Allianz Global Assistance 
Inpatriate Plan

Benefits
Exclusions
Claims
FAQ
Rates
Downloads

Administrated by: Allianz Global Assistance (AGA).
Underwritten by: CUMIS General Insurance Company, a member of The Co-operators group of companies.
24 hours Emergency Assistance Center: AGA Emergency Assistance

IMPORTANT NOTE: The product-related information on this website is for illustration purposes only. For complete benefits, terms, conditions, limitations and exclusions, please see the policy booklet at the download section below. Please read and understand your policy before you travel.

BENEFITS:
  - Maximum Benefits: $100,000; $150,000 and $200,000. 
  - Emergency Hospital: semi-private room accommodation.
  - Physician, surgical or anaesthetic services.
  - Private duty services of a Registered Nurse – up to $10,000. *
  - Diagnostic Treatments: Lab tests and X-ray examinations ordered by a physician.
  - Ambulance Transportation: Licensed local air, land, or sea ambulance (including mountain or sea evacuation) to the nearest hospital, when reasonable and necessary.
  - Medical Appliance: Rental of crutches or hospital-type bed and the cost of splints, trusses, braces or other prosthetics. *
  - Prescription drugs or medications - one-month supply, to a maximum of $1,000.
  - Professional Medical Services referred by a physician - care received from a licensed physiotherapist, chiropractor, osteopath, chiropodist, podiatrist and acupuncturist - up to $500 per category of practitioner. 
  - Dental (Accident): Up to $4,000 for repair or replacement of whole or sound natural teeth damaged by an accidental blow to the face.
  - Dental (Emergency): Up to $500 for the immediate relief of acute dental pain.
  - Follow-up Visits are covered up to $5,000, provided they are directly related to the emergency that has been reported to AGA.
  - Out-of-Pocket Expenses: up to $150 per day to a maximum of $1,500, or up to a maximum of 10 days, for accommodation, meals, essential telephone calls, taxi fares and child care costs for children under age 18, or physically or mentally handicapped travelling companion(s) who rely on you for assistance, in the event you (or your insured travelling companion) are confined to hospital on the date on which you are scheduled to return home.
  - Emergency Transportation:  The cost for air ambulance, stretcher or one-way economy airfare (and/or a medical attendant) to transport you to your country of origin. *
  - Emergency Return Home: Up to $3,000 for the cost of one-way economy transportation to your country of origin if the covered sickness or injury requires you to be returned home during the period of coverage. This benefit also includes one additional insured family member. *
  - Transportation of Family or Friend: Up to $3,000 for round-trip transportation to bring a family member or close friend to your bedside and up to $1,000 for accommodation, meals, telephone calls and taxi fares, if you are hospitalized and the attendance is recommended by a physician or to identify your remains in the event of your death. *
  - Return of Deceased (Repatriation):  up to $10,000 to prepare and return your remains to the country of origin, or up to $4,000 for cremation or burial at the place of death. The cost of a funeral service, coffin or urn is not covered.
  - Accidental Death & Dismemberment: Up to the sum insured for accidental loss of life, limbs or sight (except air flight accidents). 
  - Physical Examination: one routine examination by a physician in any 12-month period, provided coverage has been in effect for a minimum of 9 consecutive months with no lapse.
  - Eye Examination - one routine annual examination by an optometrist in any 12-month period, provided coverage has been in effect for a minimum of 9 consecutive months with no lapse.
  - Vaccines: Up to $100 annually for vaccinations in any 12-month period, provided coverage has been in effect for a minimum of 6 consecutive months with no lapse.
  - Maternity Benefit: 80% of the costs up to $10,000 for pre-natal care, childbirth or miscarriage, or related complications and for routine new-born nursing care up to 14 days following birth. Newborns can be covered under their own policy at 15 days of age.
The expected delivery date must be more than 10 months after the effective date. For multiple policies with no lapse in coverage, effective date for this benefit means the effective date of the initial policy purchased.

* Benefits are payable only when approved in advance by AGA. 

