Visitors to Canada Travel Insurance
Travel with confidence
Welcome to your travel insurance policy•

there is anything you do not understand,You put all the plans in place for a good trip, and madeyour well-being a priority by choosing travel insurance.
Allianz Global Assistance is there to support you should
an unexpected emergency happen with 24/7 assistance,
medical monitoring and guided care from our experienced
in-house team and network of trusted physicians andhospitals. This plan will also help keep your travel plans safewith protection for delays and trip cancellations.

•

you have questions about this policy,•

your travel arrangements change, or•

you have a change in health.

Please note that key terms are printed in italics throughout
the remainder of this policy and are defined in the Definitions
section on page 9 of your policy. Referring to thedefinitions will help you to better understand your policy.

Take the time to get to know your policy before you leaveon your trip and talk to your insurance representative if:

This policy must be accompanied by a Confirmation of
Coverage to complete the contract.

Important Notices
Please read your policy carefully. Travel insurance is designed to cover losses that are sudden and unforeseen. It does
not cover every situation and expense. Your coverage is subject to certain conditions, limitations and exclusions. It is
important for you to read and understand your policy before you travel.

• This policy contains a provision removing or restricting the right of the insured person to
designate persons to whom or for whose benefit insurance money is to be payable.
• This policy contains a clause which may limit the amount payable.
• Costs incurred in your country of origin are not covered.
• Your insurance contains pre-existing condition exclusions for travellers of any age. These exclusions apply to medical
conditions and/or signs or symptoms that existed on or before your departure date or effective date. Check to see
how this applies in your coverage and how it relates to your departure date, purchase date and effective date.
• In the event of an accident, injury or sickness, your prior medical history may be reviewed when a claim is reported.
•

If you are ineligible for coverage, our only liability will be to refund any premium paid. Please check your confirmationof coverage to ensure you have the coverage options you require. Payment will be limited to the coverage amounts you
selected and paid for at the time of application. You will be responsible for any expenses that are not payable by us.

• If you have a change in your health between the date you apply for coverage and the effective date, you must
contact your insurance representative to fully understand how your change in health affects your coverage under
this policy. Failure to do so may limit the amount of your claim payment or result in your claim being denied.

Underwritten by CUMIS General Insurance Company, a member of The Co-operators group of companies.
Administered by Allianz Global Assistance, which is a registered business name of AZGA Service Canada Inc.
Allianz Global Assistance provides claims and travel assistance services on behalf of the insurance company.

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Who to Contact and When
24/7 Emergency Assistance

Medical Monitoring and Assistance
You can rely on Allianz Global Assistance 24 hours a day, 7days a week. Allianz Global Assistance has an experienced
in-house medical team and a worldwide network of trusted
physicians and hospitals ready to help when an unexpected
sickness or injury arises.

Please contact Allianz Global Assistance before
seeking treatment. Medical availability and quality
varies around the world. Our agents are available
24/7 and equipped to provide you with a referral to
the nearest available medical facility, advocate on
your behalf and ensure you receive the right care foryour situation.

Allianz Global Assistance will attempt to arrange directbilling with the medical facility whenever possible. Somefacilities require payment up front and you may have to
pay for your treatment. Be sure to keep all your original,
itemized receipts.

In a serious medical emergency, get to a hospital and havesomeone call on your behalf within 24 hours of admission
and before any surgery is performed.

Allianz Global Assistance provides the following services
during an unexpected sickness or injury:

If you fail to notify Allianz Global Assistance without
reasonable cause, the insurer will only pay 80% of theeligible expenses. You will be responsible for paying theremaining 20%.

•

From the first point of contact, ensuring you receive
the of right level of medical attention,•

A referral to the closest appropriate medical
provider,•Virtual care from qualified physicians in real-time
via video or tele-conferencing, if appropriate for thesituation,•

Monitoring the status of your medical case,•Communicating with you and others you request
such as your family, your physician, travel supplier,or consulate, and•Coordinating Emergency Transportation
arrangements related to your medical emergency
as described below.

CALL US BEFORE SEEKING TREATMENT
Location

Number to call

In Canada orUSA

Toll Free: 1-800-995-1662

Outside Canadaor USA

Toll Free: 00-800-842-08420
Country code + 800-842-08420
Collect: 416-340-0049

International operator assistance may be required,depending on where you are calling from. Collect calls will
be accepted.

Allianz Global Assistance will make commerciallyreasonable efforts to provide these services during acovered unexpected sickness or injury.

It is recommended you confirm how to call Canada fromyour destination prior to departure so you are prepared in
the event of an emergency.

Right to Cancel
Please review this policy when you receive it toensure it meets your needs. If you are not completely
satisfied with this policy, you may cancel it within
10 days of purchase for a full refund of premium(premium is the amount you paid for this policy),provided you have not left on your trip and have notexperienced an event that would cause you to submit
a claim.

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How to navigate this policy
Consider this page your home base which provides you with an overview of this policy. From here you can easily explore thesections below by clicking on the topic you want to read more about.
Once you jump to your chosen section you can either continue to scroll and explore, or simply click on the
TABLE OF CONTENTS

button located on the bottom right of each page which will bring you back to this table of contents.

Table of Contents
Important Notices

1

Who to Contact and When2

24/7 Emergency Assistance
Medical Monitoring and Assistance
Right to Cancel

Coverage Details
Eligibility
Insuring Agreement
Summary of Benefits
Benefits: What’s Covered
Specific Conditions
Exclusions: What’s not Covered

2
2
2

4
4
4
5
5
7
7

Claims Procedures

9

Definitions

9

Legal Information

12

General Provisions
Premium Refunds
Privacy Notice
Contact Information

12
14
14
15

Coverage Details
What are you covered for?

d) requires assistance with activities of daily living as theresult of a medical condition or state of health.

To find out what your coverage is, please refer to yourconfirmation of coverage and read the section titled Benefits
on page 5 for details.

2.

What is not covered?

