AIR CANADA VACATIONS TRAVELLERS TRAVEL INSURANCE CERTIFICATE No. ACV

Transcription

1 AIR CANADA VACATIONS TRAVELLERS TRAVEL INSURANCE CERTIFICATE No. ACV

2 AIR CANADA VACATIONS TRAVELLERS TRAVEL INSURANCE CERTIFICATE No. ACV IMPORTANT NOTICE Please read Your certificate carefully before You travel. Travel insurance is designed to cover losses arising from sudden and unforeseeable circumstances. It is important that You read and understand Your certificate before You travel as Your coverage may be subject to certain limitations and exclusions. The Pre-existing Condition Exclusions will apply to medical conditions and/or symptoms that existed on or prior to Your Departure Date. Check to see how this applies in Your certificate and how it relates to Your Departure Date, date of purchase and Effective Date. In the event of an accident, Injury or Sickness, Your prior medical history may be reviewed when a claim is reported. You must notify TIC Emergency Assistance prior to any medical treatment. Your certificate may limit benefits should You not contact TIC Emergency Assistance within a specific time period. To be eligible for this coverage you must be 79 years old or younger on the purchase date. If You selected Trip Cancellation Insurance, Your coverage includes Benefits A, B and C. If You selected All-inclusive Coverage, Your coverage includes Benefits A through P. A. Cancellation Protection up to coverage amount purchased B. Upgrade Charges up to coverage amount purchased C. Missed Connection up to coverage amount purchased D. Emergency Hospital / Medical / Return Home up to $2 million* E. Emergency Air Ambulance $250,000 F. Trip Interruption and Delay up to coverage amount purchased G. Extended Health Care See Benefits H. Meals and Accommodation $1,000 I. Family Transportation $1,000 J. Dental Accident $1,000 K. Return of Vehicle $1,000 L. Flight Accident $50,000 M. Common Carrier Accident $20,000 N. Accidental Death & Dismemberment $10,000 O. Baggage and Personal Effects $800 P. Automatic Extension of Coverage This travel insurance can only be purchased at the time of booking Your Air Canada Vacations holiday by travellers who are age 79 or under at the time of booking. * Hospital coverage for U.S. Residents and travellers not covered under a Canadian government health insurance plan (CGHIP), is limited to a maximum of $3,000. EMERGENCY PROCEDURE TIC Emergency Assistance is available 24 hours a day and is staffed with multilingual personnel who will provide assistance in obtaining medical care, directing You to the nearest doctor or hospital, contacting family and friends, and replacing important documents. TIC EMERGENCY ASSISTANCE Toll free Canada/U.S.A.: Toll free worldwide: or If unable to contact us through the toll free numbers call collect: IF YOU REQUIRE MEDICAL SERVICES, YOU MUST CALL TIC IMMEDIATELY. You will be directed to the nearest appropriate facility. Failure to notify TIC as required will delay the processing and payment of Your claim and may limit the Company s liability (see Limitations and Exclusions). INSURING AGREEMENT In consideration of the application for insurance and payment of the appropriate premium for the coverage selected, the Company certifies that You are insured under Group Master Policy No. H (the Group Policy ) issued to Air Canada Vacations (the Policyholder ). A summary of the terms, conditions, limitations, exclusions and other provisions of the Group Policy is set out below. You will be responsible for expenses that are not payable by the Company. Additional Insuring Agreement wording is located under each benefit package, Trip Cancellation Insurance and All-inclusive Coverage. TRIP CANCELLATION INSURANCE IF YOU SELECTED TRIP CANCELLATION INSURANCE, YOUR COVERAGE INCLUDES BENEFITS A, B AND C. Insuring Agreement: If You or Your Travelling Companion must cancel an Insured Trip, the Company will pay the eligible benefits specified below, up to the coverage amount You purchased. Coverage is for scheduled trips to, from or within Canada. Coverage begins when You pay the required premium and terminates on the date and time You leave Your Departure Point. A. Cancellation Protection You will be reimbursed toward the amount that is non-refundable by Air Canada Vacations at the date the cause for cancellation occurred if You must cancel Your vacation due to one of the following reasons: an Emergency Sickness or Injury or Your death, and/or that of an Immediate Family member, Travelling Companion, business partner or their Immediate Family, or the host at the trip destination; a statement made in the Travel Report issued by the Canadian Department of Foreign Affairs and International Trade after the application date, advising or recommending that Canadians avoid travel to the booked destination for a period that would include the insured s scheduled trip. a disaster which renders Your principal residence uninhabitable; quarantine of Your residence; being subpoenaed to appear as a witness or being selected for jury duty. adverse weather which would prevent the insured from travelling for a period not less than 30% of the total duration of the insured trip when the insured chooses not to continue with the trip prior to departure from the point of origin. If an Insured Trip must be cancelled, the travel agent and TIC must be notified immediately. Failure to notify TIC as required will limit liability to the amount that would have been payable if You had notified TIC on the first business day following the cause for cancellation. TIC must be notified in writing, not later than the first business day following the cause for cancellation and transportation tickets must be surrendered within 48 hours thereafter. 1 TRAVEL INSURANCE CERTIFICATE FOR AIR CANADA VACATIONS TRAVELLERS