ELIGIBILITY:
1. Coverage is NOT AVAILABLE to any individual who, as of their effective date:
   a) has been diagnosed with a terminal illness; or
   b) has been diagnosed with or has had an episode of congestive heart failure; or
   c) has had their most recent heart surgery* more than 10 years ago; or
   d) has been diagnosed with Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV); or
   e) has been diagnosed with stage 3 or 4 cancer, or cancer of the lung, liver, pancreas, or bone; or has received treatment for any cancer (other than basal or squamous cell skin cancer or breast cancer treated only with hormone therapy) in the past 3 months; or
   f) has had a lung condition** for which, in the last 12 months, they have been prescribed or used home oxygen; or
   g) has received or is awaiting a bone marrow or major organ transplant (heart, kidney, liver, or lung); or
   h) has been diagnosed with or received treatment for kidney disease requiring dialysis; or
   i) has been diagnosed with an aneurysm that has not been repaired; or
   j) requires assistance with activities of daily living (eating, bathing, using the toilet, changing positions, including getting in and out of a bed or chair, and dressing).
2. To be eligible for coverage you must:
   a) be at least 15 days old and not more than 69 years old; and
   b) not be insured or eligible for benefits under a Canadian government health insurance plan; and
   c) be in good health at the time you purchase your policy and on the date you exit your country of origin, and know of no reason to seek medical consultation during the period of coverage; and
   d) not have exceeded two years of uninterrupted coverage under an AGA insurance plan.
* Heart surgery includes heart bypass operation, angioplasty, valve surgery (repair or replacement), valvuloplasty, implanted pacemaker, implanted defibrillator.
** Lung condition includes chronic obstructive pulmonary disease (COPD), bronchial asthma, asthma, chronic bronchitis, emphysema, tuberculosis, pulmonary fibrosis.

Waiting Period
Coverage for losses resulting from any sickness will begin 48 hours after the effective date if you purchase your policy:
a) after the expiry date of an existing AGA administered policy; or
b) after you exit your country of origin.
Any sickness that manifests itself during the 48-hour waiting period is not covered even if related expenses are incurred after the 48-hour waiting period.
The waiting period will be waved, if the application for this insurance is completed PRIOR to your exit of your country of origin or before the expiry date of the existing AGA administered policy. 

Stability period:
   a) if you are age 59 or under, is the 90 days immediately before the effective date.
   b) if you are age 60 to 69, is the 180 days immediately before the effective date.
If you are 60 to 69 years of on the effective date, you have to complete a Medical Questionnaire and have to be approved in writing by AGA in order to be covered for pre-existing medical conditions that has been stable in the 180 days immediately before the effective date.
Stable describes any medical condition or related condition, including any heart condition or lung condition, for which:
   a) there has been no new treatment; and
   b) there has been no change in treatment or change in treatment frequency or type; and   c) there have been no signs or symptoms or new diagnosis; and
   d) there have been no test results showing deterioration; and
   e) there has been no hospitalization; and
   f) there has been 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.
The following are considered stable:
  a) Routine (not prescribed by a physician) adjustment of insulin to control diabetes provided the insulin was not first prescribed during the stability period.
  b) Change from a brand name medication to a generic medication provided the medication was not first prescribed during the stability period and there is no increase or decrease in dosage.
  c) A minor ailment, which describes a sickness or injury during the stability period which ended prior to the effective date and which did not require:
       i. treatment for a period longer than 15 consecutive days; or
       ii. more than one follow-up visit to a physician; or
       iii. hospitalization, surgery, or referral to a specialist.
The following conditions are not considered stable:
  a) any lung condition for which you were prescribed or are taking prednisone;
  b) any heart condition for which you were prescribed or are taking nitroglycerin.
Heart condition includes heart attack (myocardial infarction), arrhythmia, atrial fibrillation, heart murmur, irregular heart rate or beat, chest pain or angina, arteriosclerosis, aneurysm, carotid artery occlusion, (congestive) heart failure, cardiomyopathy, heart by-pass operation, valve surgery (repair or replacement), valvuloplasty or any other kind of heart surgery, angioplasty, use of pacemaker or defibrillator, congenital heart defect or any other condition relating to the heart or blood vessels.

EXTENSIONS:
If you decide to extend your trip, you may apply for a new period of coverage provided you meet the Eligibility requirements.
Each policy or period of coverage is considered a separate contract and all limitations and exclusions will apply. 

SIDE TRIPS: Costs incurred outside of Canada other than in your country of origin are covered provided the majority of the period of coverage is spent in Canada. Your policy will remain in effect while you are in your country of origin, however costs incurred in your country of origin are not covered. 

