F026R

YOUR GUIDE TO CARD BENEFIT

Your Guide to Benefit 
describes the benefit in  
effect as of 4/1/14. 
Benefit information in this 
guide replaces any prior benefit 
information you may have 
received. Please read and retain 
for your records. Your eligibility 
is determined by your financial 
institution.

Travel Accident  
Insurance

For questions about your account, balance, or rewards points please call the customer service number on 
your Visa card statement.

Benefit Information
Principal Sum: $1,000,000

THIS IS AN ACCIDENTAL DEATH AND DISMEMBERMENT ONLY POLICY AND DOES NOT PAY BENEFITS 
FOR LOSS FROM SICKNESS.
This Description of Coverage is provided to all eligible Visa Platinum/Platinum Plus cardholders and replaces 
any and all Descriptions of Coverage previously issued to the insured with respect to insurance described 
herein.

Eligibility and Period of Coverage

As a Visa Platinum/Platinum Plus cardholder, you are covered beginning on 4/1/14 or the date your credit 
card is issued, whichever is later.
You and your dependents1 become covered automatically when the entire Common Carrier fare is charged 
to your covered Visa Platinum/Platinum Plus card account (“Covered Persons”). It is not necessary to notify 
the financial institution, the Insurance Company, or the Plan Administrator when tickets are purchased. 
Coverage ends when the policy is terminated.

Benefits

Subject to the terms and conditions, if a Covered Person’s accidental bodily Injury occurs while on a 
Covered Trip and results in any of the following Losses within one (1) year after the date of the accident,  
the Insurance Company will pay the following percentage of the Principal Sum for accidental Loss of:
Life ............................................................................................................................................. 100%
Both hands or both feet ............................................................................................................... 100%
Sight of both eyes ........................................................................................................................ 100%
One hand and one foot ................................................................................................................ 100%
Speech and hearing .................................................................................................................... 100%
One hand or one foot and the sight of one eye ............................................................................... 100%
One hand or one foot ..................................................................................................................... 50%
Sight of one eye ............................................................................................................................ 50%
Speech or hearing ......................................................................................................................... 50%
Thumb and index finger on the same hand ....................................................................................... 25%

In no event will multiple charge cards obligate the Insurance Company in excess of the stated benefit 
for any one Loss sustained by a Covered Person as a result of any one accident. The maximum amount 
payable for all Losses due to the same accident is the Principal Sum.
Loss means actual severance through or above the wrist or ankle joints with regard to hands and 
feet; entire and irrevocable loss of sight, speech or hearing; actual severance through or above the 
metacarpophalangeal joints with regard to thumb and index fingers. The life benefit provides coverage in 
the event of a Covered Person’s death. If a Covered Person’s body has not been found within one (1) year 
of disappearance, stranding, sinking, or wreckage of any Common Carrier in which the Covered Person 
was covered as a passenger, then it shall be presumed, subject to all other provisions and conditions of 
this coverage, the Covered Person suffered loss of life.
Injury means bodily injury or injuries, sustained by the insured person which are the direct cause of Loss, 
independent of disease cause of Loss, independent of disease or bodily infirmity, and occurring while the 
Covered Person is covered under this policy, while the insurance is in force.
Covered Trip means a trip (a) while the Covered Person is riding on a Common Carrier as a passenger and 
not as a pilot, operator, or crew member; (b) charged to your Visa Platinum/Platinum Plus card; and (c) that 
begins and ends at the places designated on the ticket purchased for the trip. Covered Trip will also include 
travel on a Common Carrier (excluding aircraft), directly to, from, or at any Common Carrier terminal, which 
travel immediately precedes departure to or follows arrival at the destination designated on the ticket 
purchased for the Covered Trip.
Common Carrier means any scheduled airline, land, or water conveyance licensed for transportation of 
passengers for hire.

