Prime Travel Protection TERMS AND CONDITIONS:
The following describes all of the terms, conditions and definitions of the membership and service contract you have purchased. Please read it carefully.
Should you decide to cancel this service contract you may do so in writing within ten (10) days of the date of purchase unless your trip has departed. If canceled as described, you will receive a complete refund.
To be eligible for this service you must be a citizen or resident of the United States, Mexico, or Canada.
Services begin only when full payment has been received and your enrollment is accepted at our office in Illinois. Membership is non-transferable and once accepted, non-refundable unless canceled as described above. If trip cancellation is included in your plan, that benefit is in force for you at 12:01 am the day following receipt of full payment and acceptance by Us. All other services and benefits begin on the date of your departure and end on the earlier of the actual date of your return or the scheduled date of your return as reported to us on your application for membership services. Under no circumstances will reimbursement be made to you if you are traveling to receive medical care, medication or treatment if the travel dates you submitted on your application do not reflect your actual departure and return dates, if your tickets do not indicate the travel dates, if you give incorrect data or facts or if your request for service is not submitted to us within 30 days from the date of loss except as otherwise prohibited by law.
Trip Cancellation/Interruption:
This benefit is provided up to the amount purchased for unused, non-refundable prepaid expenses for travel arrangements if you are prevented from taking your trip for any of the following reasons that occur after this plan is in effect for you:
If you or a traveling companion (who has also purchased this plan) or an immediate family member suffers an unforseen injury, sickness, or death,
Is hijacked, quarantined,
Required to serve on a jury,
Called to active duty in the military,
Subpoenaed as a witness in a legal action in which you or your traveling companion are not a party.
Have a home made uninhabitable by fire, flood, earthquake or other natural disaster,
Are directly involved in a documented traffic accident while en route to point of departure,
The filing of bankruptcy and complete cessation of service by your travel supplier provided you purchase this plan within 14 days of your initial trip deposit and that the bankruptcy filing occurs more than 15 days after full payment and acceptance of your enrollment by Us. In the event of bankruptcy we reserve the right to substitute a trip of similar value in lieu of cash payment,
Terrorism in a country which is part of your trip which causes the United States Department of State to issue a Travel Warning that you should not travel to that country for a period of time that would include your trip.
The additional cost you may incur as a result of a change in the per person occupancy rate should your traveling companion cancel their trip for a covered reason and you do not.
Benefits will be paid up to the total trip cost not to exceed the maximum benefits purchased provided the total cost of the trip has been included in the cost of the plan.
You must be medically capable of travel on the date you purchased your trip and the date you purchase this plan. If canceling for a medical reason, it must be the written opinion of the treating Physician, that the event causing cancellation was unforeseen, life-threatening, occurred after the purchase of this plan and is so disabling as to cause a trip to be canceled or interrupted. Unforeseeable sickness or injury requires that you be examined by a licensed medical doctor prior to the cancellation or interruption of your trip. If you have not covered the cost of your air transportation and are delayed by the airline for any reason, no benefits are payable.
Trip interruption benefits include unused, non-refundable land or sea expenses prepaid to your travel supplier for your trip and/or the airfare paid, less the value of applied credit from an unused return travel ticket to return to your departure city Additional benefits also include the cost of reasonable additional accommodations and transportation expenses incurred to remain near a traveling companion who is hospitalized during your trip not to exceed $l00 per day or the total amount you prepaid for your trip.
You must advise your travel supplier and Us within 72 hours of the event that is likely to cause a request of service. Under no circumstances will benefits be paid for additional charges incurred as a result of your failure to notify these parties. If your travel plans involve air tickets purchased in addition to your tour or cruise, you must notify the airline of your cancellation as well.
"Cancel for Any Reason" Option:
In the event you or a traveling companion are prevented from taking your trip for any reason and have purchased this option, you will receive a certificate for the value of all non-refundable cancellation charges imposed by your travel supplier, cruise line or airline minus a twenty (20%) percent processing fee. Benefits will be paid up to a $10,000 maximum.
Your travel certificate is payable for a period of one year (12 months) from the date of your original trip cancellation, is not transferable or refundable and must be used with the travel supplier from whom you originally purchased your canceled trip. You must complete travel prior to the expiration date of the certificate. NOTE: Purchase of this “Cancel For Any Reason” option eliminates all other methods of reimbursement for trip cancellation.