To be eligible for coverage, you must, as of the effective
date:a) be at least 15 days old and not more than 89 years
old; andTravel insurance does not cover everything. Your policy has
exclusions, conditions and limitations. You should read yourpolicy carefully so that you are aware of, and understand, thelimits of your coverage.

b) not be insured or eligible for benefits under aCanadian government health insurance plan; andc) be in good health at the time you purchase yourpolicy and on the date you exit your country of origin,and know of no reason to seek medical consultation
during the period of coverage.

How do I make a claim?
Notify Allianz Global Assistance as soon as possible in theevent of an emergency.

Start of Coverage

Where possible, Allianz Global Assistance will arrange to pay
the provider directly.

Coverage starts on the effective date.

To submit a claim under this policy, you will need to send
a completed claim form (with all original bills and receipts
from commercial organizations attached) to Allianz Global
Assistance. Please take care in filling out the form, as any
missing information may cause delay. See Claims Procedureson page 9 for details.

Waiting Period
Coverage for losses resulting from any sickness will begin 48
hours after the effective date if you purchase your policy:a) after the expiry date of an existing Allianz Global
Assistance administered policy; orWhat if my travel plans change?

b) after you exit your country of origin.

You must contact your insurance representative to make anychanges to your insurance.

Any sickness that manifests itself during the 48-hour waiting
period is not covered even if expenses are incurred after the
48-hour waiting period.

I want to stay longer. Can I purchase further coverage?
Yes, you can, subject to policy terms and conditions. Just call yourinsurance representative or Allianz Global Assistance (duringbusiness hours) before coverage under your policy expires.

End of Coverage

See Extending Your Trip on page 12 for details.

Coverage ends on the expiry date.

Travel AssistanceInsuring Agreement

Allianz Global Assistance will use its best efforts to provide
assistance for a medical emergency arising anywhere in
the world. However, we, Allianz Global Assistance and theiragents will not be responsible for the availability, quantity,
quality, or results of any medical treatment received, or for the
failure of any person to provide or obtain medical services.

In consideration of the application for insurance andpayment of the appropriate premium, and subject to theterms, conditions, limitations, exclusions and other provisionsof this policy, we will pay the reasonable and customary
costs for eligible expenses incurred during the period ofcoverage while outside your country of origin, up to theamounts specified in this policy, and the amount allowed
and/or paid for by any other insurance plan(s).

Eligibility
1.

Coverage is NOT AVAILABLE to any individual who, as of
their effective date:

Payment is limited to the amounts specified herein. Somebenefits are subject to advance approval by Allianz Global
Assistance.

a) has been diagnosed with a terminal illness; orb) has been diagnosed with stage 3 or 4 cancer; or

You will be responsible for any expenses that are notpayable by us.

c) has received treatment for any cancer (other than basal
or squamous cell skin cancer or breast cancer treated
only with hormone therapy) in the past 3 months; or
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Summary of Benefitsc) Diagnostics, lab tests and/or X-ray examinations asordered by a physician for the purpose of diagnosis.

Accidental Death & Dismemberment ......... up to sum insuredd) The services of the following legally licensed
practitioners for treatment of a covered sickness or
injury:Emergency Hospital & Medical .................... up to sum insured
Included in the overall maximum:

i. chiropractor;

Emergency Hospital ...................................... up to sum insured

ii. osteopath;

Emergency Medical ...................................... up to sum insurediii. podiatrist/chiropodist;

Emergency Transportation ......................... up to sum insured

iv. physiotherapist, when ordered by the attending
physician;Accidental Dental ................................................................. $4,000
Attendant ........................................................................ up to $500

v. acupuncturist.

Chiropractor, osteopath, podiatrist/chiropodist,
physiotherapist or acupuncturist ..... $500 per profession

Not to exceed $500 per profession.
e) Private duty services of a Registered Nurse whenapproved in advance by Allianz Global Assistance.

Dental Emergency ....................................................... up to $500
Emergency Return Home ...................................... up to $3,000

Not to exceed $10,000.

Out-of-Pocket Expenses ........................................ up to $1,500f) The use of a licensed local air, land, or sea ambulance(including mountain or sea evacuation), to the nearest
hospital, when reasonable and necessary.

Return of Deceased ............................................... up to $10,000
Transportation of Family/Friend ........................ up to $3,000g) Rental of crutches or hospital-type bed, not exceeding
the purchase price; and the cost of splints, trusses,
braces or other prosthetic appliances approved inadvance by Allianz Global Assistance.

Benefits: What’s Covered
1.

2.

Emergency Hospitalh) Emergency out-patient services provided by a hospital.

We agree to pay for hospital accommodation, includingsemi-private room, and for reasonable and customary
services and supplies necessary for your emergency careduring confinement as a resident in-patient.

i) When not hospitalized as an in-patient, drugs
or medications that require a physician’s writtenprescription, not exceeding a 30-day supply, to a
maximum of $1,000.

Emergency Medical

3.

We agree to pay for the following services, supplies ortreatment, resulting from a covered sickness or injury,
when provided by a health practitioner who is not
related to you by blood or marriage:

Out-of-Pocket Expenses
In the event you (or your insured travelling companion)
are confined to hospital on the date on which you arescheduled to return home, we agree to reimburse up
to $150 per day to a maximum of $1,500, or up to a
maximum of 10 days, for the following expenses incurredby you or any insured travelling companion:a) The emergency services of a legally licensed
physician, surgeon, or anaesthetist.

a) commercial accommodation and meals; andb) Follow-up visits as prescribed by the attending
physician at the time of the emergency. Follow-up
visits must occur during the period of coverage andbe directly related to the emergency. The emergency
must occur during the period of coverage and havebeen reported to Allianz Global Assistance.

b) child care costs for children under age 18, or
physically or mentally handicapped travellingcompanion(s) who rely on you for assistance; andc) essential telephone calls; andd) taxi fares.

