The
MEGA Life and Health Insurance Company
(Herein
called The Company)
501
West Interstate 44 Service Road Oklahoma City, Oklahoma 73118
Liaison®
International Program Summary
The Company hereby insures all persons whose
Application has been accepted by the Administrator, Specialty Risk
International, Inc. (SRI), on behalf of the Company and whose name is
identified on the ID Card, subject to all of the exclusions, limitations and
provisions as set forth herein and in the Master Policy of insurance issued by
the Company. Coverage is afforded only
with respect to the person, coverage, amounts and limits specified herein and
as identified on the ID Card for the insurance requested on such Application
and for which there specified premium has been paid to the Administrator.
Note: All
coverage and benefit amounts herein are in United States Dollars.
Part
I - INDIVIDUAL INSURANCE PROVISIONS
Eligibility
Persons while traveling outside of their Home
Country whose Application has been accepted by the Administrator. Dependents are considered to be the
Insured’s spouse and natural or legally adopted unmarried children over 14 days
and under 19 years of age while traveling outside of their Home Country. Home
Country is defined as - The country where an eligible person(s) has his/her
true, fixed and permanent home and principal establishment.
Effective Date of
Individual Insurance
Individual coverage will become effective upon the
latest of the following: 1. Moment of departure from Home Country;
or 2.
The date and time the Application and full premium are received and
accepted by SRI; or 3. The date requested on the Application.
Termination Date of
Individual Insurance
Individual coverage will terminate upon the earlier
of the following: 1. The moment of the Insured Person’s arrival
in their Home Country*; or 2. The date shown on the ID Card, for which premium
has been paid. * Except when Home
Country Coverage benefit is used.
Home Country Coverage
Coverage under the program is valid for incidental
trips to the Insured Person’s Home Country for up to 60 days per 12 months of
coverage, or pro rata thereof. Covered
Expenses described in the Medical Expense Benefit which are incurred in the
Home Country of the Insured Persons, and not listed in the Exclusions, are
limited to a maximum of $50,000 while in the Home Country of the Insured
Person, subject to the selected Deductible and Coinsurance. (limit of $50,000 does not apply after
Emergency Evacuation / Repatriation)
Refund of Premium
Premium for the full term of coverage will be
refunded only when a written request is received by SRI prior to the Effective
Date of Individual Insurance. After the
Effective Date of Individual Insurance, premium is considered fully earned and
nonrefundable.
PART
II - DESCRIPTION OF BENEFITS
ACCIDENTAL DEATH &
DISMEMBERMENT (AD&D)
The Company shall pay an indemnity determined from
the Table if an Insured Person sustains a Loss stated therein resulting from
Injury and subject to the limitations contained in PART IV - EXCLUSIONS,
provided that: (a) such Loss occurs within 365 days after the date of Accident
causing such Loss; and (b) the indemnity payable for any such Loss shall be the
Principal Sum stated on the ID Card, as applicable to such Insured Person and
this Insurance; and (c) if more than one Loss stated in said Table of Losses is
sustained as the result of one Accident, only one of the amounts, the largest,
shall be payable.
For
Loss of: Insured or Spouse Each
Child
Loss
of Life Principal Sum $5,000
Loss
of two Members Principal Sum $5,000
Loss
of one Member 50% of Principal Sum $2,500
Quadriplegia Principal
Sum $5,000 (total
paralysis of both upper and lower limbs)
Paraplegia 75% of the Principal Sum $3,750 (total paralysis of both lower limbs)
Hemiplegia 50%
the Principal Sum $2,500 (total paralysis of both upper
and lower limbs of one side of the body)
Uniplegia 25% of the Principal Sum $1,250
(total paralysis of one
limb)
The term "Loss", in reference to
quadriplegia, paraplegia, hemiplegia and uniplegia, shall mean the complete and
irreversible paralysis of such limbs and with regard to hands and feet, actual
severance through or above the wrist or ankle joints, and with regard to eyes,
entire irrecoverable Loss of sight. The
term “Principal Sum” as used herein shall mean the amount stated on the ID
Card.
