Your Guide to Benefit describes the benefit in effect as of 1/1/19. 
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  
Description of Coverage
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 Signature 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 Signature cardholder, you are covered beginning on 1/1/19 or the date your credit card is issued, 
whichever is later.

You and your dependents* become covered automatically when the entire Common Carrier fare is charged 
to your covered Visa Signature card account (“Covered Person”). 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.

*  Your spouse, unmarried dependent child(ren), under age 19 (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.

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 

Both hands or both feet 

Sight of both eyes 

One hand and one foot 

Speech and hearing 

One hand or one foot and the sight of one eye 

One hand or one foot 

Sight of one eye 

Speech or hearing 

Thumb and index finger on the same hand 

100%

100%

100%

100%

100%

100%

50%

50%

50%

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.

01/19

Insurance does not apply if your Visa Signature privileges have been suspended or cancelled. However, 
insurance benefits will still apply to Covered Trips commenced prior to the date that your account is 
suspended or cancelled 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. 

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.

ADD (10/07)

Definitions

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 and (b) charged to your Visa Signature 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.

Exclusions: 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 Signature 
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 master policy form number, VSC-VCC-01 (2/00). 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

Underwritten by:   

Virginia Surety Company, Inc.  
175 West Jackson Blvd. 
Chicago, IL 60604

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 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