Travel Insurance Canada - Dan Pucher Insurance

[21st Century Travel] [Rates] [Eligibility] [Policy] [Application]

21st CENTURY TRAVEL RATE TABLES
All applicants use Table 1 rates unless age 70 - 85 and applying for stable chronic condition coverage.
Table 1 - Daily Premium
Aggregate Policy Limit Per Person	up to 25 years	26 to 34 years	35 to 39 years	40 to 54 years	55 to 59 years	60 to 64 years	65 to 69 years	70 to 74 years	75 to 79 years	80 to 85 years	86 ^*and older

$10,000	1.55	1.65	1.75	1.85	1.96	2.88	3.09	3.76	4.33	4.69	9.01
$15,000	1.91	1.96	2.06	2.37	2.52	3.30	3.86	4.74	5.36	6.08	11.59
$25,000	2.01	2.16	2.32	2.68	2.88	3.86	4.38	5.46	5.87	6.75	13.65
$50,000	2.32	2.47	2.58	3.04	3.24	4.53	5.15	6.49	7.36	8.55	N/A
$100,000	3.04	3.35	3.55	4.53	4.69	5.61	6.95	8.14	9.58	10.82	N/A
$150,000	3.32	3.77	4.18	5.48	6.12	8.62	11.48	N/A	N/A	N/A	N/A

Notes:

^* Applicant age 86 and over must complete a medical declaration to determine eligibility.

Applicants under age 70 are automatically covered for "stable chronic conditions" (180-day stability)

$50.00 deductible per claim.
(For $0 Deductible ,up to age 85 only, add 5%)
(age 86 or greater - $500 deductible)

Maximum length of coverage is 365 days.
(age 86 or greater, coverage can be purchased to insure up to the first 180 days in Canada)

Family rate - is twice the older adult rate .

When you purchase the $100,000.00 option, you are automatically insured for $150,000.00 for covered expenses as a result of an accidental bodily injury.

Table 2 - Daily Premiums "Stable Chronic Condition" Option (age 70 to 85)
Aggregate Policy Limit Per Person	70 to 74 years	75 to 79 years	80 to 85 Years	86 and over

$10,000	4.53	5.41	7.21	N/A
$15,000	5.82	6.70	9.06	N/A
$25,000	6.28	7.62	10.56	N/A
$50,000	7.47	9.58	12.41	N/A
$100,000	9.37	11.59	15.71	N/A

$50.00 deductible per claim
(For $0 Deductible ,up to age 85 only, add 5%)

Maximum length of coverage is 365 days

Applicants age 70 to 85 who wish to purchase this option must complete the Medical Declaration to determine eligibility for coverage. (if ineligible for this option, refer to Table 1)

RATE TABLE GUIDE

Age	Stable Chronic Condition Option	Medical Declaration Required?	Premium Table	Deductible Amount
Under 70	Automatically Included	No	Table 1	$50.00**
70-85	If Option Waived	No	Table 1	$50.00**
70-85	If Option Required	Yes	Table 2	$50.00**
86 plus	Not Available	Yes *	Table 1	$500.00

* For age 86 and over, the applicant is NOT eligible for 21st Century�s Visitors to Canada Insurance if there are any Yes answers on the Medical Declaration.
** Deductible Amount options of $0, $50 and $250 are available up to age 85 as indicated on reverse. For age 86 and over, a $500 deductible applies which cannot be modified or waived.

What is the Stable Chronic Condition Option?
This option is automatically included for all applicants up to age 69, and can be purchased for ages 70 to 85 (providing the applicant is eligible). When the option is included or purchased, the pre-existing condition exclusion in the policy will not apply to insured Services incurred, after any applicable waiting period, to respond to a stable chronic condition (as defined in the policy).

Note that conditions that do not meet the definition of stable chronic condition will still be subject to the standard pre-existing exclusion, a copy of which is included below.

Please review the policy carefully for a full definition of the waiting period.

Pre-existing Condition Exclusion:
We will not reimburse you for insured services or pay an Accidental Death and Dismemberment claim arising from:

any sickness, disease or injury which had manifested itself in the 180-day period immediately preceding the effective date of this policy, Unexpected emergency sickness, disease or injury shall be considered to have manifested itself when:

medical care, advice, investigation or treatment has been received, or
drugs or medicines have been taken or prescribed to treat the sickness, disease or injury, or
you have experienced symptoms which would cause a reasonably prudent person to seek diagnosis, care or treatment.

Under this exclusion, each time you purchase another policy from us because you are staying in Canada longer, each new policy will have a new effective date and you will not be covered under the new policy for any sickness, disease or injury which had manifested itself in the 180-day period immediately preceding that new effective date.

DAN PUCHER

21st CENTURY TRAVEL

RATE TABLES

Notes:

RATE TABLE GUIDE