Page 2 - AtlasGroup_Specimen
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SPECIMENCONTENTS PRE-EXISTING MEDICAL CONDITIONS .................... 11
ACUTE ONSET OF PRE-EXISTING CONDITION 11
IMPORTANT NOTICE AND DISCLAIMER
CONCERNING THE UNITED STATES PATIENT MEDICAL & REPATRIATION EXPENSES ................... 12
PROTECTION AND AFFORDABLE CARE ACT.............3 MEDICAL EXPENSES........................................... 12
DESCRIPTION OF COVERAGE SUMMARY..................3 EMERGENCY MEDICAL EVACUATION............... 13
IMPORTANT FEATURES OF YOUR TRAVEL TRIP INTERRUPTION ........................................... 14
INSURANCE....................................................................3 RETURN OF MINOR CHILDREN.......................... 14
POLITICAL EVACUATION .................................... 14
CANCELLATION ......................................................3 REPATRIATION OF REMAINS ............................. 15
U.S. PREFERRED PROVIDER ORGANIZATION LOCAL BURIAL OR CREMATION ........................ 15
(PPO)........................................................................3
CLAIMS ....................................................................4 INDEMNITY BENEFIT & VISITATION EXPENSES...... 16
APPEALS AND COMPLAINTS ................................4 HOSPITAL INDEMNITY......................................... 16
DEFINITIONS ...........................................................4 EMERGENCY REUNION ...................................... 16
PRE-EXISTING CONDITIONS .................................4 BEDSIDE VISIT ..................................................... 16
DATA PROTECTION................................................4
RIGHTS OF THIRD PARTIES ..................................4 TRAVEL ASSISTANCE ................................................ 16
LAW AND JURISDICTION .......................................4 TRAVEL DELAY .................................................... 16
TOKIO MARINE HCC MEDICAL INSURANCE LOST CHECKED LUGGAGE ................................ 17
SERVICES GROUP (“MIS GROUP”) .......................4 NATURAL DISASTER - REPLACEMENT
MEMBER ELIGIBILITY ....................................................5 ACCOMMODATIONS ............................................ 17
CERTIFICATE EFFECTIVE & TERMINATION DATES...5 BORDER ENTRY PROTECTION .......................... 18
CERTIFICATE EFFECTIVE DATE ...........................5 PET RETURN ........................................................ 18
CERTIFICATE TERMINATION DATE ......................5
BENEFIT PERIOD & HOME COUNTRY COVERAGE 5 PERSONAL ACCIDENT ............................................... 19
BENEFIT PERIOD....................................................5 ACCIDENTAL DEATH AND DISMEMBERMENT.. 19
INCIDENTAL HOME COUNTRY COVERAGE.........5 COMMON CARRIER ACCIDENTAL DEATH
SCHEDULE OF BENEFITS AND LIMITS........................6 BENEFIT................................................................ 19
CLAIM PROCEDURES....................................................9
PROOF OF CLAIM ...................................................9 SPORTS AND ACTIVITIES .......................................... 21
CLAIMS COOPERATION .......................................10 CRISIS RESPONSE ..................................................... 22
ACCESS TO ADDITIONAL MATERIALS ...............10 PERSONAL LIABILITY ................................................. 23
OTHER INSURANCE .............................................10 TERRORISM................................................................. 24
ARBITRATION........................................................10 GENERAL EXCLUSIONS ............................................. 25
APPEAL AND COMPLAINTS PROCEDURE ................10 DEFINITIONS ............................................................... 27
APPEALING A CLAIM ............................................10 OPTIONAL ACCIDENTAL DEATH & DISMEMBERMENT
COMPLAINTS PROCEDURE ................................11 BENEFIT RIDER........................................................... 32
OPTIONAL CRISIS RESPONSE BENEFIT RIDER ...... 34
KIDNAPPING AND EXPRESS KIDNAPPING ....... 34
NATURAL DISASTER EVACUATION ................... 35
OPTIONAL PERSONAL LIABILITY BENEFIT RIDER .. 37
