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Underwritten by certain underwriters at Lloyd’s
This Certificate of Insurance covers people travelling on a Trip during the Period of Insurance to receive the Treatment listed in the schedule. The person travelling to receive the Treatment is defined as “You” for the purposes of this insurance. If selected, this insurance also provides cover to a nominated person travelling with You (called a “Companion” for the purposes of this insurance). Covered Person(s) means both You and Your Companion.
Please note that We will NOT pay for any medical expenses or legal costs incurred in relation to Your Treatment except if You have a life-threatening complication that occurs during the planned Treatment. This Certificate of Insurance explains in full, the terms, conditions and exclusions and the claims procedure. Please take the time to read through this document carefully and make sure that the cover provided is suitable for Your needs.
If You make a fraudulent claim under this insurance, We:
It is important that:
Us” section;
have given Us;
Our aim is to ensure that all aspects of Your insurance are dealt with promptly, efficiently and fairly. At all times We are committed to providing You with the highest standard of service.
You can cancel this insurance at any time by contacting Medical Travel Shield.
Some words and phrases in this Certificate of Insurance will always have the same meaning wherever they appear. To make them easier to recognise, the words are capitalised in bold.
Any terms and conditions of Your insurance will be supplied in English and We will communicate with
You in English.
Interpretation
Where the following terms are used in this Certificate they have the following meaning:
Applicable to ALL parts of this Certificate
We do not intend any third parties to this contract to have the right to enforce the terms of this contract. Only You and Us can enforce the terms of this contract. You and We can vary or rescind the contract without the consent of any third party to this contract who may assert they have rights under this Contracts (Rights of Third Parties) Act 1999.
We will not pay any indemnity claim if any loss, damage payment, or liability under this Certificate is also covered wholly or in part under any other insurance except in respect of any excess beyond the amount which would have been covered under such other insurances had this Certificate not been effected.
If a Covered Person is injured by or if death is caused by someone else’s negligence and We pay a claim under this Certificate, We may wish to attempt to recover from that person or organisation some or all of the amounts We have paid. The Covered Person agrees that We can, therefore, take over the legal rights and remedies against anyone who is responsible for the event(s) which led to the claim, but only in relation to, and to the extent of, any payment made to a Covered Person under this Certificate. If We choose to do this, We will be responsible for all costs incurred in pursuing a recovery of costs We have paid.
The Covered Person must fully co-operate with Us and give Us any assistance We need to help Us to recover some or all of the amounts We have paid under this Certificate. This includes, but is not limited to (to the extent necessary), transferring to Us the Covered Persons rights to take action but only in relation to, and up to, the amount paid by Us under this Certificate.
No sum payable under this Certificate of Insurance shall carry interest.
In no case shall Our liability exceed the largest sum insured stated in the schedule.
No (re)insurer shall be deemed to provide cover and no (re)insurer shall be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose that (re)insurer to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.
This Certificate does not cover Treatment in the UK.
Cover applies Worldwide excluding the United States and Hazardous Territories for the duration of the Trip.
If a Covered Person visits a country in the European Union they should ensure that they have a European Health Insurance Card (EHIC). This entitles them to the benefit of the reciprocal health agreement which exists between European Union countries. If any medical costs incurred have been reduced by the use of an EHIC We will waive any excess applicable under Section 1.1 Medical and Additional Expenses in respect of such costs.
If You are unable to return home before the expected return date of a Trip for reasons beyond Your control, which are not related to the Treatment, cover will be extended without charge until You return to the UK. If the reason You are unable to return before the expected return date is that You have been Hijacked, cover shall continue whilst You are subject to the control of the person(s) or their associates making the Hijack during travel direct to Your home and/or original destination, up to twelve (12) months from the date of the Hijack.
This Certificate is subject to the Laws in England and Wales. Any dispute relating to this Certificate will be subject to the jurisdiction of the courts of England and Wales.
This Certificate does NOT cover pre-existing medical conditions other than any existing condition directly related to the Treatment being sought and for which the Trip is booked.
See general exclusions.
