|
DESCRIPTION
OF COVERAGE
Policy No.
8977-9500407
|
SCHEDULE
OF COVERAGES
AND SERVICES
|
MAXIMUM
BENEFIT
(PER INSURED): |
| PART
A: TRAVEL ARRANGEMENT PROTECTION |
| Trip
Cancellation |
Total
Tour Cost |
| Trip
Interruption |
Total
Tour Cost |
| Trip
Delay |
$500 |
| PART
B: MEDICAL PROTECTION |
| Emergency
Evacuation |
$15,000 |
| Repatriation
of Remains |
$15,000 |
| Accident
Medical Expense |
$3,000 |
| Sickness
Medical Expense |
$3,000 |
| PART
C: BAGGAGE PROTECTION |
| Baggage/Personal
Effects |
$1,000 |
| Baggage
Delay |
$300 |
| PART
D: TRAVEL ACCIDENT PROTECTION |
| Accidental
Death & Dismemberment |
|
| Air
Common Carrier |
$30,000 |
| Any
Other Circumstance |
$10,000 |
| PART
E: WORLDWIDE EMERGENCY ASSISTANCE (AIG Assist) |
| Emergency
Cash Transfer Assistance |
24
Hours |
| Medical
Consultation & Monitoring |
24
Hours |
| Emergency
Legal Assistance |
24
Hours |
| Emergency
Medical & Dental Assistance |
24
Hours |
| Lost
Travel Documents Assistance |
24
Hours |
| Emergency
Medical Payment Assistance |
24
Hours |
| The
benefits provided in this program are subject to certain restrictions
and exclusions, including the Pre-Existing Condition limitation (see
below). Please read this brochure in its entirety for a complete description
of all coverage terms and conditions. |
PART A: TRAVEL ARRANGEMENT PROTECTION
Trip
Cancellation/Trip Interruption
In the event You are prevented from taking Your Tour because: (a) You,
a Traveling Companion, or an Immediate Family member suffers an Injury,
Sickness, or death; or (b) You or Your Traveling Companion (i) is hijacked,
quarantined, required to serve on a jury, or subpoenaed; (ii) has a home
made uninhabitable by fire, flood, volcano, earthquake, hurricane, or
other natural disaster; or (iii) is directly involved in a documented
traffic accident while en route to departure; the Insurer will pay benefits
up to Your total Tour cost for:
Trip
Cancellation - non-refundable cancellation charges imposed by Pacific
Delight Tours, and/or airfare cancellation charges for flights joining
or departing Your Land/ Sea Arrangements; or the additional costs You
may incur as a result of a change in the per-person occupancy rate of
prepaid travel arrangements if a person booked to share accommodations
with You cancels his/her Tour for a covered reason and You do not cancel.
Trip
Interruption - unused, non-refundable land or sea expenses prepaid
to Pacific Delight Tours and/or the airfare paid, less the value of applied
credit from an unused return travel ticket, to return home or rejoin the
original Land/Sea Arrangements (limited to the cost of one-way economy
airfare by scheduled carrier, from the point of destination to the point
of origin shown on the original travel tickets).
The Insurer will also
pay benefits, up to $100 per day, for reasonable additional accommodation
and transportation expenses incurred to remain near a covered traveling
Immediate Family member or Traveling Companion who is hospitalized during
Your Tour.
In no event shall
the amount reimbursed exceed the amount You prepaid for Your Tour.
IMPORTANT: You
must be medically capable of travel on the day You purchase this coverage.
The covered reason for cancellation or interruption of Your Tour must
first occur after Your effective date of Trip Cancellation coverage.
Special
Conditions: You must advise Your travel agent, Pacific Delight
Tours, and BerkelyCare as soon as possible in the event of a claim. The
Insurer will not pay benefits for any additional charges incurred that
would not have been charged had You notified these parties as soon as
reasonably possible.
