|

Atlas Travel Insurance
Plan Overview | Provider Network | Brochure
| Quote & Apply
Atlas International Rates | Atlas
America Rates | Benefits
| Benefit Description
| Exclusions
Medical:
- Inpatient and Outpatient charges made by a Hospital.
- Charges made by a Physician, surgeon, radiologist, anesthesiologist, and
any other medical specialist to whom the Physician has referred the case.
- Charges made for dressings, sutures, casts or other supplies prescribed
by the attending Physician or specialist, but excluding nebulizers, oxygen
tanks, diabetic supplies and all devices for repeat use at home.
- Charges for diagnostic testing using radiology, ultrasonographic or laboratory
services.
- Charges for oxygen and other gases and anesthetics and their administration.
- Charges for prescription drugs for treatment of a covered Injury or Illness,
but not for the replacement of lost, stolen, damaged, expired or otherwise
compromised drugs.
- Charges made by a licensed Extended Care Facility upon direct transfer
from an acute care Hospital.
- Emergency local ambulance transport incurred in connection with Injury
or Illness resulting in inpatient hospitalization.
Complications of Pregnancy:
Treatment of Complications of Pregnancy during the first 26 weeks of Pregnancy
is covered under this insurance. Complications of Pregnancy is defined as: Illnesses
whose diagnoses are distinct from Pregnancy, but are adversely affected by Pregnancy
or caused by Pregnancy, and not associated with a normal Pregnancy. This includes:
ectopic Pregnancy, spontaneous abortion, hyperemesis gravidarum, pre-eclampsia,
eclampsia, missed abortion and conditions of comparable severity.
Hospital Indemnity:
If you are hospitalized as an Inpatient for treatment of a covered Illness
or Injury, the Atlas Series will provide $100 for each night you spend in the
hospital. This benefit is in addition to payments for other covered expenses
and is not subject to Deductible or Coinsurance.
Acute Onset of a Pre-Existing Condition:
$15,000 Maximum for Eligible Medical Expenses
$25,000 Maximum for Emergency Medical Evacuation
**Only available to Members under age 70 (including those that turn 70 during the coverage period)
An Acute
Onset of a Pre-existing Condition is a sudden and unexpected outbreak or recurrence
of a Pre-existing Condition which occurs spontaneously and without advance warning
either in the form of Physician recommendations or symptoms. Treatment must
be obtained within 24 hours of the sudden and unexpected outbreak or recurrence.
Incidental Home Country Coverage:
For each three (3) months during which a Member is covered hereunder, Medical Expenses only are covered during incidental trips totaling no more than 15 days duration per three-month period of coverage. Incidental visit time must be used within the three-month period earned, and the Member must continue his or her international trip in order to be eligible for this benefit. Return to the Member’s Home Country must not be taken for the purpose of obtaining treatment of an Illness or Injury that began while traveling.
Emergency Dental:
The following Emergency Dental expenses are covered: Emergency Dental treatment
and Dental surgery necessary to restore or replace sound natural teeth lost
or damaged in an Accident which is covered under this insurance subject to the
Overall Maximum Limit; and Emergency Dental treatment necessary to resolve acute,
spontaneous and unexpected onset of pain subject to a maximum benefit of $100.
Emergency Medical Evacuation:
If recommended by your attending Physician, who certifies that Evacuation is
necessary to safeguard your life and that Medically Necessary treatment is not
available locally, and if approved in advance and coordinated by MultiNational
Underwriters, Inc., the Atlas Series will provide the following benefits: Emergency
air and/or ground transportation to the nearest Hospital that is qualified to
provide the Medically Necessary treatment.
**Speical Note: If, following a covered Emergency Medical Evacuation, the attending Physician
states that it is Medically Necessary for your return to your Home Country
or to the area from which you were initially evacuated for continued treatment,
recuperation and recovery, the Atlas Series will provide the following benefit:
The cost of a one-way economy air and/or ground transportation ticket for
your transportation from the area where you were hospitalized following the
Emergency Evacuation, to the area where you were initially evacuated from,
or to the terminal serving the area of your Principal Residence. (Part of the Trip Interruption Benefit listed below)
Emergency Reunion:
In the event of a covered Emergency Medical Evacuation, the Atlas Series will
provide the following benefits: The cost of an economy round-trip air and/or
ground transportation ticket for one of your relatives (parent, spouse, sibling
or child age 18 or older) for transportation to the area where you are hospitalized
following Emergency Medical Evacuation and reasonable expenses for lodging and
meals for your relative, for a period not to exceed 15 days.
