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INSURANCE POLICY
PLEASE READ THIS POLICY CAREFULLY
Coverage is subject to certain conditions, limitations and exclusions.
This document becomes a contract when You enroll and pay the full premium

10 DAY RIGHT TO EXAMINE Please take the time to read Your Policy and review all of Your coverage. If You have any questions You may contact guard.me.
You may cancel this Policy within 10 days of purchase and receive a full refund if You have not departed from Your Home Country and there is no claim in process.

DEFINITIONS
Whenever used in this Policy or any amendment, the following terms shall be capitalized and Inbound means an Eligible Insured whose Home Country is not Canada and who is
have the meaning specified below. temporarily residing in Canada. Inter-provincial travel is covered.

Accident/Accidental means a sudden, unexpected, unforeseeable, unavoidable external Injury means bodily harm to an Insured due to an Accident that first occurs during the
event, leading directly and independently of all other causes, to bodily Injury to an Insured Coverage Period.
during the Coverage Period.
Insured, You or Your means any Eligible person who submits an application and corresponding
Application means Our form You complete and submit to request insurance under this payment for coverage under this Policy, and receives acceptance of coverage from Our Plan
Policy. The Application forms part of the contract of insurance and some terms are defined in Administrator in the form of a confirmation or a valid policy ID card.
the Application, and some are defined in the Definitions section of this Policy.
Insurer, We, Us, Our means Old Republic Insurance Company of Canada.
Benefit Maximum means the amount stated as the limit payable for any particular benefit
and applies to services received during the Coverage Period. Regardless of the number of Medical Treatment means medical advice, consultation, care, service or diagnosis provided
policies issued in a 365 day period, Benefit Maximums do not renew for subsequent Coverage by a Physician or eligible paramedical provider.
Periods until:
a) 365 days have elapsed from the Effective Date of the original policy purchased and Medically Necessary means those services or supplies which are provided to You that are
on the anniversary date every year thereafter; or required to identify or treat Your Sickness or Injury and that are necessary for the relief of
b) The Effective Date of a new Coverage Period providing it is more than 365 days after the acute pain or suffering, or to identify or treat Your Sickness or Injury; or with respect to Hospital
Effective Date of the original Coverage Period on the first policy. services, those which cannot safely be provided to You as an outpatient.

Claim Administrator means Travel Healthcare Insurance Solutions Inc. (T.H.I.S.) Medication means a drug which is considered Medically Necessary for the treatment or
relief of an Injury or Sickness and which is available only with a prescription provided by a
Coverage means the benefits described herein. Coverage is effective throughout the world Physician or Dentist.
however Coverage in Home Country is limited; please refer to Enhanced Excursion (see
Benefits),and Exclusion #3. Plan Administrator means Travel Healthcare Insurance Solutions Inc. (T.H.I.S.)

Coverage Period means the period of time during which You are insured for the benefits Physician means a qualified doctor of medicine lawfully licensed to practice medicine in the
provided by this Policy, starting from 12:01 a.m. on the Effective Date until 12:00 midnight on place where medical services are performed, but does not include the Insured or a relative
either the date (a) specified as the Termination Date on the Application; or (b) of termination of the Insured.
of any extension of this Policy. If You return to Your Home Country for any reason other than
Enhanced Excursion (see Benefits), coverage terminates effective the date of Your Return to Reasonable and Customary means the amounts usually charged for treatment, services or
Your Home Country. The maximum Coverage Period including extensions is 365 consecutive supplies to provide the appropriate level of care for the severity of the condition being treated,
days from the Effective Date. in the geographical location where the treatment, services or supplies are being provided.

