AIG Leisure Travel Insurance - Policy Wording
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Date prepared: 1 December 2013. 12/00476.1 Thank you for selecting this leisure travel insurance provided by AIG Insurance New Zealand Limited (“AIG”). AIG has been meeting the needs of New Zealand consumers and businesses since 1970. AIG is a world leader in providing travel insurance, emergency travel services and travel medical advice for millions of customers worldwide. In New Zealand we have utilised this worldwide travel experience to offer local solutions to New Zealand consumers for more than 20 years, including underwriting some of New Zealand’s largest leisure travel insurance programmes. In selecting an AIG travel insurance product you travel in the knowledge that your insurer is an experienced travel insurance specialist that understands the travel insurance needs of New Zealanders. Before you travel please read your Policy through carefully because, as with all insurance policies, there are some circumstances that are not covered and you need to ensure that the Policy satisfies your insurance requirements. If you require further explanation or wish to confirm that your travel will be covered by this Policy you can speak to one of our friendly customer services representatives by contacting the AIG Travel Call Centre on 0800 787 366 between the hours of 9am and 5pm week days (excluding public holidays), or by emailing us at traveladminnz@aig.com. © AIG. All rights reserved.
Contents Page A) Important matters about your policy 2 A.1 The Insurer 2 A.2. Contact Numbers 2 A.3. Schedule Of Benefits 3 A.4. Product And Plan Selection 5 A.5. Policy Types 7 A.6. Maximum Amount Payable 7 A.7. Excess Payable 8 A.8. Travel Guard™ 8 A.9. Your Duty Of Disclosure 9 A.10. Our Privacy Statement 9 A.11. The Policy 10 A.12. General Exclusions 10 A.13. Policy Activation 11 A.14. Policy Extensions 11 A.15. Contract 11 A.16. Choice 11 A.17. Other Cover 12 A.18. Cooling Off Period 12 A.19. Fraudulent Claims 12 A.20. Compliance 12 A.21. New Zealand Resident Traveller 12 A.22. The Fair Insurance Code 12 A.23. Mature Age Traveller 12 A.24. Adventure Activities 13 A.25. Existing Health Disorders 13 A.26. Ministry Of Foreign Affairs Travel Advisory 15 B) Definitions (meaning of words) 16 C) Losses not insured under any section of this policy 18 D) Cancellation fees and lost deposits 21 E) Overseas medical, hospital, cash in hospital, dental and related expenses 24 F) Luggage and Personal Money 26 G) Emergency expenses 28 H) Accidental death 30 I) Accidental disability 31 J) Your liability for causing loss or damage to property, injury or death 31 K) Rental vehicle collision damage and theft excess cover 32 L) Loss of income 33 M) Financial default 33 N) Claims 34 1
A) Important matters about your policy This document contains Your travel insurance Policy terms and conditions. It is important that You read and understand it and retain it in a safe place. For this Policy to be effective You must have a current and valid Certificate of Insurance. A.1. The Insurer This policy is issued/insured by AIG Insurance New Zealand Limited. AIG PO Box 1745, Shortland Street Auckland 1140, New Zealand A.2. Contact Numbers Travel Guard™ (available 24 hours worldwide for emergency travel related calls) Overseas +64 9 359 1645 New Zealand (09) 359 1645 AIG Travel Call Centre (9am to 5pm week days, excluding public holidays) - 0800 787 366 Email us at traveladminnz@aig.com Claims (8.30am to 5pm week days, excluding public holidays) +64 9 355 3100 (Please ask to speak to a AIG Travel Claims Examiner) Email us at claimsnz@aig.com Travel Guard™ Medical Assessment Unit (8.30am to 5pm weekdays, excluding public holidays) - 0800 367 244 If You require assistance or need to call about a Policy that We have issued to You please quote the Policy Number as shown on Your Certificate of Insurance. Please also have close to hand any information that will assist the call operator in answering Your question or request for assistance. 2
A.3. Schedule of Benefits Your Policy wording provides information about the benefits, exclusions and the circumstances and times under which the benefits are provided. SCHEDULE OF INTERNATIONAL BENEFITS Platinum, Gold, Silver and Bronze Plans only* Maximum sum insured per Trip SINGLE FAMILY ANNUAL COVER FOR COVER FOR MULTI-TRIP ONE-TRIP ONE-TRIP BENEFITS PLANS PLANS PLANS Cancellation Fees & Lost Deposits Unlimited Unlimited Unlimited Travel Agent Fees $4,000 $8,000 $4,000 Overseas Medical and Hospital Unlimited Unlimited Unlimited Overseas Dental $2,000 $4,000 $2,000 Emergency Expenses Unlimited Unlimited Unlimited Cash in Hospital $6,000 $12,000 $6,000 Luggage $25,000 $50,000 $25,000 Personal Money $500 $1,000 $500 Resumption of Journey $3,000 $6,000 $3,000 Travel Delay $1,000 $2,000 $1,000 Hijack and Kidnap $10,000 $20,000 $10,000 Special Events, Missed Connections $2,000 $4,000 $2,000 Home Help $1,500 $3,000 $1,500 Accidental Death $25,000** $50,000** $25,000** Accidental Disability $10,000 $10,000 $10,000 Your Legal Liability $2,500,000 $2,500,000 $2,500,000 Rental Vehicle Excess $4,000 $4,000 $4,000 Loss of Income $5,200 $10,400 $5,200 Financial Default $10,000 $20,000 $10,000 * See separate Schedule of Benefits for Australia Plan benefits ** Cover is limited to up to $1000 each for the accidental death of Your dependent children and grandchildren under 21 years of age travelling with You. SCHEDULE OF DOMESTIC CANCELLATION AND EMERGENCY EXPENSES PLAN BENEFITS Maximum sum insured per insured person per Trip BENEFITS HIGH PLAN (PH12) LOW PLAN (PL12) Cancellation Fees, Lost Deposits and Emergency Expenses $2,000 $1,000 3
AUSTRALIA PLAN SCHEDULE OF BENEFITS Maximum sum insured per insured person per Trip BENEFITS SINGLE COVER FAMILY COVER Cancellation Fees & Lost Deposits $5,000 $10,000 Overseas Medical and Hospital $1,000,000 $2,000,000 Emergency Expenses (no cover under G2 & G7) $5,000 $10,000 Luggage $3,000 $6,000 Travel Delay $300 $600 Hijack and Kidnap $10,000 $20,000 Accidental Death $10,000* $20,000* Your Legal Liability $500,000 $1,000,000 Rental Vehicle Excess $2,000 $2,000 * Cover is limited to up to $1000 each for the accidental death of Your dependent children and grandchildren under 21 years of age travelling with You. SCHEDULE OF DOMESTIC BENEFITS Maximum sum insured per Trip ANNUAL SINGLE FAMILY MULTI-TRIP COVER COVER BENEFITS PLANS Cancellation Fees & Lost Deposits $10,000 $20,000 Unlimited Emergency Expenses (no cover under G2 & G7) $10,000 $20,000 Unlimited Luggage $3,000 $6,000 15,000 Travel Delay $300 $600 $1,000 Hijack and Kidnap $10,000 $20,000 $10,000 Special Events, Missed Connections $2,000 $4,000 $2,000 Accidental Death $10,000* $20,000* $25,000* Accidental Disability $10,000 $10,000 $10,000 Your Legal Liability $500,000 $1,000,000 $2,500,000 Rental Vehicle Excess $4,000 $4,000 $4,000 Loss of Income $10,000 $20,000 $10,000 Financial Default $10,000 $20,000 Unlimited * Cover is limited to up to $1000 each for the accidental death of Your dependent children and grandchildren under 21 years of age travelling with You. 4
