Life Care Insurance

Toll Free : 1 877 495 2525

Glossary

Accident(al)

means a sudden, unexpected, unforeseeable, unavoidable external event and excludes disease or infections..

Act(s) of terrorism

means an act, including but not limited to the use of force or violence and/or the threat thereof or commission or threat of a dangerous act, of any person or group(s) or government(s), committed for political, religious, ideological, social, economic or similar purposes including the intention to intimidate, coerce or overthrow a government (whether de facto or de jure) or to influence, affect or protest against any government and/or to put the civilian population, or any section of the civilian population, in fear.

Act(s) of war

means any loss or damage arising directly or indirectly from, occasioned by, happening through or in the consequence of war, invasion, acts of foreign enemies, hostilities or warlike operations (whether war is declared or not) by any government or sovereign, using military personnel or other agents, civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power.

Aggregate limit

means the total number or the maximum value of insured losses resulting from any one accident or event causing loss.

Commercial accommodation

means a hotel or motel room, or a bed and breakfast licensed under the law of its jurisdiction.

Confirmation of coverage

means the document(s) that you receive from us as a confirmation of the coverage you have purchased, which may be a confirmation of coverage letter, an application form or an internet purchase confirmation page.

Country of origin

means the country in which you maintained a permanent residence prior to entry into Canada.

Deductible amount

means the dollar amount for which you are liable for each claim before any remaining eligible expenses are reimbursed under this insurance. The deductible amount is shown on your confirmation of coverage and applies to each claim.

Dependent children

means your unmarried children who are:

  1. a) financially dependent on you; and
  2. b) at least 15 days of age; and
  3. c) age 21 or under; or
  4. d) age 25 or under and attending school full time.

Effective date

means the date and time coverage begins as indicated in the Effective Date section of this policy.

Emergency

means a sudden, unforeseen sickness or injury occurring during the period of coverage, which requires immediate intervention by a physician or legally licensed dentist and cannot reasonably be delayed.

An emergency is deemed to no longer exist when medical evidence indicates that you are able to continue your trip or return to your place of ordinary residence or country of origin.

Expiry date

means the date and time coverage ends as indicated in the Expiry Date section of this plan.

Family member

means your legal or common-law spouse, parent, brother, sister, legal guardian, step-parent, step-child, stepbrother, step-sister, aunt, uncle, niece, nephew, grandparent, grandchild, in-law, and ward, natural or adopted child.

High-risk activity(ies)

mean(s) 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, participation in any rodeo activity.

Hospital

means a facility incorporated or licensed as a hospital by the jurisdiction where such services are provided and which has accommodation for resident in-patients, a laboratory, a registered graduate nurse and physician always on duty and an operating room where surgical operations are performed by a physician. In no event shall this include a convalescent or nursing home, home for the aged, health spa, or an institution for the care of drug addicts, alcoholics or persons suffering from mental or nervous disorders.

Injury

means sudden bodily harm, which is directly caused by or resulting from an accident, being a sudden and unforeseen event, excluding bodily harm that results from deliberate or voluntary action, and independent of sickness and all other causes.

Insured person

means a person eligible for coverage and named on the application, who has been accepted by the insurer or its authorized representative, and has paid the required premium for a specific plan of insurance.

Insurer

means Insurance Company.

Medical consultation

means any medical services obtained from a physician for a sickness, injury or medical condition, including but not limited to any or all of: history taking, medical examination, investigative testing, advice or treatment, and during which a diagnosis of the medical condition need not have been definitiely made. This does not include routine annual medical check-ups where no medical signs or symptoms existed or were found during the check-up.

Period of coverage

means the period from the effective date to the expiry date as indicated on the confirmation of coverage and for which premium has been paid. As selected and paid for at the time of application, the maximum period of coverage per trip cannot exceed 365 days.

Physician

means a person other than you, who is legally qualified and licensed to practice medicine or perform surgery in the location where the services are performed, and is not related to you by blood or marriage.

Pre-existing medical condition

means a sickness, injury or medical condition, whether or not diagnosed by a physician:

  1. for which you exhibited signs or symptoms; or
  2. for which you required or received medical consultation; and
    iii. which existed prior to the effective date of your coverage.

Professional activity

means an activity that allows you to earn the majority of your income by engaging in such activity.

Reasonable and customary

means the services customarily provided or the costs customarily incurred for covered losses, which are not in excess of the standard practice or fee in the geographical area where the services are provided or costs are incurred for comparable treatment, services or supplies for a similar sickness or injury.

Sickness

means any illness or disease.

Spouse means a person who is legally married to you, or a person who has been living with you in a common-law relationship for a period of at least 12 consecutive months.

Stable

means a pre-existing medical condition that: a) did not require, or was not referred for any medical consultation; b) did not require a change in type or dosage of medication.

Travelling companion

means a person who is accompanying you on your trip, and who has prepaid shared accommodation or transportation with you. (Maximum of 5 persons including you.)

Treatment

means a medical, therapeutic or diagnostic procedure prescribed, performed or recommended by a physician including, but not limited to, prescribed medication, investigative testing and surgery.

Trip

means a period during which you are travelling outside your country of origin and for which coverage is in effect.

We, us, and our means insurance company and you or your means the insured person.

 

Special Note: We have made a sincere effort to explain various terms used by different companies in their respective policy booklet. We highly recommend that one must read carefully all the terms, provisions and features before making any decision to buy policy. Alternatively, a licensed insurance broker can also help you by calling 1 877 495 2525. The information available on this website is subject to change without any prior notice because we do not guarantee the authenticity of the information. For clear and correct understanding, refer to each company’s policy booklet before making a purchase.