Exclusions and Limitations
There are some exclusions and limitations to the coverage. For example, you need to contact the Emergency Assistance Center at 1-800--359-6704 within 48 hours of admission to hospital or as soon as is reasonably possible. If contact is not established within this timeframe the benefits will be reduced to 80% of what would otherwise be payable, to a maximum of $30,000.
Pre-existing condition exclusions may also apply. Please see the Certificate of Insurance for full details.
Pre-Existing Condition Exclusions
Coverage is not provided for treatment, services or expenses related to a pre-existing condition which is defined as a condition for which:
- you had symptoms, diagnosis or treatment, including medication; or
- you had, or it was recommended that you should have, investigations, tests or treatment (including changes to medication or dosage)
Pre-Existing Condition Period is 180 days before the trip for people 74 years of age or younger, or 365 days before the trip for people 75 years of age or older.
Please note there are additional Limitations and Exclusions. Please read the Certificate of Insurance . (Requires Acrobat Reader) for details.
The Pre-existing Condition exclusions applies to:
- customers 54 or under;
- customers 55 or over travelling 17 days or less; and
- customers enrolling in the Annual Plan.
Age for the purposes of pre-existing condition determination is based on your age on the Effective Date of the policy.
An important note for those 55 years of age or older
If you are 55 years of age or over and travelling for 18 days or more, or if you are 85 years of age or more, you must call (416) 977-2039, or toll-free 1-800-293-4941 for your individual quotation. This applies if you want to buy new insurance or if you already have Annual Plan coverage and want to buy extended coverage for a trip that will last more than 17 days.
In either case:
- your telephone request for coverage will be subject to review of a health questionnaire;
- if accepted for coverage, your premium will be based on your responses to a series of medical questions;
- the standard pre-existing exclusion will not apply to your Emergency Medical coverage, but if you have Annual Plan coverage, this exclusion will still apply to your Trip Interruption and Trip Cancellation coverage;
- you must make full disclosure of all medical conditions, including any changes to your condition before you leave on your trip; and
- applicants with certain unstable medical conditions may not qualify for coverage.
Please refer to section 4 of the Certificate of Insurance for complete details.
Please refer to the Travel Medical Insurance Plan Certificate of Insurance for a complete list of Benefits, Exclusions and Limitations. (Requires Acrobat Reader).
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