3 B. Upgrade Charges (Single Supplement) If Your Travelling Companion s vacation must be cancelled due to an Emergency Sickness, Injury, or death, or the death of an Immediate Family member, the cost incurred to adjust Your prepaid accommodation will be reimbursed, if You decide to travel on vacation alone. C. Missed Connection In the event that i) one of the events listed in Benefit A, or ii) a delay of the connecting carrier or automobile at the departure point causes a missed connection, provided the connecting carrier or automobile was scheduled to arrive not less than two hours prior to your scheduled connection time due to: a) Weather conditions or mechanical failure of the connecting carrier (airline, bus train, or government-operated ferry system); or b) Traffic accident or emergency police road closure (police report required) causes the delay of a private or commercial automobile. The insurer agrees to pay: i. the extra cost of economy transportation to the ticketed destination; ii. the unusable pre-paid, insured travel arrangements; and iii. an out-of-pocket allowance of up to $200 per day to a max of $600 for commercial accommodation and meals, essential telephone calls and taxi fares. This benefit does not provide coverage if Your travel arrangements are cancelled due to the termination of operations of any licensed commercial passenger airline for any reason including but not limited to bankruptcy or insolvency. Claims must be supported by written documentation and/or a police report. Alternate Arrangements: If You wish to accept alternate arrangements in lieu of cancellation of the entire reservation, except if cancellation is due to the termination of operations of any licensed commercial passenger airline for any reason including but not limited to bankruptcy or insolvency, up to the amount of the non-refundable cancellation penalty which applied to the original booking will be covered. IMPORTANT: If an Insured Trip is taken specifically to visit or attend to an ailing person, no benefits will be payable if the Insured Trip must be cancelled, interrupted or delayed because the medical condition of that ailing person deteriorated. The following Pre-existing Condition Exclusion applies to You and/or Your Immediate Family, whether or not they are travelling with You. Please read it carefully. This exclusion is in addition to Limitations and Exclusions numbers 2 through 17. Pre-existing Condition Exclusion: Trip Cancellation Insurance and the Trip Interruption and Delay benefit do not cover losses or expenses incurred for or as a result of a Pre-existing Condition which required medical attention, consultation, diagnosis or Treatment or for which symptoms first appeared in the 90 day period immediately prior to (a) the date You purchased coverage, if You must cancel an Insured Trip; or (b) the Departure Date, if You have purchased All-inclusive Coverage and You must interrupt or delay an Insured Trip. A Sickness controlled by the consistent use of prescribed medication is covered unless it had deteriorated, required investigation or a change in medication type or dosage during that 90 day period. ALL-INCLUSIVE COVERAGE IF YOU SELECTED ALL-INCLUSIVE COVERAGE, YOUR COVERAGE INCLUDES TRIP CANCELLATION INSURANCE BENEFITS A, B AND C PLUS ALL THE FOLLOWING BENEFITS D THROUGH P. The maximum period of coverage is 56 days. Insuring Agreement: When eligible expenses are incurred during an Insured Trip due to an Emergency during an Insured Trip, the Company will pay the Reasonable and Customary charges for eligible benefits which relate directly to such Emergency and are in excess of any amount allowed and/or paid for by any Canadian government health insurance plan (CGHIP) of Your last province of residence and/or any other health insurance plan(s). All-inclusive Coverage is limited to a maximum aggregate of $2,000,000. Coverage under Benefits D through P begins when You leave on Your vacation and terminates when You return to Your Departure Point, or on the Termination Date, whichever occurs first. U.S. residents and travellers not covered under a CGHIP, are not covered for any expenses resulting from a Pre-existing Condition or pregnancy. D. Emergency Hospital / Medical / Return Home Emergency Hospital Semi-private Hospital room accommodation