Trip Delay/Missed Connection:
We will provide reimbursement up to the Maximum Benefit Amount for:
a) Additional Transportation Cost to join the Trip or return home, including up to $150 per day for reasonable accommodations and meals, if Your delay requires an unplanned overnight stay; and/or
b) unused, non-refundable portion of the prepaid expenses as long as the expenses are supported by proof of purchase and are not reimbursable by any other source. There is no coverage for carrier delay caused by an announced, organized, sanctioned labor action, any government regulation or prohibition.
Delay must be 10 hours or more and certified due to the following reasons: 1) Delay of Common Carrier (which is certified by the Common Carrier); 2) A traffic accident in which You were directly involved (substantiated by a police report); 3) Documented weather condition preventing You from getting to the point of departure; 4) Organized Labor Strike, natural disaster, Terrorist Incident, riot, or You or Your Traveling Companion being hijacked or quarantined.
You must notify us as soon as you know your trip is going to be delayed more than 10 hours. Failure to do so may affect reimbursement.
Medical Expense:
We will provide reimbursement up to the Maximum Benefit Amount for: Expenses incurred as a result of an Injury which occurs or a Sickness which first manifests itself during the Trip. Benefits will include expenses for emergency dental treatment for injury to sound natural teeth not to exceed $750 only during your trip. No reimbursement will be provided for any dental treatment or expenses incurred after you reach your return destination regardless of the reason. Coverage for this benefit is primary for all care received outside of the United States and secondary to all other valid and collectible coverage for care received within the United States. See specific exclusions.
Medical Evacuation/Repatriation:
You are covered up to the Maximum Benefit Amount purchased for:
Medical Evacuation which is determined by a Legally Qualified Physician and the authorized Assistance Company’s medical director that an Injury or Sickness is acute or life threatening and adequate treatment is not available at a local Hospital. Transportation will be to the closest Hospital or medical facility capable of providing adequate treatment
Medical Repatriation when it is deemed Medically Necessary by a Legally Qualified Physician and the authorized Assistance Company for You to return home or to a Hospital near Your home for continued treatment. Transportation Expense incurred will be paid for You; a) to return to Your permanent residence or b) to be moved to a Hospital or medical facility closest to Your permanent place of residence capable of providing that treatment; via one-way, Economy Transportation; or commercial upgrade, based on Your condition as recommended by the local attending Legally Qualified Physician and the authorized Assistance Company;
Repatriation of Remains: In the event of covered death of You, occurring during the Trip, the Company will pay either the cost of the actual expense incurred for preparation, standard container and transportation of the body or ashes of You to the outbound point of departure or for the reasonable cost for burial or cremation abroad, in either case not to exceed $ 5,000.
Transportation for the return trip home via Economy Transportation for any dependent children under age 18 who are accompanying You if You are confined to a Hospital for more than 7 consecutive days. If You are traveling alone and are confined to a Hospital for more than 7 consecutive days, this benefit will provide, upon request by You or next of kin, one round-trip Economy Transportation for a person of Your choice to visit You in the Hospital.
These benefits provide Economy Transportation which must be by the most direct route. Covered land or air transportation includes, but is not limited to, commercial stretcher, medical escort, or the Usual and Customary Charges for air ambulance, provided such transportation has been pre-approved and arranged by the authorized Assistance Company.
Benefits are paid less the value of an unused return travel ticket. If benefits are payable under this coverage and You have other insurance that may provide benefits for this same loss, Prime Travel Protection reserves the right to recover from such other insurance.
If benefits are payable under MEDICAL EVACUATION / REPATRIATION and You have other insurance that may provide benefits for this same loss, Traveler Protection Services (Company) reserves the right to recover benefits from such other insurance. You shall: 1) notify the Company of any other insurance; 2) cooperate with the Company to exercise the Company’s rights in any reasonable way that the Company may request, including the filing and assignment of other insurance benefits; 3) not do anything after the loss to prejudice the Company’s rights; and 4) reimburse to the Company, to the extent of any payment the Company has made, for benefits received from such other insurance.
All medical transportation services must be authorized in advance and organized by our designated assistance provider. In the event that the medical transportation services are not authorized in advance and organized by our designated assistance provider, no reimbursement will be provided for this benefit.
