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Tuesday, December 23rd, 2014

21st CENTURY
Visitors Insurance

21st Century Insurance

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Benefits
Exclusions
Claims
FAQ
Rates
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Administrated by: 21st Century Travel Insurance Limited
Underwritten by: The Manufactures Life Insurance Company (Manulife Financial)
24 hours Assistance Center: Active Care Management

BENEFITS: 
  - Maximum Benefits: $10,000; $15,000; $25,000; $50,000, $100,000 and $150,000
  - Hospital and medical expenses - Up to the amount of insurance purchased for emergency hospitalization (ward accommodation) or out-patient services. 
  - Physician and Private duty registered nursing or licensed home care providers.
  - Medical Appliances - rental of crutches, hospital bed, splints, trusses, braces or other prosthetic devices, up to a maximum of $5,000.
  - Professional Medical Services referred by a physician - treatment provided by a licensed chiropodist, chiropractor, osteopath, physiotherapist, podiatrist or acupuncturist up to a maximum of $1,000 per insured.
  - Diagnostic Treatment including X-rays, ultrasounds, and laboratory tests requested by a physician up to the policy limit while hospitalized for a period of 24 hours or more or up to a maximum of $1,500 when these services are provided on an outpatient basis. 
  - Ambulance Transportation.
  - Prescription drugs or medicines up to $500 per insured maximum.
  - Funeral Expenses: In the event of death, up to $5,000 for preparing and transportation of the body to the country of origin or for cremation and/or burial at the place of death. 
  - Emergency Transportation: The cost up to the policy limit for one-way economy airfare or stretcher to transport you to your country of origin, and a medical attendant if required. This benefit must be authorized and arranged by the Assistance Centre.
  - Accidental Dental: Up to $1,000 for repair or replacement of whole or sound natural teeth damaged by an accidental blow to the face.
  - Dental Emergencies: Up to $300 during any 12 months period for the immediate relief of acute dental pain, other than provided under Accidental Dental. 
  - Accidental Death and Dismemberment – up to $10,000 (in excess of the aggregate policy limit)
  - Re-occurrence of already claimed medical condition if in the 90-days prior to that subsequent emergency this condition was stable (see 90-Day Provision exception)

EXCLUSIONS: Your coverage is subject to various exclusions, which are completely set out in the Exclusions section of the policy document. The following, although not an exhaustive list, are some of these exclusions:
ELIGIBILITY:
You are not eligible for coverage under this policy if:
   - a physician has advised you not to travel;
   - you have been diagnosed with a terminal illness with less than two years to live;
   - you have a kidney condition requiring dialysis; and/or
   - you have used home oxygen during the 12 months prior to the date of application.
AGE AND PERIOD LIMITS: 
Coverage is available under a policy for 365 days in total for ages up to 85. For those age 86 and older, coverage can be purchased to insure up to the first 180 days following the date of arrival in Canada. No further coverage can be purchased until you return to your country of origin, if you are age 86 or older.

DEDUCTIBLES: The published rates include a $50 deductible per person per policy period. The following deductible options and discounts are available: 40% savings for $10,000 deductible, 35% savings for $5,000 deductible, 20% discount for $1,000 deductible and 10% for $250 deductible. $0 deductible option is also available for visitors up to age 85. For age 86 or greater - $500 deductible only is available.

Applicants who select the “disappearing deductible” option receive a premium discount of 30% when $25,000 coverage is purchased or 25% discount if $50,000 of benefit is selected (see end of this page for more information)

WAITING PERIOD for sickness or disease:
   - No waiting period if the insurance is purchased or activated prior to your arrival in Canada or the same policy has been extended.
   - 72 hours if the policy is purchased within 30 days of your arrival in Canada.
   - 7 days if the policy is purchased after 30 days of your arrival in Canada.
   - 15 days if you are age 86 or older and if you purchased your policy after the arrival date.
If you have coverage with another insurance company during the first part of your trip, and you are purchasing this insurance after your arrival date and there will be no gap in your coverage, you may request to have the waiting period waived. You must provide proof satisfactory to the Company that you have other coverage in force prior to purchasing this policy and receive written approval from the Company. 

PRE-EXISTING CONDITIONS: 
Any sickness, disease or injury for which medication has been taken, received or prescribed, and/or treatment has been received in the 180-day period preceding the "Effective Date" of your coverage.

Note: Each time you extend or purchase another policy from the insurance company because you are staying in Canada longer, each new policy will have a new effective date and you will NOT be covered under the new policy for any sickness, disease, symptom or injury which had manifested itself in the 180-day period immediately preceding the new effective date.

