Microsoft Word - CCGG English DR.docServices provided by CORIS,
represented by COREMAX ASISTENCIA INTERNACIONAL, SRL with offices
at Av. John F. Kennedy # 604, 6th Floor, Suite 6-I-1. Ensanche
Paraiso, Santo Domingo. Dominican Republic. Effective as of March
1, 2011. PROCEDURES TO REQUEST ASSISTANCE To request assistance
services, the CARD HOLDER must first contact the PROVIDER’s Alarm
Center by phone to the numbers appearing on his CARD FOR CALLS,
stating his name, the number, term and validity of his CARD or
VOUCHER, the place where he is and the reasons for assistance
request. As from the first assistance or services provided, the
CARD HOLDER must always contact the PROVIDER’s Alarm Center in
order to obtain authorization for new assistance or supplementary
services, even when they derive from the same cause that gave rise
to the first assistance and it has been authorized to obtain
reimbursable services. GENERAL PROVISIONS and DEFINITIONS CLAUSE I.
SOLE AGREEMENT: This Travel Assistance Agreement is supplemented by
the General Conditions of the ASSISTANCE PLAN as well as the CARD
or VOUCHER and the CARD FOR CALLS, all of which constitute one
single and SOLE AGREEMENT. A) These General Conditions govern the
provision of travel assistance services by the PROVIDER and which
are outlined in the CARD or VOUCHER, during the trips made by the
CARD HOLDER. The CARD HOLDER acknowledges that he has chosen the
ASSISTANCE PLAN of his COMPANY of preference and that he has read
all terms, conditions, scopes and limitations of the assistance
services under these General Conditions. B) Assistance services
rendered in unforeseen emergency situations that take place abroad
or nationally, except for the usual city of residence of the CARD
HOLDER and depending on the type of product purchased, will not be
considered services under a medical insurance policy or an
extension of prepaid medicine programs and are in no way aimed at
providing preventive care or definite treatment. C) In order to be
fully aware of the assistance system and the many services we
provide to our customers, we recommend a thorough reading of the
instructions for the proper use of the services, guarantees and
limitations of the ASSISTANCE PLAN purchased by the CARD HOLDER,
which are clearly outlined in the CARD or VOUCHER. D) As this is a
services agreement exclusively directed towards providing
assistance in emergency situations that prevent the normal
continuation of a trip, once the medical situation affecting the
CARD HOLDER has been resolved in such a manner as it allows the
repatriation of the CARD HOLDER for medical treatment, if
necessary, the CARD HOLDER will be offered to be repatriated
or
transferred to the airport of entrance to his country of usual
residence. If the CARD HOLDER refuses to do so, he will lose the
rights or benefits under these general conditions. All subsequent
expenses incurred in connection with his treatment in the country
of origin shall be borne by the CARD HOLDER, or charged to his
health insurance taken from third parties, personal funds or any
health service purchased. E) Events and Expenses Not Included: When
an illness is excluded under the GENERAL EXCLUSIONS clause, the
PROVIDER will only take charge of the expenses up to the amount
specified in the CARD or VOUCHER and the ASSISTANCE PLAN under
“Medical Assistance for Pre-existing Conditions”. The PROVIDER will
not will not pay for any tests seeking to evaluate the medical
condition of a pre-existing condition and/or to rule out its
relation with the current condition giving rise to the need of
assistance. Upon verifying that the reason for travelling abroad
was to treat a basic pre-existing condition, and that the current
treatment has some direct or indirect connection with the
preexisting disease, the PROVIDER will be exempt from rendering
services to the CARD HOLDER. To such end, the PROVIDER reserves the
right to investigate the connection of the current fact with the
pre-existing disease. CLAUSE II: DEFINITIONS: For all purposes of
this Travel Assistance Agreement, the following terms, either in
plural or singular, regardless of gender and of tense, in the case
of verbs, will have the meaning ascribed below. If in capital
letters, the following terms as used herein will have the following
meanings. A) ACCIDENT: The event resulting in bodily injury
suffered by the CARD HOLDER caused by foreign agents, out of
control, external, violent and visible, as well as any injuries or
pain directly caused by such agents and independent of any other
cause. B) CATASTROPHE: Any accidental or unforeseen event affecting
many VOUCHER or CARD HOLDERS. C) ALARM CENTER: Group of health care
professionals who, providing supervision, control and/or
coordination services for the PROVIDER, intervene and decide in all
those matters and/or services rendered or to be rendered according
to these General Conditions and directly or indirectly related to
medical issues. D) CARD or VOUCHER: The document to be issued at
the country of Origin of the CARD HOLDER prior to his trip (except
for RECEPTIVE ASSISTANCE PLANS) and submitted to the CARD HOLDER.
It includes –among other details- personal information of the CARD
HOLDER, the number and type of ASSISTANCE PLAN purchased, which is
an integral part of the Travel Assistance Agreement, also known as
the General Conditions of the assistance services purchased by the
CARD HOLDER and agreed to be supplied by the PROVIDER. E) COMPANY:
CORAM ADVANTAGE SRL, a company duly authorized under the Argentine
laws to issue CARDS or VOUCHERS of Travel ASSISTANCE PLANS of the
PROVIDER and holder of ADVANTAGE Travel Assistance and CORIS
trademarks.
F) CONGENITAL: Pathology present or existing before the moment of
birth. G) AILMENT and/or ILLNESS: The terms “ailment” and/or
“illness” will be understood to all purposes as synonyms of
“sickness” within these General Conditions. H) ACUTE ILLNESS: The
short and relatively severe process of alteration of the status of
the body or of any of its organs, that might interrupt or disturb
the balance of vital functions, producing pain, weakness or other
manifestation alien to its normal behavior. I) CHRONIC ILLNESS: Any
pathological process, continuous and persisting in time. J)
PRE-EXISTING CONDITION: All physio-pathogical process that
recognizes an origin or etiology previous to the date of the start
of validity of the CARD or VOUCHER of the ASSISTANCE PLAN purchased
by the CARD HOLDER and that can be determined through complementary
diagnostic methods of customary use, daily accessible and frequent
in all countries of the world (including but not limited to
Doppler, MRI, Angioplasty procedures, etc.) K) SUDDEN OR UNEXPECTED
ILLNESS: Rapid, fortuitous, unforeseen illness appearing after the
starting date of validity. L) MAXIMUM GLOBAL AMOUNT: The total sum
of expenses that the PROVIDER will pay and/or reimburse in every
respect and for all the services provided under these General
Conditions M) DEDUCTIBLE FIXED AMOUNT: The fixed and specific
amount that will be borne by the CARD HOLDER and that will be paid
by him at the time the first medical assistance is provided, as
obligatory initial payment for expenses arising from such
assistance. N) MAXIMUM GLOBAL AMOUNT IN CASE OF MULTIPLE EVENTS:
The total sum of expenses that the PROVIDER will pay and/or
reimburse to all the affected CARD HOLDERS in case one single event
has caused injuries or death to more than one CARD HOLDER, in every
respect and for all the services provided under these General
Conditions. O) ASSISTANCE PLAN: The detailed group of Travel
Assistance Services offered by the PROVIDER, containing an
exhaustive list of all services to be provided and the monetary,
quantitative, geographical and age limitations applicable to the
CARD HOLDER. The Assistance Plan is detailed in the CARD or VOUCHER
and is an integral part thereof. Only those services for each
product expressly enumerated in the Assistance Plan detailed in the
CARD or VOUCHER will be provided, subject to the scope and
limitations therein stated. For all purposes of this Agreement,
only the guarantees or benefits effective as of the date of
issuance of the ASSISTANCE PLAN specified in the CARD or VOUCHER
purchased by the CARD HOLDER will be valid. P) PROVIDER: CORIS, the
entity responsible for coordinating the provision of the travel
assistances services detailed in the CARD or VOUCHER during the
CARD HOLDER trip abroad or in his country, as the case may be,
through its Alarm Center. Q) TRAVEL ASSISTANCE SERVICES: The
services offered by the COMPANY through its PROVIDER and specified
in the CARD or VOUCHER
issued by the COMPANY at the request of the CARD HOLDER and its
GENERAL CONDITIONS, ASSISTANCE PLAN and CARD FOR CALLS. For all
purposes of this AGREEMENT, only the guarantees or benefits
effective as of the date of issuance of the ASSISTANCE PLAN and
specified in the CARD or VOUCHER purchased by the CARD HOLDER will
be valid. R) CARD FOR CALLS: The credential that is submitted to
the CARD HOLDER prior to his trip and that contains his full name,
CARD or VOUCHER number, validity and type of ASSISTANCE PLAN
purchased, and telephone numbers, email addresses and any other
means to contact the PROVIDER’s Alarm Center from whichever country
the CARD HOLDER is. S) CARD HOLDER: The individual designated
within the CARD or VOUCHER of an ASSISTANCE PLAN offered by the
COMPANY as the recipient and beneficiary of the services described
in this Travel Assistance Agreement. CLAUSE III.- A) HOLDER OF THE
SERVICES. The assistance services will be rendered by the PROVIDER
only to the CARD HOLDER and are non-transferable to third parties.
