1. Hospital Accommodation:
   
   1. a) Charges up to the semi-private room rate charged by the hospital. If medically necessary, expenses for treatment in an intensive care or coronary care unit are also covered. If coverage terminates for any reason during the hospital stay, benefits continue until discharge, to a maximum of one year. In no case will expenses for in-patient stays be covered for a period greater than 365 days per insured person.
   2. b) Emergency room fees.
   3. c) Emergency out-patient services provided by a hospital when medically necessary.
2. Medical Services
   
   1. a) Medical treatment by a legally licensed physician, surgeon, anaesthetist or registered graduate nurse (other than an immediate family member of the insured person).
   2. b) Blood plasma, whole blood or oxygen including their administration.
3. Diagnostic Services Laboratory tests and x-rays that are ordered by the attending physician and that are part of the emergency medical treatment. This policy does not cover magnetic resonance imaging (MRI), cardiac catheterization, computerized axial tomography (CAT) scans, digital x-rays, sonograms or ultrasounds and biopsies unless such services are approved in advance by the Assistance Company.
4. Prescriptions: Drugs, including injectable drugs and sera, that can only be obtained upon medical prescription, that are prescribed by a physician and that are supplied by a licensed pharmacist when medically necessary for emergency medical treatment. This benefit is limited to a 30-day (60-day for Premium plan) supply per prescription, except while the insured person is hospitalized.
5. Private Duty Nurse: When approved in advance by the Assistance Company and prescribed by an attending physician, the professional services of a registered private duty nurse (other than by an immediate family member) as the result of a covered emergency when medically necessary and while hospitalized or in lieu of hospitalization. When in lieu of hospitalization this benefit is limited to $5,000.
6. Dental: When performed by a legally qualified dentist or oral surgeon, emergency dental treatment up to $2,500 ($4,000 for Enhanced or Premium plans) to repair or replace whole or sound natural teeth or permanently attached artificial teeth damaged as a result of an accidental blow to the face.
   Treatment must be initiated within 7 days from the time the emergency began and be completed no later than 90 days after treatment began and before your expiry date.
7. Medical Appliances: When approved in advance by The Assistance Company, and prescribed by the attending physician:
   1. a) minor appliances such as crutches, casts, splints, canes, slings, trusses, braces, walkers; and/or
   2. b) the temporary rental of a hospital type bed, wheelchair, iron lung or other durable equipment for therapeutic treatment, not exceeding the purchase price.
8. Emergency Transportation: When approved in advance by The Assistance Company, and prescribed by the attending physician:
   1. a) Licenced ambulance services (includes taxi fare in lieu of ambulance) to the nearest medical facility capable of providing the required emergency medical treatment;
   2. b) Transportation between hospitals when ordered by the attending physician for emergency medical treatment;
   3. c) If, as the result of a covered emergency, your treating physician or the Assistance Company’s Medical Team recommends that you be returned to Canada or your country of origin, the costs incurred for:
   1. i) one-way economy airfare on a commercial flight via the most direct route, including the cost for additional seats to accommodate a stretcher;
   2. ii) return economy airfare via the most direct route for a qualified medical attendant to accompany you if required by the airline or if your attending physician states in writing that it is medically necessary;
   3. iii) air ambulance if medically necessary
   only when approved and arranged by the Assistance Company.

