Part A - Travel Protection     [Back]

Trip Interruption

In the event You are prevented from continuing Your trip due to accidental Injury or Sickness of Yourself, an Immediate Family Member or a Traveling Companion, which results in medically imposed restrictions as certified by a Physician at the time of loss preventing Yourcontinued participation in the covered Trip, the Overseas Travelers Protection Plan will pay benefits up to the maximum listed in the Schedule of Coverages for:

The airfare paid to return home or rejoin the original Land/Sea Arrangements (limited to the cost of one-way Economy Airfare by scheduled carrier from the point of destination to the point of origin shown on the original travel tickets) less the value of applied credit from an unused return travel ticket.

In no event shall the amount reimbursed exceed the lesser of: the amount You pre-paid for Your Trip, or the maximum benefit shown on the Schedule of Coverages.

Part B - Medical Protection     [Back]

Accident and Sickness Medical Expense

The Overseas Travelers Protection Plan will pay benefits, up to the maximum shown on the Schedule of Coverages (subject to a $100 deductible per person, per occurrence for Sickness only), if as the result of an Injury or Sickness while on Your Trip, You incur, within one year of the date of the Accident or onset of the Sickness, necessary Covered Medical Expenses, provided You received initial Treatment within 90 days of the date of the Accident or the onset of Sickness.

Covered medical expenses are necessary services and supplies which are recommended by the attending Physician. They include the services of a legally qualified Physician; charges for hospital confinement and use of operating rooms; charges for anesthetics (including administration), x-ray examinations or treatments, and laboratory tests; ambulance service; drugs and medicines; prosthetics; and therapeutic services and supplies.

The Overseas Travelers Protection Plan will not pay benefits in excess of the usual, Reasonable and Customary charges commonly used by providers of medical care in the locality in which the care is furnished.

Emergency Dental Treatment

Benefits are paid for Reasonable and Customary expenses in excess of the Deductible and Coinsurance of $250 per tooth up to a maximum of $500, for the emergency repair or replacement to sound, natural teeth damaged as the result of a covered Accident.

Emergency Medical Evacuation

The Overseas Travelers Protection Plan will pay benefits for Covered Expenses up to the maximum shown on the Schedule of Coverages if an Injury or Sickness commencing during the course of the covered Trip results in Your necessary Emergency Medical Evacuation. An Emergency Medical Evacuation must be ordered by a legally licensed Physician who certifies that the severity of Your Injury or Sickness warrants an Emergency Medical Evacuation.

Emergency Medical Evacuation means:

1. Your medical condition warrants immediate transportation from the place where You are injured or sick to the nearest hospital where appropriate medical treatment can be obtained;
2. After being treated at a local hospital, Your medical condition warrants transportation to the United States, where You reside, to obtain further medical treatment or to recover;
3. All of the above.

Covered Expenses are reasonable and customary expenses, up to the maximum, for necessary transportation, medical services, and medical supplies incurred in connection with Your Emergency Medical Evacuation. All transportation arrangements made for Your evacuation must be by the most direct and economical route possible.

Expenses for Your Emergency Medical Evacuation must be:

1. Recommended by the attending Physician;
2. Required by the standard regulations of the conveyance transporting You;
3. Verified and approved in advance by Universal Assist.

Expenses for medical services and supplies must be services and supplies recommended by the attending Physician. Transportation means any land, water, or air conveyance required to transport You during an Emergency Medical Evacuation. Transportation includes, but is not limited to, air ambulances, land ambulances, and private motor vehicles. The Overseas Travelers Protection Plan will not cover any expenses provided by another party at no cost to You or already included in the cost of the scheduled Trip. All transportation must be authorized and arranged by Universal Assist.

To access Emergency Assistance, call
Universal Assist’s operation center at:
1 - 800 - 770 - 9111
or call collect:
1 - 703 - 370 - 7800

Emergency Medical Reunion

When the assistance company and Your attending Physician determine that it is necessary and prudent for You to have an Emergency Medical Evacuation or Repatriation, this Plan will arrange to bring an individual of Your choice, from Your current Home Country, to be at Your side while You are hospitalized and then accompany You during Your return to Your current Home Country. Benefits will be paid up to $1,000 for a round-trip economy airfare ticket as well as for reasonable travel and accommodation expenses up to a maximum of 10 days, as pre-approved and arranged by the assistance company.

