2 The Blue Cross Travelsafe Insurance Plans offer you the following benefits: MEDICAL TREATMENT This covers your hospitalization, surgery, visits to registered physicians or specialists, prescribed medicines, emergency ambulance and emergency care due to a covered illness or injury as well as emergency dental treatment due to accident occurring during your travel. This benefit also provides in-patient coverage for pre-existing conditions up to the specified limit. The hospital daily room rate should not exceed US$350, or its Peso equivalent as determined by the Company for Dollar and Peso Plans, and 225 for Euro Plans. HOSPITAL INCOME This provides a daily income up to ten (10) consecutive days of your hospitalization in excess of twenty-four (24) hours from the time of your admission. Your medical and surgical treatment are also covered under this plan. PERSONAL ACCIDENT This covers you when an accident occurs while traveling resulting in death or total permanent disability, including loss of one or both eyes or limbs. The maximum payable amount to a child from six (6) to fifteen (15) years old or a person above seventy () years old shall be PhP,000 for Peso Plans, US$5,000 for Dollar Plans and for the Euro Plan. PERSONAL LIABILITY This covers expenses you might incur if you have caused another person s accidental death, bodily injury or damage to property, because of situations beyond your control while you are traveling. BAGGAGE DELAY This covers you when your checked-in baggage has been delayed, misdirected, or temporarily misplaced in delivery for more than six (6) hours from the time you arrived at your destition. Additiol coverage will be provided after seventy-two (72) hours of continuous delay happening at an intended destition that is not your place of origin. BAGGAGE LOSS OR DAMAGE This covers your baggage including clothing, prescribed medicines, bags, footwear and other persol effects, if they have been lost or damaged during your travel. Items inside your bag are covered per item, pair or set of up to PhP5,000 for Peso Plans, US$150 for Dollar Plans and 95 for the Euro Plan. Blue Cross will cover up to the actual cost of repair of the damaged baggage or cost of the damaged or lost baggage, subject to depreciation, but not to exceed the maximum benefit. We will not make payment for articles that are more than five (5) years old. LOSS OF TRAVEL DOCUMENTS This covers the replacement fee of your passport including unused visa, and the re-issuance of your travel tickets of the same class. This benefit does not cover transportation, communication and other related incremental charges you might incur in the process of getting your new passport or tickets. TRIP CANCELLATION This provides reimbursement for the unused and non-refundable portion of your travel and accommodation expenses, pelties and other irrecoverable pre-paid charges related to the trip according to the contract with your Travel Agency and/or Tour Operator, if your trip is cancelled within thirty (30) days prior to the scheduled departure date or on the scheduled departure date. The cancellation must be due to death, life threatening condition or serious illness/injury, or sickness resulting to compulsory quarantine or denied boarding of the Insured, or his immediate family member, or due to tural catastrophe or unexpected outbreak of strike, riot or civil commotion at the place of origin or at the planned destition. If there was no prior outright cancellation of reservations or booking resulting in a no-show, this benefit will not apply. TRIP TERMINATION This provides reimbursement for the unused and non-refundable portion of your travel and accommodation expenses pelties and other irrecoverable pre-paid charges related to the trip according to the contract with your Travel Agency and/or Tour Operator if during traveling, you need to extend your stay away from your place of origin, or to curtail your planned onward journey, or to cut short your trip and return to your place of origin after your coverage has begun. The termition must be due to death, life threatening condition or serious illness/injury or sickness resulting to compulsory quarantine or denied boarding of the Insured, or his immediate family member, or due to tural catastrophe or unexpected outbreak of strike, riot or civil commotion at the place of departure or at the planned destition. If it was necessary for you to extend your period of stay