"Stable Chronic Condition" means: 
   - A condition which is under treatment and which has been controlled by consistent use of medication prescribed by a physician, and there have been no new symptoms or change in symptoms; and/or there has been no hospitalization or change in treatment, medication or dosage in the 180 days prior to the effective date of this policy.
   - If your physician has determined that your health condition has improved and changes, your treatment, medication or dosage due to your improved health condition, this does not constitute a change.
   - A condition that existed more than 180 days prior to the effective date and which did not require continued treatment as determined by a physician during the 180 days prior to the effective date of this policy.
   - Stable Chronic Condition option is automatically included for visitors under age 60. Applicants age 60 to 85 who wish to purchase this option must complete the medical declaration on the application to determine eligibility for coverage.

PREGNANCY: Limited coverage is provided for complications that happen outside of the 9 week period before and the 9 week period after the expected delivery date IF the pregnancy commences AFTER the effective date of the policy.

OTHER EXCLUSIONS:
   - Intentional self-injury, suicide or attempted suicide while sane or insane; a criminal act or an attempt to commit a criminal act.
   - Sickness, disease or bodily injury in any way arising from or contributed to by the misuse of drugs or alcohol.
   - An emergency resulting from: hang-gliding, rock-climbing, mountaineering, parachuting or skydiving; participating in a motorized speed contest; or your professional participation in a sport, snorkeling or scuba-diving when that sport, snorkeling or scuba-diving, is your principal paid occupation.
   - The provision of Insured Services to children 30 days of Age or younger.
   - War, invasion, terrorist acts.
   - Your obtaining medical or healthcare assessment or any form of report or document for the purposes of supporting an application to obtain immigrant status in Canada.
   - Mental and emotional disorder (other than acute psychosis) that does not require admission to a hospital.
   - General health examinations, medical and health services, including prescription drugs or medicines, provided to monitor or maintain a Stable Chronic Condition. 
    - Costs incurred in your country of origin are excluded.
    - any treatment that is elective, cosmetic and not for the emergency and/or general health examination or services.
    - any medical treatment outside of Canada when the emergency occurred in Canada.
    - the outgoing treatment, recurrence or complication of a medical condition when you have already received emergency treatment for that condition during your coverage period and the Assistance Centre determines that your medical emergency has ended (except 90-day provision benefit) 
    - If you have an emergency covered under this policy, and the Assistance Centre determines that you are able to travel, 21st Century reserves the right to transfer you to your country of origin. If you refuse or choose not to return, you will no longer be covered for any insured services under this policy. Any continuing expenses incurred after you refuse or have chosen not to return will not be covered and the payment of such expenses becomes your sole responsibility.

90-Day Provision: If you are advised by the Assistance Centre that your emergency has ended, and you are not required to return to your country of origin, you will have no further coverage under this policy for any insured services that are directly or indirectly related to ongoing treatment, recurrence or complication of that medical condition. However, if your claim is deemed to be payable under this policy then subject to the other terms, conditions and exclusions of this policy such medical condition will be covered again in the event of a subsequent emergency if, in the 90-days prior to that subsequent emergency: you have not had any recurrence, new symptom(s) or any complications; existing symptom(s) have not become more frequent or severe; your physician has not determined that your medical condition has become worse; no test findings have shown that your medical condition may be getting worse; you have not received, been prescribed, taken or had a physician recommend any new medication, or any change in medication. Exceptions: the routine adjustment of Coumadin, Warfarin, insulin or oral medication to control diabetes (as long as they are not newly prescribed or stopped) and a change from a brand name medication to a generic brand medication (provided that the dosage is not modified); you have not received, been prescribed, or had a physician recommend any new treatment, or any change in treatment; you have not been hospitalized or referred to a specialist or specialty clinic; and your physician has not advised you to see a specialist or to have further tests, and you have not undergone testing for which you have not yet received the results.

CLAIMS:
You must call prior to receiving any medical treatment: If you don't contact the Assistance Centre prior to receiving any medical treatment, you will have to pay 20% of the medical expenses the insurance company would normally pay under this insurance. If it is medically impossible for you to call when the emergency happens, the 20% co-insurance will not apply. In this case, 21st Century asks that you call as soon as you can or that someone call on your behalf.

To make a claim, you will need to complete a claim form and attach the original medical bills, receipts and invoices (always make a copy for your record), your medical and/or hospital record (diagnosis, X-ray, lab tests confirming that the treatment was medically necessary), copy of police report (in case of a Motor Vehicle Accident) and mail it to:
                   21st Century Visitors Claims
                        c/o Active Care Management
                         P.O. Box 1237, Stn A
                        Windsor, ON, N9A 6P8

Claim Assistance: In the event of claim or in the event of circumstances likely to result in a claim, please call the Claims Assistance Centre at: 1-855-297-4379 (toll-free within North America) from 8:00 AM to 8:00 PM Eastern Standard Time.