and all other necessary Hospital expenses are covered when You are confined as a registered patient due to an Emergency. Hospital coverage for U.S. Residents and travellers not covered under a CGHIP, is limited to a maximum of $3,000. Emergency Medical Emergency medical, surgical or anaesthetic services performed and authorized by a Physician or anaesthetist. Emergency Return Home If You must be transported to Your province or country of usual residence for immediate medical attention following an Emergency, the Company will pay up to a maximum of $25,000 for the extra cost (i.e., one-way economy fare, accommodation for a stretcher, and/or a medical attendant) to return You home by regular flight when approved by TIC. The unused portion of Your transportation ticket must be surrendered to TIC. E. Emergency Air Ambulance When medically necessary and TIC authorizes in writing that You must be transported by air ambulance for immediate medical attention following a Critical Emergency the Company will pay up to a maximum of $250,000 to transport You to the nearest appropriate medical facility or to Your province or country of usual residence, provided You are unable to travel by regular flight. The unused portion of Your transportation ticket must be surrendered to TIC. F. Trip Interruption and Delay If You must interrupt Your Insured Trip or delay Your return due to one of the reasons listed under Benefit A, You will be reimbursed up to the coverage amount You purchased for the cost of a one-way economy airfare from Your destination to the Departure Point, plus a refund of the cost of any unused prepaid travel arrangements. If You must interrupt Your vacation because of an Emergency Sickness or Injury, the Company will pay for the cost of a one-way economy fare to either connect You with Your tour or return You home. The unused portion of Your transportation ticket must be surrendered to TIC. If an Insured Trip must be Interrupted or Delayed, You must notify TIC immediately to assist You in making alternate travel arrangements. G. Extended Health Care The following services, Treatment or supplies must be Emergency-related and supported by a written order from the attending Physician. 1. Prescription drugs (limited to a 30 day supply) up to $10, X-rays and laboratory services up to $10, Local licensed ambulance services up to $5, Wheelchair or hospital bed rental, crutches, braces or other necessary medical appliances up to $5,000* 5. Private duty services of a Registered Nurse or Registered Medical Attendant, other than a relative up to $10,000* 6. Prescribed services of a chiropractor, chiropodist, podiatrist or physiotherapist up to but not to exceed a total of $5,000*. * Prior approval must be given by TIC. H. Meals and Accommodation The necessary and reasonable costs of commercial accommodation and meals will be reimbursed up to $100 a day, up to a maximum of $1,000, when the return portion of an Insured Trip is delayed beyond the date scheduled as the result of an Emergency or of Your death, or the death of a member of Your Immediate Family or of a Travelling Companion. 2 TRAVEL INSURANCE CERTIFICATE FOR AIR CANADA VACATIONS TRAVELLERS

4 I. Family Transportation When approved by TIC, expenses for one round-trip economy class fare are covered, up to a maximum of $1,000, to transport an Immediate Family member, who is not travelling with You, to Your bedside when Your attending Physician certifies in writing that You are hospitalized for a Critical Injury or Sickness, or if required, to identify Your remains in the event of Your death. J. Dental Accident Up to a maximum of $1,000 is payable for X-rays and treatment of Your sound natural teeth, which are damaged as the result of a direct accidental blow to the mouth. The charges for such dental services must be incurred prior to Your return to Your province or country of usual residence. Treatment must be performed by a legally qualified dentist or oral surgeon. K. Return of Vehicle When supported in writing by Your attending Physician, up to a maximum of $1,000 is payable to return Your Vehicle to Your residence or Your rental Vehicle to the nearest rental agency if due to an Emergency, You or Your Travelling Companion are unable to return the Vehicle. L. Flight Accident If You die as the result of an Injury caused by accident, loss or damage to a commercial aircraft, while travelling as a passenger, not as a pilot, officer or other crew member having duties related to the flight, the Company will pay $50,000. If Your body has not been found within 52 weeks from the date of the accident, it will be presumed that You suffered Loss of Life. M. Common Carrier Accident If You sustain an Injury or die as the result of an accident while travelling as a passenger, not as an operator, in a Common Carrier (bus, train, boat or taxi), up to The Principal Sum of $20,000 will be paid according to the Schedule of Losses table below. Accidental Injury other than Loss of Life, occurring while travelling on a commercial aircraft is also covered