away from your place of origin for medical assistance or after hospital discharge, Blue Cross will reimburse the cost of your unplanned accommodation. If there was no prior outright cancellation of reservations or booking resulting in a no-show, this benefit will not apply. FLIGHT DELAY This covers you if your flight is delayed by more than six (6) hours due to severe weather conditions, tural catastrophes or technical failure of aircraft on which you are scheduled to board. Additiol coverage will be provided after seventy-two (72) hours of continuous delay occurring from a place of departure that is not your place of origin. Delays of chartered flights are not covered. MISSED CONNECTING FLIGHT This covers you if you missed your onward connecting flight due to the late arrival of your incoming flight and no altertive onward transportation is made available to you within six (6) consecutive hours after the arrival time of your incoming flight. The delay of the incoming flight must be due to severe weather conditions, tural catastrophes, technical failure of aircraft on which you are scheduled to board or organized industrial action/strike or hijack. Coverage is for each consecutive 6-hour delay up to ninety-six (96) hours. STRIKES AND HIJACKS This provides a daily allowance for a maximum of ten (10) days for each full day your travel is delayed for more than twelve (12) hours from reaching your scheduled destition due to organized industrial action, strike or hijack. FUNERAL AND BURIAL EXPENSES This covers the cost of funeral and burial expenses to be incurred at the point of origin if death occurs due to a covered disability or medical condition while you are traveling. EMERGENCY ASSISTANCE BENEFITS A. The following benefits are available to you only if they are arranged through our Emergency Assistance partner: Emergency Medical Evacuation We will arrange and pay for the provision of air and/or surface transportation, communication and all usual ancillary services required to move you to the nearest hospital where appropriate medical care is available. Emergency Medical Repatriation We will arrange and pay for a medically supervised repatriation to your Home Country or Usual Country of Residence after stabilizing your medical condition, to the satisfaction of our Emergency Assistance partner. Care of Minor Child(ren) We will arrange for the return of your minor children to your Home Country or Usual Country of Residence, if they are left uttended as a result of your death, illness, accident, or Emergency Medical Evacuation. Compassiote Visit We will arrange and pay for an economy roundtrip transportation for one of your immediate family members or a friend to join you, when you are traveling alone and are hospitalized for a covered condition for more than seven (7) consecutive days. Return of Mortal Remains We will arrange and pay for the transportation of your mortal remains to your Home Country or Usual Country of Residence. B. The following benefits are available to you subject to the terms and conditions as agreed upon by Blue Cross and our Emergency Assistance partner: Medical Consultation, Evaluation and Referral Hospital Admission Assistance following a Medical Evacuation Medical Monitoring Prescription Assistance Emergency Message Transmission Interpreter and Legal Referrals Lost Luggage or Document Assistance Emergency Cash Coordition Pre-trip Information
3 Some terms defined and other important details: Place of origin is the place where your travel commenced. Immediate family members include your legal spouse, child, brother, sister or parent. Minor children are children six (6) weeks old to seventeen (17) years old. Travelsafe Insurance Plans (Individual Plans) cover persons six (6) weeks old to seventy-five () years old. Pre-existing condition is any illness or disability that you have, whether known to you or not and the tural history of which can be medically determined to have started prior to the period of insurance. For trip cancellation and termition, serious injury/illness refers to change in health that resulted to confinement or admission to a hospital as a registered bed patient and as ordered by a registered physician. Tripguard Privilege Peso, Executive De Luxe Dollar, Prestige Euro and Prestige Plus Plans including Annual De Luxe Dollar Plan offer no cashout facility for hospitalization/in-patient medical treatment for a covered illness or accident