MEDICAL EXPENSE BENEFITS
If
the Insured Person is traveling inside the United States and Canada:
When a covered Injury or Illness is incurred by the Insured Person, the Company
will pay 80% of the first $5,000 of Reasonable and Customary medical charges
for Covered Expenses, excess of the Policy Period Deductible as stated on the
ID Card. Thereafter, the Company will
pay 100% of Reasonable and Customary medical charges for Covered Expenses up to
the maximum as stated on the ID Card. If the Insured Person is traveling outside
the United States and Canada: the Company will pay 100% of Reasonable and
Customary medical charges for Covered Expenses, excess of the Policy Period
Deductible as stated on the ID Card, up to the maximum as stated on the ID
Card. In no event shall the Company's
maximum liability exceed the maximum as stated on the ID Card. The Deductible
and Coinsurance amount consists of Covered Expenses which would otherwise be
payable under this Policy. These
expenses must be borne each Insured Person.
A maximum of 3 Policy Period deductibles per family under the same
application will apply.
Only such expenses, incurred as the result of and
within twenty-six weeks from a Disablement, which are specifically enumerated
in the following list of charges, and which are not excluded in PART IV -
EXCLUSIONS, shall be considered as Covered Expenses:
1. Charges made by a
Hospital for room and board, floor nursing and other services inclusive of
charges for professional service and (with the exception of personal services
of a non-medical nature); charges made for an operating room.
2. Charges made for
Intensive Care or Coronary Care charges and nursing services.
3. Charges made for
diagnosis, treatment and Surgery by a Physician; charges made for the cost and administration of anesthetics.
4. Charges made for
Outpatient treatment, same as any other treatment covered on an Inpatient
basis. This includes ambulatory
Surgical centers, Physicians’ Outpatient visits/examinations, clinic care, and
Surgical opinion consultations.
5. Charges for
medication, x-ray services, laboratory tests and services, the use of radium
and radioactive isotopes, oxygen, blood transfusions, iron lungs, and medical
treatment; dressings, drugs, and
medicines that can only be obtained upon a written prescription of a Physician
or Surgeon.
6. Charges for
physiotherapy, if recommended by a Physician for the treatment of a specific
Disablement and administered by a licensed physiotherapist.
7. Ground ambulance
(within the metropolican area) to and from the nearest Hospital with facilities
for required treatment. If the Insured
Person is in a rural area, then licensed ground ambulance transportation to the
nearest metropolitan area shall be considered a Covered Expense.
8. Hotel room charge,
when the Insured Person, otherwise necessarily confined in a Hospital, shall be
under the care of a duly qualified Physician in a hotel room owing to
unavailability of a Hospital room by reason of capacity or distance or to any
other circumstances beyond control of the Insured Person.
9. Charges made for
artificial limbs, eyes, larynx, and orthotic appliances, but not for
replacement of such items.
The charges enumerated herein shall in no event
include any amount of such charges which are in excess of Reasonable and
Customary charges. If the charge
incurred is in excess of such average charge, such excess amount shall not be
recognized as a Covered Expense. All
charges shall be deemed to be incurred on the date such services or supplies
which give rise to the expense or charge are rendered or obtained.
The Insured or the provider of service
must contact the Assistance Company for pre-notification prior to: hospital
admissions and inpatient/outpatient surgeries.
In the case of an Emergency Admission, the Assistance Company must be
contacted within 48 hours, or as soon as reasonably possible. Pre-notification does not guarantee that
benefits will be paid. Failure to pre-notify
will result in a 20% reduction in Eligible Benefits.
HOSPITAL INDEMNITY
Should the Insured Person be hospitalized while
traveling outside the United States or Canada, and the hospitalization is
considered a Covered Expense, the Company will indemnify the Insured $100 for
each night spent in the hospital.