up to The Principal Sum of $20,000 and is payable according to the Schedule of Losses table below. N. Accidental Death & Dismemberment Up to The Principal Sum of $10,000 will be paid according to the Schedule of Losses table below, for Losses resulting from an accident other than a Flight Accident or Common Carrier Accident. Benefits are payable according to the following schedule: a) 100% of sum insured resulting from the same accidental Injury for loss of: i. life; or ii. entire sight of both eyes; or iii. both hands; or iv. both feet; or v. one hand and entire sight of one eye; or vi. one foot and entire sight of one eye. b) 50% of sum insured resulting from the same accidental Injury for loss of: i. entire sight of one eye; or ii. one hand; or iii. one foot. Loss of hand or hands, or foot or feet means severance through or above the wrist joint or ankle joint, respectively. Loss of eye or eyes means total and irrecoverable loss of the entire sight. Only one amount is payable (the largest) if the insured suffers more than one of these losses. Exposure and Disappearance If the insured is exposed to the elements or disappears as a result of an accident, a loss will be covered if: a) as a result of such exposure, the insured suffers one of the losses specificed in the schedule of losses above; or b) the body of the insured has not been found within 52 weeks from the date of the accident it will be presumed, subject to evidence to the contrary, that the insured suffered loss of life. O. Baggage and Personal Effects While on an Insured Trip if Your baggage is lost, stolen or damaged by burglary, fire or transportation hazards on land, sea or in the air or while in any hotel or other building, up to a maximum of $800 will be payable for covered losses supported in writing by an authorized official and/or police report. Coverage is subject to a $25 deductible and a $250 limit per item. This benefit does not cover: 1. Breakage of, or damage to fragile or brittle articles unless caused by fire or accident to the means of conveyance; 2. Loss or damage not reported to the police and/or other authorized official within 24 hours of discovery; 3. Loss due to normal depreciation in the value of Your articles; 4. Loss of, or damage to money, eyeglasses, sunglasses, contact lenses, medication, hearing aids, artificial teeth, tickets, documents, jewellery or camera equipment; 5. Loss or damage by theft from an unattended Vehicle unless it was completely locked and there was visible evidence of forced entry; 6. Loss or damage due to negligence on Your part; 7. Loss of, or damage to, fragile or perishable articles in checked baggage; and 8. any loss or damage directly or indirectly, resulting from, or arising out of, or in connection with any Act of War or Terrorism or Nuclear Incident. P. Automatic Extension of Coverage: Coverage will be automatically extended for up to 72 hours without an extra premium charge, if due to circumstances beyond Your control, Your Insured Trip is delayed due to, i) an Emergency involving You, or ii) a delay to Your Common Carrier including air travel. Other situations may be submitted for consideration. You must provide documented proof which is acceptable to the Company, supporting the cause for the delay. LIMITATIONS AND EXCLUSIONS: No benefits are payable for losses or expenses incurred for or as the result of: 1. For Medical Conditions only: a Pre-existing Condition which had deteriorated, had to be treated or investigated, or for which medication was changed in type or dosage in a) the 90 day period immediately preceding the Effective Date, if You are age 59 or under, or b) the 1 year period immediately preceding the Effective Date, if You are 60 years old or above. This exclusion may be amended if You submit a medical questionnaire to TIC for consideration and receive written approval; Exception: U.S. Residents and travellers not covered under a CGHIP are not covered for any Pre-existing Conditions. 2. any loss, Sickness or Injury occurring while coverage is not in effect; 3. hospitalization or Treatment where coverage is purchased to obtain such services, whether or not authorized by a Physician; 4. non-emergency Treatment or investigation, check-ups, cosmetic surgery, chronic care, rehabilitation, Elective Treatment or any complications directly or indirectly related thereto; 5. Treatment which can be reasonably delayed until You can return home by the next available means of transportation; 6. medicines or drugs not approved for use by the appropriate government authority, experimental drugs, preventative, patent or proprietary medicines, vaccines, vitamins or vitamin preparations, and drugs or medicines which can be purchased over the counter; 7. any loss, Sickness or Injury when travel is booked or commenced contrary to medical advice, with prior knowledge of an Unstable Condition or after determination that You have a condition which is considered Terminal; 8. any Treatment, investigation or hospitalization which is a continuation of or subsequent to Emergency medical treatment of a Sickness or Injury, unless You are declared medically unfit to return to Your province or country of usual residence, by TIC; 3 TRAVEL INSURANCE CERTIFICATE FOR AIR CANADA VACATIONS TRAVELLERS