Dentist means a qualified doctor of dentistry lawfully licensed to practice dentistry in the Sickness means the sudden onset of a disease or illness that is serious enough for You to
place where dental services are performed, but does not include the Insured or a relative of seek Medical Treatment.
the Insured.
Termination Date means the date Your coverage under this Policy ends. Coverage ends on
Effective Date means the date Your coverage under this Policy begins. Coverage begins on the later of the date (a) specified as the Termination Date on the Application; or (b) of termination
the latest of the date and time, (a) the required premium is paid, or (b) the date You request as of any extension of this Policy. If You return to Your Home Country for any reason other than
the Start Date on Your Application or (c) the date You leave Your Home Country. as defined in Enhanced Excursion (see Benefits), coverage terminates effective the date of
Your Return to Home Country.
Eligible means a person under 65 years of age travelling outside his/her Home Country to
Canada as a student, faculty, teacher, chaperone, participant in educational/business/cultural INSURING AGREEMENT
exchanges, along with the Insured’s spouse, parents and dependents over the age of 15 days If an Eligible Insured suffers an Injury or Sickness during the Coverage Period, We will pay the
and under 19 years. benefits stated in this Policy, subject to all of its terms, conditions, limitations, exclusions and
other provisions, for Reasonable and Customary Expenses that are incurred, to the lesser of
Emergency means any unexpected Sickness or Injury first occurring during the Coverage the Benefit Maximum for that particular benefit, or to the Policy maximum of $5,000,000 All
Period, which requires immediate Medical Treatment to relieve acute pain and suffering. Benefit Maximums contained in this Policy are per Insured for the duration of the Coverage
Period unless otherwise specified.
GHIP means the Canadian federal, provincial or territorial government health insurance plan
normally applicable to permanent residents of Canada that reside in the province or territory
of Canada where the Insured is staying.
BENEFITS
The benefits in this Policy are not subject to any deductible. Benefits are paid based on
Home Country means the country where the Insured permanently resides. Reasonable and Customary charges for services provided during the Coverage Period
up to the Benefit Maximum unless otherwise specified. Your insurance covers up to
Hospital means a facility which primarily treats patients on an inpatient basis, is licensed as $5,000,000 in total benefits for the following Medically Necessary services You require
a Hospital by the jurisdiction where treatment is provided, provides 24 hour a day nursing to treat Your eligible medical condition. These Medically Necessary services include
services by registered or graduate nurses, has a staff of one or more Physicians available 24 reasonable follow-up visits, tests and surgeries.
hours a day, provides organized facilities for diagnosis and surgical procedures, maintains
X-ray equipment and operating room facilities, is not primarily a clinic, nursing, rest or Hospital Services • Charges made by a Hospital for semi-private room and board and other
convalescent home or similar establishment and is not, other than incidentally, a location for necessary services and supplies, including drugs administered, while confined to a Hospital
the treatment of alcoholism or substance abuse. for medical reasons; no limitation on number of days; private room where medically required
as determined and approved by the Claim Administrator. Charges for Medical Treatment
provided on an in patient or out-patient basis; Charges for anaesthesia or blood products and
the administration of such products.
 The following benefits are covered with the prior approval from the Claim Administrator.
BENEFITS (cont’d) The maximum amount payable for the following transportation benefits cannot exceed
Physician’s Fees • All charges made by a Physician for professional services or Medical $300,000 in total per Coverage Period.
Treatment. Included is care related to pregnancy (prenatal and postnatal) even if pregnancy
began before the Insured’s arrival in Canada. Air Evacuation • The cost of transporting You to the nearest Hospital or to a Hospital in Your
Home Country, if Medically Necessary, either:
Psychiatric Services • Emergency hospitalization in standard ward accommodation a) as a stretcher fare on a regular scheduled flight, including economy return fares for
(including meals), at 100% for the first four days and to a maximum of 2.5 times the hospital’s qualified medical attendants (not a relative) and their associated fees and expenses; or
interprovincial rate for each day thereafter.
b) by appropriately equipped air ambulance, including associated fees and expenses for
X-rays, Laboratory and Diagnostic Tests • Charges for technical and interpretative services a qualified crew.
