Why international medical insurance?
Each year, millions of people travel outside of their Home Countries, beyond the boundaries of their medical insurance. They're concerned with the potential out-of-pocket expenses that could result from an injury or sickness abroad. Liaison® International offers medical coverage and emergency services to individuals and families traveling outside their Home Countries. This brochure is a brief description of Liaison® International. For a full description, see the Program Summary, which will be mailed to you once you are approved for coverage.
Liaison® International Plan provides coverage for individuals and families [including unmarried dependent child(ren) over fourteen (14) days and under nineteen (19) years of age] while traveling outside of their Home Country.
Eligible individuals may also purchase coverage for their eligible dependents. An eligible spouse shall be defined as the Primary Insured’s legal spouse. An Eligible Dependent Child shall mean the Primary Insured Person’s unmarried child(ren) over fourteen (14) days and under nineteen (19) years of age.
Home Country is defined as: The country where You have Your true, fixed and permanent home and principal establishment.
It is the Insured Person’s responsibility to maintain all records regarding travel history, age and provide any documents to the Administrator, which would verify Eligibility Requirements.
Description of Coverage
The minimum period of coverage under Liaison® International Plan is five (5) days, maximum is 45 days. Coverage can be purchased in a combination of monthly and/or daily periods by paying the appropriate Plan Cost.
Your coverage will begin on the latest of the following:
- The date and time the Company receives a completed application and Plan Cost for the Period of Coverage; or
- The Effective Date requested on the application; or
- The moment You depart Your Home Country; or
- The date the Company approves the application.
Coverage will end on the earlier of the following:
- Your return to Your Home Country (except as provided under the Home Country Coverage); or
- The expiration of 45 days from the Effective Date of Coverage; or
- The date shown on the ID card; or
- The end of the period for which Plan Cost has been paid; or
- The date You fail to be considered an Eligible Person; or
- The maximum benefit amount has been paid.
Liaison® International Plan shall pay Usual, Reasonable and Customary charges for Covered Expenses, excess of the chosen Deductible and Coinsurance up to the selected Medical Maximum, incurred by You due to an Accidental Injury or Illness which occurred during the Period of Coverage outside Your Home Country (except as provided under the Home Country Coverage). All bodily disorders existing simultaneously which are due to the same or related causes shall be considered one Disablement. If a Disablement is due to causes which are the same or related to the cause of a prior Disablement, the Disablement shall be considered a continuation of the prior Disablement and not a separate Disablement. The initial Treatment of an Injury or Illness must occur within thirty (30) days of the date of Injury or onset of Illness.
Only such expenses which are specifically enumerated in the following list of charges, which are incurred within one hundred and eighty (180) days from the date of accident or onset of Illness and which are not excluded shall be considered Covered Expenses:
- Charges made by a Hospital for room and board, floor nursing and other services inclusive of charges for professional service and with the exception of personal services of a non-medical nature; provided, however, that expenses do not exceed the Hospital’s average charge for semi-private room and board accommodations.
- Charges made for Intensive Care or Coronary Care charges and nursing services.
- Charges made for diagnosis, Treatment and Surgery by a Physician.
- Charges made for an operating room.
- Charges made for Outpatient Treatment, same as any other Treatment covered on an Inpatient basis. This includes ambulatory Surgical centers, Physicians’ Outpatient visits/examinations, clinic care, and Surgical opinion consultations.
- Charges made for the cost and administration of anesthetics.
- Charges for medication, x-ray services, laboratory tests and services, the use of radium and radioactive isotopes, oxygen, blood, transfusions, iron lungs, and medical Treatment.
- Charges for physiotherapy, if recommended by a Physician for the Treatment of a specific Disablement and administered by a licensed physiotherapist.
- Dressings, drugs, and Medicines that can only be obtained upon a written prescription of a Physician or Surgeon.
- Local transportation to or from the nearest Hospital or to and from the nearest Hospital with facilities for required Treatment. Such transportation shall be by licensed ground ambulance only to a limit of $5,000, within the metropolitan area in which You are located at that time the service is used. If You are in a rural area, then licensed air ambulance transportation to the nearest metropolitan area shall be considered a Covered Expense.
Dental - accident coverage
This Plan shall pay in excess of the chosen Deductible and Coinsurance of up to a maximum of $500, for emergency Treatment to repair or replace sound natural teeth damaged as the result of a covered accident.
Dental - emergency relief of pain
This plan shall pay in excess of the chosen Deductible and Coinsurance up to a maximum of $100, for emergency Treatment for the relief of pain to natural teeth.
