Liaison Continent Travel Medical Insurance
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® Continent offers medical coverage and emergency services to individuals and families traveling outside their Home Countries. This brochure is a brief description of Liaison® Continent. For a full description, see the Program Summary, which will be mailed to you once you are approved for coverage.
- Liaison® Continent provides coverage, as outlined in this brochure, for individuals and families (including unmarried dependent child(ren) over 14 days and under 19 years of age) while traveling outside of their Home Country.
- For persons traveling to the United States, the program must become effective within 3 months of arrival in the United States.
- Home Country is defined as - The country where a covered person(s) has his/her 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.
Before purchasing additional coverage, you must return to your Home Country for a minimum of thirty (30) days
Description of Coverage
The minimum period of coverage under Liaison® Continent Plan is five (5) days, maximum is one hundred eighty-seven 187 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 one hundred and eighty-seven (187) days months 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® Continent 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 (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 an operating room.
- 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 the cost and administration of anesthetics.
- 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 for medication, x-ray services, laboratory tests and services, the use of radium and radioactive isotopes, oxygen, blood transfusions, iron lungs, and medical treatment; dressings, drugs, and medicines that can only be obtained upon a written prescription of a Physician or Surgeon.
- Charges for physiotherapy, if recommended by a Physician for the treatment of a specific Disablement and administered by a licensed physiotherapist.
- Ground ambulance (within the metropolitan area, up to $5,000 maximum) to and from the nearest Hospital with facilities for required treatment. If the Insured Person is in a rural area and unreachable by ground ambulance, then licensed air ambulance transportation to the nearest metropolitan area shall be considered a Covered Expense.
- Hotel room charge, when the Insured Person, otherwise necessarily confined in a Hospital, shall be under the care of a duly qualified Physician in a hotel room due to unavailability of a Hospital room by reason of capacity or distance or any other circumstances beyond control of the Insured Person.
- Charges made for artificial limbs, eyes, larynx, and orthotic appliances, but not for replacement of such items.
- Charges for Home Health Care up to a $2,500 Maximum per Policy Period.
Dental - emergency only
The Emergency Dental Benefit is available to you provided you have purchased one (1) or more months of coverage. Treatment necessary to resolve acute, spontaneous and unexpected inception of pain to sound natural teeth ($100) or Dental treatment necessary to restore or replace sound natural teeth lost or damaged in an Accident is covered under the program ($500). This benefit is subject to the Deductible and Coinsurance.
Political evacuation and repatriation
If a formal recommendation from authorities is issued for you to leave the host country, due to political or military events or you are expelled or declared persona non-grata by the host country, all reasonable expenses incurred for transportation to the nearest place of safety or for repatriation to your Home Country are covered up to a maximum of $50,000. Evacuation must occur within 10 days of any such event. Evacuation costs will be paid once per insured per occurrence.*
*The Political Evacuation and Repatriation of Remains Benefit will not pay, should the Insured not heed Travel Warnings issued by the State Department or the appropriate authorities recommending that travelers avoid a certain country.
Coverage for Injuries and Illnesses up to $50,000 resulting from an Act of Terrorism, as defined in the program summary, provided all of the following conditions are met:
- You have no direct or indirect involvement in the Act of Terrorism.
- The Act of Terrorism is not in a country or location where the United States government has issued a travel warning that has been in effect within the 6 months prior to your date of arrival.
- You have not unreasonably failed or refused to depart a country or location following the date a warning to leave that country or location is issued by the United States government.
Emergency medical evacuation/repatriation
The program will pay Covered transportation Expenses incurred up to $300,000 for any covered Injury or Illness commencing during the Period of Coverage that results in a 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).
Covered Medical Expenses will be paid to the Medical Maximum, minus Your Deductible and Coinsurance, unless otherwise specifically excluded.
If the decision is made by Seven Corners Assist to evacuate you to your Home Country, the Follow Me Home limit of $5,000 does not apply
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)).*
If you are hospitalized while traveling outside of the United States or Canada, and the hospitalization is considered a Covered Expense, the program will indemnify you $150 for each night spent in the hospital, up to a maximum of thirty (30) days. This benefit is in addition to any other covered expenses of the program. You may use these incidental funds as you wish.
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: : This benefit covers you for incidental trips taken during your Period of Coverage to your Home Country (30 days per one hundred eighty-seven (187) days of purchased coverage or pro rata thereof - example: approximately 5 days per month of purchased coverage). Maximum benefit is reduced to $50,000, minus Your Deductible and Coinsurance, for any Illness or Injury occurring while on an incidental trip to your Home Country. You must first depart Your Home Country in order to utilize this benefit and it does not apply to the final trip home. In the event of a claim, You may be required to provide proof of Your travel intentions. Earned Home Country Coverage days for the current Policy Period do not extend or carry over after a completed one hundred eighty-seven (187) days. If you choose to purchase a new Policy, the earning of incidental days will start over again, i.e. 5 days for every month that You purchase. Please note: If you do not use your Home Country Coverage days within your Period of Coverage, they do not extend after your current expiration date.
Follow Me Home Coverage: 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.
You do not have to pay premium for your entire trip all at once. The minimum Period of Coverage is five (5) days. Prior to the expiration date, Seven Corners will send out a renewal notice to your e-mail address, providing you the opportunity to extend coverage. This can be done as many times as you like up to a maximum Period of Coverage of one hundred and eighty seven (187) days. A $5.00 Administrative Fee will be included on each renewal payment.
It is the insured person’s responsibility to maintain all records regarding travel history, age, student status and provide any documents to the Administrator, which would verify the Eligibility Requirements
Hazardous sport coverage
To cover motorcycle / motor scooter riding (whether as a passenger or driver), hang gliding, parachuting, bungee jumping, water skiing, wakeboard riding, jet skiing, windsurfing, snow skiing, snowmobiling and snow boarding.
Parachuting shall mean an activity involving the breaking of a free fall from an airplane using a parachute.
The following expenses must always be pre-certified:
- Any Surgery or Surgical Procedure
- Computerized Tomography (CAT Scan)
- Magnetic Resonance Imaging (MRI)
- Contact Seven Corners Assist (at the telephone number shown in the policy and on I.D. cards) as soon as possible before the expense is to be incurred; and
- Comply with Seven Corners Assist’s instructions and submit any information or documents they require; and
- Notify all physicians, hospitals and other providers that this insurance contains pre-certification requirements and ask them to fully cooperate with Seven Corners.
Emergency Pre-certification - In the event of an emergency hospital admission, pre-certification must be made within 48 hours of the admission, or as soon as reasonably possible.
If you comply with the pre-certification requirements, the expenses will then be reviewed according to the policy terms to determine if the expenses are eligible to be paid. If you do not comply with the pre-certification requirements or if the expenses are not pre-certified, your expenses will be reviewed according to the policy terms. If they are determined to be eligible for payment, they will be reduced by 50%, then the deductible will be subtracted from the remaining amount, and finally the coinsurance will be applied.
Pre-certification Does Not Guarantee Benefits - The fact that expenses are pre-certified does not guarantee either payment of benefits or the amount of benefits. Eligibility for and payment of benefits is determined after review of the policy terms, conditions, provisions and exclusions.
Concurrent Review - For Inpatient stays of any kind, the Administrator will pre-certify a limited number of days of confinement. Additional days of Inpatient confinement may later be pre-certified if an Insured receives prior approval.
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® Continent 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® Continent 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.