(Everyday, 24 hours per day)
PAYMENT OF CLAIMS
Notice of Claim: The Insured must callTravel Guard as soon as reasonably possible, and beprepared to describe the Loss, the name of the company thatarranged the Trip (i.e., tour operator, Cruise line, or charteroperator), the Trip dates, purchase date and the amount thatthe Insured paid. Travel Guard will fill in the claim form andforward it to the Insured for his or her review and signature.The completed form should be returned to Travel Guard, POBox 47, Stevens Point, WI 54481 (telephone1.800.826.1300).
All accident, health, and life claims will be administered byAIG Claims Inc., in those states where it is licensed.
Claim Procedures: Proof of Loss: The claim forms must besent back to Travel Guard no more than 90 days after acovered Loss occurs or ends, or as soon after that as isreasonably possible. All claims under the Policy must be submitted to Travel Guard no later than one year after thedate of Loss or insured occurrence or as soon as reasonably possible. If Travel Guard has not provided claim forms within15 days after the notice of claim, other proofs of Loss shouldbe sent to Travel Guard by the date claim forms would bedue. The proof of Loss should include written proof of the occurrence, type and amount of Loss, the Insured’s name, the participating organization name, and policy number. The Insured must return all unused, none refundable tickets.
Payment of Claims: When Paid: Claims will be paid as soon as Travel Guard receives complete proof of Loss and verification of age.
Payment of Claims: To Whom Paid: Benefits are payable to the Insured who applied for coverage and paid any required plan cost. Any benefits payable due to that Insured’s death will be paid to the survivors of the first surviving class of those that follow: (a) the beneficiary named by that Insured and on file withTravel Guard (b) to his/her spouse, if living. If no living spouse, then (c) in equal shares to his/her living children. If there are none, then (d) in equal shares to his/her living parents. If there are none, then (e) in equal shares to his/her living brothers and sisters. If there are none, then (f) to the Insured’s estate. If a benefit is payable to a minor or other person who is incapable of giving a valid release, the Company may pay upto $3,000 to a relative by blood or connection by marriage who has assumed care or custody of the minor or responsibility for the incompetent person’s affairs. Any payment the Company makes in good faith fully discharges the Company to the extent of that payment.
Accident Sickness Medical Expense and EmergencyEvacuation benefits may be payable directly to the provider. However, the provider: (a) must comply with the statutory provision for direct payment; and (b) must not have been paid from any other sources.
Trip Cancellation and Trip Interruption Proof of Loss: The Insured must provide Travel Guard documentation of the cancellation or interruption and proof of the expenses incurred. The Insured must provide proof of payment for theTrip such as canceled check or credit card statements, proof of refunds received, copies of applicable tour operator or Common Carrier cancellation policies, and any other information reasonably required to prove the Loss. Claims involving Loss due to Sickness, Injury, or death require signed patient (or next of kin) authorization to release medical information and an attending Physician’s statement. The Insured must provide Travel Guard with all unused air, rail, Cruise or other tickets if he/she is claiming the value of those unused tickets.
Trip Delay Proof of Loss: The Insured must provide Travel Guard documentation of the delay from the airline, Cruiseline, etc., as to the reason for the delay and proof of the expenses incurred. The Insured must provide Travel Guard with all original receipts, copies of receipts or a list of the expenses incurred that gives the amount paid, what the payment was for, and the date of the payment. Claims involving Loss due to Sickness, Injury or death require signed patient (or next of kin) authorization to release medical information and an attending Physician’s statement.
Baggage and Personal Effects Proof of Loss: The Insuredmust: (a) report theft Losses to police or other local authorities as soon as possible; (b) take reasonable steps to protect his/her Baggage from further damage and make necessary and reasonable temporary repairs; (The Companywill reimburse the Insured for those expenses. The Company will not pay for further damage if the Insured fails to protect his/her Baggage); (c) allow the Company to examine the damaged Baggage and/or the Company may require the damaged item to be sent in the event of payment; and (d) send sworn proof of Loss as soon as possible from date of Loss, providing amount of Loss, date, time, and cause of Loss, and a complete list of damaged or lost items.
Baggage Delay Proof of Loss: The Insured must provide documentation of the delay or mis direction of Baggage by the Common Carrier and receipts for the Necessary Personal Effects purchases.