PLEASE NOTE: Benefits will not be paid
for expenses not refunded due to an airline's or Pacific Delight Tours'
insolvency.
Trip
Delay - The
Insurer will pay benefits for Covered Expenses, up to $500, if Your Tour
is delayed for 12 or more hours en route to or from Your Land/Sea Arrangements
due to inclement weather, strike or other job action, or equipment failure
of a Common Carrier; a traffic accident en route to a departure in which
You or Your Traveling Companion is not directly involved; or due to lost
or stolen passports, travel documents, or money; quarantine; hijacking;
natural disaster; civil commotion, or riot.
Covered Expenses include any prepaid, unused, non-refundable Land/Sea
Arrangements, any reasonable additional expenses for meals and lodging,
and the cost of a one-way economy airfare ticket to catch up to the Land/Sea
Arrangements or return to the place of origin shown on the travel documents.
PART
B: MEDICAL PROTECTION
Emergency Evacuation
The Insurer will pay benefits for Covered Expenses if an Injury or Sickness
commencing during the course of the Tour results in Your necessary Emergency
Evacuation. An Emergency Evacuation must be ordered by a legally licensed
Physician who certifies that the severity of Your Injury or Sickness warrants
an Emergency Evacuation. Emergency Evacuations must be verified, approved,
and arranged in advance by AIG Assist.
Emergency Evacuation
means: (a) Your medical condition warrants immediate Transportation
from the place where You are injured or sick to the nearest hospital where
appropriate medical treatment can be obtained; and/or (b) after being
treated at a local hospital, Your medical condition warrants Transportation
to Your origination point to obtain further medical treatment or to recover.
Covered Expenses
are customary and reasonable expenses, up to $15,000, for Transportation,
medical services, and medical supplies necessarily incurred in connection
with Your Emergency Evacuation. Expenses for medical services and supplies
must be recommended by the attending Physician. All Transportation arrangements
made for Your evacuation must be by the most direct and economical route
possible. Expenses for Special Transportation must be:
(a) recommended by
the attending Physician;
(b) required by the standard regulations of the conveyance transporting
You; AND
(c) verified, approved, and arranged in advance by AIG Assist.
Transportation means any land, water, or air conveyance required
to transport You during an Emergency Evacuation. Special Transportation
includes, but is not limited to, air ambulances, land ambulances, and
private motor vehicles. The Insurer will not cover any expenses provided
by another party at no cost to You or already included in the cost of
the Tour. In no event will the benefits paid for Emergency Evacuation
expenses exceed the coverage limit of $15,000.
Repatriation
of Remains
The Insurer will pay the reasonable Covered Expenses incurred, up to $15,000
to return Your body to Your point of origin if You die during the Tour.
Covered Expenses include, but are not limited to, expenses for embalming,
cremation, coffin for repatriation, and Transportation.
Accident
& Sickness Medical Expense
The Insurer will pay benefits, up to $3,000, if You incur necessary Covered
Medical Expenses as a result of an Injury, or up to $3,000 if You incur
necessary Covered Medical Expenses as a result of Sickness. The accident
causing such Injury must occur while You are covered under the policy,
and the Sickness must first manifest itself during Your Tour. You must
receive initial treatment within ninety (90) days of the accident which
caused the Injury or the onset of the Sickness. All services, supplies,
or treatment must be received within 52 weeks of the date of the accident
or the onset of the Sickness.
Covered Medical
Expenses are necessary services and supplies which are recommended
by the attending Physician. They include the services of a legally qualified
Physician, surgeon, graduate nurse, dentist, or osteopath; charges for
hospital confinement and use of operating rooms; charges for anesthetics
(including administration); x-ray examinations or treatments and laboratory
tests; ambulance service; drugs, medicines, and therapeutic services and
supplies. The Insurer will not pay benefits in excess of the reasonable
and customary charges commonly used by providers of medical care in the
locality in which the care is furnished.