Follow-up treatment needed as a result of any
sickness or injury that took place while you were inyour country of origin during the period of coverage
will be covered only on prior approval by Allianz
Global Assistance. On-going expenses resulting fromsuch sickness or injury will not be covered, unlessapproved in advance by Allianz Global Assistance.

We will only reimburse these expenses if you or yourtravelling companion have actually paid for them.
Expenses must be supported by original receipts fromcommercial organizations.
4.

Allianz Global Assistance reserves the right, as
reasonably required and at its expense, to transport
you to your country of origin following an emergency.

Transportation of Family or Friend
We agree to pay up to a maximum of $3,000 for the costto transport one family member or close friend to your5

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7.

bedside by round-trip economy class (using the mostdirect route) if:

When necessary, we agree to transport you to yourcountry of origin when immediate medical consultation isrequired due to a covered emergency sickness or injury.
Any emergency transportation such as air ambulance,
one-way economy airfare, stretcher and/or a medical
attendant must be pre-approved and arranged by Allianz
Global Assistance.

a) you are hospitalized due to a covered sickness or injury,
and the attending physician advises that your family
member or close friend’s attendance is necessary; orb) the local authorities legally require the attendanceof your family member or close friend to identify yourremains in the event of your death due to a covered
sickness or injury.

8.

Benefits are payable only when approved in advanceby Allianz Global Assistance.

a) commercial accommodation and meals; andb) essential telephone calls; andYour coverage under this policy ceases once you havebeen returned to your country of origin under this benefit.

c) taxi fares.
Expenses must be supported by original receipts fromcommercial organizations.

9.

Accidental Death & Dismemberment
We agree to pay up to a maximum of the sum insured
indicated on your confirmation of coverage, for loss oflife, limb or sight resulting directly from accidental injury,
occurring during the period of coverage, except whileboarding, riding in, or alighting from an aircraft.

Return of Deceased (Repatriation)
In the event of your death due to a covered sickness or
injury, we agree to reimburse:a) up to $10,000 for costs incurred to prepare and return
your remains in a standard transportation container
to your country of origin; or

The total aggregate limit for all losses under Accidental
Death & Dismemberment is $10 million.

b) up to $4,000 for cremation or burial of your remains at
the place of death.

Benefits are payable according to the following schedule:a) 100% of sum insured resulting from the same
accidental injury for loss of:i. life; or

The cost of a coffin or urn is not covered.
6.

Emergency Return Home for You and One Family
Member
If a covered sickness or injury requires you to be returned
home during the period of coverage, we agree to reimburse
up to $3,000 for the additional cost of one-way economy
transportation by the most direct route for you and one
insured family member to your country of origin whenapproved and arranged by Allianz Global Assistance.

In addition, we agree to reimburse up to a maximum of$1,000 for the following expenses incurred by your family
member or close friend after arrival:

5.

Emergency Transportation

Dentalii. entire sight of both eyes; orWe agree to reimburse:iii. both hands; ora) up to $4,000 for emergency treatment or services towhole or sound natural teeth (including capped orcrowned teeth) which are damaged as a result of an
accidental blow to the face; andiv. both feet; orv. one hand and entire sight of one eye; orvi. one foot and entire sight of one eye.

b) up to $500 for the immediate relief of acute dental
pain caused by other than a direct blow to the face
and for which you have not previously received
treatment or advice.

b) 50% of sum insured resulting from the same
accidental injury for loss of:i. entire sight of one eye; orii. one hand; orReimbursement will not exceed the minimum fee specified
in the Canadian Dental Association schedule of fees of theprovince or territory where treatment was received.

iii. one foot.
Loss of hand or hands, or foot or feet means severance
through or above the wrist joint or ankle joint, respectively.

Treatment relating to any dental claim must begin within
48 hours after the onset of the emergency and must becompleted within the period of coverage and prior toyour return to your country of origin.

Loss of eye or eyes means total and irrecoverable loss ofthe entire sight.
Only one amount is payable (the largest) if you suffer
more than one of these losses.

Treatment must be performed by a legally qualified
dentist or oral surgeon.

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Exposure and Disappearanceb) As a result of any one or a series of acts of terrorism
occurring in any calendar year, the aggregate limit
payable shall be limited to $5 million for all eligible
policies issued by us and administered by Allianz
Global Assistance, including this policy.

If you are exposed to the elements or disappear as aresult of an accident, a loss will be covered if:a) as a result of such exposure, you suffer one of thelosses specified in the schedule of losses above; or

The amount payable for each eligible claim under (a) and(b) above are in excess of all other sources of recovery
and shall be reduced on a pro rata basis, so that the
total amount paid for all such claims shall not exceed therespective aggregate limit which will be paid after the endof the calendar year and after completing the adjudicationof all claims relating to the act(s) of terrorism.

b) your body has not been found within 52 weeks fromthe date of the accident. It will be presumed, subject toevidence to the contrary, that you suffered loss of life.

Specific Conditions
1.

In the event of a medical emergency, you must notify
Allianz Global Assistance within 24 hours of admission toa hospital and before any surgery is performed.

7.

Exclusions: What’s not Covered

Limits on Coverage

VTC1 Pre-existing Conditions Exclusion

If you fail to do so without reasonable cause, then we will
pay 80% of the claim payable. You will be responsible forthe remaining 20% of the claim payable.

a) If you are 59 years of age or under on the effective
date:
Benefits are not payable for costs incurred due toor resulting from your medical condition or related
condition that was not stable at any time during the
90 days immediately before the effective date.

You will be responsible for any expenses that are notpayable by us.
2.

We reserve the right, as reasonably required and at our
expense, to transfer you to any hospital or to transport
you to your country of origin following an emergency.

b) If you are 60 to 89 years of age on the effective date:
Benefits are not payable for costs incurred due to or
resulting from your pre-existing medical condition or
related condition that was not stable at any time during
the 180 days immediately before the effective date.

If you refuse to be transferred or transported whendeclared medically fit to travel, any continuing costs
incurred after your refusal will not be covered and thepayment of such costs becomes your sole responsibility.