A.4. Product and Plan Selection On Your Certificate of Insurance You will see Your selected Product and Plan. The selected Product is the type of cover Your Policy provides. The possible Products are International One-Trip, Domestic One-Trip, Domestic Cancellation & Emergency Expenses and Annual Multi-Trip. These Products may also be broken down further into Plans. The selected Plan shows which locations Your Policy provides cover for. This does not apply under a Domestic Cancellation and Emergency Expenses Product where the Plan shows the sum insured. The possible Plans are Platinum, Gold, Silver, Bronze and Australia. Not all Products have different Plans, and not all Plans are available with all Products. Your Product and Plan types combine together to give you a unique Plan Code. These are further explained below. 1. One-trip Products and Plans The One-trip Products cover only one Trip up to the maximum duration as shown on Your Certificate of Insurance. International One-trip Travel Product Plans F12, C12, D12, E12 and G12 (Refer to the Schedule of International Benefits for applicable Policy Sections) To be eligible for this Product You must be returning to New Zealand at the expiry date shown on Your Certificate of Insurance. PLAN PLAN DESTINATION NAME CODE Platinum F12 travel to USA, Canada, Central & South America and Antarctic cruises Gold C12 travel to Europe, Ireland, Japan, Middle East, Africa, Mauritius, Scandinavia and Russia Silver D12 travel to Asia, India, Sub-Continent, United Kingdom, Indonesia and China Bronze E12 travel to the Pacific, Norfolk Island, Australia and Bali Australia G12 travel directly to, from and within Australia only Please Note - If You select the Australia Plan then cover is restricted to Policy Sections A, B, C, D, E, F (not clause F8), G (not clauses G2, G6 and G7), H, J, K and N. Your Schedule of Benefits will also have lower limits than other One- trip Plans, and You will not be able to apply to have Your Existing Health Disorders covered if they are not already automatically accepted (See Section A25 Existing Health Disorders). If you wish to apply for Existing Health Disorder cover, or if You require additional benefits or higher limits than are available under the Australia Plan, then You should select the Bronze Plan (which also covers travel to Australia) instead. - We are not able to provide any cover for loss, injury, damage or legal liability arising directly or indirectly from travel in, to or through Afghanistan, Cuba, Democratic Republic of Congo, Iran, Iraq, Liberia, Sudan or Syria under any of our Plans. 5
- If You are travelling to a destination covered by a higher Plan then this Policy is only valid if the total time in all higher Plan destinations is less than 96 hours, otherwise We may not meet Your claim that relates to or arises in a higher Plan destination. This does not apply to the Australia Plan where Your planned Trip may only involve travelling directly from New Zealand to Australia, travelling within Australia, and returning directly from Australia to New Zealand. - Listed from highest to lowest the Plans are: Platinum, Gold, Silver, Bronze, and Australia. Domestic One-trip Travel Product Plan Q12 (Refer to the Schedule of Domestic Benefits for applicable Policy Sections) You are covered for travel within New Zealand. Your selected sum insured level for Section D (Cancellation Fees and Lost Deposits) is shown on Your Certificate of Insurance and amounts above $10,000 for Single cover and $20,000 for Family cover are subject to You having paid the extra premium required by Us. Cover is restricted to Policy Sections A, B, C, D, F (not clause F8), G (not clauses G2, and G7), H, I, J, K, M and N. 2. Domestic Cancellation and Emergency Expenses Product Plans PH12 and PL12 (Refer to the Schedule of Domestic Cancellation and Emergency Expenses Plan Benefits for applicable Policy Sections) This Product is for travel within New Zealand for Trips of up to 90 days duration only. Cover is restricted to Policy Sections A, B, C, D (not clause D5), G (not clauses G4, G5, G6 and G7) and N. 3. Annual Multi-trip Product Plans AF12 and AC12 (Refer to the Schedule of International Benefits for applicable Policy Sections) This Product covers unlimited Trips in any one period of insurance as shown on Your Certificate of Insurance, being the period between the departure date and expiry date shown on Your Certificate of Insurance. The length of any one Trip cannot exceed forty-five (45) consecutive days and must involve travel to an overseas destination or a domestic destination no less than 200 km from Your home. PLAN PLAN DESTINATION NAME CODE Platinum AF12 travel worldwide including USA, Canada, Mexico, Central & South America and Antarctica, and within New Zealand Gold AC12 travel worldwide including within New Zealand, but does not include the following destinations - USA, Canada, Mexico, Central & South America, Antarctic cruises 6
Please Note - We are not able to provide any cover for loss, injury, damage or legal liability arising directly or indirectly from travel in, to or through Afghanistan, Cuba, Democratic Republic of Congo, Iran, Iraq, Liberia, Sudan or Syria under any of Our Plans. - All sums insured for Annual Multi-trip Plans are per Trip. - If You are travelling to a destination covered by a higher Plan then this Policy is only valid if the total time in all higher Plan destinations is less than 96 hours, otherwise We may not meet Your claim that relates to or arises in a higher Plan destination. For the purpose of clarity Plan AF12 is higher than Plan AC12. - If travelling within New Zealand cover is restricted to Policy Sections A, B, C, D, F (not clause F8), G. (not clauses G2, and G7), H, I, J, K, M and N. A.5. Policy Types On Your Certificate of Insurance You will also be able to see Your selected Policy Type. The Policy Type shows which people in Your family are insured. The possible Policy Types are Single cover or Family cover. Not all Products have different Policy Types available. This is further explained below. 1. International & Domestic One Trip Products (Plan Codes C12, D12, E12, F12, G12 & Q12): Single cover If You selected Single cover the Policy covers You and Your financially dependent children or grandchildren, who are all under 21 years of age, who travel with You. Family cover If You selected Family cover the Policy covers the same persons as Single cover plus Your spouse, de facto partner of either gender or any adult Travelling Companion named in the Certificate of Insurance who travel with You. 2. Domestic Cancellation and Emergency Expenses Products (Plan Codes PH12 and PL12): These Plans cover the people named on the Certificate of Insurance as the Insured Persons. 3. Annual Multi-trip Product (AF12 & AC12): Single cover If You selected Single cover the Policy covers You and Your financially dependent children or grandchildren all under 21 years of age who travel with You. Family cover If You selected Family cover the Policy covers the same persons as Single cover plus Your spouse, defacto partner of either gender named in the Certificate of Insurance who travel with You. A.6. Maximum Amount Payable The most We will pay under any Section is the amount shown in the Schedule of Benefits for the Plan You have selected. For some Sections there is an amount of money (excess) that will be deducted from your claim and which is shown under Section A7 (Excess Payable). When You pay us the additional premium 7