provided the hospital bill is at least USD 500. Other plans Some things you need to know about our Family Plan: The Family plan is available if you plan to travel on the same departure and return trip with your family (unlimited number of children), and you are riding on the same conveyance. Also, you and your legal spouse must be eighteen (18) to fifty (50) years old and your children s age must range from six (6) weeks to seventeen (17) years old. The legal spouse and children are entitled to the same benefits as you. One exception is when the children are six (6) to fifteen (15) years old, in which case the Persol Accident Benefit becomes PhP,000, US$5,000 and for all Peso, Dollar and Euro plans, respectively. Children under six (6) years old are not entitled to any Persol Accident Benefit. The maximum limit of the Persol Accident Benefit for the entire family (including you) will not exceed % of your Persol Accident Benefit. For all other benefits, the maximum benefit limit of the entire family (including you) will not exceed 300% of your benefits. All benefits are subject to the inner limits of the plan. Exclusions The following are not covered under the Blue Cross Travelsafe Insurance Policy: Medical and physical conditions existing prior to the scheduled departure date, or any condition arising from, or contributed by such pre-existing conditions, whether known or unknown to you. Traveling contrary to doctor s advice or for the purpose of obtaining medical treatment. War and warlike risks, unlawful or crimil acts, willful exposure to danger except to save human life. Childbirth and sexually transmitted diseases. Intoxication, use of drugs not prescribed by registered physicians, selfinjury, suicide or attempted suicide, assault or fighting provoked by the Insured, psychological conditions, mental and nervous conditions. Traveling except as fare paying passenger on a fully licensed airline or sea vessel, engaging in any occupation or trade of a manual, hazardous, technical ture. Racing (other than foot), professiol sports, scuba diving, contact sports, motorcycling (except daily use for transportation on a paved road), winter sports, or other hazardous sports or activities. Certain hazardous sports can be covered at additiol cost. Routine care, convalescent or rehabilitation care. Expenses due to vaccition except the first dose of anti-rabies, antivenom and anti-tetanus. can also be accommodated for no-cash-outlay upon Company s approval. If the Insured Person is covered for domestic travel (within the Philippines), only the following Emergency Medical and Travel Assistance Benefits are available: Medical Consultation, Evaluation and Referral, Medical Monitoring and Medical Evacuation. We will provide you assistance and advice for free through our Emergency Assistance Partner, but you will be responsible for any third party charges incurred as a result of such advice or assistance, unless covered in the Policy. Medical and ambulance transport costs for Medical Evacuation and Medical Repatriation form part of the Medical Treatment Benefit if services are not coursed through our Emergency Assistance Partner. In which case, we will reimburse only if it is a result of a covered illness, accidental injury or death. Blue Cross retains the absolute right to decide whether your medical condition is sufficiently serious to warrant Emergency Medical Evacuation or Repatriation. Any benefit for which indemnity will be covered or reimbursed under any other insurance policy, existing insurance scheme, government program; or will be paid or refunded by any carrier, airline, hotel, travel agent or any other party. Communication and transportation expenses other than medically necessary telecommunications and local ambulance/transportation services. Lost cash, bank notes and traveler s checks. Baggage loss without the supporting Baggage Irregularity Report from the airline or police report if such loss occurred outside the custody of the Airline. Electronic devices including but not limited to laptops, Persol Digital Assistance (PDA), mobile phones and cameras. Delay, detention, confiscation by customs or authorities. Obesity, chronic dermatologic condition and any condition arising therefrom. Permanent artificial implants, prosthetic devices, graft, durable medical equipment and corrective devices. Confinement required wholly for executive check-ups or routine medical examitions or check-ups.