The CARD HOLDER must reside in the country of origin where the CARD
or VOUCHER is issued (except for RECEPTIVE ASSISTANCE PLANS). The
CARD HOLDER is the individual duly designated in the CARD or
VOUCHER of the ASSISTANCE PLAN purchased, including his full name
and ID number. B) AGE LIMIT: The CARD HOLDER designated in the
VOUCHER will be the beneficiary of the services described in the
ASSISTANCE PLAN purchased. However, no indemnification will be
given to persons over 75 years of age at the time the ASSISTANCE
PLAN becomes effective. Under some special products available to
elder people, persons over 75 and younger than 85 will be entitled
to 50% coverage of all services described in the products
purchased. (Detailed information specified in the Specific
Guarantees of each assistance plan.) For illustration purposes, a
person is 75 years until the day before his 76th birthday. C)
VALIDITY: The assistance services to be provided under the
ASSISTANCE PLAN and described in the CARD or VOUCHER will only and
exclusively be valid during the validity period indicated. The
validity of the CARD or VOUCHER will be conditioned to the
existence of a valid CARD or VOUCHER number assigned by the
PROVIDER, which may be verified by the CARD HOLDER by contacting
the PROVIDER Alarm Center by phone before the validity starting
date. The CARD or VOUCHER will be valid provided it has been
irrevocably purchased by the CARD HOLDER in his country of usual
residence and before the beginning of the trip; that is, it may not
be purchased by the CARD HOLDER in any country but his country of
residence and after the beginning of the trip. (Except for
RECEPTIVE ASSISTANCE PLANS) The PROVIDER prohibits issuance of a
CARD or VOUCHER whenever the CARD HOLDER is still travelling even
if it is issued as an extension, national or international. The
PROVIDER may request to the CARD HOLDER to furnish all supporting
documentation to demonstrate this fact. The PROVIDER will be
released from its obligation to provide services upon failure by
the CARD HOLDER to submit this documentation.
D) CANCELLATION AND/OR MODIFICATION OF VALIDITY: Neither any change
in the validity date nor the cancellation of the CARD or VOUCHER by
the CARD HOLDER will be accepted under any circumstances and for no
reason whatsoever once its validity has started. Requests for
cancellation and/or modification of validity dates by the CARD
HOLDER or any third party may only be made no less than 3 (three)
business days prior to the date indicated in the CARD or VOUCHER.
If accepted, the request will result in the reimbursement of the
amount paid by the CARD HOLDER, less 20% that is retained, or in
the issuing of a new CARD or Voucher with a new validity period for
the same duration as the one cancelled. Once the period above has
ended or a new period has started, the right to seek cancellation
or modification of the CARD or VOUCHER automatically expires, and
the CARD HOLDER will have no right to any indemnification of any
type. Only if due to unexpected trip prolongation abroad, the CARD
HOLDER may request the extension of the duration of the CARD or
VOUCHER for the necessary number of days, subject to the following
conditions: a) The CARD HOLDER may request the extension of a CARD
or VOUCHER only once. b) The PROVIDER reserves the right to accept
or deny the extension request for no reason. c) The CARD HOLDER
must request issuance of a new CARD or VOUCHER exclusively to the
agent that issued the previous card, indicating the number of days
to be purchased. d) The request of issuance of a new CARD or
VOUCHER must be made prior to the expiration date of the previous
CARD or VOUCHER. e) The CARD HOLDER must indicate the person that
will make payment at the Issuing Agent’s office and receive, in
return, the new CARD or VOUCHER, which will be issued and submitted
at that moment or wherever the PROVIDER deems more convenient. The
PROVIDER will not be responsible for sending the new CARD or
VOUCHER to the CARD HOLDER. f) The validity period of the new CARD
or VOUCHER must be immediately consecutive to the one of the
original CARD or VOUCHER. g) The new CARD or VOUCHER issued under
the conditions described in this Clause may not be used for any
reason to initiate or continue treatment and/or assistance for any
problems that had occurred during the validity of the original
and/or prior CARD or VOUCHER or before the validity of the new CARD
or VOUCHER, regardless if the proceedings or treatments in progress
have been authorized by the PROVIDER. E) VALID GEOGRAPHIC AREA /
TERRITORIAL VALIDITY: Depending on the type of CARD or VOUCHER
purchased, it will be exclusively valid in the geographic areas
indicated. 1. WORLDWIDE, except for the Country of Residence of the
CARD HOLDER. 2. SCHENGEN AREAS: (European Union countries + the
United Kingdom + Switzerland), except for the Country of Residence
of the CARD HOLDER. 3. REGIONAL: Bordering countries of the Country
of residence of the
CARD HOLDER + NATIONAL except beyond 100 km away from the usual
place of residence of the CARD HOLDER. 4. NATIONAL: The Country of
residence of the CARD HOLDER except beyond 100 km away from the
CARD HOLDER’s usual place of residence. The services under the
ASSISTANCE PLAN valid within the Country of issuance of the CARD or
VOUCHER will be provided within its territorial limits, beyond 100
km (one hundred kilometers) away from the usual place of residence
of the CARD HOLDER and only when he is temporarily travelling. In
all cases, assistance services provided by the PROVIDER will always
and without exception be complementary and ancillary to the
financial responsibility that might correspond to the social
security program and/or welfare program and/or insurance coverage
and/or pre-paid medical attention program that the CARD HOLDER may
be a beneficiary. CARDS or VOUCHERS within the country of issuance
will not be valid and no services will be rendered in the CARD
HOLDER’s country of residence even within the validity of the CARD
or VOUCHER, except for REGIONAL or NATIONAL ASSISTANCE PLANS. The
SCHENGEN Area (European Union countries + the United Kingdom +
Switzerland) coverage whenever used outside the area will have a
reduction in the medical expenses guarantee under the Specific
Guarantees of the product purchased, unless expressly authorized
thereby. F) OBLIGATIONS OF THE CARD HOLDER: In all cases, the CARD
HOLDER undertakes to: 1) Contact first by phone the PROVIDER’s
Alarm Center to obtain its authorization as many times as
assistance is required, before taking any action or incurring in
any expenses. 2) Should it be impossible for the CARD HOLDER or any
third person to contact the PROVIDER’s Alarm Center to request the
above-mentioned prior authorization, the CARD HOLDER may resort to
the nearest emergency medical service. In all such cases, the CARD
HOLDER must report the emergency to the PROVIDER’s Alarm Center
within 24 hours following the incident, under the risk of loss of
future reimbursement of any expenses incurred. This communication
is essential even when the emergency has been solved, as no cost
for assistance services will be borne by the PROVIDER without prior
communication to and authorization by the PROVIDER’s Alarm Center.