for the excess eliminator, which is shown on Your Certificate of Insurance, then You will not have to pay the excess. There is a special limit that applies to the accidental death benefit for all claims made for the death of Your dependent children or grandchildren. See Section H. A.7. Excess Payable For One-trip International Plans $100 For Annual Multi-trip Plans $100 For One-trip Domestic Plans $50 For Domestic Cancellation and Emergency Expense Plans $50 If You have bought out the excess for Your selected Plan while purchasing Your Policy online, then no excess shall apply. Please note, You cannot buyout the applicable excess for specified items or Existing Health Disorders. A.8. Travel Guard™ 24 Hour World-Wide Emergency Assistance Pre-trip and emergency assistance is provided by Travel Guard™. Travel Guard™ operates a network of service centres, and will provide you access 24/7 to appropriate medical facilities and where necessary air ambulances that will provide you with access to the best possible medical care. By choosing AIG, you have direct access to these vital services before and during your journey. Depending on your specific needs, we can: • Provide pre-trip advice such as what vaccinations are required and the local medical conditions at your destination • Help you in the event of lost luggage, travel documents or credit card by putting you in touch with the nearest embassy or other authorities • When medical care is needed, direct you to suitable medical facilities, monitor your condition and treatment as well as keeping Your family and friends at home informed • Decide if and when evacuation or repatriation is required and coordinate all facets • Provide help to re-schedule travel plans when your trip is interrupted by an emergency. We will try to get You medical attention when You travel but Travel Guard™ cannot guarantee that appropriate medical facilities will always be available. Travel Guard™ is only provided to assess and monitor Your condition and cannot take over the running of Your medical treatment. Please note that where Your claim is not covered under the Policy, the providing of emergency assistance will not in itself be an admission of liability of Your claim. To contact our assistance services, phone REVERSE CHARGE to New Zealand from anywhere in the world on +64 9 359 1645 or from within New Zealand on 09 359 1645. 8
A.9. Your Duty of Disclosure Before You enter into this Policy You have a duty to disclose to Us every matter that You know, or could reasonably be expected to know, is relevant to Our decision (or the decision of a prudent insurer in the circumstances) of whether to accept the risk of the insurance and if so on what terms. You have the same duty to disclose those matters to Us before You renew, extend, vary or reinstate this Policy. Your duty does not extend to matters; • that diminish the risk to be undertaken by Us. • that are of common knowledge. • that We know or in the ordinary course of Our business ought to know. • where compliance of Your duty is waived by Us. If You fail to comply with this duty of disclosure, We may be entitled to reduce Our liability under this Policy in respect of a claim, or may cancel this Policy. If Your non-disclosure is fraudulent, We may also have the option of avoiding this Policy from the inception date. Matters that We consider should be disclosed include but are not limited to: • Travel to locations designated as Extreme Risk by the New Zealand Government, refer to www.safetravel.govt.nz. • Travelling for missionary or humanitarian work purposes. • Extreme sporting activities. • You undertaking during the Trip any manual or dangerous work activity including but not limited to work carried out by trades persons, repair or maintenance persons, machine operators, handlers of toxic substances or the like. A.10. Our Privacy Statement This Policy is issued/insured by AIG Insurance New Zealand Limited. AIG collects information necessary to underwrite and administer Your Policy, to maintain and improve customer service, and to advise You of Our products. In the course of administering Your Policy, AIG may exchange or disclose Your personal information and that of any other person insured by this Policy to: (a) a related AIG company either in New Zealand or overseas; (b) contractors or third party providers providing services related to the administration of Your Policy; (c) banks and financial institutions for the purpose of processing Your application and obtaining payment of premium; 9
(d) in the event of a claim - assessors, third party administrators, emergency providers, retailers, medical providers and travel carriers; or (e) Our assistance provider who will record all calls to the assistance service provided under Your Policy for quality assurance, training and verification purposes. Your Access to Personal Information You may gain access to or request correction of Your personal information and that of any other person insured by this Policy by writing to: The Privacy Manager AIG PO Box 1745 Shortland Street Auckland 1140 New Zealand While access to this personal information may generally be provided free of charge, We reserve the right to charge for access requests in some limited circumstances. Consent Acknowledgement By completing the application form (including any associated form) and paying the premium, You consent to the use of Your personal information and that of any other person insured by this Policy stated in the Privacy Statement above. A.11. The Policy A range of benefits are available under this Policy. However there are some circumstances where cover cannot be provided. These are covered in this Policy Wording but we draw your attention to some important points below. • This Policy does not automatically provide cover for travellers who have an Existing Health Disorder. This also extends to persons on whom Your Trip depends. You should also be aware of the ongoing duty of disclosure requirement that applies through to Your departure date. For further information refer to Section A.25. of the document ‘Existing Health Disorders’. • Limits and sub-limits apply to certain benefits under each Plan • This Policy does not cover any medical, hospital, dental or ancillary benefits incurred in New Zealand. A.12. General Exclusions In addition to the specific exclusions (What is not covered) which appear under each benefit Section D to M, Your Policy Wording also contains general exclusions. Please refer to Section C of Your Policy Wording titled ‘Losses not insured under any Section of the Policy’. 10