ordered by a Physician and performed in an approved laboratory. Land ambulance costs at each end of the flight or connecting flights are included.
The attending Physician must certify that the Insured is medically fit for the type of transfer
Prescription Medication • Limited to any type dispensed during Hospital confinement for selected.
home use at the same levels and under the same conditions as stipulated and normally
payable by GHIP. Family Transportation and Subsistence Allowance • If You have no family members within
500 kilometres of Your location while You are outside Your Home Country and You are Hospi-
Home Care • When professional health service is required by the Insured and the needs talized and Your Hospitalization is expected to last a minimum of 7 days, or in the event of the
cannot be met on an out-patient basis, coverage is provided under the attending Physician’s death of the Insured, We will pay up to $5,000 towards the cost of round-trip transportation
authorization and pre-approval by the Claim Administrator. based on the lowest available fare for the most direct route for two persons nominated by You
to travel to Your bedside. We will also pay up to $1,500 for commercial accommodation and
Nursing Home Care • When the Insured requires regular medical supervision along with meals for a maximum period of 10 days for these two persons. The attending Physician must
nursing and personal care on a 24-hour-a-day basis, coverage is provided to an amount certify that the situation is serious enough to warrant the visit. Submit all bills and receipts to
equivalent to the amount normally payable by GHIP for the cost of a standard ward the Claim Administrator.
accommodation. This must be authorized by the attending Physician and pre-approved by
the Claims Administrator. Repatriation or Burial of Deceased • If death occurs during the Coverage Period as a result
of a covered Injury or Sickness, We will pay either
Physiotherapy • Charges made by a physiotherapist at the same levels and under the same
conditions as stipulated and normally payable by GHIP. (a) up to $20,000 towards the reasonable and necessary costs for the preparation and
return of the Insured’s remains to the Insured’s Home Country in a standard transportation
Medical Equipment and Supplies • Payable only if required as the result of a covered container or
Sickness or Injury. Rental charges for wheelchairs, crutches, canes, walkers, casts,
Hospital-type bed or other appliances, not to exceed purchase price. (b) up to $5,000 for the cost of preparing the remains, cremation or burial, and a burial plot
in the location where death occurs. The costs for a coffin, urn, headstone or funeral are
Emergency Transport • The full cost of licensed air and ground ambulance service to the excluded.
nearest Hospital when Medically Necessary; Emergency transfers between Hospitals when
ordered by the attending Physician, including user fee; OR, taxi fare to or from a Hospital or The Emergency Return Home and Return to Destination Benefits require prior approval
medical clinic for eligible medical care to a maximum $100. from the Claim Administrator. The maximum amount payable for these benefits cannot
exceed $2,500 in total per Coverage Period.
Paramedical Services • Charges for an osteopath or podiatrist at the same levels and under
the same conditions as stipulated and normally payable by GHIP. Emergency Return Home • If Your parent, sibling, spouse or dependent child is under age
75 and is hospitalized and their hospitalization is expected to last a minimum of 7 days, or in
Accidental Dental Care • Charges for specified dental surgery as a result of an Accident, the event of their death, and You are therefore required to return to Your Home Country, We
when Hospitalization is judged as Medically Necessary, performed by a dental surgeon who will pay the lesser of a one way fare or a change fee on an existing ticket, less any refunds, to
is a member of the Hospital staff, at the same levels and under the same conditions as return You to Your Home Country.
stipulated and normally payable by GHIP. Prior approval from the Claims Administrator is
required. Return to Destination • If, following Your Emergency Return Home, You wish to return to
Your host country, We will pay for the cost of transportation based on the lowest available fare
Annual Physician Visit • We will pay for one visit to a Physician in Canada for a non-emergency for the most direct route to return You to Your host country. This benefit is only available if:
exam and associated tests. · You have more than 6 weeks remaining in Your scheduled studies at the time You
use this benefit; or
Eye Exams • Up to $100 Benefit Maximum for one non-emergency eye exam performed · You are required to return to complete exams; or
in Canada by a licenced Optometrist. Note: the cost of glasses or contact lenses is NOT · You are required to return to take part in graduation ceremonies.
covered.