Important:
Medical benefits are subject to the Pre-Existing Condition limitations
detailed below and other exclusions (please scroll down to view specifics
under EXCLUSIONS).
PRE-EXISTING
CONDITIONS
THE INSURER WILL NOT
PAY UNDER COVERAGES IN PARTS A & B (EXCEPT EMERGENCY EVACUATION AND
REPATRIATION OF REMAINS) FOR ANY CLAIMS ARISING FROM ANY INJURY, SICKNESS,
OR OTHER CONDITION AFFECTING YOU, A TRAVELING COMPANION, OR AN IMMEDIATE
FAMILY MEMBER BOOKED TO TRAVEL WITH YOU WHICH, WITHIN THE 60-DAY PERIOD
BEFORE YOUR TRIP CANCELLATION COVERAGE BEGAN UNDER THIS INSURANCE PLAN:
(A) FIRST MANIFESTED ITSELF, WORSENED, BECAME ACUTE, OR HAD SYMPTOMS WHICH
WOULD PROMPT A REASONABLE PERSON TO SEEK DIAGNOSIS, CARE, OR TREATMENT;
(B) REQUIRED TAKING PRESCRIBED DRUGS OR MEDICINE, UNLESS THE CONDITION
FOR WHICH THE PRESCRIBED DRUG OR MEDICINE WAS TAKEN REMAINED CONTROLLED
WITHOUT ANY CHANGES IN THE REQUIRED PRESCRIPTION; OR (C) REQUIRED TREATMENT
OR TREATMENT WAS RECOMMENDED BY A PHYSICIAN.
IMPORTANT: We will
waive this Pre-Existing Condition Exclusion if You make payment for this
coverage within seven (7) days of the date Your deposit or initial Tour
payment is received by Pacific Delight Tours.
NOTE: Satisfaction
of this prerequisite will be verified during claims processing.
If You have any
questions concerning this exclusion, please call BerkelyCare at 1-(800)
343-3553 for further clarification.
EXCESS
INSURANCE PROVISION
THE INSURANCE PROVIDED
UNDER PARTS A & B SHALL BE IN EXCESS OF ALL OTHER VALID AND COLLECTIBLE
INSURANCE OR INDEMNITY AND SHALL APPLY ONLY WHEN SUCH OTHER BENEFITS ARE
EXHAUSTED.
PART
C: BAGGAGE PROTECTION
Baggage/Personal
Effects
The Insurer will reimburse You, up to $1,000, for loss, theft, or damage
to baggage and personal effects. The Insurer will pay the lesser of the
following: original cash value of the item less depreciation as determined
by the Insurer; or cost of repair or replacement. The maximum benefit
per article is $250. There will be a combined maximum limit of $500 for
the following: jewelry; watches; articles consisting in whole or in part
of silver, gold, or platinum; furs, articles trimmed with or made mostly
of fur; and cameras and their related equipment.
Baggage
Delay
You will be reimbursed for expenses of necessary personal effects, up
to $300, if Your checked baggage is delayed or misdirected by an Air Common
Carrier for more than 24 hours from the time You arrived at the destination
stated on Your ticket. You must be a ticketed passenger on an Air Common
Carrier.
Important:
Coverage for this benefit is secondary to any coverage provided by an
Air Common Carrier and/or insurance specifically insuring the lost, stolen,
or damaged item(s).
PART
D: TRAVEL ACCIDENT PROTECTION
Accidental
Death & Dismemberment
If You sustain an Injury on the Tour which results in death or loss of
limb, eyesight, speech, or hearing within 365 days of the date of the
accident, the Insurer will pay the largest applicable amount as follows:
the benefit amount shown in the Schedule of Coverages for death, loss
of speech and hearing in both ears, or loss of any combination of two
hands, feet, or eyes; one-half the benefit amount for loss of any one
of these; and one-quarter the benefit amount for loss of thumb and index
finger of the same hand. In no event will the Insurer pay more than the
maximum benefit amount shown on the Schedule of Coverages for all losses
due to the same accident.