Your Policy Wording also contains a list of: • Important Matters About Your Policy in Section A of Your Policy Wording and • Definitions in Section B of Your Policy Wording A.13. Policy Activation Your Policy is valid only when You pay the premium and a Certificate of Insurance is issued to You. Cover for Cancellations or Lost Deposits (Section D) and Financial Default (Section M) begins on the date Your Policy is issued. Cover for all other benefits commences on the date Your Trip begins, and terminates on; • completion of Your Trip, or • in the case of an Annual Multi-trip Plan, expiry of 45 days from the date Your Trip begins, or • expiry date on Your Certificate of Insurance, whichever occurs first. A.14. Policy Extensions We will automatically extend Your cover for a period that is necessary for You to complete Your Trip, if Your return is delayed due to any cause which gives rise to a claim under this Policy. If You wish to extend Your Trip under Your One-trip Plan, You may prior to the expiry date of Your original Policy, apply for an extension of Your original Policy by payment of the required premium. You will be required to confirm Your travel arrangements at the time and We will review this information and Your claims history before we decide on Your application for extended cover. Terms and conditions may apply or We may decide not to offer an extension. Cover must not exceed a period of 12 months in total from the date of the commencement of Your Trip on Your original Policy. Please note, if you have an Annual Multi-trip Plan, you cannot extend Your Trip beyond 45 days. Existing Health Disorder cover is not available on any extension of Your Policy. A.15. Contract The Policy is a contract between You and Us; You pay Us the premium and in return We give You the cover described in the Policy. The Policy is governed by the laws of New Zealand. A.16. Choice You are free to take out travel insurance with any insurer You choose. 11
A.17. Other Cover We will not cover You for loss or an event or liability to the extent that it is covered by any other insurance policy, medical or health scheme or Act of Parliament or any benefit which We are legally prohibited to pay by law. We will however pay the difference between what is payable under that other insurance policy, medical or health scheme or the relevant Act of Parliament and what You would have been entitled to recover under this Policy to the extent permitted by law. This does not apply to benefits payable under Sections H and I. A.18. Cooling Off Period You may return the Policy to Us within fourteen days of purchase for a full refund of premium paid by You, provided no claim has arisen and Your travel has not commenced. Subject to Your rights under the cooling off period, We will not refund any part of the premium if You cancel Your cover after any part of this Policy has begun or a claim has arisen. A.19. Fraudulent Claims We will not pay a claim if Your claim is fraudulent. A.20. Compliance We may refuse to pay a claim under this Policy if You do not observe any condition of this Policy or you fail to follow Our or Travel Guard™’s advice or instruction. A.21. New Zealand Resident Traveller Unless otherwise agreed by Us, this Policy is only available to permanent residents living in New Zealand who plan to return to New Zealand to live at the end of the trip. A.22. The Fair Insurance Code AIG is a signatory to the Fair Insurance Code. This Code aims to raise the standards of practice and service in the insurance industry, and it includes the following: • When You lodge a claim We will tell You in plain language what information We need and how You should go about making a claim. • We will respond promptly to any request You make for assistance with a claim and it will be considered and assessed promptly. A.23.Mature Age Traveller This Policy is available and valid only for travellers aged 69 years and under at the date of departure. Travellers 70 years and over may refer to our Mature Age Travel Insurance. Please go to the Mature Age Travel Insurance area of Our website for details on how to apply. 12
A.24. Adventure Activities Most amateur sporting and adventure activities are covered at no extra cost on all Plans. Activities covered include non competitive snow skiing/ boarding within designated ski fields, cycling, trekking below 3,000 metres, water skiing and, where provided by a local commercial operator, bungee jumping, para-sailing, white water rafting, and hot air ballooning. A.25. Existing Health Disorders This Policy does not automatically provide cover for travellers with an Existing Health Disorder. An Existing Health Disorder means: a) any illness, disease or other condition, including symptoms thereof, suffered by You or by Your Travelling Companion, Relative or close business associate which in the one (1) year period before the date the Certificate of Insurance was issued: (i) first manifested itself, worsened, became acute or exhibited symptoms which would have caused an ordinarily prudent person to seek diagnosis, care or treatment; (ii) required taking prescribed drugs or medicine, or tests or further investigation had been recommended by a medical practitioner; (iii) was treated by a medical practitioner or treatment had been recommended by a medical practitioner. or b) any congenital, hereditary, chronic or ongoing condition of Yours or of Your Travelling Companion, Relative or close business associate which You or they are aware of, or could reasonably be expected to be aware of, before the date the Certificate of Insurance was issued. Existing Health Disorder cover is only available in respect of medical conditions for persons insured under this Policy. 13
On going Duty of Disclosure If You suffer a new medical or dental event or Your general state of health deteriorates after You have activated cover under this Policy, but before Your departure for your Trip, You must contact the Medical Assessment Unit and update them, otherwise the new condition or consequences of Your change in health may not be covered under the Policy once Your Trip commences. We reserve the right to review the cover granted including withdrawing or amending cover previously approved for the Trip. If We apply new restrictions then You will have the right to lodge a claim under Policy Section D Cancellation Fees and Lost Deposits should the new cover restrictions imposed by Us prevent You from undertaking the planned Trip. Assessment of Application You are not able to apply to have Your Existing Health Disorders covered if You select the Australia Plan (G12) - please see the Automatic Acceptances section on page 15 for conditions that are covered automatically. If You do require cover for Existing Health Disorders then You should select the Bronze Plan (E12) instead. If You have selected any Plan other than the Australia Plan, and need to apply for cover; • You should read the Medical Conditions information on Our website for further details on how to apply. • Travel Guard™ will fairly assess applications but cannot guarantee acceptance. • If cover can be provided Travel Guard™ will advise the terms of cover and Plan Code, together with an Assessment Number. • Cover of Existing Health Disorders is limited to the approval for the original Policy and cannot be extended. • If accepted an additional premium charge will apply. • We are also advised of the outcome of the assessment. • You must retain a copy of Our confirmation letter, which contains your Assessment Number, and submit this with Your claim form as applicable. To be assessed You will need to: a) Telephone the Travel Guard™ Medical Assessment Unit on 0800 367 244 (8.30am to 5pm week days, excluding public holidays) b) Request an ‘Existing Health Disorder’ assessment. You will need to provide the Medical Assessment Unit with the following: i) Relevant traveller’s full name and age; ii) Details of the Trip; iii) Details of condition, current treatments and medications; iv) Contact details of the relevant traveller’s current Doctor; and v) Medical reports as required by the Medical Assessment Unit. The provision of any information or reports required by the Medical Assessment Unit will be at Your expense. 14