VTC2 Benefits are not payable for costs incurred due toany treatment, investigation or hospitalization which is acontinuation of, or subsequent to, emergency treatment ofa sickness or injury, unless approved in advance by Allianz
Global Assistance.

Coverage ceases upon your refusal and no coverage
will be provided to you for the remainder of the periodof coverage.
3.

4.

5.
6.

General Provisions of this policy apply. Refer to page 12.

Costs incurred outside of Canada other than in yourcountry of origin are covered provided the majority ofthe period of coverage is spent in Canada.

VTC3 Benefits are not payable for any costs incurred due to any
sickness for which signs or symptoms occurred within 48 hours
after the effective date, except when applying for coverage:

Your policy will remain in effect while you are in yourcountry of origin, however costs incurred in your countryof origin are not covered.

a) before the expiry date of your existing Allianz Global
Assistance administered policy; orb) prior to the date you exit your country of origin.

If you have been returned to your country of origin under
the Emergency Return Home benefit, this policy will expire.

VTC4 Benefits are not payable for costs incurred due to any
loss incurred outside of Canada when you have not spent the
majority of the period of coverage in Canada.

Act of Terrorism - Limits on Coverage and Aggregate
Limit

VTC5 Benefits are not payable for costs incurred due to any
loss incurred inside your country of origin.

When an act of terrorism directly or indirectly causes aloss that would otherwise be payable under this plan,other than Accidental Death & Dismemberment, subject
to all other policy limits, coverage will be provided asfollows:

VTC6 Benefits are not payable for costs or losses incurred
while sane or insane due to:a) your emotional or mental disorders resulting fromany cause, including but not limited to anxiety or
depression; ora) As a result of any one or a series of acts of terrorism
occurring within a 72-hour period, the aggregate limit
payable shall be limited to $2.5 million for all eligible
insurance policies issued by us and administered byAllianz Global Assistance, including this policy.

b) your suicide or attempted suicide; orc) your intentionally self-inflicted injury.
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TABLE OF CONTENTSVTC7 Benefits are not payable for costs incurred due topregnancy, abortion, miscarriage, childbirth or complications
thereof.

VTC17 Benefits are not payable for costs incurred due todental or cosmetic surgery.
VTC18 Benefits are not payable for costs incurred due tonaturopathic or holistic treatment.

VTC8 Benefits are not payable for costs incurred due toloss, death or injury, if at the time of the loss, death or injury,
evidence supports that the medical condition causing the loss
was in any way contributed to by:

VTC19 Benefits are not payable for costs that exceed thereasonable and customary rate for the area where thetreatment or services are being performed.

a) your intoxication or abuse of alcohol; or

VTC20 Benefits are not payable for costs incurred due totreatment or services that contravene, or are prohibited by,legislation under a provincial or territorial hospital/medical plan.

b) your use of prohibited drugs or any other intoxicant; orc) your non-compliance with prescribed treatment or
medical therapy; or

VTC21 Benefits are not payable for costs incurred due to,contributed to by, or resulting from any sickness or injury
when such sickness or injury occurs in a city, region, or
country for which Global Affairs Canada issued a written
warning to avoid all travel, or to avoid non-essential travel,
to that city, region, or country, before the later of:d) your misuse of medication.
VTC9 Benefits are not payable for costs incurred due to injury
resulting from training for or participating in:a) motorized speed contests; orb) stunt activities; ora) the effective date of your policy, orc) professional sport activities; orb) the date you depart for the destination underadvisory,d) high-risk activities.
VTC10 Benefits are not payable for costs incurred due tosickness or injury resulting from a motor vehicle accident
where you are entitled to receive benefits pursuant to any
policy or legislative plan of motor vehicle insurance, except
when such benefits are exhausted.

and such sickness or injury is due to, contributed to by, or
resulting from the reason for the warning.
VTC22 Benefits are not payable for costs incurred due to any:a) act of war; or

VTC11 Benefits are not payable for costs incurred due to any
sickness, injury or medical condition when a trip is undertaken
for the purpose of securing medical treatment or advice.

b) kidnapping; or

VTC12 Benefits are not payable for costs incurred due toyour travelling against the advice of a physician or any loss
resulting from your sickness or medical condition that wasdiagnosed by a physician as terminal prior to the effective
date of this policy.

d) riot, strike or civil commotion; orc) act of terrorism caused directly or indirectly by
nuclear, chemical or biological means; ore) unlawful visit in any country.
VTC23 Benefits are not payable for costs incurred due to any
nuclear occurrence, however caused.

VTC13 Benefits are not payable for costs incurred due toany treatment which can be reasonably delayed until you
return to your country of origin (whether or not you intend toreturn) by the next available means of transportation, unlessapproved in advance by Allianz Global Assistance.

VTC24 Benefits are not payable for costs incurred due tothe participation by you, a family member or travellingcompanion in:a) protests; orb) armed forces activities; or

VTC14 Benefits are not payable for costs incurred due toany medical consultation that is non-emergency, on-going,
elective or the consequence of a prior elective procedure.

c) a commercial sexual transaction; ord) the commission or attempted commission of any
criminal offence; or

VTC15 Benefits are not payable for costs incurred due tohospitalization or services rendered in connection withgeneral health examinations for check-up purposes,
treatment of an on-going condition, regular care of achronic condition, home health care, investigative testing,rehabilitation, or on- going care or treatment in connection
with drugs, alcohol or any other substance abuse.

e) the contravention of any statutory law or regulation in
the area where the loss occurred.
VTC25 Benefits are not payable for costs incurred due tobeing an occupant of an aircraft, either as passenger orcrew, except while being transported under the terms of
the Emergency Transportation or Emergency Return Home
benefits, or while boarding or alighting from an aircraft.

VTC16 Benefits are not payable for costs incurred due to any
rehabilitation or convalescent care.