3) The PROVIDER reserves the right to record and audit any
telephone conversations as may be deemed necessary for the good
rendering of its services. The CARD HOLDER expressly agrees on this
established procedure and on the eventual usage of these records as
a proof in the event of controversies arising in connection with
the assistance services provided. 4) Accept the solutions indicated
by the PROVIDER’s Alarm Center. Allow the repatriation to his
country of origin whenever his state of health so allows and as
indicated by the medical team. 5) Grant to the intervening
professionals or medical institutions
authorizations to reveal the Medical History to the PROVIDER or any
of its authorized representatives, as well as all information
necessary to pay all expenses arising from hospitalization and/or
treatment, and also to examine all related document. The PROVIDER
will not be obliged to pay any services or reimburse any expenses
if the Medical History requested has not been submitted. 6) Supply
all documentation necessary to justify the case, in addition to all
the original receipts for expenses reimbursable by the PROVIDER as
well as all medical records (including those previous to the trip)
that may be necessary for the PROVIDER’s Medical Department to
authorize the services or the payment of any assistance services
rendered. 7) Furnish a copy of the CARD HOLDER’s passport,
including the page containing his personal data and that where the
seal evidencing entrance to the country of destination and from
where assistance is required. 8) In those cases when the PROVIDER
assumes any fare difference from the original tickets, or when the
PROVIDER arranges the repatriation of the CARD HOLDER in case of
serious accident or death, he must deliver to the PROVIDER all duly
endorsed tickets that he may possess. 9) The CARD HOLDER
irrevocably and absolutely authorizes the PROVIDER to request in
his behalf any medical information to professionals either from
abroad or from his country of residence, with the purpose of
evaluating and eventually deciding about the applicability of the
restrictions in case of chronic or pre-existing conditions or
illnesses that may have arisen the assistance request. The PROVIDER
will not be obliged to pay any services or reimburse any expenses
if the Medical History requested has not been submitted. G)
OBLIGATIONS OF THE PROVIDER. The obligations of the PROVIDER
established within this Travel Assistance Agreement will only apply
and be rendered in the event of an accident and/or of a sudden or
unforeseen and acute illness suffered by the CARD HOLDER after the
beginning of the trip and/or during the validity period of the CARD
or VOUCHER, whichever is later, and up to the maximum coverage
amount offered by the product purchased. H) SPECIFIC CONDITIONS ($
USD or € Euros). The services and Specific Guarantees under the
ASSISTANCE PLAN purchased by the CARD HOLDER are printed on the
CARD or VOUCHER submitted to the CARD HOLDER at the time of
purchase and prior to the beginning of the trip, specifying as well
the characteristics of the ASSISTANCE PLAN valid as of the time of
purchase, the CARD HOLDER’s personal data, telephone numbers to
seek assistance, the General Conditions, any exclusions and
limitations, which will be denominated in US dollars ($USD) or
Euros (€). This is known as the CARD or VOUCHER and, jointly with
the General Conditions, they constitute the entire travel
assistance agreement. I) DESCRIPTION OF ASSISTANCE SERVICES The
assistance services described in this clause are the services
offered by the COMPANY through its PROVIDER. Only those guarantees
or benefits effective as of the date of issuance of the ASSISTANCE
PLAN and which are specified
in the CARD or VOUCHER purchased by the CARD HOLDER will be valid
and applicable for all effects under this AGREEMENT. No right will
be exercised if the cause that gives rise to the event is included
and specified in the GENERAL EXCLUSIONS. (1) AND (2) MEDICAL
ASSISTANCE IN CASE OF AN ACCIDENT OR ILLNESS, INCLUDING a. Doctor
consultations: medical assistance will be provided in case of an
accident or acute and unforeseen illness suffered by the CARD
HOLDER, always taking into account that the purpose of this
agreement is not the final treatment of the CARD HOLDER but to
allow the normal continuation of the trip or repatriation to the
country of origin, where he may initiate treatment at his own cost
and/or through his social security and/or welfare program and/or
health insurance and/or pre-paid medical attention program. The
PROVIDER reserves the right to decide on the most adequate
treatment out of those proposed by the intervening medical team. b.
Attention by specialists: medical assistance by specialists will be
provided whenever prescribed and authorized by the PROVIDER’s
Medical Department. c. Complementary medical examinations,
follow-ups and controls: complementary medical examinations will be
performed when prescribed and authorized by the PROVIDER’s Medical
Department. d. Hospitalizations: When the nature of the illness or
injuries so require and whenever the PROVIDER’s Medical Department
so prescribes and authorizes, the CARD HOLDER will be hospitalized
at the nearest Medical Center. e. Surgeries. Surgeries will be
performed whenever authorized by the PROVIDER’s Medical Department
in cases of emergency that urgently require such a procedure and
which may not be delayed up to the return of the CARD HOLDER to his
country of origin. If, at the discretion of the PROVIDER’s Medical
Department and of the treating physicians, the CARD HOLDER can
return to his country of origin to receive the necessary surgical
treatment, the PROVIDER will arrange the return of the patient to
the country of origin. The CARD HOLDER may not refuse to accept
this solution or otherwise all guarantees or benefits granted under
the CARD or VOUCHER will be denied. f. Intensive care and coronary
unit: When the nature of the illness or injuries so require,
intensive care and coronary unit treatments will be provided. These
treatments must have been authorized by the PROVIDER’s Medical
Department. g. Medical transfers: In case of an emergency and
whenever deemed necessary by the PROVIDER, the PROVIDER will
arrange the Medical Transfer of the CARD HOLDER to the nearest
Medical Center in the means of transportation most adequate at the
sole discretion of the PROVIDER and depending on the nature of the
injuries or illness. Even in case of surgeries or treatments
occurring in a situation that may be defined as an emergency, the
Medical Transfer of the CARD HOLDER must be requested to and
authorized by the PROVIDER’s Medical Department. Failure to comply
with the above will release the PROVIDER from assuming all expenses
incurred in connection with such transfer.
h. Medical repatriation: Medical repatriation means all the
arrangements for the transportation of the ill or injured CARD
HOLDER from where he is to the airport of entrance to his country
of usual residence and where the CARD or VOUCHER was issued. Only
the PROVIDER’s Medical Department may authorize the actions above.
The CARD HOLDER or any relative may not carry out any of the above
without the PROVIDER’s authorization. This repatriation must be
authorized and justified in medical-scientific basis by the
treating physician. Should the CARD HOLDER or any accompanying
person decide to make a medical repatriation disregarding the
opinion of the PROVIDER’s Medical Department, the PROVIDER will not
be liable for such action, and the repatriation, its costs and its
consequences will be at the sole risk and expense of the CARD
HOLDER and/or any accompanying person. No claim for reimbursement
by the PROVIDER will be valid. Whenever the PROVIDER’s Medical
Department, in agreement with the treating physician, deems it
necessary and recommends the Medical Repatriation of the CARD
HOLDER, the repatriation of the CARD HOLDER to the airport of
entrance to his country of usual residence will be performed by
regular airline, in tourist class and subject to seat availability,
accompanied by a doctor or nurse, if applicable, or by any such
other means as the Medical Department deems more convenient. The
PROVIDER will pay for any fare differences for the change of a
ticket return date or the cost of a new ticket in tourist class and
subject to seat availability. To such end, the CARD HOLDER must
submit to the PROVIDER the return tickets duly endorse for no
compensation. All expenses for this service will be charged to the
Medical Assistance Expenses Limit account, indicated in the chart
of services. Provided the CARD HOLDER remains hospitalized up to
the date of the return trip, this assistance includes his transport
by ambulance or any other means compatible with his state of health
and approved by the PROVIDER’s Medical Department, from where he is
hospitalized to the departure airport, as well as the support
structure necessary, including stretcher, wheelchair, etc. The
repatriation will always be from the location where the CARD HOLDER
is ill or injured to the airport of entrance to his Country of
usual residence as indicated as his domicile and where the CARD or
VOUCHER must have been issued. The right to Medical Repatriation
will not be recognized if the cause that gives rise to it is listed
in the GENERAL EXCLUSIONS. The COVERAGE and VALIDITY PERIOD of the
CARD or VOUCHER will cease to be valid as from the moment the CARD
HOLDER returns to the airport of entrance to his Country of usual
residence. The CARD HOLDER will be entitled to Medical Repatriation
under this clause during the VALIDITY of the CARD or VOUCHER. The
PROVIDER, always seeking the well-being of the CARD HOLDER, has
priority in the Medical Repatriation decision. Even in case of
surgeries or treatments occurring in a situation that may be
defined as an emergency, the Medical Transfer of the CARD HOLDER
must be requested to and authorized by the PROVIDER’s Medical
Department. Failure to comply with the above will release the
PROVIDER from assuming all expenses incurred in connection with
such transfer. i. Maximum Global Amount applicable for Medical
Assistance due to an accident or illness in case of multiple
events. Aggregate Limit per Catastrophe: The maximum global amount
of the guarantees or benefits of medical assistance due to an
accident or illness has an aggregate Limit per CATASTROPHE
(regardless of the number of beneficiaries) per event of USD
500,000 (five thousand). This will be the total sum the PROVIDER
will pay and/or reimburse all the affected CARD HOLDERS in case one
single event has caused injuries or death to more than one CARD
HOLDER, in every respect and for all the services as per these
GENERAL CONDITIONS. (3) MEDICATIONS: The PROVIDER will pay for the
cost of medications prescribed by the treating physician and
approved by the PROVIDER’s Medical Department. The covered
medications must be directly related to the reason for seeking
medical assistance and the resulting diagnosis. All expenses
incurred by the CARD HOLDER in the purchase of medicine previously
authorized by the PROVIDER’s Medical Department will be reimbursed
up to the limits of the guarantee or benefit and after the CARD
HOLDER has returned to his country of origin, upon submission of
the original receipts and medical prescription. Prescription
renewals will be authorized always and when the medications are
essential to the health of the CARD HOLDER. Medications purchased
for treating pre-existing illness, psychological or emotional
disturbances or problems will not receive reimbursement, even when
the consultation has been authorized by the PROVIDER’s Medical
Department. (4) EMERGENCY DENTAL TREATMENT As an exception to the
other coverage for medical expenses, this benefit is not per event,
but cumulative. The PROVIDER will only pay the expenses for
emergency dental treatment, up to the maximum global amount
specified in the Specific Guarantee of the product purchased.