EMERGENCY MEDICAL
EVACUATION/REPATRIATION
The Company shall pay benefits for Covered Expenses
incurred up to $100,000, if any covered Injury or Illness commencing during the
Period of Coverage results in the Medically Necessary Emergency Medical
Evacuation or Repatriation of the Insured Person. The Emergency Medical Evacuation or Repatriation must be ordered
by the Assistance Company in consultation with the Insured Person’s local
attending Physician.
Emergency Medical Evacuation or Repatriation means:
a) the Insured Person's medical condition warrants immediate transportation
from the place where the Insured Person is located to the nearest adequate
medical facility where medical treatment can be obtained; or b) after being treated at a local medical
facility as a result of a Emergency Medical Evacuation, the Insured Person's
medical condition warrants transportation with a qualified medical attendant to
his/her Home Country to obtain further medical treatment or to recover; or c)
both a) and b) above. All
transportation arrangements must be by the most direct and economical route.
RETURN OF MORTAL REMAINS
The Company will pay the reasonable Covered
Expenses incurred up to a maximum of $20,000 to return the Insured Person's
remains to his/her then Home Country, if he or she dies. Benefit includes - cost of casket required
for shipping, embalming, paperwork needed for shipping, cost of shipping, cost
of transfer to airport.
EMERGENCY MEDICAL REUNION
When Emergency Medical Evacuation or Repatriation
occurs, the Company will arrange and pay, up to $10,000, for round trip
economy-class transportation for one individual selected by the Insured Person,
from the Insured Person’s Home Country to the location where the Insured Person
is hospitalized and return to the Home Country. Emergency Medical Reunion must
be recommended by the attending Physician.
The benefits payable will include: 1. The cost of a round trip economy
air fare; 2. Reasonable travel and accommodation expenses (not to exceed $200
per day) incurred in relation to the maximum of $10,000. 3. The period of Emergency Medical Reunion
is not to exceed 10 days, including travel.
RETURN OF MINOR
CHILDREN(REN)
Should the Insured Person be traveling alone with a
Minor Child(ren) and is hospitalized because of a covered Illness or Injury and
the Minor Child(ren), under age 19, is left unattended, the Company will
arrange and pay, up to $5,000, for one way economy fares to their Home Country. These arrangements will be made at no cost
to the Insured Person. Meals and
lodging are the responsibility of the Insured Person. If an attendant/escort is necessary to insure the safety and
welfare of Minor Child(ren), the Company will arrange and pay for these
services to the limit stated in the Schedule of Benefits.
INTERRUPTION OF TRIP
If the Insured is unable to continue the Trip due
to the death of an Immediate Family member (parent, spouse, sibling or child)
or due to serious damage to the Insured’s principal residence from fire, flood
or similar natural disaster (tornado, earthquake, hurricane, etc.), the program
will reimburse, (up to $5,000), the Insured for the cost of economy travel,
less the value of applied credit from an unused return travel ticket, to return
home to their area of principal residence.
LOSS OF CHECKED LUGGAGE
If the Insured's checked luggage is permanently
lost by the airline, the program will reimburse the Insured for the replacement
of clothing and personal hygiene items lost to a maximum per article limit of
$50. This benefit is secondary to any
other (including airline) coverage available.
The Insured must furnish proof to the Company that full reimbursement
has been obtained from the airline.
DENTAL - EMERGENCY ONLY
Emergency Dental treatment necessary to resolve
acute, spontaneous and unexpected inception of pain to natural teeth (up to a
maximum of $100) or Dental treatment necessary to restore or replace sound
natural teeth lost or damaged in an Accident which is covered under the program
(up to a maximum of $500). *Only available to programs purchased for 1 month or
more.
