Liaison Student Travel Insurance

Medical Expenses

This Plan shall pay Reasonable and Customary charges for Covered Expenses, excess of the Deductible and Coinsurance up to the Medical Maximum, incurred by you due to a covered Injury or Illness which occurred during your 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 30 days of the date of Injury or onset of Illness. Only such expenses which are specifically enumerated in the following list of charges are incurred within your Period of Coverage, and which are not excluded shall be considered

Covered Expenses:

  1. Charges made by a hospital for semi-private 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, those expenses do not exceed the hospital’s average charge for semi-private room and board accommodation.
  2. Charges made for Intensive Care or Coronary Care charges and nursing services.
  3. Charges made for diagnosis, Treatment and Surgery by a Physician.
  4. Charges made for an operating room.
  5. 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.
  6. Charges made for the cost and administration of anesthetics.
  7. 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.
  8. Charges for physiotherapy, to a maximum of $500, if recommended by a Physician for the Treatment of a specific Disablement following hospitalization and administered by a licensed physiotherapist.
  9. Dressings, drugs, and Medicines that can only be obtained upon a written prescription of a Physician or Surgeon.
  10. 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 $350, within the metropolitan area in which you are located at the time the service is utilized. If you are in a rural area, then licensed air ambulance transportation to the nearest metropolitan area shall be considered a Covered Expense.

Pre-Notification

For each scheduled hospital admission, emergency hospital confinement, or Outpatient Treatment, you or someone on your behalf must contact the Assistance Company for prenotification as soon as possible, but no later than 48 hours prior to admission to a hospital, hospital confinement or Outpatient Treatment. For Emergency hospital Confinement, you or someone on your behalf must notify the Assistance Company as soon as possible, but no later than 48 hours after the date of admission. If you fail to pre-notify with the Assistance Company, Covered Expenses will be reduced to and payable at 50% after the Deductible. Pre-Notification does not guarantee or confirm benefits or the payment of said benefits.

Unexpected Recurrence of a Pre-existing Condition

(This benefit is only available to U.S. citizens traveling outside the United States) This Plan shall pay up to $500 subject to the chosen Deductible and Coinsurance, for Covered Expenses resulting from a sudden, unexpected recurrence of a Pre- Existing Condition while traveling outside the United States. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or treatments existent or necessary prior to the Effective Date of coverage.

Maternity

When covered maternity expenses are incurred by You or Your eligible dependents, the Company will pay Reasonable Charges for medical expenses in excess of the Deductible and Coinsurance. In no event shall the Company’s maximum liability exceed the maximum stated in the Schedule of Benefits, as to Covered Expenses during any one period of individual coverage. You or Your representative must notify the Company of a Pregnancy within the first trimester.

As stated in the Schedule of Benefits, benefits will be payable for covered expenses You incur before, during, and after delivery of a child, including physician, hospital, laboratory, and ultrasound services. Coverage for the Inpatient postpartum stay for You and Your newborn child in a hospital, will, at a minimum, be for the length of stay recommended by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists per their guidelines for perinatal care.

Coverage for a length of stay shorter than the minimum period mentioned above may be permitted if Your attending physician determines further Inpatient postpartum care is not necessary for You or Your newborn child provided the following are met:

  1. In the opinion of Your attending physician, the newborn child meets the criteria for medical stability in the guidelines for perinatal care prepared by the Academy of Pediatrics and the American College of Obstetricians and Gynecologists that determine the appropriate length of stay based upon the evaluation of:
    1. The antepartum, intrapartum, postpartum course of the mother and infant;
    2. The gestational stage, birth weight, and clinical condition of the infant;
    3. The demonstrated ability of the mother to care for the infant after discharge; and
    4. The availability of post discharge follow up to verify the condition of the infant after discharge; and
  2. One (1) at-home post delivery care visit is provided to You at Your residence by a physician or nurse performed no later than forty-eight (48) hours following discharge for You and Your newborn child from the hospital. Coverage for this visit includes, but is not limited to:
    1. . Parent education;
    2. Assistance and training in breast or bottle feeding; and Performance of any maternal or neonatal tests routinely performed during the usual course of Inpatient care for You or Your newborn child, including the collection of an adequate sample for the hereditary and metabolic newborn screening. (At Your discretion, this visit may occur at the physician’s office.)

Mental Illness

For the purpose of this section, only such expenses, incurred as the result of Treatment or Medication for Mental Illness, which are specifically enumerated in the following list of charges, and which are not excluded, shall be considered as Covered Expenses:

  1. Inpatient Care:
    1. Charges made by a Hospital or mental institution 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 or mental institution’s average charge for semi-private roomand board accommodation.
    2. Charges made for diagnosis and Treatment by a Physician.
    3. Charges made for the cost and administration of anesthetics.
    4. Charges for Medication, x-ray services, laboratory tests and services, oxygen, and medical Treatment.
    5. Drugs and Medicines that can only be obtained upon a written prescription of a Physician.
  2. Outpatient care:
    1. Charges made for diagnosis and Treatment by a Physician.
    2. Charges made for the cost and administration of anesthetics.
    3. Charges for Medication, x-ray services, laboratory tests and services, oxygen, and medical Treatment.
    4. Drugs and Medicines that can only be obtained upon a written prescription of a Physician.