Dental assistance will be only limited to the treatment of pain
and/or to tooth extraction. (5) TRANSFER OF A RELATIVE AND HOTEL
EXPENSES In case a CARD HOLDER, travelling alone, is hospitalized
abroad, and as long as the duration of the hospitalization is above
five (5) calendar days, the PROVIDER will take upon the trip of one
accompanying relative (parent, spouse, child or sibling –this is a
limited, not-illustrative list), by paying for a tourist class
airline ticket subject to seat availability, This BENEFIT will not
be recognized if the reason for hospitalization is included in the
EXCLUSIONS clause and if the VALIDITY period has elapsed by the
time it is requested. This benefit will only be rendered if it has
been handled through and authorized by the PROVIDER’s Alarm Center.
Requests for reimbursement will not be accepted subsequently under
any condition. In case of reimbursement of airline tickets, the
amount to be reimbursed will
always be the cost of a tourist class ticket at the time of
purchase, up to the maximum amount indicated in the Specific
Guarantee of the COVERAGE purchased. If contemplated under the
Specific Guarantees of the ASSISTANCE PLAN purchased, the CARD
HOLDER will be entitled to the reimbursement of the hotel expenses
incurred by the accompanying relative, up to USD 80 per day for a
maximum period of seven days. Note: Both for this clause as well as
any other that covers hotel expenses, it is understood that these
are limited to simple accommodations, and that there is no coverage
for meals, laundry, telephone calls other than to the Alarm Center,
transportation, Internet access, etc. (this is a limited,
not-illustrative list). (6) HOTEL EXPENSES The PROVIDER will
reimburse the CARD HOLDER for hotel lodging expenses, as long as
the PROVIDER’s Medical Department has previously authorized it,
when the attending physician prescribes mandatory bed rest after
hospitalization. In order to obtain this benefit, the CARD HOLDER
must have been hospitalized for a minimum period of 5 (five) days
and communicated with the PROVIDER’s Alarm Center to obtain its
authorization. The PROVIDER will pay hotel lodging expenses up to
the amount indicated in the Specific Guarantees of the ASSISTANCE
PLAN and for a maximum period of ten (10) days. Requests for
reimbursement will not be accepted subsequently without a
justification. This benefit will only be provided within the
validity period of the CARD or VOUCHER. Note: Both for this clause
as well as any other that covers hotel expenses, it is understood
that these are limited to simple accommodations, and that there is
no coverage for meals, laundry, telephone calls other than to the
Alarm Center, transportation, Internet access, etc. (this is a
limited, not-illustrative list). (7) MINORS ESCORT Should the CARD
HOLDER be travelling as the only companion of a child under the age
of 15, who is also HOLDER of a CARD or VOUCHER, and is unable to
take care of the child due to an illness or an accident as
confirmed by the PROVIDER’s Medical Department, the PROVIDER will
arrange, and pay for, the trip of the child back to his usual place
of residence in the country of origin. The choice of the means of
transportation to be used for the minor’s escort will be made
exclusively by the PROVIDER. (8) REPATRIATION OF MORTAL REMAINS In
case of death of the CARD HOLDER during the validity period of the
assistance card and whenever caused by an event not excluded in the
General Conditions, the relatives may opt for either of the two
following alternatives: a) The PROVIDER will organize, and pay for,
the repatriation of the mortal remains of the CARD HOLDER to the
airport of entrance to his country of permanent residence, by the
means that the PROVIDER deems more convenient, and will pay for the
coffin required for transportation by air up to the maximum amount
specified within the Specific Guarantees, including administrative
procedures and the transportation of mortal remains. b) The
PROVIDER will pay the expenses for the cremation and
transportation
of ashes to the airport of entrance of the country of permanent
residence of the deceased, by the means that the PROVIDER deems
more convenient, up to the maximum amount specified within the
Specific Guarantees of the ASSISTANCE PLAN purchased. Expenses for
the definitive coffin, funerary procedures, transfers within the
country of usual residence of the deceased CARD HOLDER, religious
ceremonies, relatives and friends ceremonies, and for burial are
expressly excluded and will not be paid by the PROVIDER. In either
of the two alternatives above, all services must be handled through
the PROVIDER’s Alarm Center, and the family of the CARD HOLDER or
the travel agency may take no action without the PROVIDER’s Alarm
Center prior written authorization. The PROVIDER will reimburse no
expenses unless previously requested to or authorized by it. In no
case expenses incurred by the relatives of the deceased CARD HOLDER
to return home will be paid by the PROVIDER. Thus, the PROVIDER
will take charge of no expenses incurred by third parties. Only
when expressly authorized in writing by the PROVIDER’s Alarm Center
will take charge of any penalties for the change of the return date
of a flight ticket, in tourist class and subject to seat
availability, for the transfer of an accompanying relative (parent,
spouse, child or sibling - this is a limited, not-illustrative
list), provided the accompanying relative is also HOLDER of a CARD
or VOUCHER having the same validity and duration of that held by
the deceased CARD HOLDER and when the ticket was issued at a
reduced rate and with a fixed or limited return date. (9) EARLY
RETURN DUE TO DEATH OR SERIOUS ILLNESS OF A FAMILY MEMBER In case
the CARD HOLDER must return to his country of usual residence due
to the death or serious illness of an immediate family member
(parent, spouse, child or sibling - this is a limited,
not-illustrative list) residing in that country, the PROVIDER will
pay for the fare difference for a tourist class return ticket, when
the CARD HOLDER’s original ticket was issued at a reduced rate and
with a fixed or limited return date. Serious illness means the
process of alteration of the health status implying hospitalization
for more than 5 days. In all cases, the CARD HOLDER must
communicate with the PROVIDER’s Alarm Center to obtain its
authorization. Requests for reimbursement will not be accepted
subsequently without a justification. This return trip benefit will
only be provided within the validity period of the CARD or VOUCHER.
Note: In the event of non-usage of the airline ticket initially
acquired by the CARD HOLDER, both in the event foreseen in this
clause, as well as in any other, the PROVIDER will always recover
the ticket and will only pay for the difference between ticket
price and the amount spent in rendering the service. 10) EARLY
RETURN DUE TO DEATH OR SERIOUS ILLNESS OF THE CARD HOLDER. The
PROVIDER will pay for the fare difference for a tourist or economy
class return ticket of the CARD HOLDER when his original round trip
ticket was issued at a reduced rate and with a fixed or limited
return date, and such return
date cannot be met due to the CARD HOLDER’s illness or accident.
This benefit will apply only if the CARD HOLDER has received
medical assistance authorized by the PROVIDER’s Alarm Center. The
events detailed in the Exclusions Clause 13 will not give rise to
this benefit. (11) EARLY RETURN DUE TO SERIOUS DISASTER AT HOME In
the event of fire, explosion, floods or robbery with loss of
property and violence at the CARD HOLDER’s residence when he is
travelling and provided there is no other person who can take
charge of the situation and the CARD HOLDER’s original ticket does
not permit a free change of the return date, the PROVIDER will pay
for the applicable fare differences or the cost of a new ticket in
tourist class from the CARD HOLDER’s location to the airport of
entrance to his country of residence. Right to this coverage is
obtained by providing the PROVIDER’s Alarm Center with the original
supporting police report within 24 hours of the occurrence of the
event. The CARD HOLDER must communicate with the PROVIDER’s Alarm
Center to obtain its authorization. Requests for reimbursement will
not be accepted subsequently without a justification. This benefit
will only be provided within the validity period of the CARD or
VOUCHER. (12) EXPENSES DUE TO DELAYED FLIGHT Should a CARD HOLDER’s
flight (excluding charter flights) be delayed for more than 6 (six)
consecutive hours beyond the scheduled departure time, and provided
that no alternative transportation is available during those 6
(six) hours, the PROVIDER will reimburse the expenses for hotel
lodging and communications by the CARD HOLDER during this period
and up to the maximum limits of the guarantee or benefit purchased.
The PROVIDER will only reimburse expenses upon submission of the
original receipts to support the incurred expenses and a
certificate from the airline certifying the delay or cancellation
of the flight affecting the CARD HOLDER. To be entitled to this
reimbursement, the CARD HOLDER must have contacted the PROVIDER’s
Alarm Center before leaving the airport where the event took place.