Car Rental Collision Coverage Proof of Loss: The Insuredmust: take all reasonable, necessary steps to protect the vehicle and prevent further damage to it; report the Loss to the appropriate local authorities and the rental company assoon as possible; obtain all information on any other party involved in a traffic accident, such as name, address, insurance information, and driver’s license number; and provide Travel Guard all documentation such as rental agreement, police report, and damage estimate.
The following provisions apply to Baggage/Personal Effects, Baggage Delay and Car Rental Collision Coverage:Notice of Loss.
If the Insured's property covered under the Policy is lost or damaged, the Insured must: (a) notify Travel Guard as soon as possible; (b) take immediate steps to protect, save and/or recover the covered property; (c) give immediate notice to the carrier or bailee who is ormay be liable for the Loss or damage; (d) notify the police or other authority in the case of robbery or theft within 24 hours.
Proof of Loss. The Insured must furnish Travel Guard with proof of Loss. Proof of Loss includes police or other local authority reports or documentation from the appropriate party responsible for the Loss. It must be filed within 90 days from the date of Loss. Failure to comply with these conditions shall not invalidate any claims under the Policy.
Settlement of Loss. Claims for damage and/or destruction shall be paid immediately after proof of the damage and/or destruction is presented to Travel Guard. Claims for lost property will be paid after the lapse of a reasonable time if the property has not been recovered. The Insured must present acceptable proof of Loss and the value.
Valuation. The Company will not pay more than the Actual Cash Value of the property at the time of Loss. At no time will payment exceed what it would cost to repair or replace the property with material of like kind and quality.
Disagreement Over Size of Loss. If there is a disagreement about the amount of the Loss, either the Insured or the Company can make a written demand for an appraisal. After the demand, the Insured and the Company each select their own competent appraiser. After examining the facts, each of the two appraisers will give an opinion onthe amount of the Loss. If they do not agree, they will selectan arbitrator. Any figure agreed to by 2 of the 3 (the appraisers and the arbitrator) will be binding. The appraiser selected by the Insured is paid by the Insured. The Company will pay the appraiser it chooses. The Insured will share with the Company the cost for the arbitrator and the appraisal process.
Benefit to Bailee. This insurance will in no way inure directly or indirectly to the benefit of any carrier or other bailee.
Accident Sickness Medical Expense, Emergency Evacuation & Repatriation of Remains, Accidental Death & Dismemberment and Flight Guard Proof of Loss: TheInsured must provide Travel Guard with: (a) all medical billsand reports for medical expenses claimed; and (b) a signedpatient authorization to release medical information to TravelGuard.
The following provision applies to Trip Cancellation, TripInterruption, Accident Sickness Medical Expense,Baggage Delay, Baggage and Personal Effects,Emergency Evacuation & Repatriation of Remains andCar Rental Collision Coverage:
Subrogation - To the extent the Company pays for a Loss suffered by an Insured, the Company will take over the right sand remedies the Insured had relating to the Loss. This is known as subrogation. The Insured must help the Company preserve its rights against those responsible for its Loss. This may involve signing any papers and taking any other steps the Company may reasonably require. If the Company takes over an Insured's rights, the Insured must sign an appropriates ubrogation form supplied by the Company.
As a condition to receiving the applicable benefits listedabove, as they pertain to this Subrogation provision, the Insured agrees, except as may be limited or prohibited by applicable law, to reimburse the Company for any such benefits paid to or on be half of the Insured, if such benefit sare recovered, in any form, from any Third Party or Coverage.The Company will not pay or be responsible, without its written consent, for any fees or costs associated with the pursuit of a claim, cause of action or right by or on be half of an Insured or such other person against any Third Party or Coverage.
Coverage - as used in this Subrogation section, means no fault motorist coverage, uninsured motorist coverage,underinsured motorist coverage, or any other fund or insurance policy (except coverage provided under the Policy to which this Certificate of Insurance is attached) and any fund or insurance policy providing the Policy holder with coverage for any claims, causes of action or rights the Insured may have against the Policy holder.
Third Party - as used in this Subrogation section, means any person, corporation or other entity (except the Insured, thePolicy holder and the Company).