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International Group Blanket Policy - Benefits
If an injury or illness occurs during the period of coverage and the insured person requires medical or surgical treatment, this plan will pay, subject to
the co-insurance and selected deductible, reasonable and customary charges for the following covered expenses, up to the selected policy maximum. The covered charges shall in no event include any
amount which is in excess of reasonable and customary charges for the geographical area where the services are rendered, as determined by The Company.
Maximum Medical Benefit (Accident and Sickness)
From $25,000 to $250,000
1. Charges made by a hospital for room and board, floor nursing, and other services inclusive of charges for professional services, and with the exception of personal services of a non-medical
nature provided. The expenses cannot, however, exceed the hospital's average cost for semi-private room and board, or two times the average semi-private room charge made by the servicing
hospital if confinement to an intensive care unit is required, or the average charge for intensive care unit made by the servicing hospital, whichever is less.
2. Charges made for diagnosis, treatment, and surgery by a physician.
3. Charges made for the cost and administration of anesthetics.
4. Charges for medication, x-ray services, laboratory tests and services, the use of radium and radioactive isotopes, oxygen, blood transfusion, iron lungs, and medical treatment.
5. Charges for physiotherapy, if recommended by a physician, for the treatment of a specific disablement, and administered by a licensed physiotherapist.
6. Dressings, drugs, and medicines that can only be obtained upon a written prescription of a physician.
Emergency Medical Evacuation
From $5,000 to $75,000 (optional)
If you or any covered dependents become ill or injured during the period of coverage and it has been determined that an Emergency Medical Evacuation is required to either the nearest medical
facility, where appropriate medical treatment can be obtained, or to your home country or country of residence, all eligible expenses incurred are covered up to the selected maximum. An
Emergency Medical Evacuation must be recommended by a legally licensed physician who certifies that the severity of the injury or illness necessitates such an Emergency Medical Evacuation, and
approved by The Company.
Accidental Death & Dismemberment
From $10,000 to $250,000 Principal Sum
For Accidental Death and Dismemberment Indemnity, this plan does not cover any loss caused by or resulting from:
1. Intentionally self-inflicted injry
2. Suicide or attempted suicide, while sane or insane
3. War or any act of war, declared or undeclared
4. Service in the military, naval, or air service of any country
5. Illness, disease, pregnancy, childbirth, miscarriage, or any bacterial infection other than bacterial infection occurring from an accidental cut or wound
6. Piloting or acting as a crew member or riding in any aircraft; except as a fare paying passenger on a scheduled airline
Repatriation of Remains Expenses
From $5,000 to $50,000 (optional)
If injury or illness commencing during the period of coverage results in death, all reasonable expenses incurred for preparation and return of the remains to your Home Country or Country of
Residence are covered up to the selected maximum.
Emergency Reunion
$10,000 Maximum (Optional)
In the event of an Emergency Medical Evacuation due to a covered injury or illness, where the physician feels that it would be beneficial for you to have a family member at your side during
transport, you will be reimbursed for travel and lodging expenses for that relative, up to $10,000, provided that all travel arrangements are coordinated in advance by the assistance provider.
Benefits payable include economy air ticket and other travel related expenses not to exceed $250.00 a day for a maximum of five days.
Worldwide Assistance
Provides referral to the nearest, most appropriate medical facility and provider. Medical monitoring by board certified emergency physicians. Urgent message relay between family, friends,
personal physician, and the insured. Arranging and coordinating Emergency Medical Evacuations, Emergency Reunions, and Repatriations. Referral to legal assistance. Assistance in locating lost or
stolen items including lost ticket application processing.
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