The subscribing Insurers’ obligations under contract of insurance to which they subscribe are several and not joint and are limited solely to the extent of their individual subscriptions. The subscribing Insurers are not responsible for the subscription of any co-subscribing Insurer if for any reason does not satisfy all or part of their obligations.
We reserve the right to make any change or alteration to the terms and conditions of this Certificate for the following valid reason: in the event of any change in the law affecting this Certificate or Us. We will give You Thirty (30) days’ notice of any changes by writing to You at Your last known address. If You are not happy with the alteration, You have the right to cancel Your insurance (see the section headed How to Cancel Your Policy).
All premiums and benefits are payable in Sterling in the UK.
Any benefit payable in accordance with this insurance, except benefit payable in respect of death, will be paid to You.
Payment of any death benefit will be payable to the executor(s) or personal representative(s) of the deceased Insured Person’s estate.
Note: In addition to the general exclusions there are exclusions which apply to each section
We will not be liable for claims in respect of:
“War” means:
“Terrorism” means an act, including but not limited to the use or threat of force and/or violence, of any person or group(s) or persons, whether acting alone or on behalf of or in connection with any organisation(s) or government(s), committed for political, religious, ideological or similar purposes or reasons including the intention to influence any government and/or to put the public, or any section of the public, in fear.
“Active war” means the active participation in a war by a Covered Person who is deemed under English Law to be under instruction from or employed by the armed forces of any country.
This Certificate DOES NOT cover a Covered Person’s participation in any of the Hazardous Pursuits listed immediately below:
We will not provide any cover for a claim which is in any way caused by, or results from, any disease, or the fear or threat of any disease, which:
However, this exclusion does not apply to sections 1.1, 1.2, 1.3, 1.6, 1.7, 1.10, 1.11, 1.12 and 1.13 of Your
policy, if within 14 days of the start date of Your Trip or whilst on a Trip:
We will not pay any claim which is caused by, contributed to by or arises out of:
However, this exclusion does not apply to the following sections of Your policy if a Covered Person suffers
Bodily Injury or illness which is accidentally caused by, contributed to by or arises out of i, ii or iii above:
In respect of Section 1.2 – Cancellation and Curtailment, We will also provide this cover for any member of the group travelling with a Covered Person, any person with whom a Covered Person intends to reside during the Trip, and a Relative if their Bodily Injury or illness necessitates an Covered Person’s presence in the UK.
Covers under Section 1.1 to 1.12 apply to each Covered Person. Covers under section 1.13 only apply to
You.
If within the Period of Insurance a Covered Person suffers Bodily Injury or illness during a Trip, We will pay up to GBP 2,000,000 (excess of GPB 100) for each Covered Person for the necessary expenses incurred as listed below.
Please note that We will NOT pay for any medical expenses incurred in relation to Your Treatment except if You have a life threatening complication that occurs during the planned Treatment and is secondary to the pre-agreed Treatment plan prior to departure.
Specific Exclusions applicable to Section 1.1 We shall not be liable to pay for:-
We will pay up to GBP 5,000 (excess GBP 100) for each Covered Person for any irrecoverable payments paid or contracted to be paid for travel, accommodation and unused pre-booked excursions (including reasonable additional travel and accommodation expenses incurred for return to the UK ) should the planned Trip be cancelled before commencement or curtailed before completion, directly as a result of:
Cover under this section is extended to include non-refundable deposits paid in respect of Treatment booked for You to be carried out outside of the UK. Any amount payable will be included in the overall maximum of GBP 5,000 payable under this Section 1.2.