This benefit will only be rendered in a transit city at least 100
km away from the CARD HOLDER’s usual place of residence. This
service will not be rendered if the CARD HOLDER is travelling with
a ticket subject to seat availability or to a destination within
the same country where the CARD or VOUCHER was issued, or in the
final destination of the trip. This benefit will not apply if the
delay is due to an event arising from any of the circumstances
described in Clause L “Exception Circumstances and/or Force Majeure
Events”. Note: Both for this clause as well as any other that
covers hotel expenses, it is understood that these are limited to
simple accommodations, and that there is no coverage for meals,
laundry, telephone calls other than to the Alarm Center,
transportation, Internet access, etc. (this is a limited,
not-illustrative list). (13) EXPENSES DUE TO TRIP CANCELLATION
(TRAVEL PACKAGES RESERVED) Special validity duration of clause 13.
The services agreed under this clause will only be rendered from
the date of issuance of the CARD or VOUCHER and up
to the date of commencement of VALIDITY of the CARD or VOUCHER,
which must be the same as that of the beginning of the trip
purchased. In case the CARD HOLDER must cancel a trip, he must
inform so by phone and within 24 hours of the occurrence of a
justified cause to the PROVIDER’s Alarm Center. The PROVIDER will
take charge of all expenses for trip cancellation incurred by the
CARD HOLDER provided the trip was cancelled due to any of the
detailed justified causes. This benefit will not be rendered if
trip cancellation is due to either of the following: 1. An event
arising from any of the circumstances expressly indicated in the
“GENERAL EXCLUSIONS” clause. 2. Trip cancellation due to incomplete
or deficient trip documentation of the CARD HOLDER or an
accompanying person at the time of departure. 3. Any of the
circumstances described in Section L “Exception Circumstances
and/or Force Majeure Events” of these General Conditions.
Reimbursement will be limited to the maximum limit of the
ASSISTANCE PLAN purchased. The CARD HOLDER must have obtained the
CARD or VOUCHER at the day of payment of an amount as down payment
or final payment of its trip (travel package) to the travel agency
or broker, involving one or more suppliers (flight ticket/hotel),
excluding cruises, except if specifically mentioned in the Cruise
Protector Special ASSISTANCE PLAN. JUSTIFIED REASONS TO CLAIM
REIMBURSEMENT OF EXPENSES FOR TRIP CANCELLATION ARE THE FOLLOWING:
1. Death, accident or acute illness of the CARD HOLDER or an
immediate family member (parent, spouse, child or sibling –- this
is a limited, not-illustrative list) provided it is not included in
the GENERAL EXCLUSIONS clause and, at the exclusive discretion of
the PROVIDER’s Medical Department, preventing the CARD HOLDER from
initiating the trip at the date specified in the CARD or VOUCHER.
Serious illness means the process of alteration of the health
status implying hospitalization for more than 5 days. 2. Selection
to be a party, a witness or a jury member in court preventing the
CARD HOLDER from travelling on the date specified in the CARD or
VOUCHER. 3. Loss caused by fire, robbery or nature at the CARD
HOLDER’s home or professional facilities that make them unsuitable
for living or working and justify the CARD HOLDER’s cancellation of
the trip. 4. Medical quarantine resulting from an unplanned event.
5. Notice to act as a member of a poling station in the elections
of National or Provincial Government. 6. Receipt of a child in
adoption 7. Pregnancy problems suffered by the CARD HOLDER up to
the 30th week and which, at the entire discretion of the PROVIDER’s
Medical Department, makes it impossible the initiation of the trip
at the date of start of validity indicated in the CARD or VOUCHER.
8. Cancellation of the CARD HOLDER’s marriage scheduled before the
date of
issuance of the CARD or VOUCHER, provided it is caused by any of
the events specified in paragraph 1 above 9. Dismissal from work,
duly certified, and provided it has occurred after the issuance of
the CARD or VOUCHER and the event does not derive from any of the
causes specified in the GENERAL EXCLUSIONS clause. 10. If the
accompanying person travelling with the CARD HOLDER must cancel the
trip for any of the reasons above. An accompanying person will be
any person sharing the same hotel room or cruise cabinet or an
immediate family member (parent, spouse, child or sibling - this is
a limited, not-illustrative list) travelling with the CARD HOLDER
and who is also holder of a CARD or VOUCHER of the same
characteristics of that purchased by the CARD HOLDER. The PROVIDER
will deduct from the compensation any reimbursement received by the
CARD HOLDER from any of the service providers due to the same
event. Documentation necessary for reimbursement: • Original
receipts evidencing form of payment (down payment or installments
granted at the time of purchase) and detailing all services
included, as well as a letter from the travel agent certifying that
such amounts have been retained due to trip cancelation. • Service
agreement signed by the service supplier (airline, hotel, maritime
company, etc.), including cancellation policy, in the service
supplier’s headed paper (the airline must present the fare base
rule). • Original medical history in legible format and a copy of
the medical examinations performed confirming the health problem
that gave rise to the cancellation. The medical history must
include the date of issuance, seal and signature of the treating
physician (including license number), contact information of the
physician or medical center (phone number, email address) and
diagnosis. • Copy of the document sent by the travel agency to the
operator requesting trip cancellation. • …Original letter from the
service suppliers involved, confirming cancellation and the penalty
charged. • Copy of ID documents of all passengers which are part of
the group that has to cancel its trip accordingly How to proceed:
The CARD HOLDER must: • Submit a note drafted and signed by the
passenger (printed name included), briefly explaining what happened
and providing its COVERAGE or VOUCHER number and bank data for the
deposit of the reimbursement requested. Specific Exclusion of
Clause 13: This coverage is not valid for cruises in unless
specially mentioned in the Cruise Protector Special ASSISTANCE
PLAN. (14) TRIP POSTPONEMENT If the CARD HOLDER must postpone his
trip due to any of the reasons
specified as a Justified Cause to be eligible to reimbursement of
expenses for trip cancellation and as long as it is not
contemplated under the GENERAL EXCLUSIONS clause, the PROVIDER will
take charge of any penalties for the change of the date of the
flight ticket, in tourist class, when the ticket was issued at a
reduced rate and with a fixed or limited return date. The CARD
HOLDER must communicate with the PROVIDER’s Alarm Center to obtain
its authorization. Requests for reimbursement will not be accepted
subsequently without a justification. This benefit will only be
provided within the validity period of the CARD or VOUCHER. Note:
In the event of non-usage of the airline ticket initially acquired
by the CARD HOLDER, both in the event foreseen in this clause, as
well as in any other, the PROVIDER will always recover the ticket
and will only pay for the difference between ticket price and the
amount spent in rendering the service. (15) CRUISE / TRIP FOLLOW-UP
The PROVIDER will pay to the CARD HOLDER, except if any of the
exclusions specific to this service applies, a one-way tourist
class ticket from the port of boarding to the first port of call
where the cruise can be boarded if the CARD HOLDER could not board
the cruise as scheduled due to a delay in the connection flight of
more than 6 hours from the scheduled time of arrival. (16) TRANSFER
OF EXECUTIVES DUE TO AN EMERGENCY In case the CARD HOLDER is abroad
on a business trip and is hospitalized as a consequence of a
serious medical emergency that makes it impossible for him to
continue with the purpose of the trip, the PROVIDER will pay for a
tourist class ticket, subject to seat availability, for the person
that the company of the CARD HOLDER appoints as a replacement of
the hospitalized CARD HOLDER and for hotel accommodation up to USD
80 per day during a maximum period of five days. The CARD HOLDER
must communicate with the PROVIDER’s Alarm Center within 24 hours
from the occurrence of the event in order to obtain its
authorization. Requests for reimbursement will not be accepted
subsequently without a justification. Note: Both for this clause as
well as any other that covers hotel expenses, it is understood that
these are limited to simple accommodations, and that there is no
coverage for meals, laundry, telephone calls other than to the
Alarm Center, transportation, Internet access, etc. (this is a
limited, not-illustrative list). (17) TRANSMISSION OF URGENT
MESSAGES The PROVIDER’s Alarm Center will take charge of
transmitting urgent and justified messages related to any of the
events included within the services described in the ASSISTANCE
PLAN. (18) LOCALIZATION AND ASSISTANCE IN THE EVENT OF LOST OR
STOLEN DOCUMENTS, TICKETS AND/OR LUGGAGE The PROVIDER will assist
and inform the CARD HOLDER by all means at its reach to report the
loss or theft of his luggage and personal belongings. To try to
locate lost pieces of luggage that have been shipped in the luggage
compartment of the same flight on which the CARD HOLDER was
travelling, the PROVIDER, through Alarm Center, will cooperate with
the CARD HOLDER
in the follow-up of the search of lost luggage by the airline that
received the claim. The PROVIDER will not be liable for pieces of
luggage lost or unfound by the airline. (19) TELEPHONE NUMBER FOR
QUERIES Up to 24 hours before the date of departure, the CARD
HOLDER may ask the PROVIDER’s Alarm Center for information
regarding consular, sanitary and tourist requirements, among
others, applicable at the country of destination. (20)
SUPPLEMENTARY INDEMNIFICATION FOR TOTAL AND DEFINITE LOSS OF
LUGGAGE BY AN AIRLINE The CARD HOLDER will be entitled to a
supplementary indemnity for total and definite loss of luggage by
the PROVIDER, up to the amount paid by the airline as compensation.
