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Saturday, October 21st, 2017

Allianz Global Assistance 
Students Insurance

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Benefits
Exclusions
Claims
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 Benefit: $2,000,000
  - Hospital & Medical Coverage: Semi-private hospital accommodation.
  - Physician, surgeon, anesthetist services.
  - Diagnostic Treatments: Lab tests and X-ray examinations ordered by a physician.
  - Drugs or Medications – up to 30-day supply when not hospitalized. The morning after pill is limited to one prescription per period of coverage.
  - Private duty services of a registered nurse. *
  - Ambulance Transportation: Local land or sea ambulance or up to $100 reimbursement for taxi, if an ambulance is necessary but is unavailable. *
  - Medical Appliance: Rental of crutches or hospital-type bed and the cost of splints, trusses, braces or other prosthetics, ** oxygen and rental of equipment for its administration, blood and blood plasma, except when donated. *
  - Follow-up visits related to reported emergency and recommended by the attending physician.
  - Professional Medical Services – up to $600 per practitioner per year for service of a legally licenced physiotherapist, naturopath, acupuncturist, chiropractor, osteopath, chiropodist or podiatrist.
  - Dental (Accident): Up to $5,000 for repair or replacement of whole or sound natural teeth damaged by an accidental blow to the face.
  - Dental (Emergency): Up to $600 for the immediate relief of acute dental pain. 
  - Dental (Wisdom Teeth) - up to $100 per tooth for extraction of impacted wisdom teeth.
  - Emergency Transportation / Return Home: The cost for air ambulance, one-way economy airfare or stretcher (and/or a medical attendant) to transport you to the nearest appropriate medical facility or to your country of origin. **
  - Transportation of Family or Friend: Up to $5,000 for round-trip transportation to bring up to two bedside companions (your family members or close friends), and up to $1,500 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 $15,000 to prepare and return your remains to the country of origin, or up to $5,000 for cremation or burial at the place of death. The cost of a funeral service, coffin or urn is not covered.
  - Tutorial Services: up to $20 per hour to a maximum of $500 for the costs of a private tutorial service arranged by your school, if you will be hospitalized or confined to your home for 30 or more consecutive school days, as a result of a covered sickness or injury.
  - Accidental Death & Dismemberment: Up to $15,000 for accidental loss of life, limbs or sight. 
  - Eye Examination - one routine annual examination by an optometrist when 12 months of consecutive coverage has been purchased.
  - Annual Physical Examination – up to $250 for one routine examination per year by a physician, including any related tests and laboratory fees when 12 months of consecutive coverage has been purchased.
  - Maternity (Standard Option) - up to $1,000 for pre-natal care, miscarriage, or related complications. The expected delivery date must be more than 10 months after the effective date (see Enhanced Plan for higher benefit option). For multiple AGA administered policies with no lapse in coverage, the expected delivery date must be more than 10 months after the effective date of the initial policy purchased.
  - Maternity Benefit (Enhanced Option) – 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 from 15 days of age. The benefit amount of $10,000 is for eligible expenses incurred in any consecutive 12-month period starting on the date the first pregnancy-related expense is incurred. The expected delivery date must be more than 10 months after the effective date. For multiple AGA administered policies with no lapse in coverage, the expected delivery date must be more than 10 months after the effective date of the initial policy purchased.
Enhanced Option benefit limits will only be payable if the Enhanced Option was in effect when you became pregnant and has remained in effect since that time; otherwise, the Standard Option benefit limits will apply.
 - Psychologist and Psychiatric Care (Enhanced Option only) – up to $10,000 (lifetime maximum) for hospitalization and up to $1,000 (per year) for outpatient consultation for treatment of mental, nervous or emotional disorders, including trauma counselling. 

* The total aggregate limit for all losses under Ambulance Transportation, Medical Appliance and Private Duty nurse is $10,000.
** Benefits are payable only when approved in advance by AGA


ELIGIBILITY: 
To be eligible for coverage, you must:
a) be a student; or
b) be a dependent child or the spouse of an eligible student; and
c) as of the effective date, be less than 60 years of age; and
d) not be insured or eligible for benefits under a Canadian government health insurance plan; and
e) 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.
Student means a person:
a) whose country of origin is not Canada and who is residing in Canada on a temporary basis; and
b) who:
  i. is registered at a school, college, university or other governmentally accredited educational institution in Canada and attends classes as a full-time student, as defined by the institution; or
 ii. remains in Canada for up to one year immediately after completion of studies as described above, and who is working or has applied to work in a field related to the studies completed. 

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 expenses are incurred after the 48-hour waiting period.

Pre-Existing Conditions for Standard Option: Benefits are not payable for costs incurred due to any sickness or injury or medical condition, whether or not diagnosed by a physician:
  a) for which you exhibited signs or symptoms; or
  b) for which you required or received medical consultation; and
  c) which existed prior to the effective date of your coverage.
Pre-Existing Conditions for Enhanced Option: Benefits are not payable for costs incurred due to or resulting from any sickness or injury or medical condition or related condition that was not stable at any time during the 90 days immediately before the effective date.
Stable describes any medical condition or related condition, including any heart condition or lung/respiratory 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 also considered stable:
a) Routine (not prescribed by a physician) adjustment of insulin to control diabetes provided the insulin was not first prescribed during the time period specified in the Pre-Existing Conditions Exclusion of this policy.
b) Change from a brand name medication to a generic medication provided the medication was not first prescribed during the time period specified in the Pre-Existing Conditions Exclusion of this policy and there is no increase or decrease in dosage.
c) A minor ailment.
Minor ailment means a sickness or injury which ended more than 30 days prior to the effective date and which did not require:
a) treatment for a period longer than 15 consecutive days; or
b) more than one follow-up visit to a physician; or
c) hospitalization, surgery, or referral to a specialist

EXTENSIONS: 
If you decide to extend your trip, you may apply for a new period of coverage provided you meet the Eligibility requirements of the new policy. If you have incurred a claim, we will review your file before deciding on granting an extension. Each policy or term of coverage is considered a separate contract. AGA reserves the right to decline any request for new terms of coverage.