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Claims Procedures
When submitting your Hospital & Medical claim, please
include:If you require medical care while travelling, it is criticalthat you contact Allianz Global Assistance before seeking
treatment. In a severe medical emergency, get to a hospital
immediately and have a family member or friend call
Allianz Global Assistance on your behalf within 24 hours ofadmission and before any surgery is performed. For moredetails, refer to Medical Monitoring and 24/7 Emergency
Assistance on page 2.
Claims for out-of-pocket expenses can be submitted
through the secure Allianz Global Assistance. Claims
Portal: www.allianzassistanceclaims.ca for the mostefficient claims experience.

1.

A fully completed and signed claim form with all original
bills and receipts.

2.

Medical records including an emergency room reportand diagnosis from the medical facility or a Medical
Certificate completed by the treating physician. Any fee
for completion of the certificate is not a benefit under
this insurance.

3.

For physiotherapy visits, a letter from the referring
physician recommending a referral to the physiotherapist.

4.

Any other documentation that may be required and/or
requested by Allianz Global Assistance.

IMPORTANT:

When submitting your Accidental Death & Dismemberment
claim, please include:

Notice of Claim. Claims should be reported as soon
as reasonably possible, within 30 days of occurrence,and in no event later than one (1) year after the dateof occurrence.
Proof of Loss. Written proof of loss should besubmitted as soon as reasonably possible, within 90
days of occurrence , and in no event later than one (1)year after the date of occurrence.
All eligible claims must be supported by receipts fromcommercial organizations and medical documentation
regarding your treatment. Other documentation may berequired and/or requested by Allianz Global Assistance.

Any expenses for documentation or required reports
are your responsibility.

1.

A fully completed and signed claim form by either you,or in the case of your death, by the appointed executor/
executrix.

2.

The police report including any witness statements.

3.

The coroner’s report.

4.

The death certificate (in the event of death).

5.

The Medical Certificate completed by the attending
physician or hospital medical records.

6.

Any other documents requested by Allianz Global
Assistance after initial review of the claim.

Incomplete information when submitting your claim
will cause delay.

Definitions
the consequence of: war; invasion; acts of foreign enemies;
hostilities or warlike operations (whether war is declared
or not) by any government or sovereign, using military
personnel or other agents; civil war; rebellion; revolution;
insurrection; civil commotion assuming the proportions of or
amounting to an uprising; military or usurped power.

Accident(al) means a sudden, unexpected, unforeseeable,
unavoidable external event and excludes disease or infections.
Act of terrorism means an act, including but not limited
to the use of force or violence and/or the threat thereof orcommission or threat of a dangerous act, of any person orgroup(s) or government(s), committed for political, religious,
ideological, social, economic or similar purposes including theintention to intimidate, coerce or overthrow a government(whether de facto or de jure) or to influence, affect or protest
against any government and/or to put the civilian population,or any section of the civilian population, in fear.

Activities of daily living means eating, bathing, using thetoilet, changing positions (including getting in and out of abed or chair) and dressing.
Aggregate limit means the total number or the maximum
value of insured losses resulting from any one accident or
event causing loss.

Act of war means any loss or damage arising directly or
indirectly from, occasioned by, happening through or in
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Commercial accommodation means an establishment
providing short-term accommodation for paying guests,
licensed under the law of its jurisdiction, which provides proof
of commercial transaction.

accepted program such as NAUI or PADI, or if diving depth
does not exceed 30 metres), white water rafting (except
grades 1 to 4), street luge, skeleton activity, mountaineering,or participation in any rodeo activity.

Country of origin means the country in which you maintained apermanent residence prior to entry into Canada or the country
which issued your passport. For Canadian passport holders
without a permanent residence, country of origin means thecountry you departed from before arriving in Canada.

Hospital means a facility incorporated or licensed as a
hospital by the jurisdiction where such services are provided
and which has accommodation for resident in-patients, alaboratory, a registered graduate nurse and physician always
on duty and an operating room where surgical operations
are performed by a physician. In no event shall this include
a convalescent or nursing home, home for the aged, healthspa, or an institution for the care of drug addicts, alcoholics or
persons suffering from mental disorders.

Dependent children means your unmarried children who are:a) financially dependent on you; andb) at least 15 days old and no more than 21 years old.

Injury means bodily harm, which is directly caused by or
resulting from an accident, being a sudden and unforeseen
event, excluding bodily harm that results from deliberate or
voluntary action and independent of sickness and all othercauses.

Effective date means the later of:a) the date and time the completed applicationis accepted by Allianz Global Assistance or its
representative; orb) the date indicated as the effective date on yourconfirmation of coverage; orInsured person means an eligible person named on theapplication, who has been accepted by Allianz Global
Assistance or its authorized representative, and has paid therequired premium for a specific plan of insurance.

c) the first time you exit your country of origin.
If you purchase your policy after you have exited your countryof origin, any sickness that manifests itself during the first 48
hours after the effective date is not covered even if related
expenses are incurred after the 48-hour waiting period.

Lung condition includes chronic obstructive pulmonary
disease (COPD), bronchial asthma, asthma, chronic
bronchitis, emphysema, tuberculosis, pulmonary fibrosis.

Emergency means a sudden, unforeseen sickness or injury
occurring during the period of coverage while you areoutside your country of origin, which requires immediate
intervention by a physician or legally licensed dentist andcannot reasonably be delayed. An emergency is deemed to
no longer exist when medical evidence indicates that you areable to continue your trip or return to your place of ordinary
residence or country of origin. Costs incurred in your countryof origin are not covered.

Medical consultation means any medical services obtained
from a licensed medical practitioner for a sickness, injury or
medical condition, including but not limited to any or all of:
history taking, medical examination, investigative testing,
advice or treatment, and during which a diagnosis of thecondition need not have been definitively made. This does
not include regular medical check-ups where no medical
signs or symptoms existed between check-ups or were foundduring the check-up.

Expiry date means the earlier of:

Mountaineering means the ascent or descent of a mountainrequiring the use of specified equipment including crampons,
pick axes, anchors, bolts, carabiners and lead-rope or top
rope anchoring equipment.

a) the date indicated as the expiry date on yourconfirmation of coverage; orb) the date you become eligible for coverage under aCanadian government insurance health plan.

