Chapter 8

Question 1

Why do people need travel plans?

Answer 1

Many people believe their provincial or territorial health plans will cover them for medical and other expenses incurred regardless of where they become ill or are injured. Unfortunately, this is only partially true

Question 2

While provincial and territorial medical plans have reciprocal agreements, identify four costs that may not be covered under all plans

Answer 2

• Ambulance charges
• Family visitation
• Repatriation; or
• Return of vehicle

Question 3

Provincial or territorial health plans will respond regardless of the period of time a resident is away from the home - True or False?

Answer 3

False

Question 4

When an accident or illness occurs outside of Canada, provincial or territorial plans only pay the plans’ fee regardless of

Answer 4

• The fees charged where the injury or illness occurred; or

- Any other costs incurred

Question 5

Travel policies are available for clients who travel either for:

Answer 5

• Pleasure or

- Business

Question 6

These (travel) policies may be purchased for:

Answer 6

• Individuals only, or to

- Include coverage for family members as well

Question 7

Policies (travel) can be purchased to provide coverage on:

Answer 7

• Single trips ranging from two weeks up to 180 days; or
• Coverage can also be purchased on multiple trips lasting up to 30 or 45 days, occurring any time within a year from the date of policy issue

Question 8

Major Sections of the Policy

Although no standard policy exists, identify five major sections usually found in a travel policy

Answer 8

• Insuring Agreement
• Term of Insurance
• Definitions
• Policy Coverage & Limitations
• Additional Exclusions & Limitations

Question 9

Insuring Agreement

Identify two requirements before an insured can qualify for coverage

Answer 9

• A permanent resident of Canada; and

- Covered under the provincial or territorial health care plan

Question 10

Term of Insurance

Identify the earliest of when coverage will terminate for other than annual policies

Answer 10

The return date shown on the application, but no later than the number of days shown in the application after the departure date shown in the application

Question 11

Term of Insurance

Identify the earliest of when coverage will terminate for annual policies

Answer 11

The date the insured returns to the province or territory of residence, which is 30 days after the departure date

Question 12

Define “Insured”

Answer 12

An Insured Applicant, his spouse and any Dependent Children

Question 13

Define “Insured Applicant”

Answer 13

A Canadian resident under age 65, insured under the government health insurance plan of his Province or Territory of Residence, who has been named on an invoice/application issued by his broker

Question 14

Define “Spouse”

Answer 14

The legal spouse of the Insured Applicant residing in Canada, provided there is no legal separation in effect, or an individual of the opposite sex who has been residing with the Insured Applicant for a period of at least one year

Question 15

Define “Dependent Child or Children”

Answer 15

Any natural child, step child, legally adopted child or legal ward of the Insured Applicant, residing in Canada
Who is:
- 20 years of age and under, unmarried and receiving full support and maintenance from the Insured Applicant and residing with the Insured Applicant; or
- Less than 26 years of age, unmarried and receiving full support and maintenance from the Insured Applicant for reason of full time attendance at a Canadian accredited institute, college or university; or
- Receiving full support and maintenance from the Insured Applicant by reason of mental or physical infirmity

Question 16

Define “Extended Family”

Answer 16

The dependent child, spouse, parent, guardian, brother, sister and grandparent of the Insured Applicant or spouse

Question 17

Define “Accident”

Answer 17

An unforeseen and unintended occurrence due to external, violent, sudden, fortuitous causes beyond the Insured’s control

Question 18

Define “Injury”

Answer 18

Bodily injury caused by an accident occurring while the Insured is insured hereunder

Question 19

Define “Sickness”

Answer 19

Bodily sickness or disease, contracted and commencing after the policy is issued and while the policy is in effect

Question 20

Define “Hospital”

What is not considered a hospital?

Answer 20

An institution operated pursuant to law for the care and treatment of sick and injured persons with organized facilities for diagnosis, major surgery and 24 nursing service

Does not include a convalescent or nursing home, home for the aged, health spa or a facility for the treatment of alcoholism, drug addiction or mental illness

Question 21

Define “Supervised Condition”

Answer 21

A diagnosed medical condition, illness or injury for which you require any diagnostic testing, investigation or referral not yet complete, or for which the results are still not known that requires constant consistent treatment and is controlled with medication without change for:

• At least three months preceding the date of departure if you are under the age of 60; or
• At least six months preceding the date of departure if you are age 60 or over; or
• If you have taken medication for a cardiac condition or related condition at any time within six months

Question 22

Define “Traveling Companion”

Answer 22

The person(s) who is sharing the same travel arrangements with the Insured

Question 23

Define “Professional Sport”

Answer 23

Any sport for which a participant is receiving any remuneration including but not limited to sponsorship, endorsements or other monetary compensation

