SGPS - Travel Insurance Brochure
SGPS - Travel Insurance Brochure
SGPS - Travel Insurance Brochure
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Group Explorer Travel Medical Emergency Insurance is effected with certain Lloyd's Underwriters (hereinafter called the "Insurer") through Expert Travel Financial Security (E.T.F.S.) Inc. (hereinafter called "ETFS"), a member of the ETFS Financial Group, Lennoxville, Quebec. Trademark of Expert Travel Financial Security (E.T.F.S.) Inc., a member of the ETFS Financial Group.
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IN THE EVENT OF AN EMERGENCY, YOU MUST CALL GLOBAL EXCEL IMMEDIATELY: The following emergency telephone numbers are also shown on the back of the Benefit Card provided along with this booklet. From Canada and the U.S., call toll-free . . . . . . . . . . . . . 1-866-870-1898 From anywhere else, call collect . . . . . . . . . . . . . . . . . . (819) 566-1898
Global Excel must be contacted before You seek medical treatment. If Your condition renders You unable to do so, then someone else must contact Global Excel immediately for You. Do not assume that someone will contact Global Excel on Your behalf. It remains Your responsibility to ensure that Global Excel has been contacted prior to receiving medical treatment or as soon as reasonably possible. If You incur any expenses without prior approval by Global Excel, such expenses will be covered, except where the Policy expressly requires the prior approval or authorization of Global Excel, on the basis of the Reasonable and Customary Costs that would have been payable for such expenses by the Insurer in accordance with the terms and conditions of the Policy. Such expenses may be higher than this amount, therefore You will be responsible for paying any difference between the amount You incur and the Reasonable and Customary Costs reimbursed by the Insurer.
SECTION II Benefits
The Policy covers legally insurable Reasonable and Customary Costs that are Medically Necessary and are incurred as a result of an Emergency occurring during the Coverage Period, insofar as such costs are in excess of those covered by Your Government Health Insurance Plan or Other Insurance, to a maximum of $5 million per Insured Person. The Coverage Period is specified on Your Benefit Card. The Policy provides those benefits enumerated in this section. Please note that certain benefits listed below shall be payable only if You obtain the prior approval of Global Excel before incurring such expenses. 1. Hospital Accommodation: Room and board costs up to the semi-private room rate charged by the Hospital. If Medically Necessary, expenses for treatment in an intensive or coronary care unit are also covered. If coverage terminates for any reason during Your Hospital stay, benefits continue until discharge, to a maximum of one year. In no case will expenses for In-patient stays be covered for a period greater than 365 days per Insured Person. 2. Physician Charges: Charges for treatment by a Physican. 3. Diagnostic Services: Laboratory tests and x-rays prescribed by the attending Physician and that are part of the Emergency treatment. The Policy does not cover magnetic resonance imaging (MRI), cardiac catheterization, computerized axial tomography (CAT) scans, sonograms or ultrasounds and biopsies unless such services are authorized in advance by Global Excel. 4. Paramedical Services: The services (including x-rays) of a licensed chiropractor, physiotherapist, podiatrist or osteopath, to a maximum of $250 per Insured Person, per profession listed above, when approved in advance by Global Excel. 5. Prescriptions: Drugs, including injectable drugs, and sera that can only be obtained upon medical prescription, that are prescribed by a Physican and that are supplied by a licensed pharmacist when Medically Necessary for Emergency treatment, except when needed to stabilize a chronic condition or a medical condition which You had before Your Trip. Limited to a 30-day supply per prescription, unless You are confined to Hospital. 6. Ambulance Services: When reasonable and Medically Necessary, licensed ground ambulance service to the nearest Qualified Medical Facility. 7. Medical Appliances: When approved in advance by Global Excel, minor appliances such as crutches, casts, splints, canes, slings, trusses, braces, walkers and/or the temporary rental of a wheelchair when prescribed by the attending Physician, obtained outside Your province, territory of residence or country and Medically Necessary. 8. Private Duty Nurse: The professional services of a registered private nurse, when Medically Necessary and while hospitalized, to a maximum of $5,000 per Insured Person, when approved in advance by Global Excel. 9. Emergency Air Transportation: When approved and arranged in advance by Global Excel: a) air ambulance to the nearest appropriate medical facility or to a Canadian Hospital for immediate Emergency treatment; b) transport on a licensed airline with an attendant (where required) for return to Your province or territory of residence for immediate Emergency treatment. 10. Transportation to Bedside: When approved in advance by Global Excel, a single round-trip economy airfare from Canada and up to $150 per day, to a maximum of $3,000, for the cost of meals and commercial accommodation for one of the following: Spouse, parent, child, brother, sister or business partner, to: a) be with You if You are travelling alone and have been confined to Hospital as the result of an Emergency. To be payable, this benefit requires that You eventually be hospitalized as an In-patient for at least
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All pertinent documents should be sent to: Global Excel Management Inc. 73 Queen St. Lennoxville, Quebec, J1M 1J3 Trademark of Global Excel Management Inc., a member of the ETFS Financial Group. Tel.: 1-866-870-1898 (toll-free) or (819) 566-1898 (collect) during business hours (EST)
NOTICE
Any notice to the Insurer may be validly given to the undersigned. In witness whereof this policy has been signed, as authorized by the Insurer, by Expert Travel Financial Security (E.T.F.S.) Inc.
Per
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