NOTE:
In the event of an Emergency Medical Evacuation/Repatriation, Return of Mortal
Remains, Emergency Medical Reunion, Return of Minor Child(ren), Interruption of
Trip, or Loss of Checked Luggage benefit is needed, arrangements must be made
by the Assistance Service Provider. Failure to utilize the Assistance Service
Provider for these benefits will void any payment by the Company. Complete details about required notification
of the Assistance Service Provider are listed below.
PART III - DEFINITIONS
The term "Disablement" as used with
respect to medical expenses shall mean an Illness or an Accidental bodily
Injury necessitating medical treatment by a Physician as defined in this
Policy. The term "Hospital"
as used in this Policy shall mean except as may otherwise be provided, a
Hospital (other than an institution for the aged, chronically ill or
convalescent, resting or nursing homes) operated pursuant to law for the care
and treatment of sick or Injured persons with organized facilities for
diagnosis and Surgery and having 24-hour nursing service and medical
supervision. The term "Home
Country" shall mean the country where an Insured Person has his or her
true, fixed and permanent home and principal establishment. The term "Host Country" shall
mean any country other than the country where an Insured Person has his or her
true, fixed and permanent home and principal establishment. The term "Illness" wherever used
in this Policy shall mean sickness or disease of any kind contracted and
commencing after the Effective Date of this Policy and Disablement covered by
this Policy. The term "Injury"
wherever used in this Policy shall mean bodily Injury caused solely and
directly by violent, Accidental, external, and visible means occurring while
this Policy is in force and resulting directly and independently of all other
causes in Disablement covered by this Policy.
The term “Policy Period or Period of Coverage” shall mean the period of
coverage issued by the Company to the Insured Person, typically beginning with
the Effective Date and ending with the Termination Date or the date coverage is
renewed by the Company. The term
"Physician" as used in this Policy shall mean a doctor of medicine or
a doctor of osteopathy licensed to render medical services or perform Surgery
in accordance with the laws of the jurisdiction where such professional
services are performed, however, such definition will exclude chiropractors and
physiotherapists.
PART
IV - EXCLUSIONS
For Medical
benefits, this Insurance does not cover:
1. Any Injury or Illness which meets the
following criteria: 1) condition(s)
that would have caused a person to seek medical advise, diagnosis, care or
treatment during the 36 months prior to the Effective Date of coverage under
this Policy; 2) condition(s) for which manifestation, medical advise,
diagnosis, care or treatment was recommended, received, or noticed during the
36 months prior to the Effective Date of coverage under this Policy; If the
Injury or Illness is an Unexpected Recurrence and the Insured Person is
traveling outside the United States, the program will reimburse up to $1000 for
treatment of that particular condition.
An Unexpected Recurrence is a sudden and unexpected outbreak or
recurrence of a condition defined in a & b above. The condition must occur spontaneously and without advanced
warning, for example: prior symptoms, Physician visit, failing to take
medication. For Insured Persons
traveling outside the United States and Canada, the period is 12 months instead
of 36 months.
2. Charges for treatment which exceed
Reasonable and Customary charges; or Charges incurred for Surgeries or
treatments which are Investigational, Experimental, or for research
purposes; expenses which are nonmedical
in nature; expenses for Vocational, Speech, Recreational or Music Therapy;
3. Expenses which were not recommended,
approved and certified as Medically Necessary and reasonable by a Physician;
4. Suicide or any attempt there at, while sane
or self destruction or any attempt there at, while insane; intentionally
self-inflicted Injury or Illness; or expenses as a result or in connection with
the commission of a felony offense;
5. Any consequence, whether directly or
indirectly, proximately or remotely occasioned by, contributed to by, or
traceable to, or arising in connection with war, invasion, act of foreign enemy
hostilities, warlike operations (whether war be declared or not), or civil war;
6. Injury sustained while participating in
professional, sponsored and/or organized Amateur or Interscholastic Athletics;
7. Routine physicals, inoculations, or other
examinations where there are no objective indications or impairment in normal
health;
8. Treatment of the Temporomandibular joint.
9. Services or supplies performed or provided
by a Relative of the Insured Person, or anyone who lives with the Insured
Person.