9. Maternity: In the event of pregnancy of an insured commencing during the coverage period the insurer will reimburse reasonable and customary costs incurred in Canada for emergency medical treatment for a maximum period of 6 months following the birth of the child and up to a maximum amount of $5,000 ($10,000 for Enhanced plan) for complications arising from such pregnancy and/or childbirth.
   This benefit is provided only when coverage has been in force for the entire term of the pregnancy. Costs incurred outside of Canada are not covered.
   Spontaneous, or non-induced, pregnancy terminations are covered. Induced terminations are limited to one per coverage period.
10. Psychiatric/Psychological: When deemed essential by the attending physician, the actual costs for:
    1. a) visits to a licensed psychiatrist, psychologist or social worker for the relief of acute symptoms, up to a maximum of $500 per insured person; or
    2. b) hospitalization of the insured person due to psychological, mental or emotional disorders, up to a lifetime maximum of $10,000.
    This benefit includes the cost of the initial visit to a physician.
11. Repatriation of Remains: In the event of your death as a result of covered accident or unforeseen sickness:
    1. a) up to a maximum of $5,000 ($10,000 for Enhanced or Premium plans) toward the actual cost incurred for the preparation of remains and transportation (including a standard shipping container) to your country of origin; or
    2. b) up to $5,000 ($10,000 for Enhanced or Premium plans) for cremation and/or burial at the place of death.
    The cost of the casket, urn or funeral is not covered.
12. Accidental Death & Dismemberment: The insurer agrees to pay up to $10,000 ($15,000 for Enhanced or Premium plans) for loss of life, limb or sight of an insured person resulting directly from accidental injury occurring during the coverage period.
    Benefits are payable according to the following schedule:
    1. a) 100% of sum insured resulting from the same accidental injury for loss of:
       1. i) life; or
       2. ii) entire sight of both eyes; or
       3. iii) both hands; or
       4. iv) both feet; or
       5. v) one hand and entire sight of one eye; or
       6. vi) one foot and entire sight of one eye.
    2. b) 50% of sum insured resulting from the same accidental injury for loss of:
       1. i) entire sight of one eye; or
       2. ii) one hand; or
       3. iii) one foot.
    Loss of hand or hands, or foot or feet means severance through or above the wrist joint or ankle joint, respectively. Loss of eye or eyes means total and irrecoverable loss of the entire sight.
    Only one amount is payable (the largest) if you suffer more than one of these losses.
    Exposure and Disappearance
    If you are exposed to the elements or disappear as a result of an accident, a loss will be covered if:
    1. a) as a result of such exposure, you suffer one of the losses specified in the schedule of losses above; or
    2. b) your body has not been found within 52 weeks from the date of the accident. It will be presumed, subject to evidence to the contrary, that you suffered loss of life.
13. Common Carrier: The insurer agrees to pay up to $25,000 ($100,000 for Enhanced or Premium plans) in case of death of an insured person as a result of an injury sustained during the coverage period while travelling as a fare-paying passenger on a common carrier. If the total claims for the same accident exceed $300,000, the insurer’s liability for that accident is limited to $300,000 which will be shared proportionately among all claimants involved in the same accident and who are covered under all policies underwritten by the insurer.

The following benefits apply only if you have selected and paid for the Enhanced or Premium plan as shown on your confirmation of insurance.

14. Paramedical Services:When approved in advance by the Assistance Company, the services (including x-rays) of a licensed chiropractor, physiotherapist, podiatrist or osteopath to a maximum of $500 per insured person, per profession listed above.
15. Dental: When performed by a legally qualified dentist or oral surgeon, emergency dental treatment up to $600 for relief of pain caused other than by a blow to the face and including impacted wisdom teeth for which you have not previously received treatment or advice.
    Treatment must be initiated within 7 days from the time the emergency began and be completed no later than 90 days after treatment began and before your expiry date.
16. Physical Examination: Up to $150 for one annual medical examination by a physician in any consecutive 12-month period provided a minimum of 9 months of consecutive coverage has been purchased.
17. Eye Examination: Up to $100 for one eye examination by a licenced optometrist or ophthalmologist in any consecutive 12-month period provided a minimum of 6 months of consecutive coverage has been purchased.

Benefit #5 Private Duty Nurse is deleted in its entirety and replaced with the following:

18. Private Duty Nurse: When approved in advance by the Assistance Company and prescribed by an attending physician, the professional services of a registered private duty nurse (other than by an immediate family member) as the result of a covered emergency when medically necessary and while hospitalized or in lieu of hospitalization.

19. Transportation to Bedside: : When approved in advance by the Assistance Company up to a maximum of $5,000 for single round-trip economy airfare plus up to $150 per day to a maximum of $1,500 for the reasonable commercial living expenses for one person of your choice to:
    1. be with the insured if the insured is hospitalized as the result of a covered emergency and the attending physician provides written certification that the situation was serious enough to warrant the visit; or
    2. identify the deceased insured person prior to the release of the body, where necessary.
20. Trauma Counselling: Up to 6 trauma counselling sessions if you suffer a loss under Benefit #12 - Accidental Death & Dismemberment within 90 days from the date of an accident which occurred during the coverage period.
21. Corrective Devices: Up to $1,000 to repair or replace a corrective device required by you if, during the coverage period, your required corrective device is stolen and not recovered or suffers a malfunction or defect which renders it unusable. This benefit does not cover defects or malfunctions which are covered by the manufacturer’s warranty.

