Pre-Existing Condition

• Medical
  • Pre-Existing Condition

  • Covered if purchased within 21 days of trip deposit

• What is Pre-Existing Condition?
  A Pre-Existing Condition is an illness or other medical condition that was treated, diagnosed, or changed during a policy’s lookback period.

• What am I covered for?
  Benefits are not payable for any loss due to, arising or resulting from:

  13. due to a Pre-Existing Condition, as defined in the Policy. The Pre- Existing Condition Limitation does not apply to the Emergency Medical Evacuation or Return of Remains coverage;

  Waiver of the Pre-Existing Condition Exclusion

  The exclusion for Pre-Existing Condition will be waived provided:

  (a) Your payment for this Policy and enrollment form are received within 21 days of the date Your initial Payment or Deposit for Your Trip is received; and

  (b) You are not disabled from travel at the time Your premium is paid.

  “Pre-Existing Condition” means an illness, disease, or other condition during the 60 day period immediately prior to the date Your coverage is effective for which You or Your Traveling Companion, Business Partner or Family Member scheduled or booked to travel with You: (1) received or received a recommendation for a test, examination, or medical treatment for a condition which first manifested itself, worsened or became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment; or (2) took or received a prescription for drugs or medicine.

• Definitions
  “Accident” means a sudden, unexpected unusual specific event that occurs at an identifiable time and place, and shall also include exposure resulting from a mishap to a conveyance in which You are traveling.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Actual Cash Value” means current replacement cost for items of like kind and quality.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Additional Transportation Cost” means the actual cost incurred for one- way Economy Transportation by Common Carrier reduced by the value of an unused travel ticket.

  “Air Carrier” means any air conveyance operating under a valid license for the transportation of passengers for hire.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Baggage and Personal Effects” means luggage, personal possessions and travel documents taken by You on Your Trip.

  “Bankruptcy or Default” means the total cessation of operations due to insolvency, with or without the filing of a bankruptcy petition by an airline, cruise line, tour operator or other travel provider provided the Bankruptcy or Default occurs more than 14 days following Your Effective Date for the Trip Cancellation Benefits. There is no coverage for the Bankruptcy or Default of any person, organization, agency or firm from whom You purchased Travel Arrangements supplied by others.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Business Partner” means an individual who (a) is involved in a legal general partnership with You and (b) is actively involved in the day to day management of Your business.

  “Caregiver” means an individual employed for the purpose of providing assistance with activities of daily living to You or to Your Family Member who has a physical or mental impairment. The Caregiver must be employed by You or Your Family Member. A Caregiver is not a babysitter; childcare service, facility or provider; or persons employed by any service, provider or facility to supply assisted living or skilled nursing personnel.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Child Caregiver” means an individual providing basic childcare service needs for Your minor children under the age of 18 while You are on the Trip without the minor children. The arrangement of being the Child Caregiver while You are on the Trip must be made 30 or more days prior to the Scheduled Departure Date.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Common Carrier” means any land, sea, or air conveyance operating under a valid license for the transportation of passengers for hire, not including taxicabs or rented, leased or privately owned motor vehicles.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Complications of Pregnancy” means conditions (when the pregnancy is not terminated) whose diagnoses are distinct from pregnancy but are adversely affected by pregnancy or are caused by pregnancy. These conditions include acute nephritis, nephrosis, cardiac decompensation, missed abortion and similar medical and surgical conditions of comparable severity. Complications of Pregnancy also include non-elective cesarean section, ectopic pregnancy which is terminated and spontaneous termination of pregnancy, which occurs during a period of gestation in which a viable birth is not possible.

  Complications of Pregnancy does not include false labor, occasional spotting, Physician-prescribed rest during the period of pregnancy, morning sickness, hyperemesis gravidarum, preeclampsia and similar conditions associated with the management of a difficult pregnancy not constituting a nosologically distinct complication of pregnancy.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Confirmation of Benefits” means a written confirmation specifying the coverages and amounts You have purchased and which is delivered to You.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Covered Accident” means an Accident that occurs while coverage is in force and results in a loss for which benefits are payable.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Domestic Partner” means an opposite or same sex partner who, for at least 6 consecutive months, has resided with You and shared financial assets/obligations with You. Both You and the Domestic Partner must: (1) intend to be life partners; (2) be at least the age of consent in the state in which You both reside; and (3) be mentally competent to contract. Neither You nor the Domestic Partner can be related by blood to a degree of closeness that would prohibit a legal marriage, be married to anyone else, or have any other Domestic Partner. We may require proof of the Domestic Partner relationship in the form of a signed and completed affidavit of domestic partnership.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Economy Transportation” means the lowest published available transportation rate for a ticket on a Common Carrier matching the original class of transportation that You purchased for Your Trip.