Travel Assistance Services are provided by an independent organization and not by Prime Travel Protection or Protection Partners. There may be times when circumstances beyond the assistance provider’s control hinder their endeavors to provide Travel Assistance Services. They will however make all reasonable efforts to provide Travel Assistance Services and help You resolve Your emergency situation. Travel Assistance provides a variety of travel related services.
Baggage and Personal Effects:
You are covered up to the Maximum Benefit Amount for lost, stolen, or damaged baggage or personal items with a maximum reimbursement of up to $250 per article. A maximum of $500 will be on all losses to jewelry, watches, articles consisting in whole or in part of silver, gold or platinum, articles trimmed with fur, cameras and their accessories and related equipment. In addition. the following reimbursements will apply: 1) lost or stolen passport or visa ($50 maximum); 2) lost or stolen credit cards ($50 maximum for the cost associated with unauthorized use subject to verification that You have complied with all conditions of the credit card company).
The lesser of the following amounts will be paid: 1) 75% of the actual cash value (cost less proper deduction for depreciation) at the time of loss, theft or damage; 2) the cost to repair or replace the article with material of a like kind and quality; or 3) $250 per article.
Benefits will not be paid for any expenses which have been reimbursed or for any services which have been provided by the Common Carrier, hotel or Travel Supplier; nor will benefits be paid for loss or damage to property specifically scheduled under any other insurance.
Baggage Delay:
If Your checked baggage is delayed or misdirected by a Common Carrier while on Your Trip for more than 24 hours from Your time of arrival at the destination other than Your residence, You are covered for the expense of necessary purchases of personal items up to the Maximum Benefit Amount as long as the expense is substantiated by receipts for purchases. The Common Carrier must certify the delay.
For Baggage & Baggage Delay: Benefits are not payable for animals; automobile and automobile equipment, boats or other vehicles or conveyances, trailers, motors, aircraft, bicycles (except when checked as baggage with a Common Carrier); household effects and furnishings, antiques and collector’s items; sunglasses or glasses (prescription or non-prescription), contact lenses; artificial teeth, dental bridges; hearing aids; prosthetic limbs; prescribed medications; keys; money, credit cards, tickets and documents (except as coverage is otherwise specifically provided herein), securities; stamps; professional or occupational equipment or property whether or not electronic business equipment, telephones, computer hardware or software.
Exclusions:
No benefits will be paid for Sickness, Injuries or losses of You and Your Traveling Companion caused by or resulting from:
a) Suicide, attempted suicide, or any intentionally self-inflicted Injury while sane or insane (in Missouri, sane only);
b) Resulting from a Terrorist Incident (except as specifically provided elsewhere in the policy), hostilities or an act of declared or undeclared war;
c) While participating in maneuvers or training exercises of an armed service;
d) While riding, driving or participating in races, or speed or endurance contests;
e) While mountaineering (engaging in the sport of scaling mountains generally requiring the use of picks, ropes or other special equipment);
f) While participating as a member of a team in an organized sporting competition;
g) While participating in skydiving, hang gliding, bungee cord jumping, scuba diving or deep sea diving;
h) While piloting or learning to pilot or acting as a member of the crew of any aircraft;
i) Received as a result or consequence of being Intoxicated or under the influence of any controlled substance unless administered on the advice of a Legally Qualified Physician;
j) To which a contributory cause was the commission of or attempt to commit a felony or being engaged in an illegal occupation;
k) Resulting from a governmental regulation or prohibition;
1) Unless medically fit to travel at the time of purchase of this plan;
m) Relating to a diagnosed Sickness from which no recovery is expected and for which only palliative treatment is provided and which carries a prognosis of death within 12 months of the policy Effective Date;
n) Resulting from non-physical Sickness such as mental, nervous, emotional or psychological disorders in any form whatsoever.
o) Due to normal childbirth, normal pregnancy or voluntarily induced abortion;
p) For dental treatment (except as coverage is otherwise specifically provided herein);
q) Due to a Pre-existing Condition unless the pre-existing waiver is in effect for you.
r) Where coverage has been purchased for travel to or through countries for which travel warnings have been issued by the United States Department of State at the time this plan was purchased; or a) resulting from the intentional release of a biological material.
