This plan is provided by Cultural Insurance Services International and underwritten by Ace American Insurance Company
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GLM N14285581
Schedule of Benefits
| COVERAGE AND SERVICES | MAXIMUM LIMITS |
|---|---|
| TRAVEL ACCIDENT INDEMNITY INSURANCE | |
| Accidental Death & Dismemberment Per Insured Person: | $25,000 |
| ACCIDENT AND SICKNESS INSURANCE | |
| Medical Expense (per Covered Accident or Sickness): | |
| Deductible | (zero) |
| Benefit Maximum | $250,000 @100% |
| TRAVEL ASSISTANCE INSURANCE | |
| Emergency Medical Reunion | $3,000 |
| Trip Cancellation (including Terrorism) | $1,000 |
| Trip Delay | $1,000 ($200/day) |
| Trip Interruption | $1,000 |
| PERSONAL PROPERTY INSURANCE | |
| Personal Property | $3,000 (max per item or set of items $1,500) |
| EVACUATION AND REPATRIATION INSURANCE | |
| Emergency Medical Evacuation | 100% Covered Expenses |
| Return of Baggage & Personal Property | $3,000 per trip |
| Repatriation of Mortal Remains | 100% Covered Expenses |
| Return of Baggage & Personal Property | $3,000 |
| Security Evacuation (Comprehensive) | $100,000 ($1M Aggregate) |
| Transportation of Baggage & Personal Property | $3,000 per Occurrence |
| NON-INSURANCE SERVICES | |
| Team Assist Plan (TAP): 24/7 medical, travel, technical assistance | |
| PERSONAL LIABILITY COVERAGE | |
| Maximum Benefit Per Claim | $500,000 |
| Deductible per Personal Property Claim | $0 |
| Medical Payments Coverage | $25,000 |
| Additional Living Expenses | $10,000 |
| Payment of Deductible under Homeowner's Insurance | $1,000 |
| Aggregate Limit per Insured | $500,000 |
Please contact the Team Assist line by phone at +1 312-935-1703 (collect calls accepted) or email medassist-usa@axa-assistance.us. The TeamAssist Emergency Assistance Provider is AXA Assistance.
Non-Emergency questions may be directed to CISI at 203-399-5130 (toll free 800-303-8120).