The following benefits apply only if you have selected and paid for the Premium plan as shown on your confirmation of insurance.

1. 1. Any sickness, injury or medical condition that was not stable in the 90 days prior to the effective date.
2. 2. Any medical condition for which, prior to the departure from your country of origin, medical evidence suggests a reasonable expectation that treatment or hospitalization could be required.
3. 3. Any medical treatment that is not emergency medical treatment for the immediate relief of acute pain and suffering, including any elective, plastic or cosmetic surgery or treatment including complications thereof.
4. 4. Any sickness or injury which occurred prior to the effective date of your policy when coverage has been extended after your arrival in Canada.
5. 5. Any costs incurred in the USA, after you exceed 30 consecutive days in the USA during the coverage period.
6. 6. Any costs incurred due to your travelling against the advice of a physician or any loss resulting from your sickness or medical condition that was diagnosed by a physician as a terminal illness prior to the effective date.
7. 7. Expenses incurred as a result of HIV or HIV related conditions and AIDS (Acquired Immune Deficiency Syndrome), including any associated charges.
8. 8. Any medical treatment which can reasonably be delayed until you return to your country of origin by the next available means of transportation, whether you intend to or not.
9. 9. Any medical treatment of an ongoing condition, regular care of a chronic condition, home health care, investigative testing, rehabilitation or convalescent or ongoing care.
10. 10. Any medical treatment of an acute sickness and/or injury after the initial emergency has ended.
11. 11. Pregnancy, childbirth, miscarriage, voluntary termination of pregnancy or their complications except as provided in Benefit #9 or #25– Maternity.
12. 12. Non-compliance with any prescribed medical treatment or therapy.
13. 13. Drugs and medications which are:
    
    1. a) commonly available without a prescription, preventative medications or vaccines, acne medications, baldness remedies, nicotine resin products, dietary supplements or weight loss products;
    2. b) any type of contraceptive, pregnancy test, fertility drug or test, or erectile dysfunction drugs;
    3. c) not legally registered and approved in Canada or not medically necessary.
14. 14. Expenses incurred whereby this policy was purchased specifically to obtain medical treatment outside your country of origin, whether or not recommended by your attending physician.
15. 15. Any medical treatment in your country of origin or any medical condition for which symptoms were present during a temporary visit to your country of origin during the coverage period unless there expressly in order to participate in a school-organized sporting or extra-curricular event.
16. 16. Any claims for sickness, injury, losses or damages arising directly or indirectly from any sickness, injury, loss or damage, fear or threat (whether actual or perceived) related to one or more of Diseases and Infections of Global Concern identified in the Definitions section of this policy whether acquired within Canada, external to Canada, or in an international jurisdiction.
17. 17. Transplants including, but not limited to, cornea or organ transplants or bone marrow transplants, artificial joints, prosthetic devices or implants including any associated charges. Implants required to stabilize an emergency medical condition may be covered if pre-approved by the Assistance Company.