Continued on page 2 

Travel Accident Insurance, continued

Exclusion: No payment will be made for any Loss that occurs in connection with, or is the result of: (a) 
suicide, attempted suicide, or intentionally self-inflicted injury; (b) any sickness or disease; (c) travel or 
flight on any kind of aircraft or Common Carrier except as a fare-paying passenger in an aircraft or on a 
Common Carrier operated on a regular schedule for passenger service over an established route; or (d) 
war or act of war, whether declared or undeclared.
Beneficiary: Benefit for Loss of life is payable to your estate, or to the beneficiary designated in writing by 
you. All other benefits are payable to you.
Notice of Claim: Written Notice of Claim, including your name and reference to Visa Platinum/Platinum 
Plus, should be mailed to the Plan Administrator within twenty (20) days of a covered Loss or as soon as 
reasonably possible. The Plan Administrator will send the claimant forms for filing proof of Loss.
The Cost: This travel insurance is purchased for you by your financial institution.
Description of Coverage: This description of coverage details material facts about a Travel Accident 
Insurance Policy which has been established for you and is underwritten by Virginia Surety Company, Inc. 
Please read this description carefully. All provisions of the plan are in the policy, issued to the financial 
institution trust. Any difference between the policy and this description will be settled according to the 
provisions of the policy.

Questions: Answers to specific questions can be 
obtained by writing to the Plan Administrator:
CBSI Card Benefit Services
550 Mamaroneck Avenue, Suite 309
Harrison, NY 10528

Plan Underwritten by: 
Virginia Surety Company, Inc.
175 West Jackson Blvd., 11th Floor
Chicago, IL 60604

State Amendments

For Illinois Residents Only the following statement is added: If a Covered Person recovers expenses for sickness 
or injury that occurred due to the negligence of a third party, the Company has the right to first reimbursement for 
all benefits the Company paid from any and all damages collected from the negligent third party for those same 
expenses whether by action at law, settlement, or compromise, by the Covered Person, the Covered Person’s 
parents if the Covered Person is a minor, or the Covered Person’s legal representative as a result of that sickness 
or injury. You are required to furnish any information or assistance, or provide any documents that we may 
reasonably require in order to exercise our rights under this provision. This provision applies whether or not the 
third party admits liability.
1 Your spouse, unmarried dependent child(ren), under age nineteen (19) [twenty-five (25) if a full-time 
student]. No age limit for incapacitated child. Incapacitated child means a child incapable of self-sustaining 
employment by reason of mental retardation or physical handicap, and chiefly dependent on you for support and 
maintenance. Dependent child(ren) receive fifty percent (50%) of your benefit amount.

ADDITIONAL PROVISIONS FOR TRAVEL ACCIDENT INSURANCE 

Travel Accident Insurance is provided under a master policy of insurance issued by Virginia Surety Company, Inc. 
(herein referred to as “Company”). We reserve the right to change the benefits and features of all these programs.
The financial institution or the Company can cancel or choose not to renew the Insurance coverages for all 
Insureds. If this happens, the financial institution will notify the accountholder at least thirty (30) days in advance 
of the expiration of the policy. Such notices need not be given if substantially similar replacement coverage takes 
effect without interruption and is provided by the same insurer. Insurance benefits will still apply to Covered Trips 
commenced prior to the date of such cancellation or non-renewal, provided all other terms and conditions of 
coverage are met. Travel Accident Insurance does not apply if your Visa Platinum/Platinum Plus card privileges 
have been suspended or canceled. However, insurance benefits will still apply to Covered Trips commenced prior 
to  
the date that your account is suspended or canceled provided all other terms and conditions of coverage are met.
Coverage will be void if, at any time, the accountholder has concealed or misrepresented any material fact 
or circumstance concerning this coverage or the subject thereof or the accountholder’s interest herein, or 
in the case of any fraud or false swearing by the Insured relating thereto. No person or entity other than the 
accountholder shall have any legal or equitable right, remedy, or claim for insurance proceeds and/or damages 
under or arising out of this coverage.  
No action at law or in equity shall be brought to recover on this coverage prior to the expiration of sixty (60) days 
after proof of loss has been furnished in accordance with the requirements of this Description of Coverage.
The Company, at its expense, has the right to have you examined as often as reasonably necessary while a claim 
is pending. The Company may also have an autopsy made unless prohibited by law. 

FORM #VTAI – 2013 (Stand 04/14) 

TAI-O

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