4 Travelsafe Tripguard Medical Treatment Treatment for Pre-existing Conditions * Hospital Income (per day up to 10 days) Persol Accident Persol Liability Baggage Delay Baggage Loss / Damage Loss of Travel Documents Trip Cancellation Trip Termition Flight Delay Missed Connecting Flight ** Strikes/Hijack (per day up to 10 days) Funeral & Burial Expenses Emergency Medical Evacuation Emergency Medical Repatriation Care of Minor Child(ren) Compassiote Visit Return of Mortal Remains Emergency Assistance Travel Including USA/Cada/HKG Up to 4 days Up to 8 days Up to 15 days Up to 24 days Up to 31 days Up to 45 days Up to days Each add l 10 days Travel Insurance for business or pleasure with Benefits & Premiums on a per trip basis SCHEDULE OF BENEFITS PREMIUMS as of 1 January TRIPGUARD PREMIUMS as of 1 January INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY PhP ,053 1,283 1,767 2, PhP 882 1,405 2,019 2,642 3,245 4,505 5, PhP ,177 1,430 1,683 2,189 2, PhP 500, ,000 15,000 10,000 PhP 1,152 2,082 2,929 3,587 4,257 5,581 6, PhP,000 1,500 1,500,000,000 25,000 PRIVILEGE PhP 6 1,263 1,786 2,614 3, 4,322 5, PhP 1,729 3,119 4,450 6,562 8,098 11,019 13,611 1,352 PRIVILEGE PhP 2,500,000 1,500 1,500,000,000 25,000 $ $ 25, ,000 40, * for in-patient medical treatment only ** per 6 consecutive hours, maximum of 96 hours $ $ PLAN $ 300 PLAN $ EURO PLAN 40 EURO PLAN PLUS PLAN, PLUS PLAN Travel Excluding USA/Cada/HKG Up to 4 days Up to 8 days Up to 15 days Up to 24 days Up to 31 days Up to 45 days Up to days Each add l 10 days INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY PhP ,162 1,585 2, PhP 741 1,255 1,807 2,369 2,939 4,043 5, PhP ,063 1,290 1,518 1,961 2, PhP 973 1,883 2,647 3,238 3,840 5,001 6, PhP 610 1,135 1,8 2,353 2,880 3,889 4, PhP 1,495 2,804 4,003 5,905 7,286 9,916 12,361 1,217 $ $ $ $ INDIVIDUAL FAMILY Philippine INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY Travel Only Up to 4 days PhP 242 PhP 593 PhP 359 PhP 878 PhP 568 PhP 1,389 $ 15 $ 37 $ 20 $ 49 Up to 8 days 449 1, ,661 1,035 2, Up to 15 days 641 1, ,334 1,464 3, Up to 24 days 835 2,096 1,139 2,858 2,093 5, Up to 31 days 1,029 2,3 1,341 3,392 2,499 6, Up to 45 days 1,408 3,592 1,746 4,452 3,3 8, Up to days 1,793 4,9 2,151 5,526 4,1 10, Each add l 10 days , Prestige Plus Premiums as of 1 January All other Tripguard Premiums as of 1 September Benefits as of 1 August 2014 V05.14_FOR 08.14_P06.14
5 Travelsafe Annual Travel Insurance for the frequent traveler, with Premiums on an annual basis and Benefits on a per trip basis ANNUAL PREMIUMS as of 1 SEPT 2011 SCHEDULE OF BENEFITS Medical Treatment Treatment for Pre-existing Conditions 1 Hospital Income (per day up to 10 days) Persol Accident Persol Liability Baggage Delay Baggage Loss / Damage Loss of Travel Documents Trip Cancellation Trip Termition Flight Delay Missed Connecting Flight (per 6 consecutive hrs max. of 96 hrs) Strikes / Hijack (per day up to 10 days) Funeral & Burial Expenses Emergency Medical Evacuation Emergency Medical Repatriation Care of Minor Child(ren) Compassiote Visit Return of Mortal Remains Emergency Assistance PhP 500,000 1,500, ,000 PhP,000 1,500,000,000 $ 25,000 40,000 $ ,000 1 for in-patient medical treatment only PREMIUMS as of 1 September 2011 Travel Including USA / Cada / Hong Kong PhP 6,404 PhP 9,6 $ 283 $ 345 Travel Excluding USA / Cada / Hong Kong 5,765 8, Philippine Travel Only 5,124 7, NOTES: 1. Period covered for Tripguard Plans is up to 180 days per trip. Please get in touch with the Travel Sales Department at Tel. No. (632) or for trips exceeding 180 but no more than 365 days. 2. Period covered for Annual Plans is for an unlimited number of trips per year, provided that each trip does not exceed days. 3. If you are 76 years old or older, please also get in touch with the Travel Sales Department for more details about your coverage and premium. 4. Prestige Plus Premiums as of 1 January All other Tripguard Premiums as of 1 September Annual Premiums as of 1 September All Benefits as of 1 August V05.14_FOR 08.14_P06.14