17. 18. Medical examinations performed at the request of a third party (including medical examinations for immigration purposes) or consultations with a physician by telephone or e-mail.
18. 19. Expenses for any benefit or medical treatment that requires prior approval by the Assistance Company if such approval was not provided, except in extreme circumstances where such medical treatment is performed on an emergency basis immediately upon admission to hospital.
19. 20. Loss, death or injury, if at the time of the loss, death or injury, evidence supports that you were affected by, or the medical condition causing the loss was in any way contributed to by, the use of alcohol, prohibited drugs or any other intoxicant.
20. 21. Committing or attempting to commit an illegal act or a criminal act by an insured person.
21. 22. A disorder, disease, condition or symptom that is emotional, psychological or mental in nature except as provided in Benefit #10 or #23 - Psychiatric/Psychological.
22. 23. An insured person’s suicide, attempted suicide or self-inflicted injury, whether the insured person is sane or insane.
23. 24. Rock or mountain climbing, hang gliding, parachuting, bungee jumping, or skydiving; participation in any motorized race or speed contest sport; participation in any sport as a professional athlete (for which the insured person is remunerated) or scuba diving (except if certified by an internationally recognized and accepted program such as NAUI or PADI, or if diving depth does not exceed 30 metres).
24. 25. Death or injury sustained while operating or learning to operate any aircraft as pilot or crew.
25. 26. Travel to, from or through any country, region or city for which, prior to the effective date or your departure date, any department of the Canadian Government has issued a warning to avoid all travel or to avoid non-essential travel if the loss is the result of the reason for which the warning was issued.
26. 27. War, invasion, act of a foreign enemy, declared or undeclared hostilities, civil war, riot, rebellion, revolution or military power or your unlawful visit in any country.
27. 28. Terrorism or by any activity or decision of a government agency or any other entity to prevent, respond to or terminate terrorism except for ensuing loss or damage which results directly from fire or explosion. Such loss or damage is excluded regardless of any other cause or event that contributes concurrently or in any sequence to the loss or damage.
28. 29. Contamination resulting from radioactive material or nuclear fuel or waste or the release of weapon(s) of mass destruction (nuclear, chemical or biological).
29. 30. Service in, or training for, the armed forces, national guard or organized reserve corps of any country or international authority.
30. 31. Medical treatment or services normally covered or reimbursable under any other insurance the insured person might have.

• Accident means a sudden, unforeseen, unexpected and unintentional event exclusively attributable to an external cause resulting in bodily injury.
• Assistance Company is the company designated by the insurer to provide emergency assistance services.
• Chaperone means an individual who is temporarily visiting Canada for the purposes of accompanying one or more insured students to monitor their behavior and/or to ensure their safety while they are enrolled at a recognized Canadian institution of learning.
• Common Carrier means a public conveyance which is licensed to transport passengers for hire; and is provided and operated for regular passenger service by land, water or air on a regular passenger route with a definite regular schedule of departures and arrivals between established and recognized points of departure and arrival.
• Corrective Device means a device that is required by you on the advice of a physician to compensate for a physical impairment and without which it would be a physical impossibility for you to continue your studies at the institution of learning in which you are enrolled. Includes prosthetic limbs, wheelchairs, seeing-eye dogs and hearing aids but not eyeglasses.
• Country of Origin means the country for which the insured person holds a passport. Where the insured person holds more than one passport, the country of origin will be taken to mean the country that the insured person has declared on the application.
• Dependent Children means unmarried persons residing with you and dependent on you for support if you are their parent,
  grandparent or legal guardian, and on the effective date they are at least 15 days of age and:
  1. a) 21 years of age or less; or
  2. b)26 years of age or less and a full-time student; or
  3. c) have a mental or physical impairment.
• Diseases and Infections of Global Concern means any one or more of: African Tick-Bite Fever, African Trypanosomiasis, Avian Flu, Bird Flu, Murray Valley Encephalitis Virus, Chagas Disease, Chikungunya, Crimean-Congo Haemorrhagic Fever (CCHF), Cholera, COVID-19, Dengue, Ebola, Ebola virus disease, Hendra virus infection, Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis E, Japanese Encephalitis, Lassa fever, Leptospirosis, Marburg virus disease, Meningococcal Meningitis, MERS-CoV, Monkey Pox, Malaria of any kind, Middle Eastern Respiratory Syndrome (MERS), Nipah virus infection, Plague, Polio, Polio virus of any kind, Rift Valley Fever, Ross River virus disease, SARS-CoV -1, SARS-CoV-2 including any mutation, variant(s) of concern (“VOC”), or variation thereof, Schistosomiasis, Tick-borne Encephalitis, Typhoid Fever, Tuberculosis of any kind, Tularaemia or Tullaraemia, West Nile Virus, Yellow Fever or Zika.
• Emergency means an unexpected and unforeseen sickness or injury occurring during the coverage period for which you require immediate medical treatment to alleviate danger to life or health occurring while on a covered trip, and that such medical treatment cannot be delayed until you return to your country of origin by the next available means, whether you intend to or not. An emergency no longer exists when you are deemed medically fit to travel and no further benefits are payable in respect of the medical condition which caused the emergency.
• Government Health Insurance Plan means the health care coverage provided by Canadian federal, provincial and territorial governments to their residents.
• Hospital means an institution which is designated as a hospital by law; which is continuously staffed by one or more physicians available at all times; which continuously provides nursing services by graduate registered nurses; which is primarily engaged in providing diagnostic services and medical and surgical treatment of a sickness and/or injury in the acute phase, or active treatment of a chronic condition; which has facilities for diagnosis, major surgery and in-patient care. The term hospital does not include convalescent, nursing, rest or skilled nursing facilities whether separate from or part of a regular general hospital, or a facility operated mainly as a clinic, extended or palliative care facility, rehabilitation facility, addiction treatment centre or health spa.
• Hospitalization or Hospitalized means an insured occupies a hospital bed for more than 24 hours for medical treatment and for whom admission was recommended by a physician when medically necessary.
• Immediate Family Member means the spouse, natural or adopted child, step-child, parent, step-parent, legal guardian, legal ward, brother, sister, step-brother, step-sister, in-law, grandparent, grandchild, aunt, uncle, niece, nephew of the insured person.
• Injury means an unexpected and unforeseen harm to the body that is caused by an accident, sustained by an insured person during the coverage period and that requires emergency treatment that is covered by this policy.
• Insured, Insured Person means any eligible person named on the application and confirmation of insurance for whom the required premium has been paid.