Emergency medical evacuation/repatriation
The Plan will pay Covered Expenses incurred if any covered Injury or Illness commences during the Period of Coverage that results in the Medically Necessary Emergency Medical Evacuation or Repatriation (Your medical condition warrants immediate transportation from the medical facility where You are located to the nearest adequate medical facility where medical Treatment can be obtained).*
Return of mortal remains
The Program will pay the reasonable Covered Expenses incurred up to a maximum of $50,000 to return your remains to your Home Country, if you should die.*
Emergency medical reunion
When Emergency Medical Evacuation or Repatriation is ordered and the attending Physician recommends that a family member travel with You, the plan will arrange and pay, up to $50,000, for a round trip economy-class transportation for one individual of Your choice, from Your Home Country, to be at Your side while You are hospitalized.*
Return of minor child(ren)
Should You be traveling alone with a Minor Child(ren) and are hospitalized because of a covered Illness or Injury and the Minor
Child(ren), under age nineteen (19), is left unattended, the Plan will arrange and pay up to $50,000 for a one way economy fare to their Home Country (including the cost of an attendant escort, if necessary to insure the safety and welfare of a Minor Child(ren)).*
$150 per night for a maximum of 30 days per occurrence, while traveling outside the U.S. and Canada.
Interruption of trip
If you are unable to continue the Trip due to the death of an Immediate Family member (parent, spouse, sibling or child) or due to serious damage to your principal residence from fire, flood or similar natural disaster (tornado, earthquake, hurricane, etc.). The program will reimburse you (up to $5,000) for the cost of economy travel, less the value of applied credit from an unused return travel ticket, to return you home to your area of principal residence.*
Home country coverage
Incidental Trips to Your Home Country: Incidental Trips to the Home Country: Up to $50,000 per coverage period (not available for coverage periods of less than 30 days) Extension of Benefits: Up to $5,000 per coverage period.
Extension of Benefits: This plan shall pay for Covered Expenses incurred in your Home Country up to $5,000 for conditions that are first diagnosed and treated outside Your Home Country (Does not apply for Emergency Medical Evacuation or Repatriation).
*NOTE: In the event of Emergency Medical Evacuation, Repatriation, Return of Mortal Remains, Emergency Reunion, Return of Minor Child(ren) or Interruption of Trip benefit is needed or utilized, all arrangements must be made by the Assistance Service Provider. Complete details about the benefits and about the required notification of the Assistance Service Provider are contained in the Program Summary.
A continuation of coverage option is available to participants whose initial Period of Coverage is less than 45 days. If the participant must extend their trip beyond their initial Period of Coverage, that participant may purchase an additional Period of Coverage not to exceed 45 days in total from their original effective date. While a new Period of Coverage will be issued, the participant’s original effective date will be used with regards to calculating their Deductible, Coinsurance, as well as determining any Pre-existing conditions.
Hazardous sport coverage
Hazardous Sport Coverage: You may buy coverage for the following activities: motorcycle/motor scooter riding (driver or passenger), hang gliding, parachuting, bungee jumping, water skiing, snow boarding,* snowskiing,* snowmobiling, wakeboard riding, jet skiing, paragliding, windsurfing.
*No coverage is provided while skiing/boarding in any violation of applicable laws, rules or regulations, away from prepared and marked in-bound territories; and/or against the advice of the local ski school or local authoritative body.
Pre-notification / referral
In order to ensure Your claims are addressed as efficiently as possible, You or the provider of service must contact the Assistance Company for pre-notification prior to: any medical Treatment in the U.S. as well as hospital admissions and inpatient / outpatient surgeries incurred worldwide. The Assistance Company has trained personnel available 24 hours a day, 7 days a week throughout the year to answer Your questions, provide assistance, and guide You to an appropriate facility if necessary. In the case of an Emergency Admission, the Assistance Company must be contacted within 48 hours, or as soon as reasonably possible. Pre-notification does not guarantee that benefits will be paid.
Please be aware that this is not a general health insurance policy, but an interim, limited benefit period, travel medical plan intended for use while away from Your Home Country. The Liaison® International Plan can not guarantee payment to an individual or a facility for medical expenses until it has been determined that it is an eligible expense and a signed agreement has been received from the appropriate medical facility.
Refund of premium
Seven Corners realizes that there is uncertainty in international travel. Refund of total plan cost will only be considered if written request is received by Seven Corners prior to the Effective Date of Coverage. If written request is received after the Effective Date of coverage, the unused portion of the plan cost may be refunded minus a cancellation fee, provided no claim has been submitted to Seven Corners for reimbursement.
Filing a claim with Seven Corners is easy. You will receive a Liaison® International identification card and claim form after your application has been processed. When you receive Treatment, send the original, itemized bills to Seven Corners within ninety (90) days. Eligible bills are automatically converted from local currencies to U.S. dollars. For payments of eligible medical expenses, notify Seven Corners of Pending Treatments and we can refer you to approved healthcare providers worldwide. You’re only responsible for your Deductible, Coinsurance and non-eligible expenses. For more details, consult the Program Summary that is provided with your insurance kit, or contact the Seven Corners Claim Department.
Patient Protection and Affordable Care Act (“PPACA”): This insurance is not subject to, and does not provide certain of the insurance benefits required by, the United States PPACA. PPACA requires certain U.S. residents and citizens to obtain PPACA compliant insurance coverage. In certain circumstances penalties may be imposed on U.S. residents and citizens who do not maintain PPACA compliant insurance coverage. You should consult your attorney or tax professional to determine if PPACA’s requirements are applicable to you. The policy contains the plan benefits, including a lifetime maximum that you have selected. Please review your choices to ensure that you have sufficient coverage to meet your medical needs.