Return of Dependent Children

Should You be traveling alone and are hospitalized because of a covered Sickness or Injury and Your Dependent Child(ren) is (are) left unattended, the assistance company will arrange for a one-way economy fare(s) to Your current Home Country. If an attendant/escort is necessary to ensure the safety and welfare of Your Dependent Child(ren), the assistance company will also arrange these services. The Plan will pay for these services up to a maximum of $1,000 provided all transportation and services are pre-approved and arranged by the assistance company. Meals and lodging are Your responsibility.

Repatriation of Remains

The Overseas Travelers Protection Plan will pay reasonable Covered Expenses up to the maximum shown on the Schedule of Coverages for expenses incurred to return Your body to the United States if You die during the covered Trip. Covered Expenses include, but are not limited to, expenses for embalming, cremation, minimally necessary coffins for transport, and transportation.

In Hospital Indemnity (Available for U.S. citizens only)

If You are confined to a Hospital as a registered Inpatient as the result of a Sickness or Injury which first occurs during Your Trip and that Sickness or Injury is not covered under this Plan, this Plan will pay benefits up to $100 per day of confinement up to a maximum of 30 days.

Home Country Coverage

Incidental Trips to the Home Country - During Your trip, the participant may return to their Home Country for incidental visits of up to 30 days per 12 months of coverage, or pro rata thereof. If, during an incidental Trip home, the participant suffers an Injury or Sickness, this Plan shall pay up to $1,000 of Covered Expenses for that Injury or Sickness. Treatment for this Injury or Sickness must occur within Your Home Country while on the incidental visit.

Excess Insurance Provision

The coverage provided under Parts A and B shall be in excess of all other valid and collectible insurance or indemnity and shall apply when such other benefits are exhausted.

PRE-EXISTING CONDITIONS

The Overseas Travelers Protection Plan will not pay under any coverage in Parts A and B for claims arising from an Injury, Sickness, or other condition (including any condition from which death ensues) of Yourself, a Traveling Companion, or any Immediate Family Members traveling with You, that, within the 60 day period before the date your coverage began under this protection plan, (a) first manifested itself, 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 drugs or medicine is taken remains controlled without any change in the required prescription; and/or (c) required medical treatment or treatment was recommended by a Physician.

Part C - Travel Accident Protection     [Back]

Accidental Death & Dismemberment - 24 Hour
If You sustain an Injury while on Your covered Trip that, within 180 days of the date of the Accident, results in one of the following losses, the Overseas Travelers Protection Plan will pay the largest applicable amount as follows:

• The full benefit is paid for loss of life, both hands or feet, sight of both eyes, speech and hearing in both ears, ,one hand and one foot, either hand or foot and sight of one eye.
• One half the benefit amount is paid for loss of either hand or foot, sight of one eye; speech; hearing in both ears.
• One fourth of the benefit amount is paid for thumb and index finger of the same hand.

In no event will the Insurer pay more than the maximum amount shown on the Schedule of Coverages for all losses due to the same Accident.

Loss with regard to hand or foot, means actual complete severance through and above the wrist or ankle joints; eye means an entire and irrecoverable loss of sight; speech or hearing means entire and irrecoverable loss of speech or hearing of both ears; and thumb and index finger means actual severance through or above the joint that meets the finger at the palm.

Exposure: The Insurer will pay benefits for covered losses that result from Your being unavoidably exposed to the elements due to an Accident. The loss must occur within 365 days after the event that caused the exposure.

Disappearance: The Insured will pay benefits for loss of life if Your body cannot be located one (1) year after Your disappearance due to an Accident.