• Insurer means Berkley Insurance Company, which provides this insurance.
• In-patient means a patient who occupies a hospital bed for more than 24 hours for medical treatment and for whom admission was recommended by a physician when medically necessary.
• Medical Treatment means any reasonable procedure which is medical, therapeutic or diagnostic in nature, which is medically necessary and which is prescribed by a physician. Medical treatment includes hospitalization, basic investigative testing, surgery, prescription medication (including prescribed as needed) or other treatment directly related to the sickness, injury or symptom.
• Medically Necessary, in reference to a given service or supply, means such service or supply:
  1. is appropriate and consistent with the diagnosis according to accepted community standards of medical practice;
  2. is not experimental or investigative in nature;
  3. cannot be omitted without adversely affecting the condition of the insured person or quality of medical care;
  4. cannot be delayed until the insured person returns to their country of origin.
• Mountain Climbing means the ascent or descent of a mountain requiring the use of specified equipment including crampons, pick axes, anchors, bolts, carabiners and lead-rope or top rope anchoring equipment.
• Physician means a medical practitioner who is registered and licensed to practice in accordance with the regulations applying in the jurisdiction where the person practices. A physician must be a person other than the insured person or an immediate family member.
• Reasonable and Customary Costs means costs that are incurred for approved, covered medical services or supplies that do not exceed the standard fee of other providers of similar standing in the same geographical area, for the same treatment of a similar sickness and/or injury.
• Sickness means a sudden and unforeseen disease or disorder of the body which results in loss during the coverage period. The sickness must be sufficiently serious to prompt a reasonably prudent person to consult a physician for the purpose of medical treatment.
• Spouse means the person to whom the insured is legally married or with whom the insured has been living with in a common-law relationship for at least the last 12 months.
• Stable means any medical condition, whether or not the diagnosis has been determined, for which there has been:
  1. a) no hospitalization; and
  2. b) no new diagnosis, treatment or prescribed medication; and
  3. c) no change* in treatment or medication; and
  4. d) no new, more frequent or more severe symptoms; and
  5. e) no new test results showing deterioration; and
  6. f) no referral to a specialist (made or recommended) and you are not awaiting surgery or the results of further investigations performed by any medical professional.
  * Change includes any new treatment or medication, stopped treatment or medication, increase or decrease in treatment or medication but does not include transition between generic and brand-name versions of drugs with the same active ingredient and dosage or the routine adjustment of dosage within prescribed parameters when you are taking insulin or oral diabetes medication or asthma medication.
• Teacher means an individual in the education profession who is temporarily visiting Canada for the purpose of accompanying one or more insured students and/or is sponsored by recognized Canadian institution of learning as part of a cultural or similar exchange program.
• Terminal Illness means the insured person has a condition that is cause for the physician to estimate that the insured person has less than 6 months to live.
• Terrorism means an ideologically motivated unlawful act or acts including, but not limited, to the use of violence or force or threat of violence or force, committed by or on behalf of any groups(s), organization(s) or government(s) for the purpose of influencing any government and/or instilling fear in the public or a section of the public.
• You, Your, Yourself means the insured person.

