, an Immediate Family Member or Traveling Companion;
- failure of any tour operator, Common Carrier, or other travel supplier, person or agency to provide the bargained-for travel arrangements;
- a loss that results from an illness, disease, or other condition, event or circumstance which occurs at a time when the plan is not in effect for you.
When Coverage Begins
All coverages will take effect on the later of: 1) the date the plan payment has been received by Expedia, Inc.; 2) the date and time you start your Covered Trip; or 3) 12:01 A.M. Standard Time on the Scheduled Departure Date of your Covered Trip.
Pre-Departure Trip Cancellation coverage will take effect on the day your plan payment is received by Expedia, Inc. Coverage begins at 12:01A.M. Standard Time of the effective date of the certificate if the required plan payment is received. Post-Departure Trip Interruption coverage will take effect on the Scheduled Departure Date if the required plan payment is received.
When Coverage EndsYour coverage automatically ends on the earlier of:
- the date the Covered Trip is completed;
- the Scheduled Return Date;
- your arrival at the return destination on a round-trip, or the destination on a one-way trip;
- cancellation of the Covered Trip covered by the plan.
- TRIP CANCELLATION CLAIMS: Call Expedia, Inc. and BerkelyCare IMMEDIATELY to notify them of your cancellation and to avoid any non-covered expenses due to late reporting. BerkelyCare will then forward the appropriate claim form which must be completed by you AND THE ATTENDING PHYSICIAN, if applicable. If you are cancelling due to a death, a death certificate will be required.
- ALL OTHER CLAIMS: Report your claim as soon as possible to BerkelyCare. Provide the policy number, your travel dates, and details describing the nature of your loss. Upon receipt of this information, BerkelyCare will promptly forward you the appropriate claim form to complete. If you are cancelling due to a death, a death certificate will be required