Nuclear, chemical or biological means the use of any
nuclear weapon or device or the emission, discharge,
dispersal, release or escape of any solid, liquid or gaseous
chemical agent and/or biological agent, including theresultant contamination where:

Family member means your spouse, parent, brother, sister,
legal guardian, step-parent, step-child, step-brother, stepsister, aunt, uncle, niece, nephew, grandparent, grandchild,in- law, ward, natural or adopted child.
Heart condition includes angina or chest pain, arrhythmia,
arteriosclerosis, atrial fibrillation, congenital heart defect,
congestive heart failure, cardiomyopathy, carotid artery
occlusion, heart attack (myocardial infarction), heart murmur,
irregular heart rate or beat, any other condition relating to
the heart or cardiovascular system.
High-risk activity(ies) mean(s) any skiing out of bounds,
heliskiing, ski jumping, sky-diving, sky-surfing, scuba diving(except if certified by internationally recognized and10•

Nuclear means any occurrence causing bodily injury,
sickness, disease, or death, or loss of or damage toproperty, or for loss of use of property, arising out ofor resulting from the radioactive, toxic, explosive, orother hazardous properties of source, special nuclear,or by- product material.

•

Chemical agent means any compound which, whensuitably disseminated, produces incapacitating,damaging or lethal effects on people, animals, plants
or material property.
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•

Biological agent means any pathogenic (diseaseproducing) micro-organism(s) and/or biologically
produced toxin(s) (including genetically modified
organisms and chemically synthesized toxins) whichcause illness and/or death in humans, animals or plants.

b) there has been no change in treatment or change intreatment frequency or type; andc) there have been no signs or symptoms or new
diagnosis; andd) there have been no test results showing deterioration;andOn-going expenses means any treatment, investigation or
hospitalization which is a continuation of, or subsequent to,
emergency treatment of a medical condition.

e) there has been no hospitalization; andf) there has been no referral to a specialist (made orrecommended) and you are not awaiting surgery or
the results of further investigations performed by any
medical professional.

Period of coverage means the period from the effective
date to the expiry date as indicated on your confirmation ofcoverage and for which premium has been paid. As selected
and paid for at the time of application, the maximum periodof coverage cannot exceed 365 days.

The following are considered stable:a) Routine (not prescribed by a physician) adjustment
of insulin to control diabetes provided the insulin was
not first prescribed during the stability period.

Physician means a person other than you, who is legallyqualified and licensed to practice medicine or performsurgery in the location where the services are performed, and
who is not related to you by blood or marriage.

b) Change from a brand name medication to a generic
medication provided the medication was not firstprescribed during the stability period and there is no
increase or decrease in dosage.

Pre-existing condition means a sickness, injury or medical
condition, whether or not diagnosed by a physician:a) for which you exhibited signs or symptoms; orc) A minor ailment, which describes a sickness or injury
during the stability period which ended more than
30 days prior to the effective date and which did not
require:b) for which you required or received medical
consultation; andc) which existed prior to the effective date of yourcoverage.

i. treatment for a period longer than 15 consecutive
days; or

Professional means you are considered professional by
the governing body of the sport, earn the majority of yourincome from such activity, and are paid for your participation
whether you win or lose.

ii. more than one follow-up visit to a physician; oriii. hospitalization, surgery, or referral to a specialist.
The following conditions are not considered stable:

Reasonable and customary means the services customarily
provided or the costs customarily incurred for covered losses,
which are not in excess of the standard practice or fee in thegeographical area where the services are provided or costs
are incurred for comparable treatment, services or supplies
for a similar sickness or injury.

a) any lung condition for which you were prescribed or
are taking prednisone;b) any heart condition for which you were prescribed or
are taking nitroglycerin.
Terminal applies to a medical condition for which a physician
gave a prognosis of eventual death or for which palliative
care was received prior to the effective date.

Sickness means any illness or disease.
Signs or symptoms means any evidence of disease
experienced by you or recognized through observation.

Travelling companion means a person who has prepaid
shared accommodation or transportation with you.
(Maximum of 5 persons including you.)

Spouse means a person who is legally married to you, or
has been living with you in a common-law relationship for aperiod of at least 12 consecutive months.

Treatment means medical, therapeutic or diagnostic
procedure prescribed, performed or recommended by aphysician including, but not limited to, prescribed medication,
investigative testing or surgery.

Stability perioda) if you are age 59 or under, is the 90 days immediately
before the effective date.

Trip means a period during which you are travelling outsideof your country of origin and for which coverage is in effect.

b) if you are age 60 to 89, is the 180 days immediately
before the effective date.

We, us and our means CUMIS General Insurance Company, amember of The Co-operators group of companies and/or AZGA
Service Canada Inc. operating as Allianz Global Assistance.

Stable describes any medical condition or related condition,
including any heart condition or lung condition, for which:a) there has been no new treatment; andYou or your means the insured person.
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Legal Information
General Provisions

If an insured person is recorded by us as having coverage
under more than one of our policies at the same time,
benefits will only be paid under one insurance policy, theone with the greatest sum insured. Benefits are only payablefor the plans and the specific sum insured selected, paid forand accepted by Allianz Global Assistance at the time of
application, and indicated on your confirmation of coverage.
Any benefits payable do not include interest charges.
Benefits payable as a result of your death will be payable toyour named beneficiary or to your Estate.

Assignment
Any benefits payable or which may become payable under
this policy cannot be assigned by you, and we are notresponsible for and will not be bound by any assignment into
which you have entered.

Automatic Extension of Coverage
1.

Delay of conveyance. Coverage will be automaticallyextended for up to 72 hours in the event of a delay, due
to circumstances beyond your control, of the conveyancein which you are riding or are scheduled to ride as apassenger. The delay must occur prior to the coverage
expiry date and the conveyance must be due to arriveprior to the coverage expiry date.

