Effective Date of Coverage begins on the latest of the following:
1. The date
and time the Company receives a completed application and plan cost for the
Period of Coverage; or
Effective Date requested on the application; or
3. The moment
You depart Your Home Country; or
date the Company approves the application.
Expiration Date of Coverage terminates on the earlier
of the following:
1. Your return to
Your Home Country (except as provided under the Home Country
2. The expiration of
six (6) months from the Effective Date of Coverage; or
3. The date shown on
the ID card; or
4. The end of the
period for which plan cost has been paid; or
5. The date You fail
to be considered an Eligible Person; or
6. The maximum
benefit amount has been paid.
download and review a
brochure for a description of benefits and exclusions.
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DESCRIPTION OF COVERAGE
Liaison International plan shall pay Reasonable and
Customary charges for Covered Expenses, excess of the chosen
Deductible and Coinsurance up to the selected Medical Maximum,
incurred by You due to an Accidental Injury or Illness which occurred
during the Period of Coverage outside Your Home Country (except as
provided under the Home Country Coverage). All bodily disorders
existing simultaneously which are due to the same or related causes
shall be considered one Disablement. If a Disablement is due to
causes which are the same or related to the cause of a prior
Disablement, the Disablement shall be considered a continuation of the
prior Disablement and not a separate Disablement. The initial
treatment of an Injury or Illness must occur within thirty (30) days
of the date of Injury or onset of Illness.
Only such expenses which are specifically enumerated in
the following list of charges, are incurred within one hundred eighty
(180) days from the date of accident or onset of Illness and which are
not excluded, shall be considered Covered Expenses:
made by a Hospital for room and board, floor nursing and other
services inclusive of charges for professional service and with the
exception of personal services of a non-medical nature; provided,
however, that expenses do not exceed the Hospital�s average charge for
semi-private room and board accommodations.
2) Charges made for Intensive Care or Coronary
Care charges and nursing services.
3) Charges made for diagnosis, Treatment and
Surgery by a Physician.
4) Charges made for an operating room.
made for Outpatient Treatment, same as any other Treatment covered on
an Inpatient basis. This includes ambulatory Surgical centers,
Physicians� Outpatient visits/examinations, clinic care, and Surgical
6) Charges made for the cost and administration
7) Charges for
medication, x-ray services, laboratory tests and services, the use of
radium and radioactive isotopes, oxygen, blood, transfusions, iron
lungs, and medical Treatment.
8) Charges for
physiotherapy, if recommended by a Physician for the Treatment of a
and administered by a licensed physiotherapist.
drugs, and Medicines that can only be obtained upon a written
prescription of a Physician or Surgeon.
transportation to or from the nearest Hospital or to and from the
nearest Hospital with facilities for required Treatment. Such
transportation shall be by licensed ground ambulance only to a limit
of $5,000, within the metropolitan area in which You are located at
that time the service is used. If You are in a rural area, then
licensed air ambulance transportation to the nearest metropolitan area
shall be considered a Covered Expense.
Dental - Accident
� This plan
shall pay in excess of the chosen Deductible and Coinsurance of up to
a maximum of $500, for emergency treatment to repair or replace sound
natural teeth damaged as the result of a covered accident.
Dental Class 1
� This plan shall
pay in excess of the chosen Deductible and Coinsurance up to a maximum
of $100, for emergency Treatment for the relief of pain to natural
- The plan will pay Covered Expenses incurred if any covered Injury or
Illness commences during the Period of Coverage that results in a
Medically Necessary Emergency Medical Evacuation or Repatriation
(your medical condition warrants immediate transportation from the
medical facility where you are located to the nearest adequate medical
facility where medical treatment can be obtained). This benefit
must be arranged by the Assistance Company in consultation with the
local attending Physician.*
Return of Mortal
The Program will
pay the reasonable Covered Expenses incurred up to a maximum of
$50,000 to return your remains to your Home Country, if you should
Medical Evacuation or Repatriation is arranged and the attending
Physician recommends that a family member travel with you, the program
will arrange and pay, up to $50,000, for round-trip economy-class
transportation for one individual of your choice, from your Home
Country, to be at your side while you are hospitalized and then
accompany you during your return to your Home Country.