REFUNDS:
Refunds are payable when:
1. The entire trip is cancelled prior to the effective date.
2. You return to your country of origin prior to the expiry date, without intending to return to Canada. Refunds are not payable for time spent in your country of origin between visits to Canada.
3. You become insured under a Canadian provincial or territorial health/medical plan.
A full refund will be provided for policies which are returned within 10 days of purchase, provided your coverage has not started.
When submitting your premium refund request, please include:
1. a fully completed and signed Refund Request Form; and
2. a copy of your confirmation of coverage; and
3. confirmation of your early departure such as boarding pass or itinerary, or any other written proof of your early return to your country of origin; and
4. any other documentation to support your refund request.
Important Notes: There will be no refund of premium if a claim has been made.
Refunds are payable from the date we receive the request.
Refunds for partial cancellations will be calculated by multiplying the monthly premium by the actual number of months the policy was in effect. This amount is then subtracted from the total premium paid. The refund will be calculated based on the date the refund request is received by AGA.
A refund fee may apply.
Refund amounts less than the minimum premium will not be issued.

EXCLUSIONS: 
INP1 Pre-existing Conditions Exclusion Benefits are not payable for costs incurred due to or resulting from your medical condition or related condition that was not stable at any time during the stability period.
INP2 Benefits are not payable for costs incurred due to any treatment, investigation or hospitalization which is a continuation of, or subsequent to, emergency treatment of a sickness or injury, unless approved in advance by AGA.
INP3 Benefits are not payable for any costs incurred due to any sickness for which signs or symptoms occurred within 48 hours after the effective date, except when applying for coverage:
   a) before the expiry date of your existing AGA administered policy; or   
   b) prior to the date you exit your country of origin.
INP4 Benefits are not payable for costs incurred due to any loss incurred outside of Canada when you have not spent the majority of the period of coverage in Canada.
INP5 Benefits are not payable for costs incurred due to any loss incurred inside your country of origin.
INP6 Benefits are not payable for costs or losses incurred while sane or insane due to:
   a) your emotional or mental disorders resulting from any cause, including but not limited to anxiety or depression; or
   b) your suicide, attempted suicide; or
   c) your intentionally self-inflicted injury.
INP7 Benefits are not payable for costs incurred due to pregnancy, abortion, miscarriage, childbirth or complications thereof, except as specifically provided under Maternity Benefit.
INP8 Benefits are not payable for costs incurred due to loss, death or injury, if at the time of the loss, death or injury, evidence supports that the medical condition causing the loss was in any way contributed to by:
   a) your intoxication or abuse of alcohol; or
   b) your use of prohibited drugs, or any other intoxicant; or
   c) your non-compliance with prescribed treatment or medical therapy; or
   d) your misuse of medication.
INP9 Benefits are not payable for costs incurred due to injury resulting from training for or participating in:
   a) motorized speed contests; or
   b) stunt activities; or
   c) professional sport activities (Professional means you are considered professional by the governing body of the sport, earn the majority of your income from such activity, and are paid for your participation whether you win or lose.); or
   d) high-risk activities. High-risk activity(ies) mean(s) any skiing out of bounds, heliskiing, ski jumping, skydiving, sky-surfing, scuba diving (except if certified by internationally recognized and accepted program such as NAUI or PADI, or if diving depth does not exceed 30 meters), white water rafting (except grades 1 to 4), street luge, skeleton activity, mountaineering, or participation in any rodeo activity. Mountaineering 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.
INP10 Benefits are not payable for costs incurred due to sickness or injury resulting from a motor vehicle accident where you are entitled to receive benefits pursuant to any policy or legislative plan of motor vehicle insurance, except when such benefits are exhausted.
INP11 Benefits are not payable for costs incurred due to any sickness, injury or medical condition when a trip is undertaken for the purpose of securing medical treatment or advice.
INP12 Benefits are not payable for 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 terminal prior to the effective date of this policy.
INP13 Benefits are not payable for costs incurred due to any treatment which can be reasonably delayed until you return to your country of origin (whether or not you intend to return) by the next available means of transportation, unless approved in advance by AGA.
INP14 Benefits are not payable for costs incurred due to any medical consultation that is non-emergency, on-going, elective or the consequence of a prior elective procedure, except as specifically provided under Physical Examination Benefit and Eye Examination Benefit.
INP15 Benefits are not payable for costs incurred due to hospitalization or services rendered in connection with general health examinations for check-up purposes, treatment of an on-going condition, regular care of a chronic condition, home health care, investigative testing, rehabilitation, or on-going care or treatment in connection with drugs, alcohol or any other substance abuse.
INP16 Benefits are not payable for costs incurred due to any rehabilitation or convalescent care.
INP17 Benefits are not payable for costs incurred due to dental or cosmetic surgery.
INP18 Benefits are not payable for costs incurred due to naturopathic or holistic treatment.
INP19 Benefits are not payable for costs that exceed the reasonable and customary rate for the area where the treatment or services are being performed.
INP20 Benefits are not payable for costs incurred due to treatment or services that contravene, or are prohibited by legislation under a provincial or territorial hospital/ medical plan.
INP21 Benefits are not payable for costs incurred due to, contributed to by, or resulting from any sickness or injury when such sickness or injury occurs in a city, region, or country for which Global Affairs Canada issued a written warning to avoid all travel, or to avoid non-essential travel, to that city, region, or country, before the later of:
a) the effective date of your policy, or
b) the date you depart for the destination under advisory, and such sickness or injury is due to, contributed to by, or resulting from the reason for the warning.
INP22 Benefits are not payable for costs incurred due to any:
   a) act of war; or
   b) kidnapping; or
   c) act of terrorism caused directly or indirectly by nuclear, chemical or biological means; or
   d) riot, strike or civil commotion; or
   e) unlawful visit in any country.
INP23 Benefits are not payable for costs incurred due to any nuclear, chemical or biological occurrence however caused.
INP24 Benefits are not payable for costs incurred due to the participation by you, a family member or travelling companion in:
   a) protests; or
   b) armed forces activities; or
   c) a commercial sexual transaction; or
   d) the commission or attempted commission of any criminal offence; or
   e) the contravention of any statutory law or regulation in the area where the loss occurred.
INP25 Benefits are not payable for costs incurred due to being an occupant of an aircraft, either as passenger or crew, except while being transported under the terms of the Emergency Transportation or Emergency Return Home benefits, or while boarding or alighting from an aircraft.
INP26 Benefits are not payable for costs incurred due to dental care, services or supplies, except as specifically provided under Dental Benefit.
INP27 Benefits are not payable for eye glasses, contact lenses, hearing aids and/or prescriptions for any of these items.
INP28 Benefits are not payable for costs incurred due to the purchase of:
   a) medications or drugs not approved for use by the appropriate government authority; or
   b) vitamins or vitamin preparations; or
   c) drugs or medications which can be purchased over the counter without a physician’s written prescription; or
   d) acne medications; or
   e) nicotine resin products; or 
   f) dietary supplements or weight loss products; or
   g) quantities of any drug or medication which exceed $1,000 or a 30-day supply within one month prior to the expiry date; or
   h) contraceptives prescribed for any purpose, contraceptive consultation or testing; or
   i) fertility drugs or testing; or
   j) drugs, medications, or other costs paid for by any other agency; or
   k) experimental drugs or preventative medications; or
   l) drugs purchased prior to the effective date; or
  m) vaccines or vaccinations other than as provided under Vaccines Benefit. 