  “Elective Treatment and Procedures” means any medical treatment or surgical procedure that is not medically necessary, including any service, treatment, or supplies that are deemed by the federal, or a state or local government authority, or by Us to be research or experimental or that is not recognized as a generally accepted medical practice.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Family Member” means any of the following: Your or Your Traveling Companion’s legal spouse (or common-law spouse where legal), legal guardian or ward, son or daughter (adopted, foster, step or in-law), brother or sister (includes step or in-law), parent (includes step or in-law), grandparent (includes in-law), grandchild, aunt, uncle, niece or nephew, Domestic Partner, Caregiver, or Child Caregiver.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Hospital” means: (a) a place which is licensed or recognized as a general hospital by the proper authority of the state in which it is located; (b) a place operated for the care and treatment of resident inpatients with a registered graduate nurse (RN) always on duty and with a laboratory and X-ray facility; c) a place recognized as a general hospital by the Joint Commission on the Accreditation of Hospitals. Not included is a hospital or institution licensed or used principally: (1) for the treatment or care of drug addicts or alcoholics; or (2) as a clinic continued or extended care facility, skilled nursing facility, convalescent home, rest home, nursing home or home for the aged.

  “Inclement Weather” means any weather condition that delays the scheduled arrival or departure of a Common Carrier.

  “Injury” or “Injuries” means bodily harm caused by an Accident which: (1) occurs while Your coverage is in effect under the Policy; and (2) requires examination and treatment by a Legally Qualified Physician. The Injury must be the direct cause of loss and must be independent of all other causes and must not be caused by, or result from, Sickness.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Insured” means a person(s) who is booked to travel on a Trip, completes the enrollment form and for whom the required premium is paid, also referred to as You and Your.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Intoxicated” means a blood alcohol level that equals or exceeds the legal limit for operating a motor vehicle in the state or jurisdiction where You are located at the time of an incident.

  “Legally Qualified Physician” means a physician: (a) other than You, a Traveling Companion or a Family Member; (b) practicing within the scope of his or her license; and c) recognized as a physician in the place where the services are rendered.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Maximum Benefit Amount” means the maximum amount payable for coverage provided to You as shown in the Confirmation of Benefits.

  “Medically Necessary” means a service which is appropriate and consistent with the treatment of the condition in accordance with accepted standards of community practice.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Medical Treatment” means examination and treatment by a Legally Qualified Physician for a condition which first manifested itself, worsened or became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment while coverage is in effect.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Natural Disaster” means a flood, hurricane, tornado, earthquake, mudslide, tsunami, avalanche, landslide, volcanic eruption, fire, wildfire or blizzard that is due to natural causes.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Payments or Deposits” means the cash, check, or credit card amounts, actually paid for Your Trip. Certificates, vouchers, discounts, credits, frequent traveler or frequent flyer rewards, miles or points applied (in part or in full) towards the cost of Your Travel Arrangements are not Payments or Deposits as defined herein.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Pre-Existing Condition” means an illness, disease, or other condition during the 60 day period immediately prior to the date Your coverage is effective for which You or Your Traveling Companion, Business Partner or Family Member scheduled or booked to travel with You: (1) received or received a recommendation for a test, examination, or medical treatment for a condition which first manifested itself, worsened or became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment; or (2) took or received a prescription for drugs or medicine.

  Item #2 of this definition does not apply to a condition which is treated or controlled solely through the taking of prescription drugs or medicine and remains treated or controlled without any adjustment or change in the required prescription throughout the 60 day period before coverage is effective under this Policy.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Prepaid” means Payments or Deposits paid by You for Travel Arrangements for Your Trip prior to Your actual or Scheduled Departure Date. Payments or Deposits for shore excursions, theater, concert or event tickets or fees, or sightseeing, if such arrangements are made during Your Trip and are to be used prior to the Scheduled Return Date of Your Trip, are not considered Prepaid as defined herein.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Program Medical Advisor” means One Call Worldwide Travel Services Network, Inc.

  “Scheduled Departure Date” means the date on which You are originally scheduled to leave on Your Trip.

  “Scheduled Return Date” means the date on which You are originally scheduled to return to the point of origin or the original final destination of Your Trip.