Automatic Acceptances The conditions which follow are automatically covered under this Policy, subject to You satisfying the provisions 1 and 2 below: Acne Allergies Asthma (nil attacks requiring hospitalisation or medical treatment within the last 12 months) Broken/Fractured Bones (providing these are completely healed with no ongoing treatment or residual problem) Cataracts Coeliac Disease Eczema Essential Tremor Gastric reflux Glaucoma Hay fever Haemorrhoids Hiatus Hernia Hip/Knee Replacements (performed more than 12 months ago and no ongoing treatment or residual problem) Hypothyroidism Insomnia Menopause/HRT Restless Leg Syndrome Tinnitus Varicose Veins Provisions for Automatic Acceptance: 1. Automatic Acceptance is only available for Your conditions provided there are no planned procedures, and there have been no complications or exacerbations of the condition within the last six (6) months. In all other circumstances, cover for Existing Health Disorders is subject to application and assessment. 2. Automatic Acceptance does not apply if You request an Existing Health Disorder assessment for any reason. If You request an Existing Health Disorder assessment Travel Guard will fairly assess Your application on the basis of Your entire medical history. Travel Guard cannot guarantee acceptance and the assessment outcome may be to decline cover for Existing Health Disorders even if You suffer a condition that is noted on the Automatic Acceptance list above. If in any doubt we recommend that you contact the Medical Assessment Unit. Please note additional charges apply and applications can only be made by persons travelling under this policy. A.26. Ministry of Foreign Affairs Travel Advisory Please note that You are obliged to check that it is safe to travel to Your destination. Information on safe travel is available at www.safetravel.govt.nz. 15
B) Definitions (meaning of words) Additional Accommodation, Meal and Travelling Expenses means only those reasonable and necessary expenses over and above what You expected to pay for accommodation, meal and travelling expenses including emergency personal telephone calls, had the Trip gone ahead as planned. Existing Health Disorder means: a) any illness, disease or other condition, including symptoms thereof, suffered by You or by Your Travelling Companion, Relative or close business associate which in the one (1) year period before the date the Certificate of Insurance was issued: (i) first manifested itself, worsened, became acute or exhibited symptoms which would have caused an ordinarily prudent person to seek diagnosis, care or treatment; (ii) required taking prescribed drugs or medicine, or tests or further investigation had been recommended by a medical practitioner; (iii) was treated by a medical practitioner or treatment had been recommended by a medical practitioner. or b) any congenital, hereditary, chronic or ongoing condition of Yours or of Your Travelling Companion, Relative or close business associate which You or they are aware of, or could reasonably be expected to be aware of, before the date the Certificate of Insurance was issued. Financial Default means insolvency, bankruptcy, provisional liquidation, liquidation, financial collapse, appointment of a receiver, manager or administrator, entry into any official or unofficial scheme of arrangement, statutory protection, restructuring or composition with creditors, or the happening of anything of a similar nature under the laws of any jurisdiction. Limb(s) means any part of the arm between the shoulder and the wrist or any part of the leg between the hip and the ankle. Luggage means personal items, including sporting equipment, dentures and or dental prostheses designed to be worn or carried by You which You take with You or buy during Your Trip, unless they are excluded under “What is not covered” in Sections C or F. Motor Cycle means a motorised cycle. Permanent means lasting twelve (12) calendar months from the date of occurrence and at the end of that period being beyond hope of any improvement. Relative means someone who is resident in Australia or New Zealand and is Your spouse or de facto partner of either gender, parent, parent-in-law, daughter, son, daughter or son-in- law, brother, sister, brother or sister-in-law, niece or nephew, grandchild, grandparent, step-parent, stepdaughter, stepson, aunt, uncle, fiancée, fiancé or guardian. 16
Rental Vehicle means a motor vehicle rented or hired by You from a recognised motor vehicle rental company for the carriage of passengers and does not include any vehicle designed to be used for the carriage of commercial goods. Serious Injury or Illness means a condition which necessitates treatment by a legally qualified medical practitioner and which results in You or any other person to which this insurance applies being certified by that medical practitioner and Travel Guard™ at the time as being unfit to travel or continue on with Your original Trip. In respect of a non-travelling Relative or close business associate, it is a life threatening condition that as agreed by Our medical advisor, necessitates Your immediate return to New Zealand. Terrorist Act means any actual or threatened use of force or violence directed at or causing damage, injury, harm or disruption, or committing of an act dangerous to human life or property, against any individual, property or government, with the stated or unstated objective of pursuing economic, ethnic, nationalistic, political, racial or religious interests, whether such interests are declared or not. Robberies or other criminal acts, primarily committed for personal gain and acts arising primarily from prior personal relationships between perpetrator(s) and victim(s) shall not be considered Terrorist Acts. Terrorism shall also include any act which is verified or recognised by the (relevant) government as an act of terrorism. Total Loss means the total physical loss or loss of use of one or more limbs. For an eye, it means the entire and irrecoverable loss of sight in that eye. Travelling Companion means the person who is to travel with You for at least 50% of the Trip and who made arrangements to accompany You before You began the Trip. Transport Provider means any airline, bus line, shipping line or railway that has accepted Your fare. Travel Service Provider means any scheduled service airline, hotel, accommodation provider, motor vehicle rental or hire agency, bus line, shipping line or railway company. Trip a) in respect of any One-trip Plan, means the travel You are undertaking and commences from the time You leave Your home or place of departure to start Your trip until You return home or until the end of the period of insurance shown as the expiry date on the Certificate of Insurance, whichever occurs first. In regards to International Plans travel must be to an overseas destination or for Domestic Plans, travel within New Zealand of no less than a 200km radius from Your home. b) in respect of any Annual Multi-trip Plan, means the travel You are undertaking and commences from the time You leave Your home or place of departure to start Your trip until You 17
