 | Phone: (800) 423-3632 Weekdays, 5:00am - 12:00am EST |
 | E-mail: [email protected] |
 | Mail: Trip Mate, Inc. 9225 Ward Parkway, Suite 200 Kansas City, Missouri 64114 |
REQUIRED CLAIM DOCUMENTATION
Trip Cancellation or Trip Interruption
• Payment Information - a copy of your trip itinerary andcopies of all invoices, credit card statements and canceled checks evidencing your payment for the trip.
• Refund Information - original unusednon-refundable tickets; copies of invoices, credit card statements or otherwritten documentation substantiating the non-refundable costs for your trip(retain originals for your records); and a copy of the travel supplier'sliterature that details the cancellation terms and conditions (i.e. penaltiesaccessed when a trip is canceled or refunds given when a trip is interrupted).All refundable airline tickets should be sent to the issuing party for theappropriate refund. Submitting refundable airline tickets to our office maydelay your claim.
• Cause of Your Trip Cancellation or Interruption - any documentationsubstantiating the reason you canceled or interrupted your trip (i.e. such as adeath certificate in the event of a death; for a sickness or injury, signedAttending Physician Statement and Authorization for Release of Informationforms which are included with your claim form).
Travel Delay
• Trip Information - a copy of your trip itinerary showingyour daily activities during your trip.
• Expense Reimbursement - anydocumentation of expenses for which you are requesting reimbursement, such as: receiptsfor additional hotel, meal, local transport etc. during your delay (retainoriginals for your records).
• Cause of Your Travel Delay - any documentationsubstantiating the reason you interrupted your trip (i.e. such as documentationfrom the airline or other carrier detailing the cause of your delay; or for asickness or injury, documentation of treatment for the cause of your delay).
Medical Expense
• Additional Forms - a signed "Authorization forRelease of Information" form (included with your claim form).
• ExpenseReimbursement - copies of itemized bills and/or statements from medicalproviders for services rendered in connection with your claim (retain originalsfor your records). These bills and/or statements must include the date ofservice, the service rendered, the charge for each service, and the diagnosis.Attach copies of your credit card statements and/or canceled checks showingyour payment for the medical service submitted. If medical expenses wereincurred abroad, attach copies of your passport pages which identify you as thetraveler and document your entrance into and exit from the country or countrieswhere medical services were received.
Baggage & Personal Effects
• For repaired luggage - please submit your luggage repairbill.
• For items damaged beyond repair - you must provide the date ofpurchase, a fully completed Statement of Non-Reparability, and a writtenstatement of current replacement cost from a retailer (retain originals foryour records).
• For items lost or stolen - you must provide the date ofpurchase. If you are not sure of the exact date, provide the month and year ofpurchase.
• Expense Reimbursement - you must provide documentation of theoriginal purchase price for all items over $50.00 in value which have been lostor stolen. If the original receipt is not available, benefits will becalculated based upon 75% of the Actual Cash Value at the time of loss. Foritems older than one year, you must supply a written statement of currentreplacement cost from a retailer (retain originals for your records).
Baggage Delay
• From the public carrier (airline, bus line, taxi, ship,etc.) causing the baggage delay - you must provide us with evidence of payment,claim denial, or other disposition from the responsible party (retain originalsfor your records).
• Expense Reimbursement - copies of all receipts foradditional clothing and personal articles purchased during the delay (retainoriginals for your records).
CLAIM PROVISIONS
Your duties in event of a loss: For Trip Cancellation andTrip Interruption: Immediately, or as soon as possible, call Your TravelSupplier and the Program Administrator (see Where to Report a Claim) to reportYour cancellation, interruption or delayed arrival to avoid non-covered chargesdue to late reporting. If You are prevented from taking Your Trip as scheduledor must interrupt your Trip due to Sickness or Injury, You should obtainmedical care immediately. We require a certification by the treating Physicianat the time of Sickness or Injury that medically imposed restrictions preventedYour participation or continued participation in the Trip. Provide all unusedtransportation tickets, official receipts, etc.