For residents of California, benefits are not payable if during the 60 days prior to Your Effective Date, a Legally Qualified Physician advised You or Your Traveling Companion not to travel due to a Sickness or injury.
s) Business, contractual or educational obligations.
t) Elective treatment or procedures.
Pre-Existing Condition Waiver: If you purchased this plan within 14 days of the date you made your initial payment for the covered trip a waiver of pre-existing conditions has been included.
General Plan Provisions:
Plan Costs and Fees: All protection plan costs and fees are non-refundable. In the event the plan cost paid for coverage is less than the required plan cost for coverage, benefits may be paid in direct proportion of the actual amount paid to the required plan cost due.
Medical Records: In the event of a claim, the Company reserves the right to review any and all of Your medical records, whether or not the contents of such records were made known to You.
Duplicate Coverage: If You have two or more Protection Plans with the Company that duplicate benefits, You will be paid up to the highest benefit amount under only one plan for each Covered Trip.
Coordination of Benefits: If a member is entitled to similar benefits through any other
insurer the benefits payable under this plan shall be coordinated so that total benefits from all insurers shall not exceed the actual loss incurred.
Errors or Mis-payments: If any benefit is paid in error or payment is made in excess of the amount allowed under the provisions of this plan, the Company reserves the right to recover the excess or ineligible payment from You, Your estate, any institution, insurer or person to whom the payment was made.
Currency: All monies described in this plan are expressed in United States of America
Notice to Residents of Florida: The Benefits of the Plan are governed primarily by the law of a state other than Florida. Your homeowners policy, if any, may provide coverage for loss of personal effects provided by the Baggage and Personal Effects coverage.
Note: This plan contains health insurance benefits that only apply during your Trip. You may have coverage from other sources that already provide You with these benefits. You should review Your existing policies. If you have any questions about Your current coverage, call Your insurer or health plan provider.
Protection Plan Definitions:
“Additional Transportation Cost” means the actual cost incurred for one-way. Economy Transportation by Common Carrier reduced by the value of an unused travel ticket.
“Baggage and Personal Effects” means goods being used by You during a Covered Trip. (See WHAT IS NOT COVERED.)
“Business Partner” means an individual who: a) is involved in a legal general partnership with You; and b) is actively involved in the day-to-day management of Your business.
“Common Carrier” means any public land, air or water conveyance operating under a valid license providing for the transportation of passengers for hire.
“Covered Expense” means expense incurred for services and supplies: a) listed below; and b) ordered or prescribed by a Legally Qualified Physician as Medically Necessary for diagnosis or treatment; which are limited to: the services of a Legally Qualified Physician; Hospital or ambulatory medical-surgical center services (this will also include expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a hospital room for recovery of an Injury or Sickness); transportation furnished by a professional ambulance company to and/or from a Hospital; and prescribed drugs, prosthetics and therapeutic services and supplies.
“Covered Trip” means scheduled trips, tours or cruises for which: a) coverage is requested; and b) the required plan cost is paid prior to final payment.
“Economy Transportation” means the lowest published available transportation rate for a ticket on a Common Carrier matching the original class of transportation that You purchased for the Covered Trip, reduced by the value of an unused return travel ticket.
“Eligible Person” means a resident of the United States or a person who purchases this plan within the United States.
“Family Member” means You or Your Traveling Companion’s: legal spouse or common-law spouse (where legal), legal guardian, legal ward, son or daughter (adopted, foster, step or in-law), brother or sister (includes step or in-law), parent (includes step or in-law), grandparent (includes in-law), grandchild, aunt, uncle, niece, nephew provided the Family Member resides in the United States, Canada or Mexico.
“Hospital” means: a) a place which is licensed or recognized as a general hospital by the proper authority of the state in which it is located; b) a place operated for the care and treatment of resident inpatients with a registered graduate nurse (RN) always on duty and with a laboratory and an x-ray facility; c) a place recognized as a general hospital by the Joint Commission on the Accreditation of Hospitals. Not included is a Hospital or institution licensed or used principally: 1) for treatment or care of drug addicts or alcoholics; or 2) as a clinic, continued or extended care facility, skilled nursing facility, convalescent home, rest home, nursing home or home for the aged.
“Inclement Weather” means any weather condition which delays the scheduled arrival or departure of a Common Carrier.
“Injury” or “Injuries” mean accidental bodily Injuries received while covered under this plan and prior to Your scheduled return date and resulting in loss independently of Sickness and all other causes and certified by a Legally Qualified Physician.