• Notification to Assistance Company
  The Assistance Company must approve in advance any surgery, invasive procedure, diagnostic testing or treatment (including, but not limited to, cardiac catheterization), prior to the insured undergoing such surgery, procedure, testing or treatment. It remains your responsibility to inform your attending physician to call the Assistance Company for approval, except in extreme circumstances where such action would delay surgery required to resolve a life-threatening medical crisis.
  In the event of a medical emergency, you must notify the Assistance Company prior to receiving any medical treatment and within 24 hours of admission to a hospital and before any surgery is performed. If you fail to do so, without reasonable cause, then the insurer will pay 80% of the claim payable to a maximum of $25,000. You will be responsible for any expenses that are not payable by the insurer.
• Limitation of Benefits
  Once the insured person is deemed medically stable to return to their country of origin or by virtue of discharge from a medical facility, the emergency will be deemed to have ended, whereupon any further consultation, treatment, recurrence or complication related to the emergency will no longer be eligible for coverage under this policy.
• Inability to Obtain Medical Records
  In the event that the insurer is unable to obtain medical records from your country of origin your medical history will be based on information developed from your attending physician’s report, medical examination or other sources of pertinent information.

• Availability and Quality of Care
  Neither the insurer nor the Assistance Company shall be responsible for the availability or quality of any medical treatment (including the results thereof) or the failure of the insured person to obtain medical treatment during the coverage period.
• Medical Transfer or Repatriation
  The insurer reserves the right, as reasonably required and at its expense, to transfer you to any hospital or to transport you to Canada or your country of origin during an emergency for medical treatment of your sickness or injury.
  If you refuse to be transferred or transported when declared medically fit to travel by the Assistance Company’s Medical Team, any continuing costs incurred for such sickness or injury after your refusal will not be covered and the payment of such costs becomes your sole responsibility. Coverage for the sickness or injury ceases upon your refusal and no coverage will be provided for that sickness or injury for the remainder of the coverage period.
• Limitation of Assistance Services
  The Assistance Company reserves the right to suspend, curtail or limit services in any area or country in the event that war, political instability or hostility renders the area inaccessible by the Assistance Company. The Assistance Company will use its best efforts to provide services during any such occurrence.

• AGGREGATE LIMIT
  The total aggregate limit for all losses resulting from any one incident under all travel insurance policies underwritten by the insurer is $20,000,000 CAD.


• APPLICABLE LAW
  This contract of insurance is governed by the laws of the province or territory where this policy was issued. Any legal proceeding by you, your heirs or assigns shall be brought in the courts of the province or territory where this policy was issued.


• ARBITRATION
  Notwithstanding any clause in this policy, the parties hereto undertake to submit to an arbitration process, to the exclusion of the courts, any present or future dispute relating to a claim. The arbitration proceedings shall be governed by the arbitration law in force in the Canadian province or territory of residence of the insured. The parties agree that any action will be referred to arbitration.


• CURRENCY
  All sums payable under this policy are in Canadian currency unless otherwise indicated.


• LIMITATION OF ACTIONS
  Every action or proceeding against an insurer for the recovery of insurance money payable under the contract is absolutely barred unless commenced within the time set out in the Insurance Act or any other applicable legislation.


• LIMITATION OF BENEFITS
  Once the insured person is deemed medically stable to return to Canada or by virtue of discharge from a medical facility, the emergency will be deemed to have ended, whereupon any further consultation, treatment, recurrence or complication related to the emergency will no longer be eligible for coverage under this policy.