Claim Submission
You or the claimant, if other than you, shall be responsible forproviding Allianz Global Assistance with the following:

Conveyance means a vehicle, airline, bus, train, or
government-operated ferry system.
2.

3.

Medically unfit to travel. Coverage will be automaticallyextended for up to 5 days if medical evidence supportsthat you are medically unfit to travel due to a covered
sickness or injury on or before the coverage expiry date.

1.

receipts from commercial organizations for all medical
costs incurred and itemized accounts of all medical
services which have been provided; and2.

any payment made by any other insurance plan or contract,
including a government hospital/ medical plan; and3.

substantiating medical documentation, at the request ofAllianz Global Assistance.

Failure to provide substantiating documents shall invalidate
all claims under this insurance.

Hospitalization. Coverage will be automatically extended
during the period of hospital confinement, plus 72 hours
after release to travel home, if you are hospitalized at
the end of your trip as a result of a covered injury or
sickness. This coverage will be extended to your travellingcompanion(s) remaining with you when reasonable andnecessary, under their respective Allianz Global Assistanceadministered policy.

Contract
The application, confirmation of coverage, this policy, any
document attached to this policy when issued, and any
amendment to the policy agreed upon in writing after it isissued, constitute the entire contract. Each policy or term ofcoverage is considered a separate contract.

Additional premium will not be required for any automatic
extension of coverage.

We reserve the right to decline any application for coverage.

No condition of this policy shall be deemed to have been
waived, either in whole or in part, unless the waiver is clearly
expressed in writing and signed by us.

Extending Your Trip
You can extend your coverage before you depart on yourtrip. If you decide to extend your trip after you have departed
your country of origin, you may apply for a new period ofcoverage provided you meet the Eligibility requirements on
page 4 of this policy.

Coordination of Benefits
Amounts payable under this plan are in excess of any
amounts available or collectible under any existing coverage
concurrently in force held by or available to you.

Each policy or period of coverage is considered a separate
contract and all limitations and exclusions will apply.

Other coverage includes but is not limited to:

Benefit Payments
Unless otherwise stated, all provisions in this policy apply toeach insured person during one period of coverage. Benefits
are only payable under one policy for each insured person
during the period of coverage.

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homeowners insurance;•

tenants insurance;•

multi-risk insurance;•

any credit card, third-party liability, group orindividual basic or extended health insurance;•

any private or legislative plan of motor vehicle insurance
providing hospital, medical or therapeutic coverage.
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Misrepresentation or Nondisclosure

We will coordinate all benefits in accordance with theCanadian Life and Health Insurance Association guidelines.

Your failure to disclose or misrepresentation of any
material fact, or fraud, either at the time of application
or at the time of claim, shall render the entire contractnull and void at our option, and any claim submitted
thereunder shall not be payable.

Reimbursement will not be made for any costs, services
or supplies that are payable to you under a motor vehicle
insurance policy or legislative plan under any Insurance
Act, or for which you receive benefits from any other party
pursuant to any policy or legislative plan of motor vehicle
insurance, until such benefits are exhausted.

Where there is an error as to your age, provided that yourage is within the insurable limits of this policy, the premiums
will be adjusted according to your correct age.

You may not claim or receive in total more than 100% of theloss caused by the insured event.

Premiums

Currency

The total premium amount is due and payable at the timeof application. The premium is calculated using the mostcurrent rates for your age on the effective date of this policy
as indicated on your confirmation of coverage.

All amounts stated in the policy, including premium, arein Canadian currency. If currency conversion is necessary,
we will use the exchange rate on the date the service wasrendered to you. At our option, benefits may be paid in thecurrency of the country where the loss occurred.

Rights of Examination

Policy terms and conditions are subject to change with eachnew policy purchased, without prior notice, to reflect actual
experience in the marketplace.

The claimant shall provide us with the opportunity to
examine you when and so often as it reasonably requires
while a claim is pending. In the case of your death, we may
require an autopsy, subject to any laws of the applicablejurisdiction relating to autopsies.

Governing Law

Right to be Reimbursed (Subrogation)

This policy will be governed by the laws of the Canadianprovince or territory where the policy was issued.

As a condition to receiving benefits under the policy, youagree to:General Termsa) reimburse us for all emergency medical and hospitalcosts paid under the policy from any amounts you
receive from a third party responsible (in whole or inpart) for your injury or sickness whether such amounts
are paid under a judgment or settlement agreement;

Language
The parties request that the policy and all related
documentation be drawn in English. Les parties demandent
que la présente police ainsi que toute documentation
pertinente soient rédigées en anglais.

b) whenever reasonable, initiate a legal action against
the third party to recover your damages, which
include emergency medical and hospital costs paid
under the policy;

Limit on Liability
It is a condition precedent to liability under this policy that at
the time of application and on the effective date, you are ingood health and know of no reason to seek medical attention.

c) include all emergency medical and hospital costs
paid under the policy in any settlement agreement
you reach with the third party;

Limitation of Actiond) act reasonably to preserve our right to be reimbursed
for any emergency medical or hospital costs paid
under the policy;

Every action or proceeding against an insurer for the recovery
of insurance money payable under the contract is absolutely
barred unless commenced within the time set out in the
Insurance Act (for actions or proceedings governed by thelaws of Alberta and British Columbia), The Insurance Act (foractions or proceedings governed by the laws of Manitoba),
the Limitations Act, 2002 (for actions or proceedings
governed by the laws of Ontario), The Limitations Act(for actions or proceedings governed by the laws of
Saskatchewan), or other applicable legislation. For thoseactions or proceedings governed by the laws of Quebec, theprescriptive period is set out in the Quebec Civil Code.

e) keep us informed of the status of any legal action
against the third party; andf) advise your counsel of our right to reimbursement
under the policy.
Your obligations under this section of the policy in no way
restricts our right to bring a subrogated claim in your nameagainst the third party and you agree to cooperate with us
fully should we choose to exercise our right of subrogation.