Immunization • Charges for immunization up to a maximum of $150, provided it is a

requirement of Your course of studies. EXCLUSIONS
Excursion Benefit: We will not pay for any expenses resulting directly or indirectly from:
A) If You travel outside Your province while You are in Canada, You will have to pay for any
medical services You receive and send original receipts with a claim form to us 1. plastic or cosmetic surgery except as a result of a covered Injury;
for payment. We will pay for medical expenses, the same as if You were in Your Canadian
province/territory of temporary residence. 2. elective or non-emergency surgery that is not pre-approved by the Insurer;

B) If You travel outside Canada, We will pay only for medically necessary Emergency 3. any expenses incurred outside the Coverage Period or while You are in Your Home Country
expenses, Coverage is very limited. We pay for: (except as provided under the Enhanced Excursion Benefit);
• Emergency hospital outpatient services, with the exception of dialysis, to a maximum of
4. any interest, finance or late payment charge;
$50 (Canadian) for all out patient services provided on any one day;
• dialysis treatment, up to $210 (Canadian) per day; 5. Injury or Sickness covered under any other form of insurance, indemnity or plan or that
• Emergency in-patient hospitalization, limited to $400 (Canadian) a day for complex is the liability of a third party.
hospital care such as surgery, coronary, neonatal, paediatric, or intensive care and
up to $200 for less-intensive medical care; For Enhanced Excursion Benefit Only: In addition to the Exclusions above, we will not pay for
any expenses resulting directly or indirectly from:
• Emergency care from a Physician or other eligible health care provider, to the amount
billed or the cost of the same Physician service in Your Canadian province/territory a) a pre-existing condition which means a sickness, injury or other condition that was
of temporary residence, whichever is less; causing signs or symptoms, and/or required medical advice or investigation, whether a
• repatriation to Your Canadian province/territory of temporary residence, at the diagnosis was established or not, and/or any form of medical treatment provided by a
discretion of the Insurer (to another hospital of the Insurer’s choice, with 48 hours notice, Physician or other practitioner during the 3 month period immediately preceding the date
if the transfer is approved by the attending Physician). You depart on Your Enhanced Excursion, or if upon the commencement of the coverage,
a condition was known or present such that costs could reasonably have been expected
Coverage under the Excursion Benefit is subject to the GHIP regulations at the time a claim to be incurred. The following does not constitute medical treatment for the purpose of
is incurred. this pre-existing conditions exclusion:
Enhanced Excursion Benefit • Travel outside Canada (other than to Your Home Country) is
covered subject to the following conditions (a) more than 50% of the total Coverage Period i) the consistent use of medication, meaning that no change in medication, dosage or
must be spent in Canada and (b) travel to the United States is limited to 30 days per trip. usage, has been prescribed by a Physician or other practitioner;
Expenses will not be paid when incurred in Your Home Country except where the trip to Your ii) a check-up when the Physician or other practitioner observes no adverse change
Home Country is expressly taken in order to participate in a school-organized sporting or in a previously noted condition, symptom or problem;
extra-curricular event.
• Any surgical procedure and major diagnostic testing, including but not limited to b) Elective or non-Emergency Medical Treatment, including any treatment given to
magnetic ronance imaging (MRI) and computer axial tomography (CAT) scans requires maintain the stability of a chronic sickness or condition, including visits for the
prior approval from the Insurer, unless a delay will be life threatening. refill of medication, tests or examinations forming part of a normal regime, or for
treatment of congenital or genetic disorders or conditions, or for treatment not
• We reserve the right to arrange transportation to return You to Your Home Country, either required for the immediate relief of pain and suffering, or that could reasonably
before or after You receive Medical Treatment, or Hospital or Medical Services. If You be postponed until the Insured returns to his/her Home Country;
decline to return when declared medically fit to travel by the Claim Administrator, We will
not pay for any continuing expenses, recurrence or complications arising from or directly
or indirectly related thereto
 Governing Law. This Policy is governed by the laws of the Canadian province of
EXCLUSIONS(cont’d) Ontario where this Policy was issued. Any action or proceeding against the Insurer
for recovery of claims under this Policy must be brought in the Canadian province of
c) medication commonly available without a prescription (including but not Ontario and must commence within 2 years from the date on which the cause of action
limited to ‘over-the-counter’ medications such as acetaminophen or cold/ arose. Despite any other provisions contained in this Policy, this Policy is subject to the
allergy remedies); fertility drugs; contraceptives; erectile dysfunction drugs; statutory conditions of the Insurance Act respecting contracts of accident and sickness
anti-baldness drugs; smoking cessation drugs; vaccinations, immunizations insurance.
or injections; vitamin preparations or supplements; or medication received on a
preventive or maintenance basis; Benefit Payments. All benefits are payable to You unless You assign Your right to payment
directly to the service provider or another named assignee. In the event of Your death
d) normal pregnancy; normal childbirth; elective abortion; all benefits are payable to the beneficiary noted by the Insured. If a beneficiary is not
otherwise designated by the Insured, benefits will be paid to the first of the following
e) the Human Immunodeficiency Virus (HIV) or Acquired Immune Deficiency surviving preference beneficiaries:
Syndrome (AIDS) or Aids Related Complex (ARC); 1. the Insured’s spouse;
2. the Insured’s child or children jointly;
f) suicide, attempted suicide, self-inflicted injuries, mental or emotional disorders 3. the Insured’s parents jointly if both are living, or the surviving parent if only one survives;
(including but not limited to stress, anxiety, panic attacks, depression, eating 4. the Insured’s brothers and sisters jointly; or
disorders/weight problems), or psychiatric treatment; 5. the Insured’s estate.