EXCLUSIONS
The following exclusions apply to Parts A, B and C. The plan does not cover any loss caused by or resulting from:

1. Pre-Existing Conditions (Except Emergency Medical Evacuation and Repatriation of Remains);
2. Suicide or attempted suicide;
3. Intentionally self-inflicted Injury;
4. War, invasion, acts of foreign enemies, hostilities between nations (whether declared or not), or civil war;
5. Participation in any military maneuver or training exercise;
6. Piloting or learning to pilot or acting as a member of the crew of any aircraft;
7. Mental or emotional disorders, unless hospitalized;
8. Participation as a professional in athletics or underwater activities;
9. Being under the influence of drugs or intoxicants unless prescribed by a Physician;
10. Commission or the attempt to commit a criminal act;
11. Participating in bodily contact sports; skydiving; hang gliding; parachuting; mountaineering; any race; bungee cord jumping; and/or speed contest;
12. Dental Treatment except as a result of accidental Injury to sound, natural teeth within twelve (12) months of the accidental Injury;
13. Any non-emergency treatment or surgery, routine physical examinations, hearing aids, eye glasses or contact lenses;
14. Pregnancy and childbirth (except for complications of pregnancy);
15. Curtailment or delayed return for other than covered reasons; and
16. Losses sustained after the anniversary date following Your 70th birthday.

DEFINITIONS

1. "Accident" means an event, independent of Sickness or self-inflicted means, which is the direct cause of bodily Injury to You.
2. "Coinsurance" means the percentage amount of Covered Expenses, after the Deductible, which is Your responsibility to pay.
3. "Common Carrier" means an air conveyance operating under a license for the transportation of passengers for hire.
4. "Covered Expenses" means expenses which are for Medically Necessary services, supplies, care, or treatment due to Sickness or Injury; prescribed, performed or ordered by a Physician; Reasonable and Customary charges; incurred while insured under this Plan; and which do not exceed the maximum limits under each stated benefit.
5. "Deductible" means the amount of Covered Expenses which is Your responsibility to pay before benefits under the Plan are payable.
6. "Dependent Child(ren)" means Your child (or children), including an unmarried child, stepchild, legally adopted child or foster child who is: (1) less than age 19 and primarily dependent on You for support and maintenance; or (2) who is at least age 19 but less than age 23 and who regularly attends an accredited school or college; and who is primarily dependent on You for support and maintenance.
7. "Economy Airfare" means the lowest published rate for a one-way ticket.
8. "Home Country" means the country where You have Your true, fixed and permanent home and principal establishment.
9. "Immediate Family Member" means any children, adopted children, stepchildren, children-in-law, parents, stepparents, parents-in-law, siblings, siblings-in-law, grandparents, grandchildren, legal spouse, aunts, uncles, nieces, and nephews of You or Your Traveling Companion who reside in the United States of America.
10. "Injury" means bodily injury caused by an Accident occurring while this plan is in force, and resulting directly and independently of all other causes in loss covered by the plan. The Injury must be verified by a Physician.
11. "Insurer" means Virginia Surety Company, Inc.
12. "Land/Sea Arrangements" means land and/or sea arrangements by Overseas Insurance Consultants for travel outside the United States.
13. "Physician" means a licensed practitioner of medical, surgical or dental services acting within the scope of his/her license. The treating Physician may not be Yourself, a Traveling Companion, or an Immediate Family Member.
14. "Reasonable and Customary" means the maximum amount that the Plan determines is Reasonable and Customary for Covered Expenses You receive, up to, but not to exceed, charges actually billed. The determination considers: 1) amounts charged by other service providers for the same or similar service in the locality where received, considering the nature and severity of the bodily Injury or Sickness in connection with which such services and supplies are received; 2) any usual medical circumstances requiring additional time, skill or experience; and 3) other factors included, but not limited to, a resource based relative value scale.
15. "Sickness" means illness or disease which is diagnosed and treated by a Physician on or after the effective date of the protection plan and while You are covered under this plan.
16. "Traveling Companion" means a person who is sharing travel arrangements with You (to a maximum of four persons including You).
17. "Treatment" means a specific in-office or hospital physical examination of, or care rendered to You; consultation; diagnostic procedures and services; surgery; medical services and supplies, including medication prescribed or provided by a service provider.
18. "Trip" means prepaid Land/Sea Arrangements and shall include flight connections to join and depart such Land/Sea Arrangements, provided such flight connections are scheduled to commence within one (1) week of the Land/Sea Arrangements.
19. "You or Your" means a person who has purchased a Trip and who has paid the required plan cost for the protection plan provided herein.