return home or until the end of the period of insurance shown as the expiry date on the Certificate of Insurance, whichever occurs first. The length of any one trip cannot exceed forty- five (45) consecutive days and must involve travel to an overseas destination or a domestic destination of no less than a 200km radius from Your home. Unattended means, but is not limited to, when an item is not on Your person at the time of loss, left with a person other than Your Travelling Companion or official responsible for Your items when travelling (e.g. airline check-in agent or hotel porter), left in a position where it can be taken without Your knowledge including on the beach or beside the pool while You swim, leaving it a distance where You are unable to prevent it from being unlawfully taken. War means war, whether declared or not, or any warlike activities, including use of military force by any sovereign nation to achieve economic, geographic, nationalistic, political, racial, religious or other ends. We, Our, Us means AIG Insurance New Zealand Limited. You, Your, Yourself means the person or persons named on the Certificate of Insurance. If You select Single cover the Policy covers You and Your financially dependent children or grandchildren all under 21 years of age who travel with You. If You select Family cover the Policy covers the same persons as Single cover plus Your spouse, de facto partner of either gender or any adult Travelling Companion named in the Certificate of Insurance. C) Losses not insured under any section of this policy What is not covered Your Policy does not provide for losses, liability or expenses that are for, related to or as a result of: C.1. You not acting in a responsible way to protect Yourself and Your property or to prevent or reduce Your loss. C.2. Something of which You were aware at the time of taking out this Policy, or of which You could have been expected to be aware, that could bring about Your making a claim under this Policy. C.3. Hunting, racing other than on foot, playing polo, professional sport, mountaineering or rock climbing using ropes or climbing equipment (other than hiking), pot holing, travelling in international waters in a private sail vessel or privately registered sail vessel, or any travel to, from or within inhospitable locations including but not limited to Antarctica (except when such locations are visited as a fare paying passenger on a commercial cruise liner). 18
C.4. You or Your Travelling Companion, or any other person for whom You may cancel or alter Your travel Plans, whether that person is directly involved with Your travel or not, being affected by alcohol or drugs unless the drugs were prescribed and used as directed by a legally qualified medical practitioner. C.5. You acting illegally or breaking any government prohibition or regulation. C.6. War, civil war, invasion, insurrection, revolution, use of military power or usurpation of government or military power. C.7. Any consequential loss, economic or otherwise, loss of enjoyment or other loss not mentioned in this Policy, whether financial or non-financial, including but not limited to any legal or other professional costs and/or travel expenses arising directly or indirectly out of any claim made by You under this Policy. C.8. Nuclear explosion including all effects thereof; or radioactive contamination caused by ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste caused by the combustion and or ongoing combustion of nuclear fuel; or the radioactive, toxic, explosive or other hazardous properties of any nuclear equipment or component there of. C.9. The dispersal or application of pathogenic or poisonous biological or chemical materials; or the release of pathogenic or poisonous biological or chemical materials. C.10. Any claim if You are not a permanent resident in New Zealand or if You do not plan to return to live in New Zealand at the end of Your Trip. C.11. Parachuting, BASE jumping, sky diving or travel in any other air supported device other than as a passenger in a licensed passenger aircraft operated by an airline 19
or charter company. This does not apply to hot air ballooning or parasailing. C.12. Any loss, consequential loss or liability arising directly or indirectly out of any failure, malfunction, breakdown, inability to perform normal functions or interruption of operation of any computer hardware, integrated circuit, operating system, application, software, electronic equipment, computer chip, programmed or embedded logic control system or similar device being affected due to date based functionality or performance being affected by the use of any date format. C.13. Travelling against medical advice or for the purpose of obtaining medical advice or treatment or if a terminal or malignant prognosis was given before You applied for this insurance. C.14. Diving underwater using an artificial breathing apparatus unless You hold an open water diving licence or You were diving under licensed instruction. C.15. You operating a Motor Cycle without You holding a valid licence for the country the Motor Cycle is being operated in. C.16. A government authority seizing, withholding or destroying anything of Yours or any prohibition by or regulation or intervention of any government. C.17. The refusal, failure or inability of any person, company or organisation, including but not limited to any airline, other transportation provider, hotel, car rental agency, tour or cruise operator, travel wholesaler, booking agent or other provider of travel or tourism related services, facilities or accommodation, to provide services, facilities or accommodation, by reason of their own Financial Default or the Financial Default of any person, company or organisation with whom or with which they deal unless otherwise provided under Section M. C.18. Any claim arising from errors or omissions in Your booking arrangements by You, Your travel agent or any other person acting on Your behalf. C.19. Any costs which You would have been expected to pay had the reason for the claim not occurred (for example, the cost of food which You would have paid for in any case). C.20. Any claim where You have failed to follow the advice or instruction of Us, or Travel Guard™, such as when You refuse to come back to New Zealand when Travel Guard™ considered You were fit to return home. We will not provide cover or service for: C.21. Any loss, injury, damage or legal liability arising directly or indirectly from travel in, to or through Afghanistan, Cuba, Democratic Republic of Congo, Iran, Iraq, Liberia, Sudan or Syria. 20