Only those expenses specifically described above which are incurred within the following Limits from the onset of the Mental Illness and which are not excluded are considered Covered Expenses. Mental Illness must first manifest itself during the Period of Coverage.

  • Inpatient Care – Shall be payable at 50% to $10,000, subject to a maximum of 40 days of Inpatient care.
  • Outpatient – Shall be payable at 80% up to a maximum of $500.

Emergency Dental Treatment

Benefits are paid for Reasonable and Customary expenses in excess of the Deductible and Coinsurance of $250 per tooth up to a maximum of $500, for the emergency repair or replacement of sound, natural teeth damaged as the result of a Covered Accident.

Emergency Medical Evacuation & Repatriation

Benefits are paid for Covered Expenses incurred up to $100,000, for any covered Injury or Illness commencing during Your Period of Coverage that results in a Medically Necessary Emergency Medical Evacuation or Repatriation. The decision for an Emergency Medical Evacuation or Repatriation must be pre-approved and arranged by the Assistance Company in consultation with your local attending Physician.

Emergency Medical Evacuation or Repatriation means: a) your medical condition warrants immediate transportation from the place where you are located (due to inadequate medical facilities) to the nearest adequate medical facility where medical Treatment can be obtained; or b) after being treated at a local medical facility, your medical condition warrants transportation with a qualified medical attendant to your Home Country to obtain further medical Treatment or to recover; or c) both a) and b) above.

Covered Expenses are expenses for transportation, medical services and medical supplies necessarily incurred in connection with Emergency Medical Evacuation or Repatriation. All transportation arrangements must be by the most direct and economical route. Expenses for special transportation and medical supplies and services must be: a) pre-approved and ordered by the Assistance Company and b) required by the standard regulations of the conveyance transportation. Transportation means any land, water or air conveyance required to transport you. Special transportation includes, but is not limited to, licensed ground and air ambulances, commercial airlines, and private motor vehicles.

Return of Mortal Remains

Benefits will be paid for Reasonable and Customary Covered Expenses incurred up to $25,000, to return your remains to your Home Country, if you should die. Covered Expenses include, but are not limited to, expenses for embalming or Cremation, a minimally necessary container appropriate for transportation, shipping costs, and the necessary government authorizations. All Covered Expenses in connection with a Return of Mortal Remains or Cremation must be pre-approved and arranged by the Assistance Company.

Emergency Medical Reunion

When the Assistance Company and your attending Physician determine that it is necessary and prudent for you to have an Emergency Medical Evacuation or Repatriation, this Plan will arrange to bring an individual of your choice, from your Home Country, to be at your side while you are hospitalized and then accompany you during your return to your Home Country. Benefits will be paid up to $5,000 for a round-trip economy airfare ticket as well as for reasonable travel and accommodation expenses up to a maximum of 10 days, as pre-approved and arranged by the Assistance Company.

Spinal Manipulation

Benefits shall be paid for Spinal Manipulation which is prescribed, performed, or ordered by a licensed chiropractor for the relief of pain. Benefits are payable up to $500.

Home Country Coverage

Incidental Trips to the Home Country – During Your Period of Coverage, the Insured may return to their Home Country for incidental visits of up to 30 days per year (or pro-rate thereof ). If during an incidental trip home, the Insured suffers an Injury or Illness, this Plan shall pay up to $1,000 of Covered Expenses for that Injury or Illness. Treatment for this Injury or Illness must occur within the Insured’s Home Country while on the incidental visit.

Home Country Extension of Benefits – The Plan shall pay up to a maximum of $1,000 for Covered Expenses incurred in your Home Country related to an Injury or Illness which occurred, was diagnosed and treated outside your Home Country during your Period of Coverage. Only those covered expenses incurred within 30 days of your return to your Home Country shall be considered eligible.

Continuing Coverage

For those who are intending longer international trips, an option is available to you. If you choose this option on the application and enroll for at least three (3) months of coverage, a notice will be sent to your address of correspondence, allowing you to purchase an additional period of coverage (minimum of 1 month, maximum of 12 months). If you purchase at least three months of coverage, Seven Corners will continue to send notices to your address of correspondence. If you choose to purchase less than three months of coverage, Seven Corners will assume that your international trip is complete and will not send any further notices.

While a new period of coverage will be issued, your original effective date will be used with regards to determining any Preexisting Conditions.

This option is available as long as you continue to meet the Eligibility Requirements. It is important to note that rates and benefits may change for each subsequent Period of Coverage. A $5.00 Administrative Fee will be included on each notice. This option is not available if you allow coverage to expire prior to reapplying. If this happens, an entirely new program must be purchased (Pre-existing Conditions begin again).

Continuing Coverage is available in periods as short as 5 days at a time when purchased utilizing Seven Corners’ online system.

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.

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.