Limitations and Exclusions

Current Underwriter (2019) – Royal & Sun Alliance Insurance Company of Canada

All Exclusions & Limitations apply to each insured person under this insurance regardless of plan type or Health Option.

Your day of departure applies to:

  • Emergency Medical Insurance benefits; and
  • Trip Interruption & Delay Insurance benefits.

Your day of booking applies to:

  • Trip Cancellation Insurance benefits.

This insurance does not cover any expenses incurred directly or indirectly as a result of the following:

  1. Pre-existing Medical Condition Limitation

A medical condition or related condition (other than a minor ailment), if in the 90 days before your day of departure or day of booking, that medical condition or related condition was not stable.

A heart condition, if in the 90 days before your day of departure or day of booking:

a) any heart condition has not been stable;
b) you have taken nitroglycerin more than once per week specifically for the relief of angina pain for any heart condition.

A lung condition, if in the 90 days before your day of departure or day of booking:

a) any lung condition has not been stable; or
b) you have been treated with home oxygen or taken oral steroids (prednisone or prednisolone) for any lung condition.

For Trip Cancellation, Interruption & Delay Insurance benefits, the Pre-Existing Medical Condition Limitation also applies to your family member, close business associate, caregiver, travelling companion or your travelling companion’s family member.

2.  Any medical condition if any of your answers provided in the Health Option Questionnaire are not complete and accurate.

3.  Any treatment that is not emergency treatment.

4.  An emergency and/or event which requires you to submit a claim while the coverage is not in force.

5.  Any portion of the benefits that require prior authorization and arrangement by the MEDOC Claims Assistance Centre if the MEDOC Claims Assistance Centre has not pre-authorized and arranged them.

6.  Any medical condition for which prior to the effective date of this policy, or prior to your day of booking your travel arrangements, or prior to making any additional payments for your travel arrangements, or prior to your day of departure:

  • You were awaiting the outcome of medical tests, the results of which show any irregularities or abnormalities;
  • Future investigation, consultation with any physician, treatment or surgery (except routine monitoring) is recommended by a physician or planned before your trip.

This does not include regular check-ups or routine tests where no medical signs or symptoms existed or were found during the check-up.

7.  • Routine pre-natal care;

  • Any medical treatment, relating to your pregnancy or childbirth, occurring within 9 weeks before or after the expected date of delivery;
  • Childbirth occurring within 9 weeks before or after the expected date of delivery; or
  • Any child born during the trip.

8.  Your participation as a professional in sports, participation as a professional in underwater activities, scuba diving as an amateur unless you hold a basic scuba designation from a certified school or other licensing body, participation in a motorized race or motorized speed contest, bungee jumping, parachuting, rock climbing, mountain climbing, hang-gliding or skydiving.

9.  Your committing or attempting to commit a criminal offence.

10.  Intentional self-inflicted injury, suicide or attempted suicide.

11.  Anxiety or panic attack or a state of mental or emotional stress unless such state was sufficiently severe as to require a medical consultation which resulted in a diagnosis.

12.  Medication, drugs or toxic substance abuse or overdose or your deliberate non-compliance with prescribed medical therapy or treatment: alcohol abuse, alcoholism or an accident while being impaired by drugs or alcohol or having an alcohol concentration that exceeds 80 milligrams in 100 millilitres of blood.

13.  Your active participation in and/or voluntary exposure to any risk from: war or act of war, whether declared or undeclared; invasion or act of foreign enemy; declared or undeclared hostilities; civil war, riot, rebellion; revolution or insurrection; act of military power, or any service in the armed forces.

14.  Any illness, injury or medical condition you suffer or contract, or any loss you incur in a specific country, region or area for which the Government of Canada, including Foreign Affairs, Trade and Development Canada, has issued a travel advisory or formal notice, before your day of departure, advising travellers to avoid non-essential travel or to avoid all travel to that specific country, region or area. If the travel advisory or formal notice is issued after your day of departure, your coverage under this policy in that specific country, region or area will be limited to a period of 10 days from the date the travel advisory or formal notice was issued, or to a period that is reasonably necessary for you to safely evacuate the country, region or area.

15.  Expenses for which no charge would normally be made in the absence of insurance.

16.  The continued treatment, recurrence, investigation or complications of a medical condition following emergency treatment for that medical condition during your trip if the medical advisors of the MEDOC Claims Assistance Centre determine you were medically able to return to your province or territory of residence and you chose not to. After receiving emergency treatment for a medical condition, this insurance will not cover you for that medical condition, or related condition, for any other trips within the 90 days following your emergency treatment.

17.  Treatment of any heart or lung condition following emergency treatment for any related or unrelated heart or lung condition during your trip, if the medical advisors of the MEDOC Claims Assistance Centre determine you were medically able to return to your province or territory of residence and you chose not to. After receiving emergency treatment for any heart or lung condition, this insurance will not cover you for any heart or lung condition for any other trips within the 90 days following your emergency treatment.

18.  Invasive testing or surgery (including cardiac catheterization, angioplasty, and MRI) unless pre-approved and arranged by the MEDOC Claims Assistance Centre.

19.  Any emergency transplants including but not limited to organ transplants and bone marrow transplants.

20.  Any medical condition or related condition that arises during a trip you undertake with the knowledge acquired before your day of departure, that you will require or seek treatment or surgery for that medical condition or related condition, whether or not recommended by your physician.

21.  Treatment or surgery for a specific medical condition, or a related condition, which caused a physician to advise you not to travel.

22.  Air travel, other than as a passenger in a commercial aircraft licensed to carry passengers for hire.

23.  When riding as a passenger on a commercial carrier which is not licensed for the transportation of passengers for compensation or hire.

24.  Any expenses incurred during Supplemental Plan coverage purchased after your day of departure which are related to any illness, injury or medical condition for which you incurred a claim after your day of departure and prior to the confirmed day of commencement of the Supplemental Plan, if such Supplemental Plan was purchased after your day of departure.

25. Any reason, circumstance, event, activity, or medical condition affecting you, an immediate family member, a travel companion, a travel companion’s immediate family member, a caregiver, business associate, close friend, or your host at trip destination, of which, on the day you:

a) booked your trip,
b) made any additional payments on your travel arrangements, or
c) purchased this insurance,

you were aware may eventually prevent you from starting and/or completing your covered trip as booked.

26.  Loss arising as a result of a common carrier work stoppage, or the bankruptcy or insolvency of a travel agent, agency, broker or travel supplier.

27.  Points Program redemptions of any type, or points used to purchase travel arrangements, or the cost of purchasing or repurchasing travel redemption points from any Points Program Supplier.

28.  Eye glasses, contact lenses, hearing aids, or prescriptions for the same.

The Insurer is required to comply with economic, financial and trade sanctions (“Sanctions”) imposed by Canada and may be required to comply with Sanctions imposed by the United States in certain circumstances. The Insurer is a member of the RSA Group whose principal insurance company in the United Kingdom is required to comply with Sanctions imposed by the European Union and the United Kingdom and the parties acknowledge that the Insurer intends to adhere to the same standard. Accordingly, the Insurer shall not provide any coverage or be liable to provide any indemnity or payment or other benefit under this Policy which would breach applicable Sanctions imposed under the laws of Canada, the European Union, the United Kingdom, or the United States.