5 9. hospitalization if You failed to notify TIC within 24 hours of admission, unless by reason of Your medical condition You were lacking the capacity (mental or physical) or the ability to notify TIC, and this is supported in writing by Your attending Physician; 10. childbirth, miscarriage or any complications incident to pregnancy occurring within eight weeks of the expected delivery date; Exception: U.S. Residents and travellers not covered under a CGHIP are not covered for expenses incurred for or as the result of pregnancy; 11. mental, nervous or emotional disorders, misuse of medication, abuse of drugs or intoxicants or treatment therefor or accidents related thereto; 12. suicide or attempt thereat or self-inflicted Injury, whether sane or insane; 13. any loss, Sickness or Injury, directly or indirectly resulting from, or arising out of, or in connection with any Act of War or Terrorism or any Nuclear Incident, whether or not You are controlling, preventing, suppressing or retaliating against or responding to any Act of War or Terrorism or any Nuclear Incident; 14. eye examinations, eyeglasses, sunglasses, contact lenses, hearing aids or their prescriptions; 15. committing or attempting to commit any illegal or criminal activity; 16. air travel other than as a passenger in a commercial aircraft licensed to carry passengers for hire; 17. expenses in excess of $2,000,000 if the total claims against the Company for the same accident exceed $2,000,000; in which case the Company s liability for such accident will be limited to $2 million which will be shared proportionately among all Insureds and/or beneficiaries entitled to claim. If You are insured under more than one policy issued by the Company in which Benefit L, M and/or N is a benefit, and You have paid the appropriate premium, the maximum amount You are entitled to receive in the event of a claim, is the lessor of; the largest amount specified for that benefit in any one policy, or Your proportion of a claim as described in the above paragraph. TIC reserves the right, as reasonably required, to transfer You to any Hospital or to return You to Your province or country of usual residence, if You are medically fit to travel. If You decline to return, any continuing expenses for such Sickness or Injury will not be covered. DEFINITIONS (Complete definitions are listed in the Master Policy.) Act of War or Terrorism means, and is not limited to: civil war, rebellion, revolution, insurrection, civil commotion, invasion, acts of foreign enemies, hostilities, or warlike operations by any government or sovereign, using military personnel or other agents (personnel), with the use of force or violence and/or the threat thereof or commission or threat of a dangerous act, against any person or group(s) or government(s); committed for political, religious, ideological, social, economic or similar purposes including the intention to intimidate, coerce or overthrow a government (whether de facto or de jure) or to influence, affect or protest against any government and/or to put the civilian population, or any section of the civilian population in fear. Common Carrier means a public land or water conveyance licensed to carry passengers for hire. Company means Co-operators Life Insurance Company and The Sovereign General Insurance Company. Critical means in danger of death or life threatening. Departure Point means the location from which travel services booked through Air Canada Vacations begin. Effective Date means the date coverage begins being the latest of the date (i) You leave Your Departure Point, or (ii) You leave Your province or country of usual residence on an Insured Trip, or (iii) indicated as the Effective Date on the application. Trip Cancellation Insurance (Benefits A, B and C) is effective on the date the application and premium are received by TIC or its Representative. Elective Treatment means Treatment, surgery or any other procedure scheduled by Your Physician to occur at a future date. Emergency means an unforeseen Sickness or Injury which requires immediate Treatment to prevent or alleviate existing danger to life or health. An Emergency no longer exists when the medical evidence indicates that the person is able to continue the trip or return to his or her country of residence. Hospital means a facility equipped to perform surgery and which regularly treats patients on an Emergency in-patient and out-patient basis and is identified and licensed as a Hospital in the area where the Hospital services are performed, but in no event shall this include a nursing home, rest home, convalescent home, rehabilitation centre, or home for the aged. Immediate Family means Your spouse (legal or common law), children, stepchildren, grandchildren, brothers, sisters, parents, grandparents, in-laws, aunts, uncles, nieces, nephews. Injury