Chapter 8 travel insurance Flashcards
Why do people need travel insurance?
Provincial plans are not all the same, & if ill or injured, not all costs covered. Can have limits on time away to 90 days
4 costs that may not be covered under all travel insurance plans
- Ambulance charges
- Family visitation
- Repatriation
- Return of vehicle
True or False? provincial heath plans will respond regardless of the amount of time a resident is away
False - can be limited to 90 days
Travel polices are available for clients who travel for these two types of reasons……..
Business or pleasure
Travel policies can be purchased for……..
Individual or include family members
Policies can be purchased for coverage on……
single trip (from 14 days - 180 days) or multiple trip ( from 30 days - 45 days)
5 major sections usually found in travel policies
- insuring agreement
- term of insurance
- definitions
- policy coverage & limitations
- additional exclusions & limitations
2 requirements before insured can qualify for coverage
- permanent resident of Canada
- covered under the provincial/territorial health care plan
When will coverage terminate for other than annual policies
- the return date shown on the application, but no longer than the number of days shown in the application after the departure date shown
when will coverage terminate for annual policies?
date the insured returns to the province or territory of residence or which 30 days after the departure date
Define insured
means an insured applicant, their spouse & any dependent children
define Insured applicant
Canadian residence under 65 years of age, insured under the government health plan, who has been named on the invoice/application issued by broker
Define spouse
legal spouse of the insured applicant residing in Canada, no legal separation in effect, or individual of opposite sex who has been residing for period of at least 1 year
who is a dependent child/children
- 20 yrs or younger, unmarried, dependent on applicant & residing with the applicant
- under 26 yrs old, unmarried & dependent on applicant & at full time Canadian college or university (accredited)
3.Receiving full support & maintenance from applicant, by reason of mental or physical infirmity
Define Extended Family
means the dependent child, spouse, parent, guardian, brother, sister, & grandparent of insured or spouse
Define Accident
An unforeseen & unintended occurrence due to external, violent, sudden, fortuitous causes beyond the insureds control
Define sickness
means bodily sickness or disease, contracted & commencing after the policy is issued & while the policy is in effect
Define Injury
bodily injury caused by an accident occurring while the insured is insured hereunder
Define Hospital
an institution operated pursuant to law for the care & treatment of sick & injured persons with organized facilities for diagnosis, major surgery & 24 hour nursing care
What’s not considered a hospital?
- nursing home
- home for aged
- heath spa
- facility for the treatment of alcoholism, drug addiction or mental illness
Define Travel companion
the person(s) who is sharing the same travel arrangements with the issued
identify emergency medical (outpatient) expenses covered by the policy?
- out patient emergency room charges
- treatment by legally qualified physician or surgeon
- employment of a registered nurse when recommended by the attending physician to mx $5000
- rental of wheelchair, cane, casts, brace, splint, walker, or crutches
- x-rays & laboratory examinations that are required for diagnostic purpose
Max limit for emergency dental expenses
$2,500
3 types of drugs that are NOT covered under emergency drug reimbursement
- patent drugs
- oral contraceptives (plan B)
- vitamins, repeat prescriptions, maintenance & chronic care drugs
identify when insurer would reimburse insured for trip interruption expenses
- when an insured has left the province of residence & a trip is interrupted due to sickness or injury
3 reasons which coverage will be provided under Trip Cancellation for Medical reasons
i) death of an insured or extended family member occurring within 21 days of departure
ii) injury or sickness of insured that prevent the insured from starting trip, with confirmation from physician in writing that trip cancellation is advised, & not from pre-existing condition
ii) unexpected subpoena to act as a witness in a court proceeding during the trip, or the sudden call to jury duty
Explain convalescence or extended stay for medical reasons
pays up to $1000 when insured applicant is discharged from hospital ,but not yet authorized to travel
Explain expenses for return of auto
covers up to $1000 for the return of the automobile to home due to sickness or injury of applicant or traveling companion
Explain repatriation benefit ,burial or cremation
in event of death or insured as a result of injury or sickness, will cover homeward transportation of deceased or cremated remains up to $3000 or $1500 if cremation or burial at place of death
7 exclusions common in a travel policy
- war
- pregnancy, miscarriage, child birth within 8 weeks of due date
- suicide or any attempt thereat
- commission, or attempt to commit a criminal act
- expense incurred as result of alcohol related illness disease or abuse of drugs over .8 reading
- mental or emotional disorders unless hospitalized
- participation in pro sports
travel policies are for excess over other plans the client may own. What are 4 other plans an insured may own?
- other individual or group plans
- provincial or territorial health plans
- workers compensation coverage
- credit card coverage, & private automobile insurance
How long does an insured/agent have to notify in case of emergency surgery?
48 hours
max limit of coverage if not notified to the insurer within the 48 hour period is $10,000