Travel Delay orMissed Connection: Obtain any specific dated documentation, that provides proofof the reason for delay (airline or cruise line forms, medical statements,etc). Submit this documentation along with Your trip itinerary and all receiptsfor additional expenses incurred.
Medical Expenses: Obtain receipts from the providers ofservice, etc., stating the amount paid and listing the diagnosis and treatment.Submit these first to other medical plans. Provide a copy of their finaldisposition of Your claim.
For Baggage and Personal Effects, Sports Equipment, BusinessEquipment Rental, Sports Equipment Rental and Baggage Delay: In case of lost,stolen, damaged, destroyed or delayed Baggage and Personal Effects and SportsEquipment. You must: a) take all necessary and reasonable steps to protect,save or recover the property; b) notify, within 48 hours of the loss inwriting, the police, hotel proprietors, ship lines, airlines, railroad, bus,airport or other station authorities, tour operators or group leaders, or anyCommon Carrier or bailee who has custody of Your property at the time of loss;c) obtain a copy of the reported loss, damage, delay or theft of the item fromthe Common Carrier who had possession of the item at the time of the loss toinclude the Common Carrier’s liability for such loss; d) produce records neededto verify the claim and its amount, and permit copies to be made; e) provideUs, within 90 days from the date of loss, a detailed proof of loss signed andsworn to; and f) allow the property to be examined, if requested.
For Rental Car Damage: You must: a) Take all necessary andreasonable steps to protect the Rental Car and prevent further damage to it; b)Report the loss to the appropriate local authorities and the rental car companyas soon as possible; c) Obtain all information on any other party involved inthe Accident, such as name, address, insurance information and driver’s licensenumber; d) Provide Us all documentation such as rental agreement, police reportand damage estimate.
Notice of Claim: Notice of claim must be reported to Uswithin 30 days after a loss occurs or as soon as is reasonably possible. You orsomeone on Your behalf may give the notice. The notice should be given to Us orOur designated representative and should include sufficient information toidentify You.
Claim Forms: When notice of claim is received by Us or Ourdesignated representative, forms for filing proof of loss will be furnished. Ifthese forms are not sent within 15 days, the proof of loss requirements can bemet by You sending Us a written statement of what happened. This statement mustbe received within the time given for filing proof of loss. Obtain claim formsfrom Trip Mate, Inc. or at www.mhross.com which will provide all the detailsfor filing Your claim appropriately. Please read the instructions carefully.The instructions will direct You toward filing all the correct, necessarydocumentation and following the appropriate procedures in order to have Yourclaim settled as quickly as possible. Proof of Loss: Proof of loss must beprovided within 90 days after the date of the loss or as soon as is reasonablypossible. Proof must, however, be furnished no later than 12 months from thetime it is otherwise required, except in the absence of legal capacity.
Payment of Claims: Benefits for Loss of life will be paid toYour designated beneficiary. If a beneficiary is not otherwise designated byYou, benefits for Loss of life will be paid to the first of the followingsurviving preference beneficiaries: a) Your spouse; b) Your child or childrenjointly; c) Your parents jointly if both are living or the surviving parent ifonly one survives; d) Your brothers and sisters jointly; or e) Your estate.
All other benefits will be paid directly to You, unlessotherwise directed. Any accrued benefits unpaid at Your death will be paid toYour estate. If You have assigned Your benefits, we will honor the assignmentif a signed copy has been filed with us. We are not responsible for thevalidity of any assignment.
All or a portion of all benefits provided by the plan may,at Our option, be paid directly to the provider of the service(s) to You. Allbenefits not paid to the provider will be paid to You.
If any benefit is payable to: (a) an Insured who is a minoror otherwise not able to give a valid release; or (b) Your estate, We may payany amount due under the plan to Your beneficiary or any relative whom We findentitled to the payment. Any payment made in good faith shall fully dischargeUs to any party to the extent of such payment.