10. Treatment and the provision of false teeth
or dentures, normal ear tests and the provision of hearing aids, cosmetic or
plastic Surgery (including deviated nasal septum), routine dental expenses, eye
care or eye related expenses, unless caused by Accidental bodily Injury
incurred while insured hereunder;
11. Treatment in connection with alcoholism and
drug addiction, or use of any drug or narcotic agent; any Mental and Nervous
disorders or rest cures; Injury sustained while under the influence of or
Disablement due to wholly or partly to the effects of intoxicating liquor or
drugs;
12. Congenital abnormalities and conditions
arising out of or resulting therefrom;
13. Expenses incurred during a hospital
emergency room visit which is not of an emergency nature;
14. Injury sustained while taking part in
mountaineering where ropes or guides are normally used, hang gliding,
parachuting, bungee jumping, racing by horse or motor vehicle or motorcycle,
snowmobiling, motorcycle / motor scooter riding, scuba diving involving
underwater breathing apparatus (unless PADI certified), water skiing, snow
skiing and snow boarding; *
15. Treatment paid for or furnished under any
other individual, government, or group
policy or charges provided at no cost to the Insured Person.
16. Treatment of venereal or sexually
transmitted disease.
17. Pregnancy expenses or Illness resulting from
pregnancy, childbirth, or miscarriage; or for miscarriage resulting from
Accident.
18. Drug, treatment or procedure that either promotes or prevents conception, or
prevents childbirth;
19. Expenses incurred while the Insured Person
is in their Home Country (except after approved Emergency Evacuation /
Repatriation or if treatment is a follow-up to a covered disablement during
coverage or if the expenses pertain to the Home Country Coverage Benefit);
20. Expenses incurred for which travel was
undertaken to seek medical treatment for a condition; or incurred after the
Insured Person’s physician has limited or restricted travel.
* Option is available to include all or
part of these risks.
With regards to Accidental Death and Dismemberment,
Emergency Medical Evacuation/Repatriation, Return of Mortal Remains, Emergency
Medical Reunion, and Return of Minor Child, this Insurance does not cover:
1. Suicide or attempt thereof by the Insured
Person while sane or self destruction or any attempt thereof by the Insured
Person while insane;
2. Disease or sickness of any kind; (only
applicable to AD&D)
3. Bacterial infections except pyogenic
infection which shall occur through an accidental cut or wound; (only applicable to AD&D)
4. Hernia of any kind; (only applicable to AD&D)
5. Injury sustained while the Insured Person
is riding as a pilot, student pilot, operator or crew member, in or on,
boarding or alighting, from any type of aircraft;
6. Injury sustained while the Insured Person
is riding as a passenger in any aircraft (a) not having a current and valid
Airworthy Certificate and (b) not piloted by a person who holds a valid and
current certificate of competency for piloting such aircraft.
7. Any consequence, whether directly or
indirectly, proximately or remotely occasioned by, contributed to by, or
traceable to, or arising in connection with:
a. war, invasion, act of foreign enemy
hostilities, warlike operations (whether war be declared or not), or civil
war. b. mutiny, riot, strike, military
or popular uprising insurrection, rebellion, revolution, military or usurped
power. c. any act of any person acting on behalf of or in connection with
any organization with activities directed towards the overthrow by force of the
Government de jure or de facto or to the influencing of it by terrorism or
violence. d. martial law or state of
siege or any events or causes which determine the proclamation or maintenance
of martial law or state of siege (hereinafter for the purposes of this
Exclusion called the “Occurrences”).
Any consequence happening or arising during the existence of abnormal
conditions (whether physical or otherwise), whether directly or indirectly,
proximately or remotely occasioned by, or contributed to by, traceable to, or
arising in connection with, any of the said Occurrences shall be deemed to be
consequences for which the Company shall no be liable under this Policy except
to the extent that the Insured Person shall prove that such consequence
happened independently of the existence of such abnormal conditions.