In no case, the sum of the compensation paid by the airline and the
supplementary indemnification of the PROVIDER will be higher than
the maximum amount specified in the ASSISTANCE PLAN purchased.
Supplementary indemnification refers exclusively to pieces of
luggage shipped in the luggage compartment of a commercial flight,
subject to IATA regulations. This supplementary compensation will
be subject to the following terms and conditions. 1. The CARD
HOLDER must have informed the PROVIDER’s Alarm Center of the
missing piece of luggage before leaving the airport where it was
confirmed to be missing and the P.I.R. (Property Irregularity
Report) form has been issued or the claim form has been submitted
to the airline. 2. The piece of luggage must have been lost during
its transportation on an international flight on a regular airline
or a domestic connection flight 3. The piece of luggage must have
been duly checked in into the aircraft’s luggage compartment. 4.
The piece of luggage must have been lost between the moment it was
handed over to authorized personnel of the airline in order to be
loaded on board the aircraft and the moment it should have been
returned to the passenger when the flight ended. 5. The airline
must have been assumed its liability for the loss of the luggage
and paid the CARD HOLDER the corresponding compensation established
by the airline. 6. If the airline offers to the CARD HOLDER, as
compensation, the possibility to receive an amount of money or one
or more tickets, the PROVIDER will pay the monetary compensation
for loss of luggage, once such option has been exercised. SPECIFIC
EXCLUSIONS: In no case will the PROVIDER be liable for loss of
luggage if: (1) The CARD HOLDER is a crew member, employee or
officer of the transportation that caused the event. (2) The
luggage has been kept or retained by the customs or any other
government authorities. (3) In no case will the PROVIDER be liable
for any missing goods and/or partial or total damage to the content
of the luggage, or the pieces of luggage or any
other element of transportation. In case of loss of luggage, follow
these instructions: • …Proceed to the airline counter or individual
in charge in the luggage claim area as soon as you confirm that
your luggage is missing, request and complete a P.I.R. (Property
Irregularity Report) form. • Before leaving the airport, call the
PROVIDER’s Alarm Center, to report that your luggage has been lost,
indicating the P.I.R. form number for monitoring purposes before
the airline. Once you return to your country of origin and after
payment of compensation by the airline, submit to the COMPANY’s
offices the following documentation: • P.I.R. form + ID or Passport
+ Original CARD or VOUCHER • Original receipt of payment of
compensation from the airline to the CARD HOLDER The CARD HOLDER
must furnish the original documentation to require this benefit.
Copies will not be accepted. The CARD HOLDER is entitled to collect
coverage established in the guarantees of the ASSISTANCE PLAN
purchased, regardless the number of events and losses that may take
place over the validity period of the CARD or VOUCHER, even if it
is a yearly card. This benefit is per person. When two or more
individuals share the same lost piece of luggage, reimbursement
will be divided between them, provided their names are specified in
the P.I.R. form. Compensation will be paid in the country of origin
where the CARD or VOUCHER was purchased, within 30 days following
receipt of all documentation required. (21) REIMBURSEMENT OF
EXPENSES FROM THE PURCHASE OF BASIC NECESSITY ITEMS DUE TO DELAY IN
THE LOCATION OF LUGGAGE If the luggage is not found within six (6)
hours from flight arrival and from the time of call to the
PROVIDER’s Alarm Center by the CARD HOLDER before leaving the
airport where the luggage was confirmed to be missing, and the
P.I.R. (Property Irregularity Report) form was issued or the claim
form was submitted to the airline, informing of the missing piece
of luggage, the PROVIDER will reimburse the CARD HOLDER, up to the
amount established within his ASSISTANCE PLAN, for expenses arising
from the purchase of basic necessity items made within the moment
of notification of missing luggage and until the luggage has been
returned by the airline. Should the lost luggage not be found after
thirty six (36) hours from the time of flight arrival and from the
time the PROVIDER’s Alarm Center was informed of the loss, the CARD
HOLDER may receive an additional amount up to the maximum amount
established within his ASSISTANCE PLAN purchased, upon submission
of the receipts evidencing the purchase of basic necessity items
within time elapsed from the moment of notification of missing
luggage and until the luggage has been returned by the airline. To
obtain this benefit, the CARD HOLDER must have communicated with
the PROVIDER’s Alarm Center within six (6) hours from flight
arrival and also after
thirty six (36) hours from flight arrival and from the time the
CARD HOLDER communicates with the PROVIDER’s Alarm Center to inform
the loss and request authorization. To obtain reimbursement, the
CARD HOLDER must submit evidence of the date and time the airline
has furnished him the found luggage. Restrictions: Once the luggage
has been declared lost and the applicable compensation has been
paid by the airline, the amount paid will be deducted from the
payment applicable for definite loss of luggage. This benefit will
not apply in the event of loss of luggage in the return trip to the
Country of usual residence of the CARD HOLDER or country of
issuance of the CARD or VOUCHER. This benefit will be rendered only
if the loss of luggage has taken place in a transit city at least
100 km away from the usual place of residence of the CARD HOLDER.
The CARD HOLDER will not be entitled to this benefit when
travelling with a ticket subject to seat availability and to a
destination within the country where the CARD or VOUCHER was
issued. No compensation will be paid in case of loss of luggage at
the final destination of the trip. (22) TRANSFER OF FUNDS AND
BAILMENT During the trip and in case of urgent and unforeseen need,
the PROVIDER will arrange the transfer of money to the CARD HOLDER
in the country where he is, up to the limit specified in the
ASSISTANCE PLAN purchased, prior deposit in the COMPANY’s office.
This benefit will be rendered only once during the validity of the
CARD or VOUCHER. Should the CARD HOLDER be incarcerated as a
consequence of a traffic accident, the PROVIDER will arrange the
transfer of amounts of money specified in the ASSISTANCE PLAN to
pay bailment, prior deposit of the amount requested in the
COMPANY’s offices, at the CARD HOLDER’s expense. (23) LEGAL
ASSISTANCE IN CASE OF TRAFFIC ACCIDENT Should a CARD HOLDER be
charged with liability for a traffic accident, the PROVIDER will
pay for all expenses arising from the defense of the CARD HOLDER in
a civil or criminal action. The PROVIDER will take charge of
lawyer’s fees up to the maximum amount specified within the
ASSISTANCE PLAN purchased. (24) ACCIDENTAL DEATH AND/OR
DISMEMBERMENT. (DOES NOT APPLY IN THE CARIBBEAN) The CARD HOLDER is
automatically insured against accidental death and/or dismemberment
and at no additional cost when the ASSISTANCE PLAN purchased
includes this coverage. This insurance has been taken from the
insurance company indicated in this COVERAGE. The insurance policy
for Personal Accidents is subject to its own particular and general
conditions and it is available to any interested parties at the
offices of the insurance company. The Accidental Death and/or
dismemberment benefit has an aggregate limit per disaster
(regardless of the number of beneficiaries) of USD 5,000,000.00
(five million). This amount will be distributed among the total
number of CARD HOLDERS that died in the event. In no case will the
amount payable to the
beneficiaries of each CARD HOLDER be able than the amount purchased
by the CARD HOLDER. SPECIFIC EXCLUSIONS: (1): Accidents that have
taken place in non-regular flights that are not operated by duly
authorized and ruled commercial airlines. (25) CHRONIC OR
PRE-EXISTING ILLNESSES Except for the monitoring and control of
prior checkups and/or treatments, the PROVIDER will take charge of
the expenses of the first medical assistance due to an acute
episode during the trip, related to a chronic or pre-existing
illness, and up to the maximum amount specified within the
ASSISTANCE PLAN detailed in the CARD or VOUCHER. The PROVIDER will
not pay for any medication or treatment related to such chronic or
pre-existing illness. (26) Deductible (US$) / (Km.): 1. In the
event that the payment of a deductible has been established for the
product acquired, the CARD HOLDER must pay it when seeking
assistance for any service rendered. In the case of using the
PROVIDER’s assistance services for a second time for an event
unrelated to the previous one, the CARD HOLDER must pay the
deductible for the second time at the moment of assistance. 2. If
the product acquired has a kilometer deductible, the CARD HOLDER
cannot use the assistance services in the event that the distance
between his place of usual residence and the place where he seeks
assistance is less than the kilometer deductible (Specified under
the CARD or VOUCHER in KM). (27) MULTITRIP ANNUAL AND LONG STAY
PLANS (FOR A VALIDITY PERIOD OVER TWO MONTHS) Multitrip Annual
ASSISTANCE PLANS will be valid for 365 days. However, the CARD
HOLDER may not remain abroad for more than 90, 60, 45 or 30 days,
as indicated under the ASSISTANCE PLAN purchased, per trip during
the validity duration of the plan, except for Long Stay Special
ASSISTANCE PLANS. Once this period has elapsed, the CARD HOLDER
will not be entitled to any assistance services under the
ASSISTANCE PLAN purchased. The CARD HOLDER will be required by the
PROVIDER’s Alarm Center to submit a copy of his passport by fax,
evidencing the date of departure from his country of usual
residence or the date of entrance to the country where medical
assistance is required. Except for Long Stay Special ASSISTANCE
PLANS for students abroad and for CARD HOLDERS sent abroad on
business by their company, the purpose of the trip must be
exclusively for tourism, with no coverage for a person involved in
a professional activity abroad. Students that have purchased this
type of ASSISTANCE PLAN must, at the moment of seeking assistance,
send their credentials from the University or School where they are
studying, via fax, to the PROVIDER’s Alarm Center. As for
businessmen, they should ask the company in the country of origin
to send a letter with company letterhead that states the validity
of the business trip, or should request that such proof be sent via
e-mail by the company. SPECIFIC EXCLUSION: The CARD HOLDER will
receive no assistance if he is in an illegal migration or labor
condition (including any job not declared in the
country where assistance is required). (28) REPATRIATION DUE TO THE
BANKRUPTCY OF THE AIRLINE In the event of bankruptcy or ceasing of
operations of the airline or Tour Operator after the beginning of
the trip, and as long as no private or public agency has the
obligation to take charge of the return of passengers to their
country of origin, the PROVIDER will arrange and provide the CARD
HOLDER with a return ticket in tourist class to his country of
origin. (29) ADMINISTRATIVE REPATRIATION In the event the CARD
HOLDER, for any reason, is deported from the country to which he
traveled, during the validity period of the CARD or VOUCHER, the
PROVIDER will supply, at the request of the authorities, an economy
class return ticket. The CARD HOLDER will return the ticket he
possesses to the PROVIDER, properly endorsed, without compensation.