C.22. Any loss, injury, damage, or legal liability suffered or sustained directly or indirectly by an insured person if that insured person is: (i) a terrorist; (ii) a member of a terrorist organisation; (iii) a narcotics trafficker; or (iv) a purveyor of nuclear, chemical or biological weapons. D) Cancellation fees and lost deposits You may have to pay an excess for each problem or incident You claim for under this Section unless You have paid for the excess eliminator. See Section A7 for details. If You make a claim You will be required to give Us things like reports or a certificate from the medical practitioner who treated You to show that Your claim is necessary. What is covered D.1. The cost of cancellation fees and lost deposits on prepaid tickets and bookings (other than tickets purchased using frequent flyer or similar points, cover for which is detailed under D5) that You cannot claim from anyone else if Your Trip is shortened or cancelled because of something unexpected and outside Your control or the reasonable cost of rearranging Your travel because of something unexpected and outside Your control, provided this cost is not greater than the cancellation fees or lost deposits which would have been incurred if the Trip had been cancelled. D.2. If We pay a claim under E4 or G2 then You cannot claim for unused non refundable tickets that are for the return trip to New Zealand. D.3. The cost of cancellation fees and lost deposits on prepaid tickets and bookings (other than tickets purchased using frequent flyer or similar points, cover for which is detailed under D5) that You cannot claim from anyone else, if Your travel is cancelled prior to the commencement of Your Trip because Your annual leave is cancelled by Your employer after You have booked Your holiday, provided that: a) You are a full time employee of armed forces, police, fire or ambulance services; and b) Your employer has to cancel Your leave: (i) so You can attend an unforeseen emergency; or (ii) to relocate You overseas unexpectedly. The maximum We will pay under Section D3 is $1,000 for single cover and $2,000 for family cover. D.4. Non-recoverable Fees You have been charged by Your travel agent, up to $4,000 for Single cover or $8,000 for Family cover, but We will not pay more than the loss 21
of the normal remuneration available to the agent had the Trip gone ahead as planned. D.5. Where an airline ticket was purchased using frequent flyer or similar air points, We will pay You for frequent flyer or similar air points lost following cancellation of Your air ticket. The amount payable will be calculated as follows: If the airline will not refund Your points, We will refund to You the cost of the equivalent class air ticket based on the quoted retail price at the time the ticket was issued. If the airline will only refund a portion of Your points, We will refund to You the cost of the equivalent class air ticket based on the quoted retail price at the time the ticket was issued, less the value of the portion of Your points refunded back to You. For this benefit to become payable: a) the reason for cancellation must be covered under this Section of the Policy, and b) the loss of such points cannot be recovered from any other source. c) before You submit a claim under this Section You must first request the airline refund Your points. The cover under D5. is not available under Cancellation and Emergency Expenses Plans (PH12 and PL12). What is not covered Losses, liability or expenses that are for, related to or as a result of: D.6. Any Existing Health Disorder unless agreed to by Us in writing. See Section A25 and B for details. D.7. Any medical or dental problem of Yours which You told us about when You took out this insurance and We told You We would not cover. D.8. You not taking precautions to avoid a claim after there was a warning in the mass media of a strike, riot or bad weather or other circumstances. D.9. A change of plans because You or Your Travelling Companion change Your mind and decide not to proceed with Your original Trip. D.10. Claims arising from Your business (other than severe damage to Your business premises), Your financial or contractual obligations or those of Your Travelling Companion, Relative or close business associate. This exclusion shall not apply to any circumstances covered under Section D3. D.11. You not complying with what Your ticket conditions require. 22
D.12. Tours being cancelled because there were not enough people to go. This does not apply in relation to pre paid travel arrangements purchased separately to get to and/ or from Your destination. D.13. You knowingly making travel arrangements through an unbonded travel agent. D.14. Cancellation, delays or rescheduling caused by Your Transport Provider. D.15. Mechanical breakdown of any means of transport. D.16. The death, injury or illness of any Relative who is not residing in Australia or New Zealand. D.17. The government of any country not allowing You to enter or stay in that country. D.18. Your or any other person’s pregnancy or related complications after 26 weeks of pregnancy, or childbirth after 26 weeks of pregnancy unless the childbirth was accelerated by accidental injury, irrespective of whether or not the pregnancy was known at the date the Certificate of Insurance was issued. D.19. Using a hospital for addiction treatment or as a nursing, convalescent or rehabilitation place. D.20. Your or any other person’s depression, stress, anxiety, mental or nervous disorder, suicide or attempted suicide or self injury. D.21. Sexually transmitted diseases of any sort, Acquired Immune Deficiency Syndrome (AIDS) or AIDS related complex (ARC) or Human Immunodeficiency Virus (HIV). D.22. The cost of a return ticket if You have not purchased a return air ticket to New Zealand. We will deduct from Your claim the cost of the fare between Your last intended place of departure to New Zealand, at the same cabin class as Your initial departure fare. D.23. Any Terrorist Act or any loss arising out of the intentional use of military force to intercept, prevent, or mitigate any known or suspected Terrorist Act. D.24. The non-refundable unused portion of travel or accommodation arrangements where alternative travel or accommodation is paid for by Us as part of a claim under this Policy. This exclusion will not apply where the unused portion of the accommodation arrangements result directly from the hospitalisation or death of You or Your Travelling Companion, and are agreed by Us. D.25. See also Section C. 23
E) Overseas medical, hospital, cash in hospital, dental and related expenses You may have to pay an excess for each injury or illness You claim for under this Section except for E2 and E6 unless You have paid the excess eliminator. See Section A7 for details. What is covered E.1. Necessary overseas medical and hospital expenses You have to pay as a result of an injury or illness (including injury arising from a Terrorist Act subject to Policy terms and exclusions including C9) which first occurs or becomes apparent after the issue date of Your Certificate of Insurance. All medical treatments must be provided by a legally qualified medical practitioner. We will pay up to 12 months from the time You first received treatment for the injury or illness. E.2. If You are hospitalised overseas for more than 48 hours We will also pay $50 for each 24 hour period You are in hospital from the first day of hospitalisation. E.3.a. Up to $2,000 for emergency overseas dental expenses incurred following an injury to sound and natural teeth caused solely and directly by external and visible means as a result of an accident and which does not result from an illness or disease, but not treatment that can be delayed until You return to New Zealand. E.3.b. Up to $500 for emergency dental costs for relief of sudden and acute pain given or prescribed by a legally qualified practitioner and necessarily incurred outside New Zealand. E.4. The cost of moving You to another country or to bring You home to New Zealand. If You want to move and want Us to pay for it, You must contact Us first and get Our agreement. At Our discretion, We will decide on which action to take subject to medical constraints and as agreed by Our medical advisor. If We bring You home to New Zealand We will use Your return ticket towards Our costs. E.5. Additional Accommodation, Meal and Travelling Expenses of Your Travelling Companion or Relative if We agree with Your medical practitioner that a Travelling Companion or Relative must travel to see You, or stay with You until You are able to resume Your Trip, or escort You home. E.6. Funeral expenses if You die while overseas. We will pay the cost incurred overseas for a funeral or cremation and the return of Your remains to New Zealand - but the most We will pay is $20,000. 24
