Page 2 - Atlas_MultiTrip_Sspecimen
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CONTENTS SPECIMENPRE-EXISTING MEDICAL CONDITIONS .................... 10
ACUTE ONSET OF PRE-EXISTING CONDITION 11
IMPORTANT NOTICE AND DISCLAIMER
CONCERNING THE UNITES STATES PATIENT MEDICAL & REPATRIATION EXPENSES ................... 11
PROTECTION AND AFFORDABLE CARE ACT.............3 MEDICAL EXPENSES........................................... 11
DESCRIPTION OF COVERAGE SUMMARY..................3 EMERGENCY MEDICAL EVACUATION............... 12
IMPORTANT FEATURES OF YOUR TRAVEL TRIP INTERRUPTION ........................................... 13
INSURANCE....................................................................3 RETURN OF MINOR CHILDREN.......................... 13
POLITICAL EVACUATION .................................... 14
CANCELLATION ......................................................3 REPATRIATION OF REMAINS ............................. 14
U.S. PREFERRED PROVIDER ORGANIZATION LOCAL BURIAL OR CREMATION ........................ 15
(PPO)........................................................................3
CLAIMS ....................................................................3 INDEMNITY BENEFIT & VISITATION EXPENSES...... 15
APPEALS AND COMPLAINTS ................................4 HOSPITAL INDEMNITY ........................................ 15
DEFINITIONS ...........................................................4 EMERGENCY REUNION ...................................... 15
PRE-EXISTING CONDITIONS .................................4 BEDSIDE VISIT ..................................................... 15
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 ................................ 16
SERVICES GROUP (“MIS GROUP”) .......................4 NATURAL DISASTER - REPLACEMENT
MEMBER ELIGIBILITY ....................................................4 ACCOMMODATIONS............................................ 16
CERTIFICATE EFFECTIVE & TERMINATION DATES...5 BORDER ENTRY PROTECTION .......................... 17
CERTIFICATE EFFECTIVE DATE ...........................5 PET RETURN ........................................................ 18
CERTIFICATE TERMINATION DATE ......................5
CERTIFICATE PERIOD ...........................................5 PERSONAL ACCIDENT ............................................... 18
BENEFIT PERIOD & HOME COUNTRY COVERAGE ....5 ACCIDENTAL DEATH AND DISMEMBERMENT.. 18
BENEFIT PERIOD....................................................5 COMMON CARRIER ACCIDENTAL DEATH
HOME COUNTRY COVERAGE ...............................5 BENEFIT................................................................ 19
SCHEDULE OF BENEFITS AND LIMITS........................6
U.S. PREFERRED PROVIDER ORGANIZATION (PPO) SPORTS AND ACTIVITIES .......................................... 19
REQUIREMENTS ............................................................8 CRISIS RESPONSE ..................................................... 21
CLAIM PROCEDURES....................................................9 PERSONAL LIABILITY ................................................. 22
PROOF OF CLAIM ...................................................9 TERRORISM................................................................. 23
CLAIMS COOPERATION.........................................9 GENERAL EXCLUSIONS ............................................. 24
ACCESS TO ADDITIONAL MATERIALS .................9 DEFINITIONS ............................................................... 26
OTHER INSURANCE ...............................................9 OPTIONAL ACCIDENTAL DEATH & DISMEMBERMENT
ARBITRATION..........................................................9 BENEFIT RIDER........................................................... 31
APPEAL AND COMPLAINTS PROCEDURE ................10 OPTIONAL CRISIS RESPONSE BENEFIT RIDER ...... 33
APPEALING A CLAIM ............................................10
COMPLAINTS PROCEDURE ................................10 KIDNAPPING AND EXPRESS KIDNAPPING ....... 33
NATURAL DISASTER EVACUATION ................... 34
OPTIONAL PERSONAL LIABILITY BENEFIT RIDER .. 36
2 Atlas MultiTrip Description of Coverage | Tokio Marine HCC - MIS Group
ACUTE ONSET OF PRE-EXISTING CONDITION 11
IMPORTANT NOTICE AND DISCLAIMER
CONCERNING THE UNITES STATES PATIENT MEDICAL & REPATRIATION EXPENSES ................... 11
PROTECTION AND AFFORDABLE CARE ACT.............3 MEDICAL EXPENSES........................................... 11
DESCRIPTION OF COVERAGE SUMMARY..................3 EMERGENCY MEDICAL EVACUATION............... 12
IMPORTANT FEATURES OF YOUR TRAVEL TRIP INTERRUPTION ........................................... 13
INSURANCE....................................................................3 RETURN OF MINOR CHILDREN.......................... 13
POLITICAL EVACUATION .................................... 14
CANCELLATION ......................................................3 REPATRIATION OF REMAINS ............................. 14
U.S. PREFERRED PROVIDER ORGANIZATION LOCAL BURIAL OR CREMATION ........................ 15
(PPO)........................................................................3
CLAIMS ....................................................................3 INDEMNITY BENEFIT & VISITATION EXPENSES...... 15
APPEALS AND COMPLAINTS ................................4 HOSPITAL INDEMNITY ........................................ 15
DEFINITIONS ...........................................................4 EMERGENCY REUNION ...................................... 15
PRE-EXISTING CONDITIONS .................................4 BEDSIDE VISIT ..................................................... 15
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 ................................ 16
SERVICES GROUP (“MIS GROUP”) .......................4 NATURAL DISASTER - REPLACEMENT
MEMBER ELIGIBILITY ....................................................4 ACCOMMODATIONS............................................ 16
CERTIFICATE EFFECTIVE & TERMINATION DATES...5 BORDER ENTRY PROTECTION .......................... 17
CERTIFICATE EFFECTIVE DATE ...........................5 PET RETURN ........................................................ 18
CERTIFICATE TERMINATION DATE ......................5
CERTIFICATE PERIOD ...........................................5 PERSONAL ACCIDENT ............................................... 18
BENEFIT PERIOD & HOME COUNTRY COVERAGE ....5 ACCIDENTAL DEATH AND DISMEMBERMENT.. 18
BENEFIT PERIOD....................................................5 COMMON CARRIER ACCIDENTAL DEATH
HOME COUNTRY COVERAGE ...............................5 BENEFIT................................................................ 19
SCHEDULE OF BENEFITS AND LIMITS........................6
U.S. PREFERRED PROVIDER ORGANIZATION (PPO) SPORTS AND ACTIVITIES .......................................... 19
REQUIREMENTS ............................................................8 CRISIS RESPONSE ..................................................... 21
CLAIM PROCEDURES....................................................9 PERSONAL LIABILITY ................................................. 22
PROOF OF CLAIM ...................................................9 TERRORISM................................................................. 23
CLAIMS COOPERATION.........................................9 GENERAL EXCLUSIONS ............................................. 24
ACCESS TO ADDITIONAL MATERIALS .................9 DEFINITIONS ............................................................... 26
OTHER INSURANCE ...............................................9 OPTIONAL ACCIDENTAL DEATH & DISMEMBERMENT
ARBITRATION..........................................................9 BENEFIT RIDER........................................................... 31
APPEAL AND COMPLAINTS PROCEDURE ................10 OPTIONAL CRISIS RESPONSE BENEFIT RIDER ...... 33
APPEALING A CLAIM ............................................10
COMPLAINTS PROCEDURE ................................10 KIDNAPPING AND EXPRESS KIDNAPPING ....... 33
NATURAL DISASTER EVACUATION ................... 34
OPTIONAL PERSONAL LIABILITY BENEFIT RIDER .. 36
2 Atlas MultiTrip Description of Coverage | Tokio Marine HCC - MIS Group