Return of Minor Children:
If you are the only person age 18 or older, traveling with one or more child(ren)
under the age of 18, who are also covered by the Atlas Series, and you are Hospitalized
for treatment of a covered Illness or Injury resulting in the child(ren) being
left unattended for a period of time expected to exceed 36 hours, the Atlas
Series will provide the following benefit: The cost of a one-way economy air
and/or ground transportation ticket for each covered child to the terminal serving
the area of Principal Residence of each covered child.
Terrorism
The Atlas Series provides Medical coverage for Injuries and Illnesses resulting
from an Act of Terrorism, subject to a $50,000 lifetime maximum, provided all
of the following conditions are met:
- The Injury or Illness does not result from chemical, nuclear or biological
weapons or events.
- You have no direct or indirect involvement in the Act of Terrorism.
- The Act of Terrorism is not in a country or location where the United States
government has issued a travel warning that has been in effect within the
6 months prior to your date of arrival.
- You have not unreasonably failed or refused to depart a country or location
following the date an warning to leave that country or location is issued
by the United States government.
An Act of Terrorism is defined as: an act, including but not limited
to, the use of force or violence and/or the threat thereof, of any person or
group(s) of persons, whether acting alone or on behalf of or in connection with
any organization(s) or government(s) committed for political, religious, ideological
or similar purposes including the intention to influence any government and/or
to put the public, or any section of the public, in fear.
Political Evacuation:
If, after the Member’s arrival to the destination country, the United States government issues a travel warning for that country, the plan will provide for the cost of transportation by the most economical means possible for the Member to the nearest country for which the United States government has not issued a travel warning or to the Member’s Home Country, provided that the Member contacts Underwriters within 10 days of the date the warning is issued.
Accidental Death and Dismemberment:
In the event of your Accidental Death (except while traveling on a common carrier)
or Dismemberment resulting from a covered Injury, the Atlas Series will provide
the following benefit:
- Accidental Death - Principal Sum to the Beneficiary designated on your
Application
- Loss of 2 eyes or 2 or more limbs - Principal Sum to you
- Loss of 1 eye or limb - Principal Sum to you
| Age |
Principal Sum |
| 14 days to 17 years |
$5,000 |
| 18-69 |
$25,000 |
| 70-74 |
$12,500 |
| 75+ |
$6,250 |
The Accidental Death and Dismemberment benefit is not available for losses
incurred during participation in a Hazardous Sport or in respect to losses resulting
from an Act of Terrorism.
Common Carrier Accidental Death:
In the event of your Accidental Death while traveling on board a commercial
common carrier, the Atlas Series will provide the following benefit: Principal
Sum of $50,000 ($25,000 for children under age 18), subject to a maximum of
$250,000 per family, to the Beneficiary designated on your Application. This
benefit is not available in respect to losses resulting from an Act of Terrorism.
Repatriation of Remains:
In the event of a covered Injury or Illness resulting in your death, the Atlas
Series will provide the following benefit: Air and/or ground transportation
of bodily remains or ashes to the area of your Principal Residence, and reasonable
costs of preparation of your remains necessary for transportation.
Natural Disaster:
In the event of natural disaster (hurricane, flood, tornado, tsunami, etc)
the Atlas Series will provide up to $100 a day for 5 days if the member is Displaced
from planned, paid accommodations due to evacuation from forecasted disaster
or following a disaster strike. Displaced is defined as required to depart the
destination due to an evacuation ordered by prevailing authorities. Proof of
paid accommodations must be submitted at time of claim.
Trip Interruption:
- If, after you have departed, you learn of the death of a parent, spouse,
sibling or child, or you learn of the substantial destruction of your Principal
Residence by fire or weather, the Atlas Series will provide the following
benefit: The cost of an economy one way air and/or ground transportation ticket
for you to the area of your Principal Residence; or
- If, following a covered Emergency Medical Evacuation, the attending Physician
states that it is Medically Necessary for your return to your Home Country
or to the area from which you were initially evacuated for continued treatment,
recuperation and recovery, the Atlas Series will provide the following benefit:
The cost of a one-way economy air and/or ground transportation ticket for
your transportation from the area where you were hospitalized following the
Emergency Evacuation, to the area where you were initially evacuated from,
or to the terminal serving the area of your Principal Residence.
Lost Checked Luggage:
In the event your checked luggage is permanently lost by the carrier, the Atlas
Plan will provide the following benefit: Up to $250 for replacement of clothes
and personal hygiene items, not to exceed $50 for any one item. You must file
a formal claim with the transportation provider and provide copies of all claim
forms and proof that the transportation provider has paid you its normal reimbursement
for the lost checked luggage.
|