Specific Exclusions applicable to Section 1.2 We shall not be liable to pay for:
We will pay up to GBP 500 (excess GBP 100) for each Covered Person for additional travel and accommodation expenses incurred in meeting a reserved mode of transport, travel connection, reaching reserved accommodation or upon return to the UK if at commencement of, or during a Trip a Covered Person misses a reserved air, sea, coach or rail journey through any of the following contingencies directly affecting the means of transport in which a Covered Person is travelling or intending to travel:-
Specific Exclusions applicable to Section 1.3 We shall not be liable to pay for:
If during the Period of Insurance and during a Trip the aircraft, sea vessel, coach, or train on which a Covered Person is booked to travel be delayed as a result of strike, locked out workers, industrial action, riot or civil commotion, bomb scare, criminal or terrorist action, Hijack, fire, avalanche, landslide, earthquake, flood, adverse weather conditions, or accident to or mechanical breakdown of such passenger transport, then We will pay for each a Covered Person:-
Specific Exclusions applicable to Section 1.4 We shall not be liable to pay for:
If within the Period of Insurance and during a Trip, a Covered Person becomes legally liable to pay claims for bodily injury to the public or accidental loss of or damage to property, We will indemnify up to GBP 1,000,000 (excess GPB 250) for each Covered Person for any one event or series of events, including legal expenses up to a maximum of GBP 25,000 per Covered Person
Specific Conditions applicable to Section 1.5
We shall be entitled at any time and at Our own discretion to pay to a Covered Person the sum insured stated in the Schedule less any costs incurred by Us or any lesser sums for which any claim or claims under any section of this Certificate can be settled. In this event We shall not be under any further liability.
Specific Exclusions applicable to Section 1.5 We shall not be liable to pay for:-
man-made substances, forces, organisms or any combination of them whether permanent or transitory.
If during the Period of Insurance and during a Trip a Covered Person sustains Bodily Injury which results in Accidental death, Loss of Limb(s), Loss of Eye(s) or Permanent Total Disablement as a result of an Accident, We will pay the amounts specified in the table of benefits below and includes Accidental death whilst undergoing the surgical operation during Treatment.
Specific Conditions applicable to Section 1.6
We will pay GBP 50 for each complete 24 hour period a Covered Person spends as an in-patient in a hospital outside the UK, other than time spent as an in-patient in relation to the Treatment, up to a maximum of GBP 1,500.
Specific Exclusions applicable to Section 1.7 We shall not be liable to pay for:
If during the Period of Insurance and during a Trip a Covered Person suffers loss of or damage to accompanied Property and/or Money (including reasonable expenses incurred as a result of loss of Money), We will pay up to GBP 3,500 (excess GBP 100) for each Covered Person, subject to:-
If accompanied Property is temporarily lost for more than 12 hours by the carrier, We will pay up to GBP 100 for the purchase of immediate necessities, but such payment will be deducted from the final claim if the loss becomes permanent. Receipts for such purchases must be provided.
Specific Conditions applying to section 1.8
Specific Exclusions applicable to Section 1.8 We will not pay for:
We will pay up to GBP 250 to each Covered Person for reasonable expenses incurred in obtaining a replacement passport, tickets and other travel documents should the original be lost or stolen during the Period of Insurance.
Specific Conditions applicable to Section 1.9
Specific Exclusions applicable to Section 1.9 We will not pay for:
In the event that You need to stay at Your destination for a time longer than the Normal Recovery Period We will pay You the following:
This benefit is payable until You are deemed fit to fly by a Qualified Medical Practitioner and are booked on the first reasonable economy flight or up to a maximum total claim of GBP 1,500, (excess GPB 100) whichever occurs first.
provided that;
The Certificate of Insurance DOES cover the sporting and leisure activities listed immediately below provided that:
UK)
waters)
Also included:
SCUBA diving to a maximum depth of 30 meters provided that a Covered Person holds a British Sub Aqua Club or equivalent certificate of proficiency for the dive to be undertaken, or they are under the direct supervision of a qualified instructor and diving with proper equipment and not contrary to BSAC codes of good practice.
Cover will not apply to:
This section only applies to You.
If You require further medical consultation at the place of Treatment after Your discharge and prior to Your return to the UK, We will pay for reasonable medical expenses necessarily incurred in relation to the Treatment, up to a maximum amount of GBP 400. Medical expenses will be limited to consultation fees and medication costs incurred after You have been discharged from the hospital by a Qualified Medical Practitioner and You have been provided with a medical certificate confirming that You are fit to travel.
Specific Exclusions applicable to Section 1.13 We will not pay for:
The benefits from this insurance may be subject to tax depending upon the personal circumstances of the insured and beneficiaries
Within this Personal Information Notice, the following defined words shown in bold will have the meaning set out below:
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