Question 24

Define “Whole or Sound Teeth”

Answer 24

Whole in appearance whereby some part is natural (cannot be artificial teeth). Capped or crowned teeth are considered to be whole or sound. Teeth that have received a root canal are considered sound

Question 25

Policy Coverage and Limitations

Identify any three Emergency Hospital (inpatient) expenses covered by the policy

Answer 25

• Surgery
• Nursing Care
• Laboratory Tests

Question 26

Policy Coverage and Limitations

Identify any Emergency Medical (outpatient) expenses covered by the policy

Answer 26

• Oxygen
• Whole blood, blood plasma and blood products
• Service of a licensed local ambulance

Question 27

Identify the maximum limit for Emergency Dental expense

Answer 27

Up to a maximum of $2,500 per Accident

Question 28

Identify three types of drugs or medicines that are not covered under Emergency Prescription Drug Reimbursement

Answer 28

• Oral contraceptives
• Vitamins
• Repeat prescriptions

Question 29

Briefly explain the purpose of Emergency Air Ambulance Evacuation

Answer 29

Addresses expenses incurred when the client has been injured and must return home, or if the client has been injured while travelling and a family member goes to his bedside, or if a child has to return home following the injury to a parent

Question 30

Identify three examples of the expenses covered for Emergency Air Transportation or Unexpected Return

Answer 30

• The cost up to $10,000 for return airfare for the client, his family, and if necessary a medical attendant
• If the client were to be injured while travelling alone and is hospitalized for more than seven days, the company will pay up to $1,500 towards the cost of airfare for his spouse or child to attend the client
• If the client were to be hospitalized the company will pay the cost up to $2,000 to return any children home. These limits do vary from insurer to insurer

Question 31

Identify when the insurer would reimburse the insured for Trip Interruption Expenses

Answer 31

If the client’s trip is interrupted or shortened due to an insured accident or injury the insurer will pay any non-refundable costs paid by the client up to a maximum of $1,500

Question 32

Identify three reasons for which coverage will be provided under Trip Cancellation for Medical Reasons

Answer 32

• The death of an Insured or an Extended Family Member occurring within 21 days of the scheduled departure date
• The injury or sickness of an Insured that prevented the Insured from starting the trip. The attending physician must verify in writing that he advised the insured to cancel the trip. The injury or illness was not a result of a preexisting condition of the insured or extended family member
• The unexpected subpoena to act as a witness in a court proceeding during the trip, or the sudden call to jury duty

Question 33

Briefly explain the purpose of the following:

Hotel Convalescence or Extended Stay for medical Reasons

Answer 33

Designed to pay any additional costs incurred by the client after discharge from hospital if he has to stay in a hotel after the normal return day of the trip

Question 34

Briefly explain the purpose of the following:

Expenses for Return of Auto

Answer 34

If the client or his travelling companion were unable to drive his vehicle home following an insured event the insurer will pay up to the stated limit, which will vary from policy to policy,m to have the vehicle returned home

Question 35

Briefly explain the purpose of the following:

Repatriation Benefit, Burial or Cremation

Answer 35

Although the limit may vary from insurer to insurer the purpose of this benefit under the policy is to pay towards the return of the client’s remains to home for burial, or if preferred by the family, to pay towards burial at the place of death

Question 36

Briefly explain the purpose of the following:

Identification of Deceased

Answer 36

The insurer will pay the costs, if necessary, for someone appointed by the family to travel and identify the deceased and make arrangements for the return of the client’s remains

Question 37

Briefly explain the purpose of the following:

Involuntary Extension

Answer 37

Allows an automatic extension of the policy if the client’s return is delayed because the scheduled carrier has had to delay the departure time, otherwise the client could be without accident insurance

Question 38

Additional Exclusions & Limitations

Identify any six exclusions usually found in a travel policy

Answer 38

• Declared or undeclared war or any act thereof
• Suicide or any attempt thereat while sane or insane; or intentionally self-inflicted injury
• Mental or emotional disorders unless hospitalized
• Participation in professional sports
• Any elective (non-emergency) treatment or surgery
• Any expenses incurred before the effective date of this policy

Question 39

Travel policies are considered “excess” over other plans of insurance the client may own. Identify four such other plans an insured may own

Answer 39

• Other individual or group plans
• Provincial or territorial health plans
• Worker’s compensation
• Credit card coverage

Question 40

Identify how long does an insured or agent have to notify the insurer in case of confinement or emergency surgery

Answer 40

No later than 48 hours from the date of hospitalization or emergency surgery

Question 41

What is the maximum limit of coverage if the insurer is not notified within the time period (no later than 48 hours…)

Answer 41

$10,000 of all expenses incurred