The Air Common Carrier
benefit applies only to Injury sustained by You (1) while in, on, boarding,
or alighting from an air conveyance organized and licensed for the transportation
of passengers for hire; and (2) being struck or run down by an aircraft.
Beneficiary:
Your estate, unless notice of a designated beneficiary is provided to
BerkelyCare.
PART
E: WORLDWIDE EMERGENCY ASSISTANCE
(AIG Assist)
AIG
Assist provides a 24-hour emergency telephone assistance service for Your
benefit so that, in the event of an emergency during the term of this
coverage, English-speaking help and advice may be furnished.
Emergency
Cash Transfer Assistance:
If You need emergency cash during Your Tour, AIG Assist can help arrange
a transfer through Your credit cards, family, friends, employer, or similar
source.
Medical
Consultation and Monitoring:
Should You need local medical care during Your Tour, AIG Assist can assist
in contacting Your personal Physician or family, if necessary, to provide
information on the care You are receiving.
Emergency
Legal Assistance:
During the course of Your Tour, You may visit many foreign countries.
Should any problems arise requiring legal assistance, AIG Assist can help
You find English-speaking local counsel.
Emergency
Medical & Dental Assistance:
Unexpected medical and dental emergencies can happen anywhere, anytime.
You may be in unfamiliar surroundings when You suddenly need medical or
dental care. AIG Assist can help You locate an English-speaking Physician
or dentist or the nearest qualified medical facility, and can also assist
in arranging for special emergency medical transportation, such as an
air ambulance.
Lost
Travel Documents Assistance:
AIG Assist's multilingual staff can provide assistance in handling unexpected
complications such as lost passports, tickets, luggage, or other valuable
travel documents or belongings.
Emergency
Medical Payment Assistance:
Many foreign hospitals require immediate settlement of bills before treatment
or may withhold Your passport until they receive full payment. Physicians
and hospitals worldwide can contact AIG Assist to arrange, if required,
immediate settlement of Covered Medical Expenses if other sources are
not available.
TO
ACCESS EMERGENCY ASSISTANCE, CALL:
1-(800) 543-3797
FROM OUTSIDE THE U.S. OR CANADA, CALL COLLECT:
1-(972) 699-0200
FAX:1-(713) 974-3422
Note
that the problems of distance, information, and communications make it
impossible for National Union Fire Insurance Company, BerkelyCare, or
AIG Assist to assume any responsibility for the availability, quality,
use, or results of any emergency service. In all cases, You are still
responsible for obtaining, using, and paying for Your own required services
of all types.
Definitions
1. "Air
Common Carrier" - means an air conveyance operating under
a valid license for the transportation of passengers for hire.
2. "Business Partner" - means an
individual who is: (a) involved with You in a legal partnership; and (b)
actively involved in the day-to-day management of the business.
3. "Common Carrier" - means an
air, land, or sea conveyance operating under a valid license for the transportation
of passengers for hire.
4. "Immediate Family" - means children,
step- or adopted children, children-in-law, parents, step-parents, parents-in-law,
siblings, step-siblings, siblings-in-law, grandparents, grandchildren,
legal or common law spouse, aunts, uncles, nieces, nephews, or a Business
Partner of You or Your Traveling Companion.
5. "Injury" - means bodily injury
caused by an accident occurring while this plan is in force and resulting
directly and independently of all other causes in loss covered by this
plan. The Injury must be verified by a Physician.
6. "Insurer"- means National Union
Fire Insurance Company of Pittsburgh, PA.
7. "Land/Sea Arrangements" - means
land and/or sea arrangements made by, and prepaid to, Pacific Delight
Tours.
8. "Physician" - means a licensed
practitioner of the healing arts acting within the scope of his/her license.
The treating Physician may not be yourself, a Traveling Companion, or
an Immediate Family member.
9. "Sickness" - means an illness
or disease which is diagnosed or treated by a Physician after the effective
date of coverage and while You are covered under this plan.