g) Your actions while they are impaired or adversely influenced by medication, Benefit payments do not provide for the payment of any interest. This Policy contains a
drugs, alcohol or intoxicants; any medical claims related to the use or misuse clause which may limit the amount payable.
of drugs or alcohol;
Currency. All premium amounts, Benefit Maximums and benefit payments are stated
h) participation in professional sports or hazardous activities such as motorized in Canadian Dollar currency. For reimbursement purposes, the exchange rate on foreign
contests of speed, parachuting, skydiving, hang gliding, bungee jumping, cave currency shall be the rate determined at the date the expense was paid and quoted by
exploring, mountaineering, rock or cliff climbing, or scuba diving; the financial institution selected by the Claim Administrator. At Our option We may pay
a claim for benefits in the currency where the loss occurred.
i) operating any type of aircraft or travelling as a passenger on any non-commercial
flight; operating any form of motorized transport on land or water without a licence Co-ordination of Benefits. The benefits in this Policy are payable in excess of those
valid for the area where operating; travelling in or on a motorcycle, snowmobile, available under any other valid and collectible insurance Policy or plan under which
or any kind of vehicle while racing or off-road, unless no roads exist in the area in You are entitled to claim including but not limited to, a government health insurance
question; plan, group or personal accident and sickness insurance or extended health/medical
care coverage, any automobile insurance or benefits plan, homeowner, tenant, or other
j) injury or sickness caused while You are training or serving in any capacity as a multi-peril insurance, credit card benefit insurance, and other travel insurance. Any
member of any armed forces or while actively participating in any conflict of war, payment made under this Policy will be co-ordinated with any other plan providing
or sustained in criminal activity. However, if You sustain an Injury as a direct result similar coverage such that the total benefits payable under all policies or plans does not
of war-like actions in which You were not an active participant and within 48 hours exceed 100% of the eligible expenses incurred.
of the commencement of such hostilities, any expenses incurred arising from such
incident will be covered; Rights of the Company and Claimant: When You purchase this Policy, You agree to
provide the Company with access to all pertinent records or information about You from
k) injury or sickness while travelling to a destination for which Your Home Country any licensed Physician, dentist, medical practitioner, Hospital, clinic, insurer, individual,
Government has issued a travel advisory stating that travel to the destination institution or other provider of service to determine the validity of any claim submitted
should not be undertaken; by You or on Your behalf.