Overseas Travelers Protection Plan Assistance Services
     Universal Assist Worldwide Emergency Assistance

A 24-hour emergency telephone assistance service is available so that, in the event of an emergency while on the Trip, English speaking help and advice may be furnished to You.

PART I - TRAVELER'S ASSISTANCE

Our multilingual staff can assist You in solving a variety of unexpected complications during the Trip such as lost tickets or belongings. If necessary, we may also help locate legal counsel. Pre-Trip information such as cultural, visa requirements and exchange rates can also be provided.

PART II - MEDICAL ASSISTANCE

If a medical emergency arises during travel, we may help You find local medical care. Physicians and hospitals worldwide can contact us to confirm coverage and, if required, help You arrange immediate settlement of medical expenses resulting from an Injury during the covered Trip. We will coordinate emergency medical situations with Your home Physician and arrange Emergency Medical Evacuation services.

PART III - EMERGENCY CASH TRANSFER

We can help arrange a fund transfer through Your credit cards, family, friends, employer or similar source if You need cash while on the Trip.

NOTE:   Problems of distance, information and communication make it impossible for Virginia Surety Company, Inc., BerkelyCare, or Universal Assist to assume any responsibility for the availability, quality, use or result of any emergency service. In all cases, You are still responsible for obtaining, using and paying for Your own required services of all types.

CLAIMS PROCEDURE

To facilitate prompt claims settlement, please submit the following information, accompanied by a Claimant’s Statement and Authorization form, based on your claim type:

TRIP INTERRUPTION: Obtain medical statements from the attending Physician(s) in the country where the Sickness or Accident occurred. These statements should include complete diagnosis and state that the Sickness or Accident prevented traveling on dates contracted. Provide all unused transportation tickets, official receipts, etc.

MEDICAL EXPENSES: Obtain receipts from the providers of service stating the amount paid and listing the complete diagnosis and treatment details. Submit these first to other medical plans, if applicable. After receiving final disposition of Your claim from other medical plans, submit the overseas documentation and a copy of the final disposition to Overseas Insurance Consultants.

For all claims, You are encouraged to make copies of all documentation for your records prior to submission. The Claimant’s Statement and Authorization form may be obtained by contacting Overseas Insurance Consultants.

TO OBTAIN CLAIM FORMS AND ANY ADDITIONAL
INFORMATION ON HOW TO REPORT A CLAIM, CALL
OR WRITE THE PLAN ADMINISTRATOR AND
REFER TO PLAN: HTP08263

ENROLLMENT PROCEDURE

1. In order to quickly effect coverage, make payment for the applicable plan cost to Overseas Insurance Consultants upon booking Your Trip.
2. Remit all payments for this plan to Overseas Insurance Consultants.
3. The Overseas Travelers Protection Plan must be purchased prior to Your departure date.

TERM OF COVERAGE

1. This plan is provided to U.S. Citizens and residents in consideration of the payment in advance of the total required plan cost and fees.
2. All coverages take effect at 12:01 a.m. local time at Your location on the departure date of Your Trip.
3. All coverages shall terminate on the earlier of the following dates: (a) Your return to the origination point as specified in the travel tickets; (b) 11:59 p.m. local time at Your location on the date Your Trip is completed, (c) The date You cancel Your Trip; (d) The anniversary of Your Plan following age 70.
4. Coverage is extended if You are involved in a natural disaster or a Common Carrier delay. All coverages will terminate at 11:59 p.m. local time at Your location on the date Your Trip is completed.

Protection Plan fees are non-refundable

FOR GENERAL QUESTIONS, SERVICE OR TO
ENROLL IN THIS PROGRAM, CONTACT:
OVERSEAS INSURANCE CONSULTANTS
1-800-474-2601 or 770-663-0114
www.otpplan.com

BENEFICIARY

In the event of Your Accidental Death, the Beneficiary shall be Your estate, unless written notice of a designated beneficiary is provided to the Plan Administrator.

FOR PLAN INQUIRIES OR INFORMATION ON FILING
A CLAIM PLEASE CONTACT THE PLAN
ADMINISTRATOR AT:

BerkelyCare
P.O. Box 9022
Jericho, NY 11753
1-800-453-4063
or call collect:
1-516-342-2950
Mon-Fri  9:00am-5:00pm (EST)