10. "Tour" - means Land/Sea Arrangements
prepaid to Pacific Delight Tours and shall include flight connections
to join and depart such Land/Sea Arrangements.
11. "Traveling Companion" - means
one person who is booked to accompany You on Your Tour.
12. "You" or "Your"
- means a person who has purchased a Tour and who has paid the required
plan cost for the coverage provided hereunder.
EXCLUSIONS
Naturally,
as with any protection program, limitations exist. These exclusions enable
us to provide a broad range of benefits at an economical cost to You,
without the necessity of medical questionnaires, and to supplement Your
existing coverage plans.
THIS
INSURANCE DOES NOT COVER:
IN PARTS
A & B
(except Emergency Evacuation and Repatriation of Remains):
ANY LOSS CAUSED BY OR RESULTING FROM: Pre-Existing Conditions,
unless this exclusion has been waived in accordance with the parameters
set forth in the Pre-Existing Condition Exclusion section included above
(please scroll up).
IN PARTS A, B,
& D:
ANY LOSS CAUSED BY OR RESULTING FROM: Sickness or disease except as
provided for in the policy; war or any act of war whether declared or
not; while serving as a member of the armed services; while or as a result
of riding in any device for aerial navigation other than as provided for
in the policy; participation in any professional, semi-professional, or
inter-scholastic team sports; being under the influence of drugs or intoxicants
unless prescribed by a duly licensed Physician; participation in any felonious
act or attempt thereat; scuba diving; skydiving, snowskiing; hang gliding;
parachuting (not including parasailing); contests of speed; elective surgery;
elective, non-emergency dental treatment or surgery; elective abortion;
normal pregnancy, except if hospitalized; mental or nervous disorders,
except if hospitalized.
IN PART C:
ANY LOSS OR DAMAGE TO: animals; automobiles and their equipment; boats;
motors; motorcycles; other conveyances and their equipment (except bicycles
while checked as baggage with a Common Carrier); household furniture;eyeglasses,
sunglasses, and contact lenses; artificial teeth and dental bridges; hearing
aids; prosthetic limbs; money and securities; tickets and documents; sporting
equipment if loss or damage results from the use thereof.
ANY LOSS CAUSED
BY OR RESULTING FROM: breakage of brittle or fragile articles, such
as cameras, musical instruments, radios, and similar property; wear and
tear, gradual deterioration; insects or vermin; inherent vice or damage;
confiscation or expropriation by order of any government; radioactive
contamination; war or any act of war whether declared or not; theft or
pilferage while left unattended in any vehicle; mysterious disappearance.
IN PART D:
ANY LOSS CAUSED BY OR RESULTING FROM: suicide or attempted suicide
while sane; intentionally self-inflicted injuries.
TERM
OF COVERAGE
1) This protection
is valid only upon payment of the total required plan cost in advance
of any losses and will not cover any losses suffered prior to purchase.
2) In order to quickly
effect coverage and protect Your Tour deposit(s) and to waive the Pre-Existing
Condition Exclusion, make payment for the applicable plan cost within
7 days of Your deposit or initial Tour payment to Pacific Delight upon
booking Your Tour. If You have already paid Your deposit, remit payment
for the applicable plan cost to Pacific Delight prior to or upon final
payment of Your Tour cost. The Trip Cancellation protection will become
effective at 12:01A.M. local time on the date this payment is received
by Pacific Delight. The remaining coverages and services provided take
effect at 12:01A.M. local time at Your location on the contracted departure
date of Your Tour.
3) All coverages and
services shall terminate on the earlier of the following events:
a) Your return to Your origination point (as specified in the travel tickets);
b) 11:59 P.M. local time at Your location on the day the Land/Sea Arrangements
are completed.