l) travelling contrary to the medical advice of a Physician or practitioner or for the Termination by Insured. The Insured may terminate this contract at any time by giving
purpose of obtaining Medical Treatment or when a terminal prognosis was given to written notice of termination to the Plan Administrator acting on behalf of the Insurer,
the Insured prior to the Coverage Period; or by delivery thereof to an authorized agent (e.g. school or organization). If this Policy
is cancelled prior to the Effective Date for medical reasons, the Insured or the Insured’s
m) any expenses incurred as a result of the Insured’s failure to accept or follow a authorized agent where applicable, will receive a full refund of premiums paid. If the
Physician’s advice, treatment or recommended treatment. Policy is cancelled for any other reason, an administration fee of $25 may be charged.
If this Policy is cancelled after the Effective Date, We will refund the premiums paid for
GENERAL POLICY LIMITATIONS unused coverage less an administration fee of $25, provided that no claims have been
incurred or paid, or are pending. A waiting period applies to all refunds.
Limitation
on Liability
The Insurer, the Plan Administrator and/or the Claim Administrator are not responsible for Refunds. Other than the 10 Day Right to Examine, refunds are calculated on a pro-rata
the availability, quality or results of any Medical Treatment, or Your failure to obtain Medical basis from the date postmarked on Your written request or on the date such fax or
Treatment or transportation and shall not be held liable for any negligence, wrongful acts e-mail request is received by the Plan Administrator and are subject to a minimum
or omissions of any service providers. refund amount of $10. This Policy is not transferable.
Termination by Insurer. (1) The Insurer may terminate this contract at any time by
GENERAL CONDITIONS giving written notice of termination to the Insured. Unused premiums will be refunded
The Contract. The Application, this Policy, any document attached to this Policy when in the event that no claims are paid or pending. (2) The notice of termination may be
issued, and any amendment to the contract agreed upon in writing after the Policy is mailed to the Insured, or sent by fax or email, or where the application has been sent
issued, constitute the entire contract, and no agent has authority to change the contract by another party or agent, that party or agent may be notified by mail, fax or email. (3)
or Where the notice of termination is given, 5 days notice of termination shall be given,
waive any of its provisions.
effective the date of mailing, fax or email.
Waiver. The Insurer shall be deemed not to have waived any condition of this contract,
either in whole or in part, unless the waiver is clearly expressed in writing signed by the Subrogation (Right of Recovery). If any benefit paid to You or on Your behalf is in
Insurer excess of the amount allowed by the provisions of this Policy, or if payment is made due
to a clerical or administrative error, then We reserve the right to recover such amount
Copy of Application. The Insurer shall, upon request, furnish to the Insured under the from You or any institution, insurer, or other organization or party to whom such payment
contract a copy of the Application. was made. If any payment is made under this Policy, then We have the right to proceed
in Your name against any third party that may be responsible for giving rise to a claim
Premium Payment. The full premium is due and payable when You apply for insurance. under this Policy. We or Our designated representatives shall have full rights of
If for any reason the premium paid for the coverage applied for is incorrect, We will a) subrogation. You shall not do anything to prejudice such rights and shall co-operate
charge and collect the difference, or b) shorten the Coverage Period if an underpayment fully with Us or Our designated representatives, by agreeing to sign, execute and/or
in premium cannot be collected, or c) refund any overpayment. Coverage will be null deliver such documents as are required to proceed against any third party that may
and void if for any reason Your payment is not honoured by the financial institution. The be liable.
premium is calculated using the most current premium rates on the date You apply for
coverage, for Your age on the Effective Date. We reserve the right to decline any Policy Extensions. The maximum Coverage Period available under this Policy, including
application for insurance. extensions, is 365 consecutive days from the Effective Date. Any request for an
extension must be made to the Plan Administrator no later than 7 business days
Duplicate Contracts or Policies. In the event that more than one contract is issued to immediately before the Termination Date of Your existing coverage. Coverage for this
one Insured, benefits shall be limited to the maximum payable under one contract at any time, Policy extension will be void from inception if any payment is not honoured by Your
and a refund for duplicate premiums will be issued. financial institution. The Plan Administrator or the Insurer has the right to refuse any
extension. If a claim has been received for any Insured, an extension may be granted
Misrepresentation or Nondisclosure. All coverage under this Policy shall be void, if, with an exclusion for the claimed condition.
whether before or after a loss, the Insured has concealed or misrepresented any material
fact or circumstance concerning this coverage or subject thereof, or the interest of the
Insured therein, or in the case of any fraud or false swearing of the Insured.