means sudden bodily harm directly caused by an accident which is independent of Sickness and all other causes. Insured means a person for whom insurance coverage is in effect. Insured Trip means a trip booked through Air Canada Vacations, on which You are travelling during the Period of Coverage. Nuclear Incident means any occurrence causing bodily Injury, Sickness, disease, or death or loss of or damage to property, or for loss of use of property, arising out of or resulting from the radioactive, toxic, explosive, or other hazardous properties of source, special nuclear, or by-product material. Period of Coverage means the period between the Effective Date and Termination Date during which coverage is in effect under this Certificate. Physician means a person who is legally qualified and licensed to practice medicine or perform surgery in the location where the services are performed. Pre-existing Condition means a medical condition for which Treatment has been received or taken, or which exhibited symptoms which would lead a reasonable person to believe or to make inquiries regarding whether Treatment was required, prior to the trip in question, and includes a medically recognized complication or the appearance of symptoms caused by or related to a medical condition which was previously diagnosed by a Physician or for which Treatment was previously received. Reasonable and Customary means the costs customarily charged for covered benefits which are not in excess of the standard fee in the geographical area where the charges are incurred for comparable Treatment, services or supplies for a similar Sickness or Injury. Representative means the location where acceptance of payment arrangements have been made by TIC. Sickness means illness or disease. Stable and Controlled means the medical condition is not worsening and there has been no alteration in any medication for the condition or its usage or dosage, nor any Treatment prescribed or recommended or received by a Physician before the trip in question. Terminal means a medical condition for which, before the trip in question, a Physician gave a prognosis of eventual death or palliative care was received. Termination Date means the date coverage ends, being the earliest of the date i) determined by adding the number of days of coverage purchased to the Effective Date, or ii) You return to Your Departure Point, or iii) indicated as the Termination Date on the application. Trip Cancellation Insurance coverage terminates on the date and time You leave Your Departure Point. Travelling Companion is the person or persons up to a maximum of 4, with whom You are sharing prepaid accommodation and/or transportation arrangements on Your vacation. Treatment means a medical, therapeutic or diagnostic procedure prescribed, performed or recommended by a Physician, including but not limited to prescribed medication, investigative testing and surgery. Treatment does not include the unaltered use of prescribed medication for a medical condition which is Stable and Controlled or a medical examination in which a Physician observes no change in a previously identified condition. 4 TRAVEL INSURANCE CERTIFICATE FOR AIR CANADA VACATIONS TRAVELLERS

6 Unstable Condition means a Sickness or Injury which would cause an ordinarily prudent person to expect the need for Treatment or investigation following departure. Vehicle means a private passenger automobile or station wagon, or mini-van. You or Your means an Insured. TERMS AND CONDITIONS EXTENDING YOUR STAY If You plan to extend Your vacation beyond the originally scheduled Termination Date of this Travel Insurance Certificate, You must contact TIC at least five (5) days prior to the Termination Date and pay an additional premium. Coverage will be extended at the option of TIC provided no event has occurred which would result in a claim. Minimum premium levels apply. COORDINATION OF BENEFITS WITH OTHER INSURANCE PLANS This Travel Insurance Certificate is designed to pay and will pay eligible claims in excess of all or any existing coverage held by You and shall not substitute for any other coverage which would have been in effect and would have provided reimbursement for expenses incurred if this insurance was not in effect, including but not limited to homeowners insurance, tenants insurance, multi-risk insurance, extended health care insurance, automobile insurance, or any credit card policy or plan. Payment under this Travel Insurance Certificate will be coordinated with any other coverage available to You so that benefits payable under all policies or plans shall not exceed 100% of the eligible expenses incurred. This provision does not apply to the Flight Accident, Common Carrier Accident or Accidental Death and Dismemberment benefits. The Company will not coordinate with retiree benefit plans that have fixed lifetime benefits of $50,000 or less. SUBROGATION If You acquire any right of action against any individual, firm or corporation for a covered loss for which a