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Sanctions

A refund fee may apply.

Benefits are not payable under this policy for any losses or
expenses incurred due to or as a result of your travel to a
sanctioned country for any business or activity that would
violate any Canadian or any other applicable national
economic or trade sanction law or regulation.

Refund amounts less than the minimum premium will not be
issued.

Time

Protecting your personal information

Expiry time of coverage is the time within the Canadian timezone where the coverage was purchased.

Protecting your personal information is a top priority. This
Privacy Notice explains how and what types of personal
data will be collected, why it is collected and to whom it isshared or disclosed. PLEASE READ THIS NOTICE CAREFULLY.

Privacy NoticePremium Refunds

CUMIS General Insurance Company (the “insurer”) and theinsurer’s insurance administrator, Allianz Global Assistance,
and the insurer’s agents, representatives and reinsurers (forthe purpose of this Privacy Notice collectively “We” “Us” and“Our”) require Your personal information.

A full refund will be provided for policies which are returned
within 10 days of purchase, as described in the section titled
Right To Examine Policy.
Refunds are payable when:1.

The entire trip is cancelled prior to the effective date.

2.

You return to your country of origin prior to the expiry
date, without intending to return to Canada. Refunds
are not payable for time spent in your country of origin
between visits to Canada.

Personal information we collect
We will collect your personal information including but notlimited to:•

Surname, First name

You become insured under a Canadian provincial or
territorial health/medical plan.

•

Address•

Date of Birth

When submitting your premium refund request, please
include:•Telephone numbers•

Email addresses

1.

A fully completed and signed Refund Request Form; and•Credit/debit card and bank account information

2.

A copy of your confirmation of coverage; and•3.

Confirmation of your early departure such as boarding
pass or itinerary, or any other written proof of your early
return to your country of origin; andEmployment details including termination notices
and accepted offers of employment•

4.

Any other documentation to support your refund request.

Sensitive personal information such as: Medical
information relating to Your health status, excluding
genetic test results

3.

How will we obtain and use your personal information?

Important Notes

This personal information is collected for the following
insurance purposes when offering and providing insurance
and related services:

Premium refunds, regardless of method of payment, must
be obtained from the agent where coverage was originallypurchased unless purchased directly from Allianz Global
Assistance.
There will be no refund of premium if a claim has been made.
Refunds are payable from the date Allianz Global Assistancereceives the request.
Refunds for partial cancellations will be calculated bymultiplying the daily premium by the actual number of days
the policy was in effect; if this amount is less than the minimum
premium required for the plan purchased, the minimum
premium will be used. This amount is then subtracted from thetotal premium paid. The refund will be calculated based on thedate the refund request is received by Allianz Global Assistance.
14•

To identify and communicate with you•

To consider any application for insurance•

If approved, to issue a Policy or Certificate of Insurance•

To administer insurance and related benefits•

To evaluate insurance risk, manage and coordinate
claims, re-price medical expenses and negotiate
payment of claims expenses•

To adjudicate claims and to determine eligibility forinsurance benefits•

To provide assistance services

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For fraud prevention and debt collection purposes•

As required or permitted by law

How long do we keep your personal data?
We will retain the personal information We collect for a
specified period of time and in a storage method appropriate
with legal and Our internal corporate requirements.
Personal information will be securely destroyed following the
expiration of the appropriate retention period. Individuals
have a right to request to access or correct personal
information We have on file by contacting the Privacy Officer
at privacy@allianz-assistance.ca or by writing to:

We reserve our right to collect personal information, necessary
for insurance purposes, from the following individuals:•

Individuals who apply for insurance products•

Certificate holder and/or Policyholders•

Insureds and/or Claimants•

Family members, friends or travelling companions
of a Certificate or Policyholder, Insured or Claimant,in cases where you, for medical or other reasons,cannot communicate directly with Us.

Privacy Officer
Allianz Global Assistance
700 Jamieson Parkway
Cambridge, Ontario N3C 4N6 Canada

Who will have access to your personal information?

How can you contact us?

We disclose information for insurance purposes, to and with,third parties such as, but not necessarily limited to, other Allianz
group companies, health care practitioners and facilities in
Canada and abroad, government and private health insurers,
family members and friends/ travelling companions of theCertificate holder or Policyholder, Insured or Claimant andagencies. We may also use and disclose information from
Our existing files for insurance purposes. Our employees who
require this information for the purposes of administering yourinsurance will have access to this file. Upon Your request andauthorization, We may also disclose this information to otherpersons. From time to time, and if permitted by applicablelaw, We may also collect, use or disclose personal informationin order to offer additional or upgraded products andservices (the “optional purposes”). In some instances We may
additionally maintain or communicate or transfer information
to health care and other service providers located outside of
Canada. As a result, personal information may be accessible toregulatory authorities in accordance with the law of these otherjurisdictions.

For information about how to obtain access to written
information about Our policies and procedures with respect
to service providers outside of Canada, please contact thePrivacy Officer at privacy@allianz-assistance.ca.
For a complete copy of Our Privacy Policy, please visit
www.allianz-assistance.ca.

How often do we update this privacy notice?
We regularly review this Privacy Notice. We will ensure themost recent version is available on Our website,www.allianz-assistance.ca.

Contact Information
Administrator:
Allianz Global Assistance
700 Jamieson Parkway
Cambridge, Ontario N3C 4N6
1-800-670-4426

What are your rights in respect of your personal data?
When permitted by applicable law and regulations you havethe right to:•Access your personal data held about you•

Withdraw consent at any time where your personal
data is processed•

Update or correct your personal information so that it
is always accurate•

Delete your personal information from our records, if it
is no longer needed for the purposes indicated above•

File a complaint with Us and/or relevant dataprotection authority

Insurer:
CUMIS General Insurance Company
P.O. Box 5065, 151 North Service Road
Burlington, Ontario L7R 4C2
1-800-263-9120

You may exercise these rights by contacting the Privacy
Officer at privacy@allianz-assistance.ca.

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