In the case of any disagreement with 21st Century Travel Insurance Limited claim decision you may choose to follow the Claim Complain Process:
   - Request in writing, a Mandatory Claims Review Meeting with 21st Century Travel Insurance Limited. A Mandatory Claims Review Meeting will be scheduled within 30 days of receipt of your written request.
   - Arbitration in accordance with the law governing arbitration proceedings in the Province in which your policy was issued in case of any disagreement after the Mandatory Claims Review Meeting. Legal action to recover a claim must start within 12 months of the date of bodily injury or the date on which you first received any emergency medical service.

F.A.Q.:
REFUNDS:
Request for premium refunds due to non-arrival can be submitted for consideration as long as this insurance has not been issued as part of the requirements necessary to obtain or maintain a visitor visa in which case proof of visa refusal must be provided. You can also cancel your insurance with proof of departure from Canada but that is considered an early return and means that 21st Century will refund only the unused premium amount provided that there has been no claim reported, paid or denied. If you are applying for a partial refund due to an early return home and have a payable claim that has not been paid, (or the total amount of all reported eligible expenses will not exceed the deductible amount), you may apply to have such claim(s) withdrawn, subject to a file handling fee of $250 per claim.

REFUNDS for "Super Visa Monthly Payment Option" plan: If your Parent and Grandparent Super Visa application is denied by Citizenship & Immigration Canada, or your application is formally withdrawn and your policy has not been activated, 21st Century will refund any premium paid (subject to administration fee of $25 for annual and $50 for monthly payment option). Proof of the denial or withdrawal of your application must be provided to 21st Century with a written request for a refund. If you applied for "Super Visa" plan Monthly Payment Option, the first two months of premium and the $50 policy fee are NON-REFUNDABLE in any circumstance where the Super Visa is approved and issued by Citizenship & Immigration Canada. 
In case of early departure from Canada, the Monthly Payment Option will refund ONLY the full monthly premiums (except the first two months premium). Partial months will NOT be refunded. You must submit a written notification to terminate your policy and include a copy of your return airline tickets and stamped passport or a copy of your boarding pass and a statement saying that you will not report or submit any claims on this policy after your termination date.
All refunds are subject to approval by 21st Century.
In addition, a $25 policy administration fee will be applied to any refund or cancellation. 

EXTENSIONS: 
Each time you purchase another policy from the insurance company because you are staying in Canada longer, each new policy will have a new effective date and you will NOT be covered under the new policy for any sickness, disease or bodily injury which had manifested itself in the 180-day period immediately preceding the new effective date. Waiting period will apply if you decrease your deductible amount or change from Standard to Stable Chronic Condition coverage option or increase your policy limit.

SIDE TRIPS:
This insurance provides coverage for up to 30 days in total within a 365-day period while traveling outside Canada as long as you spend not less than 51% of your time in Canada. Coverage is provided for uninterrupted flights to and from Canada, if insurance was purchased prior to leaving the country of origin. You are not covered under this insurance policy in your country of origin. An uninterrupted flight shall include a stop-over provided you do not leave the airport. Proof of all travel dates will be required in the event of a claim.

If you hold a PG-1 Super Visa and return to your country of origin without cancelling your policy, your coverage will be suspended while you are in your country of origin and will be reinstated when you return to Canada (or other country as permitted under the "Side-Trips Outside of Canada" provision). There will be no refund of premium related to your suspension of coverage and your expiry date will not change.

ABOUT 21st CENTURY TRAVEL INSURANCE:
21st Century Travel Insurance Limited is a Managing General Agency that provides all types of travel insurance products to individuals and groups across Canada. The head office is in Cobourg, Ontario and all insurance policies are underwritten by Manulife Financial.