4) The duration of
coverage shall be extended under the following conditions: (a) when You
commence air travel from Your origination point (i) within 7 days before
the commencement of the Land/Sea Arrangements, coverage shall apply from
the time of departure from the origination point; (ii) greater than 7
days before the commencement of
the Land/Sea Arrangements, the extension coverage shall be provided only
on the day of Your air travel; and (b) if You return to Your origination
point (i) within 7 days after the completion of the Land/Sea Arrangements,
coverage shall apply until the time of return to the origination point;
(ii) greater than 7 days after the completion of the Land/Sea Arrangements,
the extension coverage shall be provided only on the day of Your air travel.
CLAIMS
PROCEDURE
POLICY NO. 8977-9500407
1) EMERGENCIES
ARISING DURING YOUR TOUR: For covered emergencies requiring evacuation
or interruption of Your Tour, call AIG Assist immediately at the numbers
listed above. Identify yourself by the above policy number and give the
details of Your problem or medical emergency.
2) TRIP CANCELLATION
CLAIMS: Call Your travel agent, Pacific Delight Tours, and BerkelyCare
IMMEDIATELY at the number below 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.
BerkelyCare:
1-(800) 343-3553
3) CLAIMS NOTIFICATION
UPON YOUR RETURN: Report Your claim in writing as soon as possible
to BerkelyCare. Provide the policy number above, 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.
IMPORTANT:
In order to facilitate prompt claims settlement upon Your return, be sure
to obtain as applicable: detailed medical statements from Physicians in
attendance where the accident or Sickness occurred; receipts for medical
services and supplies; receipts from the hospital; or police reports or
claims reports from parties responsible (e.g., airline, hotel, etc.) for
loss, theft, damage, or delay. In the event of a baggage claim, receipts
for any lost or damaged items will be required. In the event of a baggage
delay or trip delay claim, receipts for any additional covered expenses
will be required, as well as verification of the delay.
WHERE
TO REPORT CLAIMS
1. WORLDWIDE EMERGENCY
ASSISTANCE (AIG Assist)
For traveler's assistance
or emergencies during Your Tour, call within the U.S. and Canada:
1-(800)
543-3797
or, outside the U.S.
and Canada, call collect:
1-(972)
699-0200
Fax: 1-(713) 974-3422
2. FOR ALL OTHER
CLAIMS:
| Write to: |
Telephone: |
| BerkelyCare |
1-(800) 343-3553 |
| 100 Garden City
Plaza |
1-(516) 294-0220 |
| P.O. Box 9366 |
Office Hours:
9AM - 5PM EST |
| Garden City,
NY 11530 |
Monday - Friday |
ENROLLMENT
PROCEDURE
In order to quickly
effect coverage and waive the Pre-Existing Condition Exclusion make, payment
for the applicable plan cost within 7 days of your initial Tour or deposit
payment.
PLEASE NOTE:
- The Trip Cancellation
protection will become effective on the day that Pacific Delight Tours
receives the correct plan cost payment.
- Payment for the
coverage may not be accepted after the Tour cost has been paid in full.
Eligibility
- This coverage is available to U.S. and Canadian residents only.
Extension
Premium: If
You are planning independent travel more than 7 days before or after the
Pacific Delight Tours-booked Land/Sea Arrangements, You must purchase
additional coverage in order to extend coverage for these independent
arrangements. This extension coverage, available at a cost of $15 per
person, provides an extension of all plan coverage, except Trip Cancellation/Interruption
coverage for all Land/Sea Arrangements not booked through Pacific Delight
Tours.
This
program was designed for the
Passengers of Pacific Delight Tours by:
BerkelyCare
FOR
ADDITIONAL INFORMATION, PLEASE CALL BERKELYCARE AT:
1-(800)
343-3553
or
1-(516) 294-0220
Office
Hours: 9AM-5PM (EST), Monday - Friday
Ask for the Pacific Delight Tours Help Line
This
plan is underwritten by:
National
Union Fire Insurance Company of
Pittsburgh, PA
Executive Offices: New York, New York
A Member Company of
American International Group
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