What is not covered Losses, liability or expenses that are for, related to or as a result of: E.7. Any Existing Health Disorder unless agreed to by Us in writing. See Section A25 and B for details. E.8. The replenishment of any medication in use at the time Section D is activated for the Trip to which the claim relates or for the maintenance of any form of treatment commenced before then. E.9. Any medical or dental problem of Yours which You told Us about and We told You We would not cover it. E.10. Medical, hospital, dental or any ancillary expenses incurred in New Zealand or for which we are prevented from paying by reason of any statutory legislation or government regulation or expenses incurred for dental treatment due to normal wear and tear or the normal maintenance of dental health or lack thereof. E.11. Medical, hospital, dental or any ancillary benefits expenses incurred more than 12 months from the time You first received treatment for the injury or illness. E.12. Any claim for which You are entitled to receive reimbursement from workers compensation or other statutory scheme or private health insurance. E.13. Your or any other person’s pregnancy or related complications after 26 weeks of pregnancy, or childbirth after 26 weeks of pregnancy unless the childbirth was accelerated by accidental injury, irrespective of whether or not the pregnancy was known at the date the Certificate of Insurance was issued. E.14. Using a hospital for addiction treatment or as a nursing, convalescent or rehabilitation place. E.15. Your or any other person’s depression, stress, anxiety, mental or nervous disorder, suicide or attempted suicide or self injury. E.16. Sexually transmitted diseases of any sort, Acquired Immune Deficiency Syndrome (AIDS) or AIDS related complex (ARC) or Human Immunodeficiency Virus (HIV). E.17. The cost of a return ticket if You have not purchased a return air ticket to New Zealand. We will deduct from Your claim the cost of the fare between Your last intended place of departure to New Zealand, at the same cabin class as Your initial departure fare. E.18. See also Section C. 25
F) Luggage and Personal Money You may have to pay an excess for each incident You claim for under this Section except F4 and F5 unless You have paid the Excess Eliminator. See Section A7 for details. What is covered F.1. We will pay for the repair cost or loss in cash of any Luggage You lose or which is stolen or damaged after allowing for depreciation that We think is reasonable. At Our sole discretion We also have the option to repair or replace the Luggage. F.2. Payment will not exceed the original price You paid. The most We will pay for each item depending on the Plan You have selected is: ITEM F12, C12, D12, Q12 E12, G12, AF12, AC12 Camera, video camera, laptop computer equipment and set of golf clubs $3,000 $500 Dental prostheses (including dentures) $1,000 N/A Each other item $1,000 $500 A pair or set of items is treated as one item (e.g. a pair of earrings, a camera body and its standard lens and accessories, or a set of golf clubs). The limit for any specified item may be increased to $4,000 with a maximum for all specified items of $8,000. You must have paid the appropriate additional premium and in the event of any claim can show us in support of Your claim a receipt or valuation issued in the twelve months before the commencement of Your Trip. F.3. Luggage left in a motor vehicle is only covered during daylight hours if it is locked in the boot or locked luggage compartment and forced entry was gained. No cover applies if left Unattended in the passenger compartment or overnight in the motor vehicle nor does cover apply to mobile phones, computer equipment, or jewellery items left Unattended in a motor vehicle at any time. F.4. If Your travel documents, credit cards or travellers cheques carried with You are lost or illegally used by someone other than You, Your Relative or Travelling Companion, We pay any amounts You have to pay to replace them or resulting from their fraudulent use. The maximum we will pay is $3,000. F.5. If You have to buy essential clothing and personal items overseas because Luggage carried by Your Transport Provider overseas is delayed by more than 10 hours, We 26
will pay up to $300 per Trip for Single cover and $600 per Trip for Family cover. Receipts must be provided as proof of purchase of such items and be dated prior to the date of recovery of Your delayed Luggage. The amount paid by Us will be deducted from any Luggage claim payable under F1. F.6. Following a loss under this Policy Section We will allow on settlement one automatic reinstatement of the sum insured. F.7. If Your golf or snow skiing equipment is lost, delayed or damaged while on the Trip (other than whilst in use), We will pay the necessary cost of hiring replacement equipment up to the amount of $100 for Single cover and $150 for Family cover. Any claim must be supported by receipts. F.8. If Your personal money is accidentally lost or stolen whilst overseas, then We will pay the value of this personal money up to $500 per Trip for Single Cover and $1,000 per Trip for Family Cover. For the purpose of this section, personal money means cash which is carried as hand luggage or on Your person unless secured in a safe or strong-room where available, otherwise out of sight in a locked private residence or room. It is the responsibility of the Insured Person to provide proof of ownership of any accidentally lost or stolen personal money and We are under no obligation to make payment without this proof of ownership. What is not covered F.9. Furniture. F.10. Items for trade, trade samples or Your tools of trade or profession. F.11. Brittle or fragile items, glassware, china, ceramics, pottery etc or an electronic component that becomes broken or scratched unless it is: • the lens of spectacles, laptop computers, binoculars, photographic or video equipment • a breakage or scratch caused by an accident involving any vehicle You were travelling in. F.12. The loss of Your travel documents, credit cards or travellers cheques if You do not report it immediately to the company that issued them and follow their instructions. F.13. Negotiable items, gold or precious metals, precious unset or uncut gemstones. F.14. Luggage that You leave Unattended or with someone You do not know looking after it. 27
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