• MISREPRESENTATION AND NON-DISCLOSURE
  The entire coverage under this policy shall be voidable if the insurer determines, whether before or after loss, that the insured person has concealed, misrepresented or failed to disclose any material fact or circumstance concerning this policy or his/her interest therein, or if the insured person refuses to disclose information or to permit the use of such information, pertaining to any of the insured persons under this policy. Consequently and following a loss, no claim shall be payable by the insurer and the insured person shall be solely responsible for all expenses relating to his/her claim, including medical repatriation costs.


• OTHER INSURANCE
  This insurance is a second payor plan. For any loss or damage insured by, or for any claim payable under any other liability, group or individual basic or extended health insurance plan, or contracts including any private or provincial or territorial auto insurance plan providing hospital, medical, or therapeutic coverage, or any other insurance in force concurrently herewith, amounts payable hereunder are limited to those covered benefits incurred that are in excess of the amounts for which an insured person is insured under such other coverage.


• OVERPAYMENT OF BENEFITS
  Nothing in this policy will prevent the insurer from recovering from the person or organization to which such payment has been made any overpayment of benefit, irrespective of the cause of such overpayment.

• PREMIUM PAYMENT
  The required premium is due and payable at the time of application and will be determined according to the rate schedule then in effect. Premium rates, policy terms and conditions are based on your age as of the effective date. If the premium paid is insufficient for the coverage selected, the insurer will charge and collect any underpayment. Coverage will be null and void if the premium is not received, if a cheque is not honoured for any reason, if credit card charges are invalid or if no proof of your payment exists.


• PROTECTING YOUR PRIVACY
  The insurer places great importance on the protection of your privacy. Your personal information will be collected, used and disclosed only for the purpose of providing you with the insurance services you requested. This information remains confidential, as is required under applicable federal and provincial laws. In the event of a claim, the Assistance Company and the insurer may collect your personal health information held by a third party. This information may be released to employees of the Assistance Company and the insurer for claims analysis and to better serve you. In no case will the insurer release this information to any person or organization that is not clearly entitled to it without first seeking your consent. For details of the insurer’s privacy policy please see: www.berkleycanada.com/privacy.


• REFUNDS
  
  1. If cancellation of your policy is requested prior to the effective date, the full premium will be refunded.
  2. A pro-rata refund for the unused portion of the premium may be granted if:
     1. the required visa necessary for admission to a recognized Canadian institution of learning has been refused;
     2. the student permanently leaves the recognized Canadian institution of learning;
     3. you permanently return to your country of origin with no intention to return 30 days or more before the expiry date; or
     4. you become eligible for a government health insurance plan in your province or territory of residence in Canada.
  A request for a premium refund will be considered only if no claim has been paid or is pending. No refund will be issued if the amount of premium to be reimbursed is less than $20 per policy.


• SUBROGATION
  If an insured person suffers a loss covered under this policy, the insurer is granted the right from the insured person to take action to enforce all the insured person’s rights, powers, privileges, and remedies, to the extent of benefits paid under this policy, against any person, legal person or entity which caused such loss. Additionally, if "no fault" benefits or other collateral sources of payment of medical expenses are available to the insured person, regardless of fault, the insurer is granted the right to make demand for, and recover, those benefits. If the insurer institutes an action it may do so at its own expense, in the name of the insured person, and the insured person will attend at the place of loss to assist in the action, in addition to providing the insurer all information, cooperation and assistance as the insurer may reasonably require. If the insured person institutes a demand or action for a covered loss, the insured person shall immediately notify the insurer so that the insurer may safeguard its rights. The insured person shall take no action after a loss that will impair the rights of the insurer set forth in this paragraph and shall do all such things as are necessary to secure such rights.

• THE CONTRACT
  The application, this policy, any document attached to this policy when issued, and any amendment to the contract agreed upon in writing after the policy is issued, constitute the entire contract, and no agent has authority to change the contract or waive any of its provisions.


• WAIVER
  The insurer is deemed not to have waived any condition of this contract, either in whole or in part, unless the waiver is clearly expressed in writing signed by the insurer.


• COPY OF APPLICATION
  The insurer shall, upon request, furnish to the insured or to a claimant under the contract a copy of the application.


• MATERIAL FACTS
  No statement made by the insured or person insured at the time of application for this contract shall be used in defence of a claim under or to avoid this contract unless it is contained in the application or any other written statements or answers furnished as evidence of insurability.