“Intoxicated” means a blood alcohol level which equals or exceeds the legal limit for operating a motor vehicle in the state or jurisdiction where You are located at the time of an incident.
“Legally Qualified Physician” means a physician or a Christian Science Practitioner: a) other than You, a Traveling Companion or a Family Member; b) practicing within the scope of his or her license; and c) recognized as a physician in the place where the services are rendered.
“Maximum Benefit Amount” means the maximum amount payable for each coverage as shown on the Schedule of Benefits.
“Medical Treatment” means treatment, advice or consultation by a Legally Qualified Physician.
“Medically Necessary” means a service or supply which: a) is recommended by the attending Legally Qualified Physician; b) is appropriate and consistent with the diagnosis in accordance with accepted standards of community practice; c) could not have been omitted without adversely affecting Your condition or quality of medical care; d) is delivered at the most appropriate level of care and not primarily for the sake of convenience; and e) is not considered experimental unless coverage for experimental service or supplies is required by law.
“Organized Labor Strike” means any stoppage of work; a) as a result of a combined effect of workers which was unannounced and unpublished at the time this plan was purchased; and b) which interferes with the normal departure and arrival of a Common Carrier.
“Pre-existing Condition” means any injury, Sickness or condition (including any condition from which death ensues) of you or your Traveling Companion, you and/or your Traveling Companion’s Family Member or your Business Partner which within the sixty (60) day period prior to the Effective Date of the Insured’s Protection Plan coverage under this plan; a) manifested itself, became acute or exhibited symptoms which would have caused one to seek diagnosis, care or treatment; b) required taking prescribed drugs or medicine, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or c) required Medical Treatment or treatment was recommended by a Legally Qualified Physician. (Note, In California, part “a” is not applicable.)
“Scheduled Departure Date” means the date on which You are originally scheduled to leave on Your Trip.
“Scheduled Return Date” means the date You are originally scheduled to return to the point of origin or the original final destination,
“Sickness” means an illness or disease which is diagnosed or treated by a Legally Qualified Physician after the Effective Date of Your plan and while You are covered under this plan.
“Terrorist Incident” means the unsanctioned and illegal use of violence which caused destruction of property, injury or death by an individual or group for the express or implied purpose of achieving a political, ethnic, or religious goal or result. A Terrorist Incident does not include general civil disturbance, rioting, an act of war (declared or undeclared) or the intentional release of a biological material. The Terrorist Incident must be documented in a travel warning issued by the United States Department of State advising that one should not travel to Your country of destination or, for U.S. cities, reported by the major news media.
“Transportation Expense” means: a) the cost of the conveyance of You and any medical personnel (if Medically Necessary); and b) Medically, Necessary services and supplies.
“Traveling Companion” means a person or persons, up to a maximum of 4 people, with whom a covered person is sharing the same room accommodations.
“Travel Supplier” means any entity or organization that coordinates or supplies travel services for You.
“Unforeseen” means circumstances occurring after the effective date of this plan.
“Usual and Customary Charges” means those comparable charges for similar treatment, services and supplies in the geographic area where treatment is performed.
“You” or “Your” means an individual who has purchased a Trip and for whom the required rate for this Protection Plan has been paid.
Filing a Claim is Simple:
To receive a claim form: Within 30 days of your loss, call (800) 219-1891, or send Your name, address, travel dates, details of Your loss along with the ID# to:
Prime Travel Protection Service Department 5310 Ward Road Suite G-01 Arvada, CO 80002
IMPORTANT:
To provide prompt reimbursement, you will be asked to provide proof of your loss within 30 days after the date of loss or as soon as is reasonably possible. Proof must however be furnished no later than 6 months from the time of loss, except in the absence of legal capacity. Benefits under this plan will not be paid for expenses reimbursed or services provided by any other source. There is no coverage for carrier delay caused by an announced, organized, sanctioned labor action, any government regulation or prohibition.
All suits, actions or legal proceedings arising from the programs, benefits, or services provided through the programs (collectively “Controversies”) may be submitted to binding desk arbitration in accordance with the rules then applying to the American Arbitration Association. No demand for arbitration can be brought to recover benefits until 60 days have elapsed following submission of Your entire request for service to Prime Travel Protection.