8. Service in the military, naval or air
service of any country.
9. Flying in any aircraft being used for or in
connection with acrobatic or stunt flying, racing, endurance tests,
rocket-propelled aircraft, crop dusting or seeding or spraying, fire fighting,
exploration, pipe or power line inspection, any form of hunting or herding,
aerial photography, banner towing or any experimental purpose.
10. Being under the influence of alcohol or
having taken drugs or narcotics unless prescribed by a legally qualified
physician or surgeon.
11. Injury occasioned or occurring while the
Insured Person is committing or attempting to commit a felony or to which a
contributing cause was the Insured Person being engaged in an illegal
occupation.
12. Riding or driving in any kind of
competition.
13. Pregnancy, childbirth, miscarriage or
abortion.
14. Covered Expenses incurred after the Insured
Person’s physician has limited or restricted travel; or Covered Expenses incurred
as a result of a change in prescribed treatment during, or within the three
months prior to the effective date of coverage.
For Cancellation of Trip, this insurance does not
cover: 1) war or any act of war,
whether declared or not; participation in a felony, riot or insurrection;
participation in contests of speed; a Pre-existing Condition existing prior to
the Insured’s departure from their Home Country that has the likelihood of
causing death.
For Lost of Checked Luggage, this insurance does
not cover: animals; automobiles or
automobile equipment; boats; motors; motorcycles; other conveyances or their
appurtenances (except bicycles while checked as baggage with a Common Carrier);
household furniture; eye glasses or contact lenses; artificial teeth or dental
bridges; hearing aids; prosthetic limbs; musical instruments; money or
securities; tickets or documents; or sporting equipment if loss or damage
results from the use thereof.
Renewal
Option (when applicable)- Intended for longer
international trips, this option allows for continuous coverage for up to three
years while paying premiums on a minimum quarterly basis (however, you may
purchase longer increments if you wish).
If this option is chosen, SRI will send you renewal notices to your
Address of Correspondence, giving you the option of continuing coverage under
the same program. To be valid, you
must purchase at least 3 months initially (you can purchase up to 12 months
if desired). The renewal notices will
be sent one month before your expiration date.
Coverage may then be renewed for between 1 and 12 months (at the premium
rate in force at the time of renewal), depending upon your specific need. If you choose to renew for less than 3
months, SRI will assume that your international trip will be over and not send
any further notices. If you renew
coverage for 3 months or more, SRI will continue to send the renewal
notices. Maximum period of coverage is
3 years. For persons age 70 and over,
maximum period of coverage is 1 year. A
$5.00 Administrative Fee will be charged each time coverage is renewed. Please note that the maximum policy period
for the deductible and coinsurance is 12 months.
Hazardous
Sport Coverage (when applicable)- To cover motorcycle/motor
scooter riding, mountaineering (4500 meter limit), hang gliding, parachuting,
bungee jumping, water skiing, snow skiing, snowmobiling, and snow boarding.
Please be aware that this is not a general health
insurance policy, but an interim travel medical program intended for use while
away from your Home Country or Country of Residence. Liaison International does not guarantee payment to a facility or
individual for medical expenses until the Company determines that it is an
eligible expense.
PART V - POLICY
PROVISIONS
1. Notice of Claim: Written notice of claim must be given to the
Company within 90 days after the occurrence or commencement of any Disablement
covered by the Policy, or as soon thereafter as is reasonably possible. Notice given by or on behalf of the claimant
to the Administrative Offices of the Company, or to any authorized agent of the
Company, with information sufficient to identify the Insured Person shall be
deemed notice to the Company.
2. Claim
Forms: The Company, upon receipt of a
notice of claim, will furnish to the claimant such forms as are usually
furnished by it for filing Proofs of Loss.