Material Facts. No statement made by an Insured at the time of Application for this
contract shall be used in defence of a claim under or to avoid this contract unless it is
contained in the Application or any other written statements or answers furnished as
evidence of insurability.
 GENERAL CONDITIONS (cont’d.) CLAIM PROCEDURE
Automatic Continuation of Coverage. If the Insured is unavoidably delayed for a 1. You must call the Emergency Assistance Number shown below BEFORE admission to
reason in no way attributable to the Insured, beyond the end of the Coverage Period, Hospital as an in-patient and for prior written approval BEFORE any expenses are
this Policy will automatically remain in effect at no extra premium for a period not to incurred for the following:
exceed: • Major Diagnostic tests • Accidental Dental Care
a) 72 hours, if delayed while travelling as a fare paying passenger in a licensed public • Surgery • Air Evacuation
conveyance or by private vehicle and the delay is caused by mechanical • Family Transportation • Repatriation / Burial
breakdown, a traffic Accident or inclement weather; or • Home Care • Nursing Home Care
b) the period of confinement as an in-patient in a Hospital (unless said period of
confinement is in excess of the maximum limitation for Psychiatric Hospitalization) 2. Present Your guard.me I.D. Card to Your medical service providers.
O R t h e p e r i o d d u r i n g w h i c h Yo u a re u n a b l e t o t r a v e l o n m e d i c a l g ro u n d s
( e x c l u d ing psychiatric conditions) acceptable to the Claim Administrator. Following 3. Complete a claim form for EACH new Sickness or Injury when FIRST treated. Take it with
discharge from Hospital or following medical approval to travel, an additional 72-hour You on Your first appointment if possible. You may photocopy a blank claim form for
future use or obtain forms from Your organization or from our website at www.guard.me
Notice and Proof of Claim. The Insured, or a beneficiary entitled to make a claim, or
the agent of any of them, shall, (a) give written notice of the claim including a completed 4. Within 30 days of the first medical expense, log on to www.guard.me to file your claim
Claim Form, and originals of all bills to the Claims Administrator or Plan Administrator, electronically or MAIL:
acting on behalf of the Insurer by delivery thereof, or by sending it by mail, not later • Completed claim form
than 30 days from the date that a claim arises under the contract on account of an • Original itemized bills / receipts
Injury or Sickness; (b) within 90 days from the date a claim arises under the contract • Include medical reports, emergency room report, history & physical, surgical, lab,
on account of an Injury or Sickness, furnish to the Claim Administrator or x-rays and discharge reports to:
t h e P l a n A d ministrator such proof as is reasonably possible in the circumstances of
the happening of the Accident or commencement of the Injury or Sickness, and the loss
occasioned thereby, the right of the claimant to receive payment, and (c) if so required
guard.me Claims
by the Claim Administrator or Plan Administrator, furnish a satisfactory certificate as to
300 John Street, Suite 405
the cause or nature of the of the Injury or Sickness for which claim may be made under
Thornhill, Ontario Canada L3T 5W4
the contract.
Remember to keep a copy for Your files.
Failure to give Notice or Proof. Failure to give notice of claim or furnish proof of claim
within the time prescribed above does not invalidate the claim if the notice or proof is given or
5. For a death claim, the beneficiary or other person entitled to claim must call Travel
furnished as soon as reasonably possible, and in no event later than one year from the date
Healthcare Insurance Solutions Inc. to report the claim. Details of claim must be
of the incident or Accident or the date a claim arises under the contract on account of Injury
submitted with an original death certificate or other proof of death, acceptable to Us.
or Sickness if it is shown that it was not reasonably possible to give notice or furnish proof
within the time so prescribed. We will not accept liability for any claim submitted to Us more than 1 year after the date
the loss was incurred.
Plan Administrator to Furnish Forms for Proof of Claim. Claim Forms are provided with
each ID Card issued, and are also provided to all schools and organizations. Where a Claim Claims cannot be considered unless the claim form is fully completed and signed by
Form is required, the Plan Administrator will provide one to the Insured by fax, email or mail. the claimant and submitted with all the ORIGINAL required documentation which must
Claim Forms are also available at our website: www.guard.me. be provided free of expense to Us.
Rights of Examination. As a condition precedent to recovery of insurance money under this Payment will not be released until all original invoices and receipts are received by the
contract, (a) the claimant shall afford to the Insurer an opportunity to examine the Insured Claim Administrator.
when and so often as it reasonably requires while the claim hereunder is pending. The Underwritten by:
physician and the location of such examination shall be at the Insurer’s discretion. The Old Republic Insurance Company of Canada
Insured agrees to cooperate and to provide full details to the physician. This physician may, 100 King Street West, 11th Floor
in conjunction with input from the treating physician, make additional recommendations to Hamilton, Ontario CANADA
assist in recovery or cure. and (b) in the case of death of the person insured, the Insurer may
require an autopsy subject to any law of the applicable jurisdiction relating to autopsies.