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. In addition, trips to the United States are limited to 30 days per period of coverage. 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:
A full refund will be provided for policies which are returned within 10 days of purchase, provided your coverage has not started.
Refunds are payable when:
1. The student fails to meet visa eligibility requirements.
2 You return to your country of origin prior to the expiry date, without intending to return to Canada, 30 days or more before the expiry date.
3. You become insured under a Canadian provincial or territorial health/medical plan.
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 Note: 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 daily premium by the actual number of days the policy was in effect; if this amount is less than the minimum premium required, the minimum premium will be used. This amount is then subtracted from the total premium paid.
Refund amounts less than the minimum premium will not be issued.

CLAIMS:
AGA must be notified within 24 hours of admission to a hospital and before any medical consultation or any surgery is performed. If you fail to do so without reasonable cause, then AGA will reduce the benefits payable to you under this policy by 20%.
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 
2100-250 Yonge Street
Toronto ON, Canada M5B 2L7

EXCLUSIONS: 
IS1 Pre-existing Conditions Exclusion

Standard Option

Benefits are not payable for costs incurred due to any sickness or injury or medical condition, whether or not diagnosed by a physician:

a) for which you exhibited signs or symptoms; or

b) for which you required or received medical consultation; and

c) which existed prior to the effective date of your coverage.

Enhanced Option

Benefits are not payable for costs incurred due to or resulting from any sickness or injury or medical condition or related condition that was not stable at any time during the 90 days immediately before the effective date.

IS2 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.

IS3 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.

IS4 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.

IS5 Benefits are not payable for costs incurred due to any loss incurred inside your country of origin.

IS6 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, except as specifically provided under Psychologist and Psychiatric Care; or

b) your suicide or attempted suicide; or

c) your intentional self-inflicted injury.

IS7 Benefits are not payable for costs incurred due to pregnancy, abortion, miscarriage, childbirth or complications thereof except as specifically provided under Maternity benefit.

IS8 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 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 before or after the effective date; or

d) your misuse of medication.

IS9 Benefits are not payable for costs incurred due to injury resulting from training for, competing 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 and are paid for your participation whether you win or lose); or

d) high-risk activities. High-risk activity(ies) includes any skiing or snowboarding out of bounds, ski jumping, sky-diving, 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 metres), 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.

IS10 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.

IS11 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.

IS12 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.

IS13 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.

IS14 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 and Eye Examination benefits.

IS15 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 ongoing care or treatment in connection with drugs, alcohol or any other substance abuse.

IS16 Benefits are not payable for costs incurred due to learning or educational assessments.

IS17 Benefits are not payable for costs incurred due to any rehabilitation or convalescent care.

IS18 Benefits are not payable for costs incurred due to dental or cosmetic surgery, except as specifically provided under Dental benefit.

IS19 Benefits are not payable for costs incurred due to holistic treatment.

IS20 Benefits are not payable for costs that exceed the reasonable and customary rate for the area where the treatment or services are being performed.

IS21 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.

IS22 Benefits are not payable for costs incurred due to any sickness or injury when such sickness or injury occurs in a city, region, or country for which the Department of Foreign Affairs and International Trade of the Canadian Government issued a written warning prior to the effective date to avoid all travel, or to avoid non-essential travel, to that city, region, or country, and such sickness or injury is related to or due to the reason for the warning.

IS23 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.

IS24 Benefits are not payable for costs incurred due to any nuclear occurrence, however caused.

IS25 Benefits are not payable for costs incurred due to the participation by you or a family member 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.

IS26 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/Return Home benefit, or while boarding or alighting from an aircraft.

IS27 Benefits are not payable for costs incurred due to dental care, services or supplies, except as specifically provided under Dental.

IS28 Benefits are not payable for eye glasses, contact lenses, hearing aids and/or prescriptions for any of these items, unless required as the result of an injury.

IS29 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) patent or proprietary medications when a generic equivalent is available in the marketplace; or

c) vitamins or vitamin preparations; or

d) drugs or medications which can be purchased over the counter without a physician's written prescription; or

e) acne medications; or

f) nicotine resin products; or

g) dietary supplements or weight loss products; or

h) quantities of any drug or medication which exceed a 30- day supply within one month prior to the expiry date; or

i) contraceptives prescribed for any purpose, with the exception of the morning after pill, which is limited to one per period of coverage; or

j) contraceptive consultation or testing; or

k) fertility drugs or testing; or

l) drugs, medications, or other costs paid for by any other agency; or

m) experimental drugs or preventative medications; or

n) drugs purchased prior to the effective date; or

o) vaccines or vaccinations.

RATES:

 

PLAN TYPE

PER DAY

PER YEAR

Standard Plan

   

Student

$1.45

$485

Each dependent

$2.30

$840

     

Enhanced Plan

   

Student

$2.21

$807

Each dependent

$4.75

$1,733

- Dependent(s) include spouse or common-law partner and children up to age 21. They must be on the same policy and plan as the eligible student and living in the same residence.
- Maximum period of coverage: 365 days.
- $30 minimum premium per policy.

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 International Student POLICY PDF

Allianz International Student CLAIM FORM PDF


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