(30) MULTISPORTS (a) – Guarantee of trip interruption. In the event
of accident or illness when the repatriation of the CARD HOLDER
becomes necessary, or if the Medical Department of the PROVIDER’s
Alarm Center believes that the CARD HOLDER should stay resting, the
PROVIDER will reimburse prorrata temporis (after auditing the
original proof documents), Ski Pass expenses, sports lessons, or
the rental of sports material up to the maximum amount of US$300.
(b) - Practice of covered sports: All sports in the amateur
category, except: Bobsleigh, Ski and Snowboard outside authorized
tracks, Olympic luge, hunting dangerous animals, mountain climbing
over 6,000 meters, speleology and skeleton. (C) – Search and rescue
costs: The PROVIDER will be responsible for a maximum amount of US$
1,000 for the expenses of search and rescue operations including
helicopter or airplane at the moment of organizing the rescue of
the CARD HOLDER, resulting from the practice of an amateur sport.
SPECIFIC EXCLUSION: Excluded is the practice of sports by
professionals in competitions or training for professional
competitions. (Professional sports persons are defined as the
persons who live from the practice of their sport without
exercising other professional activities). (31) MEDICAL ASSISTANCE
IN CRUISES IN CASE OF ILLNESS OR ACCIDENT When seeking medical
assistance on board a ship, the CARD HOLDER is authorized to hire
such assistance services as may be necessary inside the ship. The
CARD HOLDER must communicate with the PROVIDER’s Alarm Center to
obtain its authorization. Requests for reimbursement will not be
accepted subsequently without a justification. This benefit will
only be provided within the validity period of the CARD or VOUCHER.
The CARD HOLDER must contact the PROVIDER’s Alarm Center, as many
times as assistance is required, at the phone numbers appearing in
the CARD FOR CALLS in order obtain authorization before taking any
action or incurring in any expenses. If the CARD HOLDER or a third
party is unable to communicate with the PROVIDER’s Alarm Center,
the PROVIDER’s Alarm Center must be informed
of the emergency and the services rendered within 24 hours
following the occurrence of the event or at the first port, or
reimbursement will be denied. Reimbursement of medical expenses
must be requested by the CARD HOLDER at his return, upon submission
of original receipts and medical prescription. The PROVIDER will
cover medical expenses due to accident or illness up to the maximum
amount established within the Specific Guarantees of the ASSISTANCE
PLAN. J) Subrogation: Up to the total amount of the sum reimbursed
in fulfillment of its obligations under this General Conditions,
the PROVIDER is automatically subrogated in the rights and actions
that may correspond to the CARD HOLDER or his heirs against third
parties, either individuals or legal entities, in connection with
the event that caused the assistance to be rendered. The CARD
HOLDER commits himself to return, on the spot, to the PROVIDER any
amount he may have received from the person who caused the accident
and/or from the Insurance Company as advance payments due to the
final settlement to which the CARD HOLDER is entitled up to the
responsibility limits assumed by the PROVIDER. Expressly
comprehended by this subrogation are the rights and actions that
may be exercised with respect to the following persons: 1) Third
parties liable for traffic accidents, 2) Transportation companies
in that which is related to the total or partial restitution of the
price of tickets not used when the PROVIDER took on financial
responsibility for the transfer of the CARD HOLDER or of his mortal
remains. As a consequence, the CARD HOLDER irrevocably assigns to
the PROVIDER the rights and actions included in this clause,
committing himself to carry out all the legal actions that may be
necessary and also to cooperate whenever required for the purpose
of the subrogation hereby agreed upon. Upon refusal by the CARD
HOLDER to cooperate or to subrogate such rights to the PROVIDER,
the latter will automatically be released from the obligation to
cover the expenses of the assistance provided. 3) Other companies
covering the same risk.- K) Unduly paid services: The PROVIDER
reserves the right to demand reimbursement to the CARD HOLDER of
any expenses unduly incurred by the PROVIDER for the provision of
services after the expiration of the CARD or VOUCHER and/or not
contemplated under this agreement. For collection purposes, a copy
of receipts of payment made by the PROVIDER and the Specific
Guarantees of the CARD or VOUCHER will be sufficient and conclusive
evidence. L) Exceptional Circumstances and/or Force Majeure Events
As specified within this travel assistance agreement, the PROVIDER
is expressly released, exempt and excused from any of its
obligations and liabilities in the event the CARD HOLDER suffers
any damage or requires assistance as the consequence and/or arising
from fortuitous or force majeure events, such as, catastrophes,
earthquakes, floods, storm, declared or undeclared international or
civil war, rebellion, internal uproar, actions of guerrillas or
counter-guerrillas, hostilities, reprisals, conflicts, seizures,
internal
riots, strikes, mass movements, lock-out, public riots or acts of
sabotage or terrorism, etc. as well as problems and/or delays
resulting from the termination, interruption or suspension of
communication services. When elements of this kind are involved,
and once such event is terminated, the PROVIDER will fulfill its
commitments and obligations within the shortest possible time. M)
Liability: The PROVIDER will not be liable nor compensate the CARD
HOLDER for any damage, illness, infirmity or injuries caused by a
professional upon the CARD HOLDER’s request or medical, legal or
pharmacy assistance services rendered. The PROVIDER only
coordinates and facilitates assistance services so that third party
professionals render such services upon request. Thus, the PROVIDER
will be released from liability for any of the circumstances above.