Non compliance With Obligations. We may choose to limit or refuse payments when (a) the
Insured or the party concerned with the payment is negligent in the fulfilment of any
obligation resting upon him/her and has thus harmed the interests of the insurer; (b) facts
have been incorrectly or insufficiently provided, or have been misrepresented, or if false data
has been provided, (c) where an Insured suffers an Injury or Sickness, the Insured is required
to seek immediate medical treatment and to follow all doctors advice, prescriptions and
orders. Failure to comply may result in reduction or refusal of payments.

When Money Payable. All money payable under this contract shall be paid by the Insurer
within 90 days after it has received acceptable proof of claim.

Limitation of Actions. An action or proceeding against the Insurer for the recovery of a claim
under this contract shall not be commenced more than two years after the date the insurance
money became payable or would have become payable if it had been a valid claim.

PRIVACY
The Company and Our Plan Administrator (collectively “We” “Our” in this privacy section) are committed to protecting Your privacy. The information provided will be
used only for determining Your eligibility for coverage under the Policy, assessing insurance risks, managing and adjudicating claims and negotiating or settling payments to third
parties. This information may also be shared with third parties, such as other insurance companies, health organizations and government health insurance plans to adjudicate and process
any claim. We take great care to keep Your personal information accurate, confidential and secure. If You have any questions about the Company’s Privacy Policy, please contact our Privacy
Officer at (905) 523-5587 or by email to: privacy@oldrepublic-group.com.
EMERGENCY PROCEDRUES
Contact the 24 Hour Toll-Free Emergency Assistance Number at 1-800-334-7787 (Canada & United States) or operator assisted collect 905-667-0587

1. within 24 hours of admission to Hospital, or if incapacitated, as soon as reasonably possible;

2. for any benefit where prior approval is required;
3. for any Excursions, prior to incurring ANY medical expenses.
Failure to notify the Claim Administrator as required will limit Our liability to 90% of the eligible expenses incurred.

08 2016 @RRU E