payment has been made under the policy, then if requested by the Company, You shall transfer such claim or right of action to the Company. The Company shall reserve the right to subrogate to the extent of the payment made to all of Your rights of recovery against any third party who is liable. GENERAL PROVISIONS A The required premium is due and payable at the time of application and will be determined according to the schedule of premium rates then in effect. Premium rates and policy terms and conditions are subject to change without prior notice to reflect actual experience in the marketplace. The Company reserves the right to deny coverage. Insurance premiums are non-refundable. B If the premium paid is inappropriate for the Period of Coverage, the Company will a) shorten the Period of Coverage by written amendment changing the Termination Date if the premium received is insufficient, or b) refund any overpayment of premium. Coverage will be null and void if the premium is not received, if a cheque is not honoured for any reason, if credit card charges are invalid, or if no proof of Your payment exists. C The application, the Travel Insurance Certificate and any endorsements, amendments, or riders attached hereto shall be considered as part of Your insurance coverage. D All benefits are payable to You unless assigned. In the event of Your death, such benefits are payable to Your beneficiary or Your estate. E Unless otherwise specified, all benefit payments made under this Travel Insurance Certificate shall be in Canadian currency. At the option of TIC, benefits may be payable in the currency of the country where the loss occurred, or in U.S. currency. F Notwithstanding any other provisions contained herein, this Travel Insurance Certificate is governed by the laws of Ontario in all respects including matters of construction, validity and performance. Legal actions or proceedings must be brought in the Canadian province where You permanently reside or in the Canadian province where this Travel Insurance Certificate was purchased, if You reside outside Canada. G All policy provisions stated herein are per Insured per Sickness or Injury during one Period of Coverage. H Fraud, misstatement or non-disclosure shall render coverage null and void and any claim submitted thereunder shall not be payable. CLAIM PROCEDURE If You must cancel Your Air Canada Vacations holiday, please contact Your travel agent and TIC immediately and send Your travel tickets along with written notification to TIC within 48 hours. TO SUBMIT A CLAIM PLEASE INCLUDE: a brief explanation of the medical situation, e.g., how, where and when the loss, Sickness or Injury took place; completed claim form and originals of all bills, invoices and receipts; medical records and diagnosis from the medical facility; completed authorization form required to obtain necessary medical information and medical records from the facility; name and policy number of group insurance plan or other insurance coverage; proof of provincial plan payment when necessary; for a death claim, a death claim form completed by the beneficiary or other person entitled to claim, along with proof of death acceptable to the Company; for a Baggage claim, (i) an itemized list and value of all lost or stolen baggage and personal items along with proof of ownership, (ii) the official airline claim/police report, and (iii) correspondence and confirmation of any payment from another source (i.e. airline, tour company, homeowner/tenant insurance, etc.); for a Trip Cancellation, Interruption or Delay claim, (i) an original medical certificate from the attending Physician indicating the diagnosis, history of illness, cause of Injury, or a death certificate, and/or other evidence for any other eligible reason as outlined in Benefit A, (ii) cancelled and unused transportation tickets, (iii) receipts for all prepaid deposits, and (iv) any correspondence and the amount of reimbursement from Your travel agent. IMPORTANT Claims must be reported within 30 days of occurrence. Written proof of claim is required within 90 days of occurrence. Claims cannot be considered unless the claim form is duly completed and signed by the claimant and submitted along with all required documentation. All documentation must be supplied free of expense to the Company. MAIL OR DELIVER CLAIMS TO TIC CLAIMS DEPARTMENT University Avenue Toronto, Ontario M5G 2K8 Claims Inquiries: (416) or TIC, Air Canada Vacations, or the Company are not responsible for the availability, quantity, quality or results of any medical treatment received by You or Your failure to obtain medical assistance. Managed by: TIC Travel Insurance Coordinators Ltd University Avenue, Toronto, ON, Canada M5G 2K8 IN WITNESS WHEREOF, the Company has issued this policy. Underwritten by: The Sovereign General Insurance Company Macleod Trail S.E., Calgary, AB, Canada T2H 0L3 and Co-operators Life Insurance Company 1920 College Avenue, Regina, SK, Canada S4P 1C4 5 TRAVEL INSURANCE CERTIFICATE FOR AIR CANADA VACATIONS TRAVELLERS