• NOTICE AND PROOF OF CLAIM
  The insured or a person insured, or a beneficiary entitled to make a claim, or
  the agent of any of them, shall,
  1. a) give written notice of claim to the insurer,
     1. i) by delivery thereof, or by sending it by registered mail to the head office or chief agency of the insurer in the province, or
     2. ii) by delivery thereof to an authorized agent of the insurer in the province,
  not later than 30 days from the date a claim arises under the contract on account of an accident, sickness or disability;
  2. b) within 90 days after the date a claim arises under the contract on account of an accident or sickness, furnish to the insurer such proof as is reasonably possible in the circumstances of:
     1. i) the happening of the accident or the start of the sickness,
     2. ii) the loss caused by the accident or sickness,
     3. iii) the right of the claimant to receive payment,
     4. iv) the claimant's age, and
     5. v) if relevant, the beneficiary’s age; and
  3. c) if so required by the insurer, furnish a satisfactory certificate as to the cause or nature of the accident, sickness or disability for which claim may be made under the contract and as to the duration of such sickness or disability.

• FAILURE TO GIVE NOTICE OR PROOF
  Failure to give notice of claim or furnish proof of claim within the time prescribed by this statutory condition does not invalidate the claim if,
  1. a) the notice or proof is given or furnished as soon as reasonably possible, and in no event later than one year from the date of the accident or the date a claim arises under the contract on account of sickness or disability if it is shown that it was not reasonably possible to give notice or furnish proof within the time so prescribed; or
  2. b) in the case of the death of the insured person, if a declaration of presumption of death is necessary, the notice or proof is given or furnished no later than one year after the date a court makes the declaration.


• INSURER TO FURNISH FORMS FOR PROOF OF CLAIM
  The insurer shall furnish forms for proof of claim within 15 days after receiving notice of claim, but where the claimant has not received the forms within that time the claimant may submit his or her proof of claim in the form of a written statement of the cause or nature of the accident, sickness or disability giving rise to the claim and of the extent of the loss.


• RIGHTS OF EXAMINATION
  As a condition precedent to recovery of insurance money under this contract,
  1. a) the claimant shall afford to the insurer an opportunity to examine the person of the insured person when and so often as it reasonably requires while the claim is pending; and
  2. b) in the case of death of the insured person, the insurer may require an autopsy subject to any law of the applicable jurisdiction relating to autopsies.


• WHEN MONEYS PAYABLE
  All money payable under this contract shall be paid by the insurer within 60 days after it has received proof of claim.

1-844-879-8379

toll-free from Canada and the USA

+1-416-285-1722

collect where available

• CLAIMS PROCEDURES
  Claims must be submitted within 30 days of the first medical expense. The insured person is responsible for providing all the documents outlined below and for any charges levied for these documents. To file a claim, the insured person must:
  1. complete and submit a claim form for each new sickness or injury;
  2. submit all original itemized bills from the medical provider(s) stating the patient's name, diagnosis, all dates and type of treatment, and the name of the medical facility and/or physician;
  3. provide original prescription drug receipts (not cash receipts) from the pharmacist, physician or hospital showing the name of the prescribing physician, prescription number, name of preparation, date, quantity and total cost;

4. provide proof of the departure date(s) and return date(s);
5. provide written proof of claim within 90 days of the date of receipt of services covered under this policy;
6. provide additional information pertinent to the insured person's claim, as may be required by the Assistance Company after receipt of the claim;
7. return the unused portion of the insured person's air ticket to the Assistance Company, if the Emergency Air Transportation benefit is used.

All pertinent documents should be sent to the Assistance Company
Epic Health Solutions.
25 Millard Ave West, Second Floor
Newmarket, Ontario L3Y 7R6

Underwritten by:
Berkley Insurance Company
145 King Street West
Suite 1000
Toronto, Ontario M5H 1J8

Administered Through:
Risk Care Insurance Ltd
7895 Tranmere Drive
Suite 16
Mississauga, Ontario L5S 1V9
(905) 672-9172

Claims Administered by:
Epic Health Solutions.
25 Millard Avenue West
Second Floor
Newmarket, Ontario L3Y 7R6