DAN PUCHER

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

21st CENTURY TRAVEL

1. Emergency treatment provided by a "Physician". Emergency "Insured Services" shall also include the cost of standard hospital ward accommodations but does not include the cost of services provided by a convalescent home, nursing home, home for the aged or health spa.
    
2. Medical, hospital or out-patient services, except when expressly prohibited by legislation.
    
3. Private duty registered nursing or licensed home care providers and rental of crutches, hospital bed, splints, trusses, braces or other prosthetic devices, up to a maximum of $5,000.00 following emergency Insured Services when prescribed in writing by a "Physician" or "Healthcare Practitioner".
    
4. Treatment provided by a "Healthcare Practitioner" up to a maximum of $1,000.00 provided such treatment is prescribed by a "Physician".
    
5. Diagnostic treatment including x-rays, ultrasounds, and laboratory tests requested by a "Physician" up to the Aggregate Policy Limit while hospitalized for a period of 24 hours or more or up to a maximum of $1,000.00 when these "Insured Services" are provided on an outpatient basis.
    
6. The use of a licensed ambulance service for emergency transportation.
    
7.  Drugs or medications prescribed, in writing, for "You" by a "Physician" up to a maximum of $500.00. However, "We" will not reimburse "You" if the prescribed drugs or medication or a generic form thereof can be legally purchased without a "Physician's" prescription, unless "You" are an admitted patient in any licensed hospital or other provincially licensed treatment facility.
    
8. In the event of "Your" death, the cost up to a maximum of $5,000.00 of preparing "Your" body for burial, transportation (including shipping container) to "Your" country of origin, and the cost of preparing legal documentation. In no event will "We" pay for the cost of the purchase of a coffin. In the event that "Your" body is cremated or "You" are buried in Canada or the United States, the most "We" will pay for this "Insured Service" is $1,500.00.
    
9. The extra cost via the most cost-effective itinerary of an economy air fare to return "You" to "Your" country of origin including, if medically necessary or required by the airline, stretcher fare and/or the return economy class fare and reasonable fees and expenses of a medical attendant. To be eligible for this benefit, your treating "Physician" must recommend that "You" return home because of "Your" medical condition or "Our" medical advisor must recommend that "You" return home after "Your" "Emergency" treatment. Such costs must be pre-authorized and arranged by "Us" following an "Emergency" "Insured Services" covered under this policy.
    
10. Treatment to natural teeth and repairs to dentures or other dental devices if such treatment is necessitated by direct unintended or unexpected blow to "Your" face up to a maximum of $1,000.00.
     
11. Emergency treatment to natural teeth, excluding fillings and repairs to dentures or other dental devices when such treatment is necessitated by a cause other than a direct unintended or unexpected blow to "Your" face up to a per insured maximum of $300.00 during any twelve (12) month period.
     
12. Obtaining hospital, medical, or "Healthcare Practitioner" records or a medical report from a "Physician" or "Healthcare Practitioner" provided "We" request the record or report. Under no circumstances will "We" reimburse "You" for the cost of an attending physician's report.

 “We” will not reimburse “you” for “insured services” or pay an Accidental Death and Dismemberment claim arising from:

1. 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:
   1. medical care, advice, investigation or treatment has been received, or
   2. drugs or medicines have been taken or prescribed to treat the sickness, disease or “injury”, or
   3. “you” have experienced symptoms which would cause a reasonably prudent person to seek diagnosis, care or treatment.

Important Note: A “stable chronic condition” is covered (Exclusion #1 a) to c) will not apply) in the following circumstances:

1. to a condition that was diagnosed or treated more than 180 days prior to the “effective date” and which did not require any treatment during this 180-day period, or
2. to “insured services” incurred after any applicable “waiting period” to respond to a “stable chronic condition”, if “you” are under 70 years of “age” on the policy “effective date”, or
3. to “insured services” incurred after any applicable “waiting period” to respond to a “stable chronic condition”, if “you” are 70 to 85 years of “age”, completed the Medical Declaration and paid the required premium to purchase the “stable chronic condition” option. Note that the “stable chronic condition” option is not available to applicants who are “age” 86 or over on the “effective date” of coverage.

Under Exclusion #1, 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”.

2. Intentional self injury, suicide or attempted suicide while sane or insane. 
3. any loss, sickness, “injury” or death related to the misuse, abuse, overdose, or chemical dependence on medication, drugs, alcohol, or other intoxicant, whether sane or insane;
4. an “emergency” resulting from: hang-gliding, rock-climbing, “mountaineering”, parachuting or skydiving; participating in a motorized speed contest; or “your” professional participation in a sport, snorkeling or scuba-diving when that sport, snorkelling or scuba-diving is “your” principal paid occupation;
5. any pregnancy that commences prior to the “effective date” of this policy; “your” routine pre-natal care; “your” routine pregnancy or childbirth; complications of “your” pregnancy or childbirth when they happen in the 9 weeks before or after the expected date of delivery; or “your” child born during “your” Coverage Period;
6. The provision of "Insured Services" to children 30 days of Age or younger.
7. an “act of war” or an “act of terrorism” when “you” are outside of Canada and covered under this insurance;
8. Elective, non-emergency, or cosmetic surgery
9. Elective, non-emergency, medical or healthcare treatment or any "Insured Services" which "You" knew would be required when "You" applied for this Policy.
10. A continuation of treatment or service first recommended or prescribed by a "Physician" or "Healthcare Practitioner" before the "Effective Date" of this Policy or where such "Insured Services" were first initiated prior to the "Effective Date" of this Policy or during the "Waiting Period".
11. The requirement to acquire, repair or replace eyeglasses, contact lenses or hearing aids.
12. "Your" obtaining medical or healthcare assessment or any form of report or document for the purposes of supporting an application to obtain immigrant status in Canada.
13. Travel and accommodation expenses incurred for the purposes of receiving "Insured Services".
14. a mental or emotional disorder (other than acute psychosis) that does not require admission to a hospital;
15. General health examinations, medical and health services, including prescription drugs or medicines, provided to monitor or maintain a "Stable Chronic Condition".
16. any medical condition “you” suffer or contract in a specific country, region or city for which Foreign Affairs and International Trade Canada has issued a formal Travel Warning before “your” “effective date”, advising against all or non-essential travel to that specific country, region or city. In this exclusion “medical condition” is limited to the reason for which the formal Travel Warning was issued and includes complications arising from such medical condition;
17. a criminal act or an attempt to commit a criminal act.