2 Atlas Group Description of Coverage | Tokio Marine HCC - MIS Group
ACUTE ONSET OF PRE-EXISTING CONDITION 11
IMPORTANT NOTICE AND DISCLAIMER
CONCERNING THE UNITED STATES PATIENT MEDICAL & REPATRIATION EXPENSES ................... 12
PROTECTION AND AFFORDABLE CARE ACT.............3 MEDICAL EXPENSES........................................... 12
DESCRIPTION OF COVERAGE SUMMARY..................3 EMERGENCY MEDICAL EVACUATION............... 13
IMPORTANT FEATURES OF YOUR TRAVEL TRIP INTERRUPTION ........................................... 14
INSURANCE....................................................................3 RETURN OF MINOR CHILDREN.......................... 14
POLITICAL EVACUATION .................................... 14
CANCELLATION ......................................................3 REPATRIATION OF REMAINS ............................. 15
U.S. PREFERRED PROVIDER ORGANIZATION LOCAL BURIAL OR CREMATION ........................ 15
(PPO)........................................................................3
CLAIMS ....................................................................4 INDEMNITY BENEFIT & VISITATION EXPENSES...... 16
APPEALS AND COMPLAINTS ................................4 HOSPITAL INDEMNITY......................................... 16
DEFINITIONS ...........................................................4 EMERGENCY REUNION ...................................... 16
PRE-EXISTING CONDITIONS .................................4 BEDSIDE VISIT ..................................................... 16
DATA PROTECTION................................................4
RIGHTS OF THIRD PARTIES ..................................4 TRAVEL ASSISTANCE ................................................ 16
LAW AND JURISDICTION .......................................4 TRAVEL DELAY .................................................... 16
TOKIO MARINE HCC MEDICAL INSURANCE LOST CHECKED LUGGAGE ................................ 17
SERVICES GROUP (“MIS GROUP”) .......................4 NATURAL DISASTER - REPLACEMENT
MEMBER ELIGIBILITY ....................................................5 ACCOMMODATIONS ............................................ 17
CERTIFICATE EFFECTIVE & TERMINATION DATES...5 BORDER ENTRY PROTECTION .......................... 18
CERTIFICATE EFFECTIVE DATE ...........................5 PET RETURN ........................................................ 18
CERTIFICATE TERMINATION DATE ......................5
BENEFIT PERIOD & HOME COUNTRY COVERAGE 5 PERSONAL ACCIDENT ............................................... 19
BENEFIT PERIOD....................................................5 ACCIDENTAL DEATH AND DISMEMBERMENT.. 19
INCIDENTAL HOME COUNTRY COVERAGE.........5 COMMON CARRIER ACCIDENTAL DEATH
SCHEDULE OF BENEFITS AND LIMITS........................6 BENEFIT................................................................ 19
CLAIM PROCEDURES....................................................9
PROOF OF CLAIM ...................................................9 SPORTS AND ACTIVITIES .......................................... 21
CLAIMS COOPERATION .......................................10 CRISIS RESPONSE ..................................................... 22
ACCESS TO ADDITIONAL MATERIALS ...............10 PERSONAL LIABILITY ................................................. 23
OTHER INSURANCE .............................................10 TERRORISM................................................................. 24
ARBITRATION........................................................10 GENERAL EXCLUSIONS ............................................. 25
APPEAL AND COMPLAINTS PROCEDURE ................10 DEFINITIONS ............................................................... 27
APPEALING A CLAIM ............................................10 OPTIONAL ACCIDENTAL DEATH & DISMEMBERMENT
COMPLAINTS PROCEDURE ................................11 BENEFIT RIDER........................................................... 32
OPTIONAL CRISIS RESPONSE BENEFIT RIDER ...... 34
KIDNAPPING AND EXPRESS KIDNAPPING ....... 34
NATURAL DISASTER EVACUATION ................... 35
OPTIONAL PERSONAL LIABILITY BENEFIT RIDER .. 37
2 Atlas Group Description of Coverage | Tokio Marine HCC - MIS Group