  “Sickness” means an illness or disease of the body which: 1) requires examination and treatment by a Legally Qualified Physician; and 2) commences while Your coverage is in effect.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Strike” means any organized and legally sanctioned labor disagreement resulting in a stoppage of work: a) as a result of a combined effort of workers which was unannounced and unpublished at the time travel services were purchased; and b) which interferes with the normal departure and arrival of a Common Carrier.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Terrorist Incident” means an act of violence, that is deemed terrorism by the United States Government other than civil disorder or riot (that is not an act of war, declared or undeclared) that results in loss of life or major damage to property, by any person acting alone or in association with other persons on behalf of or in connection with any organization of foreign government which is generally recognized as having the intent to overthrow or influence the control of any other foreign government. The Terrorist Incident must be documented in a Travel Advisory or Travel Warning issued by the United States’ Department of State advising Americans to avoid that certain country.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Third Party” means a person or entity other than You or Us.

  “Transportation Expense” means the cost of Medically Necessary conveyance, personnel, and services or supplies.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Travel Advisory or Travel Warning” means a U.S. State Department communication advising caution in traveling to specified destinations due to reasons such as armed violence, civil or political unrest, high incidence of crime (specifically kidnapping and/or murder), natural disaster or outbreak of one or more contagious diseases.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Travel Arrangements” means: (a) transportation; (b) accommodations; and c) other specified services arranged for Your Trip.

  “Traveling Companion” means a person or persons whose names appear with Yours on the same Travel Arrangements and who, during Your Trip, will accompany You. A group or tour organizer, sponsor or leader is not a Traveling Companion as defined, unless sharing accommodations in the same room, cabin, condominium unit, apartment unit or other lodging with You.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Travel Supplier” means any entity or organization that coordinates or supplies travel services for You.

  “Trip” means a scheduled trip for which coverage for Travel Arrangements is requested and the premium is paid prior to Your actual or Scheduled Departure Date of Your Trip.

  “Us”, “We”, “Our” means United States Fire Insurance Company.
  *This definition changes for residents of the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

  “Usual and Customary Charges” means those comparable charges for similar treatment, services and supplies in the geographic area where treatment is performed.

  *Additional definitions apply to the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.

• Exclusions
  Benefits are not payable for any loss due to, arising or resulting from:

  1. suicide, attempted suicide or any intentionally self-inflicted injury of You, a Traveling Companion, Family Member or Business Partner booked to travel with You, while sane or insane;

  2. an act of declared or undeclared war;

  3. participating in maneuvers or training exercises of an armed service, except while participating in weekend or summer training for the reserve forces of the United States, including the National Guard;

  4. riding or driving in races, or speed or endurance competitions or events;

  5. mountaineering (engaging in the sport of scaling mountains generally requiring the use of picks, ropes, or other special equipment);

  6. participating as a professional in a stunt, athletic or sporting event or competition;

  7. participating in skydiving or parachuting except parasailing, hang gliding, bungee cord jumping, extreme skiing, skiing outside marked trails or heli-skiing, any race, speed contests, spelunking or caving, or scuba diving if the depth exceeds 120 feet (40 meters) or if You are not certified to dive and a dive master is not present during the dive;

  8. piloting or learning to pilot or acting as a member of the crew of any aircraft;

  9. being Intoxicated as defined herein, or under the influence of any controlled substance unless as administered or prescribed by a Legally Qualified Physician;

  10. the commission of or attempt to commit a felony or being engaged in an illegal occupation;

  11. normal childbirth or pregnancy (except Complications of Pregnancy) or voluntarily induced abortion;

  12. dental treatment (except as coverage is otherwise specifically provided herein);

  13. due to a Pre-Existing Condition, as defined in the Policy. The Pre- Existing Condition Limitation does not apply to the Emergency Medical Evacuation or Return of Remains coverage;

  14. any amount paid or payable under any Worker’s Compensation, Disability Benefit or similar law;

  15. a loss or damage caused by detention, confiscation or destruction by customs;

  16. Elective Treatment and Procedures;

  17. medical treatment during or arising from a Trip undertaken for the purpose or intent of securing medical treatment;

  18. failure of any tour operator, Common Carrier, or other travel supplier, person or agency to provide the bargained-for travel arrangements for reasons other than Bankruptcy or Default;

  19. a mental or nervous condition, unless hospitalized for that condition while the Policy is in effect for You; or

  20. a loss that results from a Sickness, Injury, disease or other condition, event or circumstance which occurs at a time when the Policy is not in effect for You.

  Waiver of the Pre-Existing Condition Exclusion
  The exclusion for Pre-Existing Condition will be waived provided:

  a) Your payment for this Policy and enrollment form are received within 21 days of the date Your initial Payment or Deposit for Your Trip is received; and

  b) You are not disabled from travel at the time Your premium is paid.

  *These exclusions change for the following states: Alaska, Colorado, Indiana, Massachusetts, Montana, New Hampshire, New York. Please click here to refer to your certificate of coverage.