Misrepresentation or Nondisclosure:
Your failure to disclose or misrepresentation of any material fact, or fraud, either at the time of application or at the time of claim, shall render the entire contract null and void at the option of the insurer, and any claim submitted thereunder shall not be payable.
Where there is an error as to your age, provided that your age is within the insurable limits of this policy, the premiums will be adjusted according to your correct age.

CLAIMS:
In the event of a medical emergency, you must notify AGA Emergency Assistance (toll-free 1-800-995-1662 or worldwide collect 416-340-0049) within 24 hours of admission to a hospital and before any surgery is performed.
If you fail to do so without reasonable cause, then AGA will pay 80% of the claim payable. You will be responsible for the remaining 20% of the claim payable.
1. Notice of Claim. Claims must be reported within 30 days of occurrence.
2. Proof of Claim. Written proof of claim must be submitted within 90 days of occurrence.
3. Any costs incurred for documentation or required reports are your or the claimant's responsibility.
4. To submit your claim, fill out the claim form completely and include all original bills. Incomplete information will cause delay.
5. All eligible claims must be supported by original receipts from commercial organizations.
SEND YOUR CLAIMS TO:
Allianz Global Assistance Claims Department 
P.O. Box 277
Waterloo, ON, N2J 4A4
For Online Claim Submission visit: www.allianzassistanceclaims.ca

RATES:

Deductible options for additional savings:
$500 = 5% premium savings
$1,000 = 10% premium savings
$5,000 = 30% premium savings

IMPORTANT NOTE: The product-related information on this website is for illustration purposes only. For complete benefits, terms, conditions, limitations and exclusions, please see the policy booklet at the download section below. Please read and understand your policy before you travel.

DOWNLOADS:

Allianz Inpatriate POLICY PDF

Allianz Inpatriate Endorsement PDF

Allianz Inpatriate CLAIM FORM PDF

Allianz Inpatriate APPLICATION FORM - DocuSign (fillable)

Allianz Inpatriate Detailed Medical Questionnaire - DocuSign (fillable)

Please, CONTACT US for more information or to apply for AGA Inpatriate Plan

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