RATES:

Table 1 - Stable Chronic Condition Coverage
Single Rates
Age/Sum $10,000 $15,000 $25,000 $50,000 $100,000 $150,000
0-25 $1.70 $2.10 $2.30 $2.55 $3.50 $4.10
26-34 $1.85 $2.15 $2.35 $2.75 $3.75 $4.40
35-39 $1.90 $2.25 $2.50 $2.85 $4.00 $4.60
40-54 $2.05 $2.61 $2.90 $3.40 $4.90 $5.81
55-59 $2.15 $2.70 $3.10 $3.55 $5.25 $6.40
60-64 $3.06 $3.50 $4.10 $4.81 $6.60  
65-69 $3.28 $4.15 $4.65 $5.50 $7.45  
70-74 $5.00 $6.30 $7.40 $8.40 $10.90  
75-79 $6.10 $7.95 $9.10 $11.25 $13.40  
80-85 $9.15 $10.75 $13.75 $16.50 $20.00  
             
Family Rates (based on age of oldest person)
0-25 $3.40 $4.20 $4.60 $5.10 $7.00 $8.20
26-34 $3.70 $4.30 $4.70 $5.50 $7.50 $8.80
35-39 $3.80 $4.50 $5.00 $5.70 $8.00 $9.20
40-54 $4.10 $5.22 $5.80 $6.80 $9.80 $11.62
55-59 $4.30 $5.40 $6.20 $7.10 $10.50 $12.80

Applicant age 86 and over must complete a medical declaration to determine eligibility.
   - Applicants under age 60 are automatically covered for "stable chronic conditions"
   - Applicants ages 60 to 85 who wish to purchase this option must complete the Medical Declaration to determine eligibility for coverage
   - $50.00 deductible per claim. (age 86 or greater - $500 deductible). Other deductible options availabel for visitors up to age 85: $0 (5% surcharge), $250 (10% discount), $1,000 (20% discount), $2,500 (disappearing), $5,000 (35% discount) and $10,000 (40% discount).

   - Minimum policy premium is $25.00.
   - Maximum length of coverage is 365 days. For age 86 and over, coverage can be purchased to insure up to the first 180 days following the arrival date.
   - Family rate - is twice the older adult rate. "Family" means 3 or more of: parent(s) or legal guardian(s) and their unmarried children under age 21 who are visiting Canada with them and dependent on them for their sole means of support.
   - When you purchase the $100,000 option, you are automatically insured for $150,000 for covered expenses as a result of an accidental bodily injury.

Table 2 - No Stable Chronic Condition Coverage
Single Rates
Aggregate policy limit per person

Age 60
to 64

Age 65
to 69
Age 70
to 74
Age 75
to 79
Age 80
to 85
Age 86 and over (deductible $500)
$10,000 $2.76 $2.96 $4.05 $4.80 $6.05 $9.74
$15,000 $3.30 $3.75 $5.20 $6.00 $7.70 $12.54
$25,000 $3.75 $4.25 $5.95 $7.00 $9.10 $14.76
$50,000 $4.34 $5.00 $7.15 $8.40 $10.20  
$100,000 $5.43 $6.73 $8.80 $10.80 $14.00  

RATE TABLE GUIDE:

Age Stable Chronic Condition Option Medical Declaration Required? Premium Table Deductible Amount
Under 60 Automatically Included No Table 1 $50.00
60-85 If Option Waived No Table 2 $50.00
60-85 If Option Purchased Yes Table 1 $50.00
86 plus Not Available Yes * Table 2 $500.00

 * For age 86 plus, if there are any "Yes" answers on the Medical Declaration, no coverage of any kind is available from 21st Century.

What is Disappearing Deductible Option?
The disappearing deductible option is available to any applicant, of any age, who purchases benefit of $25,000 or $50,000. All other deductibles are waved (including the $500 for age 86+) and replaced with a $2,500 deductible that applies to each sickness-related claim when eligible expenses are $2,500 or less. When eligible expenses for a sickness-related claim exceed $2,500, the deductible amount is waived (“disappears”) and eligible expenses will be reimbursed from the first dollar, ie. $0 deductible becomes applicable.
For injury-related claims, the deductible is waived. Applicants who select the disappearing deductible option receive a premium discount of 30% when $25,000 coverage is purchased or 25% discount if $50,000 of benefit is selected.

What is the Stable Chronic Condition Coverage Option?
This option is automatically included for all applicant up to age 59, and can be purchased for ages 60 to 85 (providing the applicant is eligible). When the option is included or purchased, exclusion 1 in the policy will not apply to eligible expenses incurred, after any applicable waiting period, to respond to a stable chronic condition (as defined in the policy).
Note: conditions that do not meet the definition of stable chronic condition will be subject to the pre-existing exclusion in the policy.

Note: This information is an illustration only. It is not an insurance policy. Travel insurance does not cover everything. For the complete terms, conditions, limitations and exclusions please see the policy wording online or refer to your policy booklet.

DOWNLOADS:

21st Century Travel Insurance Inc.
Visitors Insurance Policy PDF

21st Century Travel Insurance Inc.
Visitors Claim Form PDF

21st Century Travel Insurance Inc.
Medical Declaration PDF

 

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