In these cases, the persons appointed by the PROVIDER will be
deemed as agents of the CARD HOLDER without any action against the
PROVIDER for such appointment. The PROVIDER undertakes to provide a
service but guarantees no result. N) Statute of limitation: Any
claim seeking enforcement of any of the PROVIDER’s obligations
under this General Conditions must be made in writing within 30
(thirty) consecutive calendar days from the expiration of CARD or
VOUCHER. After expiration of this period, which may not be
extended, no other claim may be brought. O) Jurisdiction: The
parties hereby expressly agree that any controversy arising in
connection with the contractual relationship between the CARD
HOLDER and the PROVIDER and/or any other legal claim, which may not
settled by the mutual agreement of the parties, will be submitted
to the courts of the City of Buenos Aires, expressly waiving any
other jurisdiction that may apply. P) Exemption from liability: The
PROVIDER will not be responsible for any claims arising in
connection with the relationship between the CARD HOLDER and the
PROVIDER, after 365 calendar days following the occurrence of the
event. Q) Exemption from responsibility of sales agents: The
COMPANY’s sales agents and/or representatives (travel agencies,
tour operators, transportation companies and any other issuing
agent) are not parties to this Travel Assistance Agreement and,
consequently, are free of any responsibility pertaining to the
purpose of this agreement. R) Non-cumulative services and/or
intervention of other companies: In no case will the PROVIDER
render assistance services to the CARD HOLDER under the ASSISTANCE
PLAN and/or reimburse any expenses incurred if the CARD HOLDER has
required assistance for the same problem and/or illness to any
other company during, before or after having required the
assistance services to the PROVIDER. REIMBURSEMENTS General
provisions: For any type of reimbursement to apply, the CARD HOLDER
must have first contacted, and obtained authorization from, the
PROVIDER’s Alarm Center, asking for advice on the documentation to
be submitted.
In case of an accident, illness or injuries, the CARD HOLDER may
use, with no cost, the services of the professionals and/or medical
facilities that are indicated and/or provided by the PROVIDER’s
Alarm Center, within the limits and conditions established in this
agreement. If at the time of the assistance requested to the
PROVIDER’s Alarm Center, a medical team that can provide care
within a reasonable period is not immediately available in the
location, the CARD HOLDER may use all the medical services that
might be necessary. All such costs may be paid directly to the
service provider and reimbursed to the CARD HOLDER, provided the
following conditions are met. Conditions for reimbursement: For the
purposes of reimbursement, the cause of the assistance must not be
included in the EXCLUSIONS clause. The CARD HOLDER must report to
the PROVIDER’s Alarm Center within the first 24 (twenty-four) hours
after the occurrence of the event that gave rise to the service
rendered, providing data related to the physician and/or medical
center used, as well as the reasons that hindered him from seeking
assistance directly from the PROVIDER’s Alarm Center. Failure to
provide this information to the PROVIDER’s Alarm Center within this
24-hour period will result in the annulment of the reimbursement
payment. The cost of the service contracted must be in accordance
with the prices and fees in effect in the country in which it was
provided. Appropriate documentation: The CARD HOLDER or the service
provider, as the case may be, must submit original documentary
evidence, invoices and receipts of payment of all expenses incurred
for previously-authorized services. The PROVIDER reserves the right
to verify and audit the content of such documentation or request
further explanations. The documentation provided must be original
and contain: clinical history, diagnosis and medical prescription,
a letter from the CARD HOLDER describing the event, the original
CARD or VOUCHER. The documentation must be submitted to the
PROVIDER’s offices within 30 (thirty) business days from the
expiration of the CARD or VOUCHER. Upon expiration of this period,
the CARD HOLDER will not be entitled to reimbursement. Only
expenses accompanied by original proof documents will be
reimbursed. Reimbursement in foreign currency will follow
applicable rules issued by the Central Bank and will be exchanged
at the US dollar exchange rate applied when the CARD or VOUCHER was
issued (or when the invoice for the services rendered was
received). Effective payment will be made within 30 (thirty) days
from receipt of the complete documentation by the PROVIDER. GENERAL
EXCLUSIONS The following shall be expressly excluded from the free
medical assistance detailed in the ASSISTANCE PLAN of the CARD or
VOUCHER to be rendered by the PROVIDER: 1. All chronic,
pre-existing, congenital or recurrent conditions, known or
unknown to the CARD HOLDER, existing before the beginning of the
trip and/or of the validity of the CARD or VOUCHER, as well as its
consequences and acute episodes (even when they appear for the
first time during the trip), except as specified in clause (25),
Chronic or pre-existing illnesses include without limitation the
following: kidney lithiasis, vesicle lithiasis, diabetes,
phlebitis, deep venous thrombosis and ulcers of any kind of
etiology. this is a limited, not-illustrative list 2. Diseases
affecting the immunological system, both as a consequence of the
disease or drugs used for treatment, oncology drugs, cardiovascular
disorders, chronic respiratory illnesses, chronic kidney
infections, hepatitis, any type of endemic, epidemic and/or
pandemic diseases, etc., known or not to the CARD HOLDER. 3.
Illnesses, infirmities, injuries and their complications, resulting
from the treatment or care given by persons or professionals not
authorized by the PROVIDER’s Medical Department 4. Homeopathic
treatments, acupuncture, kinesiotherapy, thermal treatments,
podiatry, etc. 5. Infirmities, diseases, or injuries resulting from
criminal actions or torts directly or indirectly performed by the
CARD HOLDER. 6. Treatment of illnesses or pathological conditions
caused by the intentional ingestion or administration of toxics
(drugs) narcotics, or because of the use of medications without a
doctor's prescription. 7. Expenses for prosthesis, orthesis,
synthesis or mechanical-help devices of any type, either of
internal or external use, including but not limited to: orthopedic
articles, dental prosthesis, hearing aids, glasses, contact lenses,
splints, crutches, nebulizers, respirators, etc. 8. (This exclusion
clause is only applicable for Multisports Special Assistance Plan).
Accidents resulting from training, practice, or active
participation in (professional or amateur) sports competitions as
well as any events arising from the practice of hazardous sports,
including but not limited to motorcycling, motor car racing,
boxing, polo, water skiing, diving, paragliding, hang-gliding,
flights in any device that is not commercial, parachuting, bungee
jumping, mountaineering, kite surf, skiing, snowboard and, in
general, other winter sports. 9. Diagnosis, control, follow-up and
treatment of pregnancy, childbirth, abortions and their
consequences, except in consequence of an accident. 10. Mental
illnesses of any sort, emotional and psychological disturbances or
treatments of any kind. 11. Illnesses, injuries or complications
resulting from the use of alcohol or drugs of any nature. 12. Blood
pressure controls. Hypertension and hypotension or any consequence
thereof. 13. Auto-Immune Deficiency Syndrome, AIDS and HIV in
any/all of its forms, as well as its consequences. Venereal or
sexually-transmitted diseases, and/or any service, study and/or
treatment performed without prior authorization from the
PROVIDER.
14. Events in consequence of the release of forces of nature,
nuclear radiation y radioactivity, epidemic, as well as any other
extraordinary phenomenon or event that due to its proportions or
gravity, may be considered to be a national disaster or catastrophe
15. Suicide, suicide attempt or injuries intentionally provoked by
the CARD HOLDER to himself and/or his family, as well as any act of
manifest irresponsibility or imprudence on the part of the CARD
HOLDER. 16. Events derived from acts of war, terrorism or other
serious disturbances of the public order. 17. Intentional or bad
faith actions of the CARD HOLDER or any of his attorneys-in-fact.
If it is confirmed that the true purpose of the trip was the
treatment abroad of an existing disease and that the current
treatment is directly or indirectly related to the pre-existing
infirmities, the PROVIDER will be released from its obligation to
provide services. To such end, the PROVIDER reserves the right to
investigate the connection between the actual facts with the prior
infirmity. 18. Cancer and all its treatments. 19. Lesions to
drivers or passengers caused by the unlicensed use of uninsured
vehicles, including aircraft and motorcycles without a helmet. 20.
Injuries resulting from participating in wagers or fights. 21.
Plastic surgeries and esthetic or rejuvenation treatments 22. Tests
and/or hospitalization for tests, stress tests, and every kind of
preventive checkups. 23. Any type of hernia and its consequences
24. Kidnapping and/or kidnapping attempts. 25. Risks resulting from
situations not included under the definition of personal accident,
such as injuries resulting, depending, predisposed or facilitated
by repeated efforts or cumulative micro traumas, or which have a
cause and effect relationship, as well as injuries classified as:
lesions due to repetitive strain, work-related musculoskeletal
disorders, continuous or cumulative trauma disorders, or similar
ones, as well as their consequences, treatments and posttreatments,
including surgeries at any time. 26. Situations equivalent to or
recognized by official social security agencies, or a similar
entity, as disability due to an accident, in which the event that
caused the injuries does not entirely fit the description of
invalidity due to a personal accident. 27. Professional Risks: If
the CARD HOLDER’s trip involves the execution of works or tasks
which entail a professional risk. In every case, the services
described in the PROVIDER’s General Conditions will be
complementary to those that have to be provided by assistance and
insurance entities according to the industrial and professional
risk security regulations that apply in the country where the
illness or accident takes place. 28. Illegal labor or migration
condition of the CARD HOLDER: Professional Risks: If the CARD
HOLDER’s trip involves the execution of works or tasks which entail
a professional risk. (In every case, the services described in
the