If such forms are not furnished within fifteen days after the giving of
such notice the claimant shall be deemed to have complied with the requirements
of the Policy as to Proof of Loss upon submitting, within the time fixed in the
Policy for filing Proofs of Loss, written proof covering the occurrence, the
character and the extent of the Disablement for which claim is made.
3. Proof of
Loss: Written Proof of Loss must be
furnished to the Company at its said office in case of claim for loss for which
this Policy provides any periodic payment contingent upon continuing loss
within 90 days after the termination of the period for which the Company is
liable and in case of claim for any other loss within ninety days after the
date of such loss. Failure to furnish
such proof within the time required shall not invalidate nor reduce any claim
if it was not reasonably possible to give proof within such time, provided such
proof is furnished as soon as reasonably possible.
4. Time of Payment
of Claims: Indemnities payable under
the Policy for any loss other than loss for which the Policy provides any
periodic payment will be paid immediately upon receipt of due written proof of
such loss. Subject to due written Proof
of Loss, all accrued indemnities for loss for which the Policy provides
periodic payment will be paid at the expiration of each four weeks during the
continuance of the period for which the Company is liable, and any balance
remaining unpaid upon the termination of liability will be paid immediately
upon receipt of due written proof.
5. Payment of
Claims: Indemnity for loss of life will
be payable in accordance with the beneficiary designation and the provisions
respecting such payment which may be prescribed herein and effective at the
time of payment. If no such designation
or provision is then effective, such indemnity shall be payable to the estate
of the Insured Person. Any other
accrued indemnities unpaid at the Insured Person's death may, at the option of
the Company, be paid either to such beneficiary or to such estate. All other indemnities will be payable to the
Insured Person.
If any
indemnity of the Policy shall be payable to the estate of an Insured Person, or
to an Insured Person who is a minor or otherwise not competent to give a valid
release, the Company may pay such indemnity, up to an amount not exceeding
$1,000, to any Relative by blood or connection by marriage of the Insured
Person who is deemed by the Company to be equitably entitled thereto. Any payment made by the Company in good
faith pursuant to this provision shall fully discharge the Company to the
extent of such payment.
Subject to any
written direction of the Insured Person all or a portion of any indemnities
provided by this Policy on account of Hospital, nursing, medical or Surgical
service may, at the Company's option and unless the Insured Person requests
otherwise in writing not later than the time for filing proof of such loss, be
paid directly to the Hospital or person rendering such services, but it is not
required that the service be rendered by a particular Hospital or person.
6. Physical
Examination and Autopsy: The Company at
its own expenses shall have the right and opportunity to examine the person of
any individual whose Injury or Illness is the basis of claim when and as often
as it may reasonably require during the pendency of a claim hereunder and to
make an autopsy in case of death, where it is not forbidden by law.
7. Legal
Actions: No actions at law or in equity
shall be brought to recover on the Policy prior to the expiration of sixty days
after written proof of loss has been furnished in accordance with requirements
of this Policy. No such action shall be
brought after expiration of three years after that time written Proof of Loss
is required to be furnished.
How to obtain travel assistance
To
receive assistance worldwide, call SRI Assist at the numbers below and provide
them with your policy #:
MDC-010101-01TM
For
Emergency Medical Evacuation, Return of Remains, Emergency Reunion, Return of
Minor Child, Assistance Services, Call:
If
in the United States or Canada:
1-800-690-6295 If outside the United
States or Canada: 1-305-463-0249
(collect)
Claims
Services:
To
report claims or verify eligibility, send the original bills and claim forms to
Specialty Risk International, Inc. or call or fax to the numbers below. Be certain to include your ID# shown on the
ID Card will all correspondences:
Specialty
Risk International, Inc. (SRI)
9200
Keystone Crossing, Ste 300;
Indianapolis, IN 46240
800-335-0477 or 317-575-2656 FAX 317-575-2659 email: info@specialtyrisk.com www.specialtyrisk.com